Cardio Wellness

Save the Date...January 26th, 2012

2011-12-29T23:44:00.000-06:00

Ever wonder what you should eat? Ever wonder if you get enough protein? What are the different kinds of protein? Ever wonder what foods are carbs and if you are getting too much? If so this program is Free and is made just for YOU!

Are You Too Sweet For Your Own Health?

2011-11-18T04:21:00.000-06:00

I recently did a Webinar on Nutrition and how to prevent Type II Diabetes or better manage Type II Diabetes. If you are interested in some practical daily tips on how to eat better, prevent diabetes, or better control your diabetes click here to see the Webinar.

How to Make this Halloween Healthy

2011-10-29T00:43:00.000-05:00

While sharing an experience with your kids, walking around outside and bonding with your neighbors are great things to come from Halloween, the copious amounts of candy and other unhealthy snacks give me mixed emotions about Halloween. However, there are tips I regularly tell my patients about how they may make it a healthy one.

11 Tips for a Healthy Halloween:

Do not buy Halloween candy in advance. The day before at the earliest to avoid temptation of eating the candy and having to buy more before Halloween comes.
Increase exercise the week of Halloween. Make sure you are getting plenty of lean proteins and fruits and vegetables too.
Fill up your kids with a healthy snack before trick-or-treating to help prevent them from gorging throughout the Halloween festivities.
Make sure the kids and parents walk when they go trick or treating vs. driving them around or using golf cart, etc.
Darker chocolate options for candy is better – more antioxidants.
Make sure to have a full dinner before going trick or treating.
Allow only a few pieces of Halloween candy to be consumed that day. Do not allow the kids to stash the candy in their rooms.
Get involved with a pumpkin carving party or go for an outing at a pumpkin maze. It’s healthy Halloween fun for adults and kids alike.
Host a Halloween party. In supplement to or in lieu of trick-or-treating, try hosting a party where you control what foods are consumed. Include such healthy snacks as vegetables and dip, apples and peanut butter or even whole grain bread and lean meats for sandwiches. Not only is it a healthier option, but good way to bond with your neighbors and other parents.
As the night is coming to an end, watch a Halloween movie with your kids instead of allowing them to acclimate with their new found goodies which could lead to unhealthy blood sugar levels.
Donate the candy the next day to a local charity or church. If you have to dump it, dump it, and don’t feel guilty – after all it’s your family’s health we are talking about.

Heart Failure Hospitalizations Decline – First Ever Documented Decline

2011-10-23T10:31:00.000-05:00

Heart Failure is when the heart is unable to pump blood out of the heart efficiently and then fluid backs up into the heart and lungs. Heart failure occurs from damage to the heart. Two of the biggest contributors to heart failure are heart attack and high blood pressure. If a heart pumps against increased pressure for a long period of time the wall of the heart thickens and the heart swells causing an enlarged heart. Many people do not want to treat their high blood pressure because they don’t feel any different with high blood pressure and would prefer not to be on prescription medications. Usually what would take 1 or 2 medications to control blood pressure could lead to having to take 5 medications or more to control heart failure later.

The decline in heart failure hospitalizations was reported in the October 19th issue of the Journal of the American MedicalAssociation. Heart Failure hospitalizations dropped 29.5% nationally over the past decade. This occurred from 1998 to 2008 as documented through fee for service Medicare claims analysis done by Dr. Jersey Chen and colleagues of Yale University. This is the first ever documented decline in heart failure hospitalizations in the United States and is reported to have saved $4.1 billion in Medicare costs since 1998.

Reasons given for the decline are better control of risk factors, particularly modest improvements in blood pressure control, better evidence based therapies for heart failure treatment and shift towards better outpatient management. There is still a lot of work to do to further lower not only heart failure hospitalizations; but, also to lower heart failure incidences.

Do you know your risk factors for heart failure? Do you know your blood pressure numbers? Be an active participant in your health…know your numbers and prevent heart disease in your life. Click here for simple lifestyle modificationsto help lower blood pressure. If you have high blood pressure; see your health care provider for optimal recommendations for treatment.

What Choices Are There When Patients Can’t Take Prescription Medications to Lower Their Cholesterol?

2011-09-12T07:06:00.001-05:00

Some of the patients we see in the Cardio Wellness Center prefer not to take prescription medications or are unable to take some of the prescription medications we use to lower cholesterol due to side effects. Fortunately, I have been able to rely on quality over the counter supplements to help my patients get to their cholesterol goals. Two of the over the counter supplements I use often are CardioTabs high dose quality fish oil for triglyceride lowering and CardioTabs Red Yeast Rice for LDL and triglyceride lowering.

Recently we did an open label study on 8 patients who took CardioTabs Red Yeast Rice 2 capsules twice daily with food and 1 teaspoon of CardioTabs liquid fish oil daily. After just 6 weeks of taking these supplements we saw significant changes in their cholesterol profiles. The average changes were as follows:

Total Cholesterol Reduction: 22 %

LDL Reduction: 28%

Triglycerides Reduction: 22%

HDL (Good Cholesterol) Raising 15%

Total Cholesterol/HDL ratio Reduction: 27%

These results are similar to what we have seen with some cholesterol lowering prescription medications. The patients in the study were amazed at the results they achieved with these over the counter supplements. This is an excellent non prescription regimen that is both safe and effective for patients who need support for achieving optimal cholesterol levels.

*Please note Red Yeast Rice should not be taken with statin medications. If you are interested in changing your current regimen or need advice on how to better control your cholesterol profile please consult with your health care provider.

Clutter = Energy Drain

2011-08-08T22:39:00.000-05:00

I remember a few years back attending a conference where one of the presenters spoke on “clutter”. The more clutter in one’s life would lead to decreased energy. Not only does it decrease energy but it is also a distraction; thus, making it hard to complete the tasks at hand. Clutter leads to losing items and wasted time trying to find them (if you can). It clouds your natural energy field, can effect your work performance, your health and ultimately your life.

Since that presentation I have tried to make a mental note of what is “cluttering” my life. I remember coming home from the presentation and I decide to take on the kitchen closet. This is where we kept the trash, recycle bins, trash bags, phone books, and all the dog stuff. It was easy since the trash was close. I pitched everything that we hadn’t used in the prior 6 months. I added another shelf for neatness – so we can see what we have. Just by doing that small area-it made a big difference in energy. When we would go to give our dog a treat or take out the trash it was an up lifter instead of a downer.

Do You Have Clutter In Your Life? Don’t know where to start? Here are a few tips:

· Work on one room at a time. Pick the room you spend the most time in for starters. Pitch items you haven’t used in the last 6 month. If you can’t pitch them-donate them

· Give yourself a full day or a full week per room/area if needed (remember you didn’t collect all this clutter overnight)

· Set a time limit for cleaning each day…1 to 3 hours so you don’t get overwhelmed

· Once you have decided to pitch or donate your items- put them in the trash or in your car to take to the donation destination. Do NOT “store” them in another location in your home.

· Do a little each day- for some of you it may have taken years to accumulate all your clutter

We recently put new carpet in our home. I remember thinking I’d rather move than ever install new carpet again -as everything that touches the floor has to come up. That means everything in your closets that are on the floor has to be moved. Books and papers in bookshelves have to come out so they can be moved. It was a lot of work-but now all our closets are cleaned, book shelves are de-cluttered and the energy in our home is boosted.

Make a commitment today to work on de-cluttering you life and adding energy back into your life.

Weight Loss Competition Winners

2011-05-18T15:34:00.000-05:00

Congratulations to the Winners of our Weight Loss Competition!

                                    Prize Money                 Name              Percentage Weight Lost
Women's
1st place                      $2,239.59                    Deborah                          16.25%
2nd place                        $447.92                    Dana                                15.14%
3rd place                        $298.61                    Meghann                          14.32%

Men's
1st place                        $415.41                    Jason                                 16.79%
2nd place                         $83.08                    Ben                                   13.42%
3rd place                         $55.39                    Jim                                     12.28%

There were 147 weight loss contestants who used the motivation of the competition to reach personal milestones and goals. We will continue to hold this competition annually each February thru May as we see the difference it makes in lives. Keep persuing your goals and congratulations to all who participated.

How Is the Work Force Wellness Index Holding Up?

2011-04-16T17:44:00.000-05:00

Thomson Reuters Workforce Wellness Index measures the cost of 6 modifiable risk factors in employed, privately insured populations. The 6 risk factors include: Body Mass Index (BMI), Total Cholesterol, Blood Sugar, Blood Pressure, Tobacco Use, and Alcohol Use.

The U.S. Workforce Wellness Index is on a declining trend. The ideal state where no behavioral risk factors are present would be reported as a Wellness Index of 100. The U.S. Wellness Index from 2005 to 2009 has declined from 86.4 to 84.4.

Thomson Reuters research demonstrates around 14% of increased health care expenditures in the employed, privately insured workforce is related to the 6 modifiable risk factors above. Thomson Reuters data suggests in the third quarter of 2010 these risk factors accounted for about $670 per employee of the rising healthcare costs annually.

More specifically, employees with a high Body Mass Index accounted for approximately $400 of the increased healthcare expenditures per employee annually in 2009. High blood sugar level came in as the next most significant risk factor in increasing health care costs. Each of which can be changed given the right wellness plan and the right motivation.

Want to decrease costs in the work place? Enroll your employees in a Wellness Program that will assist your employees in optimizing their health and taking charge of their life. Here's a Wellness Program that addresses each of these risk factors and offers individulized health care assessments and plans: http://cardiowellnesscenter.org/ The Cardio Wellness center will also provide educational presentations to your employees.

Want to Reduce Your Risk Of Developing Type 2 Diabetes?

2011-04-10T21:06:00.000-05:00

I see a lot of patients with pre-diabetes (fasting blood sugars 100-125) and with Type 2 Diabetes (2 fasting blood sugars of 126 or greater). For the most part, patients can prevent Type 2 Diabetes through diet and lifestyle. That is often why I tell my patients they are sitting in a good seat...this is something they can prevent.

In October 2010 Dr. Salas-Salvado and colleagues published a study on how the Mediterranean diet reduced development of Type 2 Diabetes by 52%. There was no change in physical activity or weight. Just a change in diet. The study reported by utilizing the Mediterranean diet, development of Type 2 Diabetes was cut in half (52%). The principle components of the Mediterranean diet utilized in the study:

Increased use of olive oil for cooking and dressing (participants were given free allotment of 1 liter virgin olive oil per week and 30 g of mixed nuts per day)
Increased consumption of fruits and vegetables
Increased consumption of legumes and fish
Decreased consumption of meat (recommending white instead of red meat)
Avoidance of fast food, sweets, pastries (simple sugars)
In alcohol drinkers, moderate consumption of red wine

So, if you are pre-diabetic or have Type 2 Diabetes, change up your diet to optimize your health. Type 2 Diabetes in many cases can be prevented.

Salas-Salvado, Jori, MD and Colleagues. Reduction on the Incidence of Type 2 Diabetes with the Mediterranean Diet. Oct. 7, 2010 Diabetes Care.

Alcohol: Slippery Slope

2011-04-10T10:47:00.000-05:00

I am in New Orleans presenting at the Nurse Practitioner Associates of Continuing Education (NPACE) seminar. This morning at 0830, I walked down the stairs from my hotel room to the front lobby...looking for some oatmeal, nuts and fruit. When I got to the lobby, there was a man sitting on the sofa drinking from an oversized bottle of Blue Moon and his buddy, holding a big jug of whiskey and taking sips. Both participating in a conversation that made no sense to the sober passerby and both leaning on their free hand to keep their heads propped up for the conversation. The front desk employee saw me take a triple look smiled and said, "Welcome to New Orleans - what can I do for you?"

So, as I sat down to eat my healthy breakfast I couldn't help but think about those 2 guys in the lobby. Obviously, this isn't the time or place to inform them of the effects of alcohol; but, alcohol is the source of much individual and societal suffering and morbidity. In fact, alcohol abuse is the 3rd largest preventable cause of Death. There are health benefits to alcohol as well. In fact, light to moderate drinking is associated with cardioprotective benefits. This constitutes 1 drink daily for women and 1-2 drinks daily for men. (For further clarification: 1 drink is equivalent to 12 ounces of beer or 5 ounces of wine or 1.5 ounces 80 proof spirits, or 1 ounce 100 proof spirits. All of these contain 13 g- 15 g of ethanol.)

Many people who are light drinkers believe that occasional "binge drinking" won't hurt their health. But binge drinking even in light drinkers increases cardiovascular events and mortality(death). Alcohol is a double edge sword and if you misuse it ... it can lead to much suffering (physical suffering too- heart disease, stroke, hypertension, liver disease, etc). Because of that, the AHA guidelines caution people not to start drinking if you do not already drink alcohol; because it is not possible to predict who will develop alcohol abuse tendencies. If you do drink without addiction tendencies 1 drink for ladies and 1-2 drinks daily for men will add some cardioprotection.

After I finished my breakfast and headed back through the lobby to my room the employee said, "Be glad you weren't here for Mardi Gras".

J Am Coll Cardiol. 2007 Sep 11;50(11):1009-14. Alcohol and cardiovascular health: the razor-sharp double-edged sword. O'Keefe JH, Bybee KA, Lavie CJ.

6 Ways to Lower Your Blood Pressure Naturally

2011-04-07T20:11:00.002-05:00

High blood pressure is the measurement of the force applied to the artery wall as the heart pumps blood through the body. Having high blood pressure can raise your risk of having a heart attack, stroke and for developing heart failure if left untreated.

Normal blood pressure is less than 120/80.

Prehypertension is 120-139/80-89.

Hypertension is greater than 140/90.

Fortunately, high blood pressure is a risk factor that can be managed. Here are 6 simple ways to lower your blood pressure naturally.

Exercise
Decrease sodium in diet
Reduce stress
Weight loss (if needed)
Limit alcohol to no more than 2 drinks daily
If you snore - see your health care provider

Ever Wonder How a High Fat Meal Affects Your Arteries?

2011-03-13T07:58:00.003-05:00

What Exactly Does a 6,190 Calorie Lunch Do to Your Body? - The World Newser

Check out this short video (click above) to see the affects of a high fat meal on your arteries. And since we need our arteries to live by; each meal counts. Make them healthy!

Stay Focused

2011-03-12T06:39:00.011-06:00

We have had several people weigh in this past week for the Month 1 weigh in. Congrats to all of you who are participating both formally and informally. If you have lost a pound or 2- Congrats! It's just been 4 weeks and you are off to a great start and a healthy weight loss. Stay with it! This second month is one of the most important months of the competition. This is where we lose people due to inability to keep their inner drive and mental energy focused on their health and weight loss program. For those of you who have lost 5-10 pounds or more...stay with it and keep your mental energy up. Sometimes when we start out of the gate strong we often lose steam. The key for this month is to stay focused. If you hit a plateau, it will pass....just keep at it.

After all, this isn't just about weight loss-it's about your total health, empowering yourself to live the life you've always wanted. You can start living the life you were meant to live when you decide too. Remember the strongest tool to assist you in your weight loss and optimal health is your Mind. You will lose weight and change your life when you decide to. All weight loss consists of is less calories in and more calories out.

Need a boost? Join us in our 3 Week Health Challenge. Start now and make it your 2 Week Health Challenge. You CAN do this- and when you do, not only will it inspire others; but, it will have a ripple effect on your life.

WOW! Lose Weight AND Win BIG!

2011-03-07T09:37:00.007-06:00

For those of you in our Weight Loss Competition (WLC) don't forget the monthly weigh in for March is this week! March 9th, 10th and 11th.

The prize Monies are as follows:

Women's Weight Loss Competition Prize Monies

1st Place - $2,239.59
2nd Place - $447.92
3rd Place - $298.61

Men's Weight Loss Competition Prize Monies

1st Place - $415.41
2nd Place - $83.08
3rd Place - $55.39

Wow! What a way to get healthy AND win BIG. Good Luck to all our participants.

You might want to check out our 3 week Health Challenge that starts today to help Rev up your weight loss!

3 Week Health Challenge

2011-03-05T08:47:00.009-06:00

*For those of you in our Weight Loss Competition (WLC) you'll want to participate after you hear the prize money you can win just for being healthy and losing your weight. We'll announce prize monies on Monday, March 7th, 2011.

Rules of the 3 Week Challenge

Eating Habits

1. No simple carbs or sugars for 3 weeks

2. Each meal will have a lean protein and 2 colors (fruits and/or vegetables)

3. One day per week you can have a higher calorie meal (if you want to)

Exercise Routine

1. Complete 30 min of aerobic (cardio) exercise (or what you can work up to) 4 days per week *Even if you start at 2 minutes twice per day it's better than nothing! Increase each week by 2 minutes. So on week 2 you are completing 4 minutes of cardio twice daily.

2. Complete light weight lifting or toning of the arms 2 days per week

3. Complete 2-3 different abdominal exercises 2 days per week

*Encourage each other by posting progress and stumbling blocks on Fridays!

Dramatic Cholesterol Results withOUT Presciption Medications

2011-02-26T09:14:00.005-06:00

For the past decade I have recommended CardioTabs supplements because they are pure, high quality AND they work. Many patients and providers ask how much change I expect to see in someone’s cholesterol on these products. Here is just one of many examples.

Erik is a good friend of mine who has a worrisome family history of heart disease. Despite his efforts to follow a healthy diet and a regular exercise program, his cholesterol levels run in dangerous ranges, which puts him at high risk for developing heart disease at a young age, like his father did.

Erik is only 36 years old and he has reservations about getting started on potent prescription cholesterol lowering drugs like Lipitor or simvastatin that are typically taken for the remainder of one’s life. He has no heart plaque at this time. So he decided to give CardioTabs supplements a try instead.

Upon my advice he took:
CardioTabs Red Yeast Rice, 4 capsules daily,
CardioTabs CardioSterol, 4 capsules daily,
CardioTabs Omega 3, Extra-strength, 2 capsules per day.

He measured his fasting lipid profile at baseline, prior to starting the supplements and then rechecked the lipid profile after one month on the CardioTabs regimen outlined above. And here’s what happened to his cholesterol levels:

Total cholesterol: 230 to 150
HDL (good cholesterol): 42 to 49
LDL (bad cholesterol): 138 to 76
Triglycerides: 250 to 125

His bad cholesterol fell by about 45% and his good cholesterol rose by 17%. The CardioTabs regimen of safe and effective over-the-counter supplements cut the ratio of total cholesterol/HDL almost in half from a worrisome 5.5 to a very healthy 3.1. These types of dramatic improvements in his cholesterol profile can be expected to help keep Erik’s heart and blood vessels clean and healthy, and the results rival those that would be expected by the most potent of our prescription drug regimens. And Erik is delighted because he feels good about accomplishing these strikingly beneficial changes without having to resort to expensive and sometimes troublesome prescription drugs.

Please note: You should not take Red Yeast Rice AND a prescription statin (Lipitor, simvastatin, etc) together.

Rev Up Your Metabolism: 4 Simple Steps

2011-02-22T23:18:00.006-06:00

Start Your Engines
Begin your day with a healthy breakfast. It prevents mindless nibbling and gets your metabolism going for the day. Cooked Oatmeal with nuts and fruit, egg white omelets, or a handful or healthy nuts and fruits and vegetables are all examples of a healthy breakfast.

Increase Your Workout Intensity
For those of you who have been walking the same 2 miles the last 6 months in the same timeframe…change it up! Increase your intensity for 30 seconds to 1 minute intervals and then return to your regular pace. Do this throughout your workout and you will see results. Once or twice a week I recommend increasing your workout intensity. You will be amazed at the changes you will start to see.

Build Muscle
If you do the same activity everyday; how do you expect your body to change? Choose a weight you can lift with good form for 12-15 reps (1 set). Make sure you are pushing yourself some. Lifting weights is just as much mental as it is physical. Slowly work yourself up to 2 to 3 sets at this weight (adding a set every 1 to 2 weeks). When you’ve added sets and can comfortably lift your current weights increase your weight to the point where you can only do 8-10 reps and then repeat the process. Muscles use more energy than fat cells.

Green Tea
New studies suggest, catechins, the active ingredient in green tea may actually boost metabolism and reduce belly fat. These studies were completed in individuals who drink 5- 8 ounce cups of green tea daily.

The only thing standing between the old you and the new you is your Mind. Focus, commit and the changes you will begin to see will have a ripple effect on your entire life. We all have but one life. Let’s make it our best.

Preparing for Weight Loss?

2011-02-16T07:39:00.004-06:00

If so, you better bring the right tools!

For those of you in the Weight Loss Competition (WLC) or those of you wanting to lose weight....your strongest tool to assist you in your weight loss is your MIND. Thoughts become behavior. The way you think of yourself turns into your reality. Your self talk can make all the difference. So let's change it up! "I am going to eat healthy today." " I am going to lose weight." "I can do this."

Sodas and Orange Juice Lead to Gout?

2011-02-10T09:07:00.008-06:00

Twenty-two year prospective study which included 78,906 (gout free) women in the Nurses Health Study found intake of sugar sweetened soda increased risk of gout. Women who consumed 1 serving per day of sweetened soda had a 74% higher risk of developing gout than women who consumed less than one serving a month. Women who had 2 or more servings of sugary soda daily had a 2.4 times higher risk of developing gout.

Think your off the hook if you consume Orange Juice? Think again. The study also revealed that women who had 1 serving of OJ daily had a 41% increase risk of developing gout than women who had less than 6 ounces a month. Women who consumed 2 or more servings of OJ daily had a 2.4 times higher risk of developing gout.

There is no way around it, consuming sugary drinks leads to health issues. Remember yesterday's decisions affect your health today; but, today's decisions affect your health tomorrow.

Clinical Advisor 2011

Tip For Your Health

2011-02-06T06:45:00.005-06:00

You should never ignore persistent fatigue or nausea, shortness of breath, jaw, shoulder or arm pain. You should also never ignore any type of pressure especially if it radiates across the chest; these could be symptoms of a heart attack. (Time is muscle...the longer you wait the chances for loss of heart muscle increases.)

New Dietary Guidelines: Get off your SoFAS

2011-02-04T19:48:00.004-06:00

The U.S. Department of Agriculture (USDA) released new Dietary Guidelines on January 31, 2011. One of the main themes is to "Get off our SoFAS" (get moving and stay away from Solid Fats and Added Sugars). For Americans, that may change many of our meals. No more morning Lattes (fancy milkshakes) and pastries. No more fast food after a long day at work. It's back to the basics. Lean proteins and fruits and vegetables.
Recommendations Include:

Consume more seafood (at least 8 ounces per week)

Consume more fruits and vegetables

Consume more fiber

Lower sodium intake

Maintain plenty of potassium and Vitamin D

Avoid fast foods

Avoid sugary drinks

Eat/Drink more nonfat or low fat dairy products

Replace high fat meals with lean meats

Lets get moving and get off our SoFAS.

Taking Care of Our Bodies: 5 Simple Actions

2011-01-31T07:14:00.008-06:00

Being healthy can be quite simple. Here are the 5 things we need to do everyday to take care of the "homes" we are given to live in. And if we don't take care of the "homes" we are given to live in, Where would we live?

1) Get 6-8 hours of sleep each night

2) Exercise (hunt & gather our food or get in some exercise each day....even a 15 min walk)

3) Have 4 Fruits & all the Veggies you want (at least 4)

4)Have Lean Protein for Breakfast, Lunch and Dinner

5)Drink water (replenish the fluids you excrete)

If you are hungry make sure you have fed your bodies before you have anything else. The more color in your diet the better.

The MacStatin

2010-09-10T16:24:00.007-05:00

“I’ll take a quarter pounder, fries, and a statin to go, please.”

Crazy? Not really. In the American Journal of Cardiology, August 15th, 2010 issue the “MacStatin” strategy was introduced. A group of British Cardiologists suggested fast food restaurants, such as McDonald’s, offer a statin with their meal. How about that? A statin right next to the ketchup, mayonnaise, salt and sugar. Why not? People eat unhealthy meals and complete life compromising acts without a providers consult…so why need a prescription and see a provider for a statin? The statin could be sprinkled in the milkshake, on top of the hamburger or on the French Fries.

The researchers compared the increase in relative risk of cardiovascular disease associated with total and trans-fat content of the meal to the reduction in the relative risk observed in a meta analysis of primary prevention statin trials. The authors were able to show the risk of a heart attack could be reduced by adding a statin to their high fat and high trans fat meal. The risk associated with a cheeseburger and milkshake meal can be offset with one statin tablet.

However, there are other concerns associated with high fat, high trans fat and high calorie meals that lead to further health risk…such as obesity, high blood pressure, diabetes, etc. So, it doesn’t eliminate all the risk; but, perhaps, lessens the initial insult to the system. We’d all be better off with a colorful salad, lean protein and water to go.

Ferenczi EA, et.al, Am J Cardiol. 2010 Aug 15;106(4):587-92.

Tea = Healthy Heart

2010-08-07T21:18:00.007-05:00

Get ready to change your Starbucks order. Despite all the Starbucks coffee stores, tea is the most widely consumed beverage in the world next to water, and can be found in almost 80% of all U.S. households. But the relationship between tea/coffee consumption and coronary heart disease death/stroke has been unclear.

A recent study published in the Arteriosclerosis, Thrombosis, and Vascular Biology Journal in June of 2010, looked at the connections of both coffee and tea consumption with coronary heart disease death and stroke as well as all cause mortality. Approximately 37,000 participants were followed for 13 years. The participants were assessed for stroke, heart disease death and all cause mortality. It was found that high tea consumption (6.0 cups) per day was associated with a reduced risk of coronary heart disease death. These findings were statistically significant. However, in moderate coffee drinkers the results only suggested a slight risk reduction for coronary heart disease death and were not a statistically significant reduction. Neither tea nor coffee were found to have an effect on stroke nor do they have an effect on all cause mortality.

The heart benefits of tea consumption may be explained by the antioxidants found in tea called flavonoids. Flavonoids are also found in dark chocolate, blueberries, red grapes and red wine. Next time you plan to stop for a morning drink on your way to work or have a friend over, serve up some heart healthy tea. Tea is enjoyed all year round as it cools you down in the summertime and warms you up in the winter months.

de Koning Gans, J. Arteriosclerosis, Thrombosis, and Vascular Biology: Journal of the American Heart Association, August, 2010

Omega 3 Fish Oils Help Slow the Aging Process

2010-07-30T15:44:00.010-05:00

Why do some people die of “old age” in their 70s and others in their 90s? Do our cells reach a point where they no longer function? Researchers from the University of California @ San Francisco (UCSF) have discovered Omega 3 fish oils help slow our aging process by protecting our DNA. We typically have a double strand of 23 chromosomes—one-half from our mother and one-half from our father. The ends of our chromosomes are protected by telomeres, much like the caps at the end of our shoelaces; thus, preventing our chromosomes from “fraying”. Each month our cells divide so they can reproduce many times. During cell division our telomeres can become shortened or “snipped” (the shorter the telomere the older the cell). If the telomere becomes too short the cell either dies or enters an inactive state-making one more vulnerable to disease; thus, the longer the telomere the longer your life potential.

Researchers completed a prospective study on 608 California outpatients with stable coronary artery disease. Researchers measured both the length of the telomere in the white blood cells and the Omega 3 blood levels at the beginning of the study and five years later at the end of the study. The study demonstrated an inverse relationship between baseline blood levels of Omega 3 fatty acids and the shortening rate of the telomere over five years. Small increases in the Omega 3 blood levels were associated with 30-35% reduced risk of shortened telomeres.

The American Heart Association recommends for individuals without heart disease to take 500 mg of the DHA + EPA. For patients with heart disease it is recommended you take 1000 mg of the DHA + EPA.

Slow your aging process: reduce stress, eat healthy, exercise and take your Omega 3 fish oils.

Ramin Farzaneh-Far, MD; et.al. JAMA. 2010;303(3):250-257.

How Much Do You Know About Cholesterol?

2010-07-09T22:32:00.003-05:00

Take the Cholesterol Quiz..... click here

Daily Health Planner

2010-07-08T22:49:00.006-05:00

Click below for your Daily Health Planner. It contains five daily actions to take care of the homes we are given to live in...our bodies.

After all, if we don't take care of it, where will we live?
Your Daily Health Planner Here

Who's Driving Health Care?

2010-07-07T09:45:00.003-05:00

Can you pick out a patient with VA insurance from their medication list? Who's delivering patient care and health care policies? Check this out:

http://tinyurl.com/27mad8u

10 Tips to Improve Your Health

2010-05-26T00:10:00.004-05:00

1. Get some exercise every day.

Buy a Pedometer and make sure you walk 10,000 steps daily
Take daily walks
Use the stairs
Park further away

2. Eat Healthy

Lean protein and 2 colors at each meal (fruits/vegetables)
Make sure you eat breakfast (prevents mindless nibbling throughout day and prevents overeating at lunch)

3. Stop Smoking – or don’t start

We now have several options to help you quit smoking
Set Quit date

4. Drink Plenty of Water daily (unless you have a fluid restriction)

5. Get 7-8 hours of Sleep Nightly

6. Floss daily

Lots of data suggesting unhealthy gums increases inflammation markers and can lead to poor health.

7. Keep your Brain Active

Complete crossword puzzles
Participate in discussions and forums
Stay aware of what is going on in the world

8. Get a Hobby

Arts/crafts
Blogging
Gardening
Restoring Cars
Decorating
Healthy cooking
Record collections/Music

9. Reduce Stress

Think Positive
Spend 30 minutes a day doing something YOU like (visit a friend, read a book, play with your dog, listen to soothing music, get a facial, massage, meditate)
Exercise
Laugh more

10. Make small goals and reward yourself when meeting them

Example: make a goal to complete at least 7 of the 10 tips daily for one month. When you meet this goal reward yourself with a new workout outfit, CD, new tennis shoes, massage, personal trainer session, etc
Example: For every 20 sessions of exercise you complete reward yourself

Too Sweet For Your Own Good

2010-05-22T19:30:00.003-05:00

Have you been told you are “pre-diabetic” or “borderline for diabetes”? Or perhaps you have been told you have diabetes and are beginning to make the necessary lifestyle changes to manage it with diet, lifestyle…and maybe an oral medication or two. Most of Type II Diabetes (which used to be called adult onset diabetes…only now it is affecting our kids) can be prevented through healthy eating and exercise. We used to see Type II Diabetes in people ages 50s-60s…the years people began to let themselves go-not eat as healthy, less exercise, etc. Now, our teenagers and young kids are eating bad and letting their health slide at much earlier ages. Many patients I see are surprised to learn that a fasting blood sugar of 100-125 places them in the pre-diabetic category or that 2 fasting sugars of 126 or greater diagnosis one with diabetes. Well, those are the reference points. Do you know what your fasting blood sugar is? Yes, get out your lab results from your last annual physical and check out your fasting blood sugar (glucose) number. It is important for all of us to know our fasting blood sugar levels in order to optimize our health and prevent diabetes in our life.

Fortunately Pre-Diabetes and Type II Diabetes for the most part can be prevented through diet and lifestyle. This would involve decreasing simple carbohydrates and sugars in your diet (see Curbing Your Sweet Tooth) and adding aerobic exercise to your daily regimen. As a Nurse Practitioner I often depend on supplements to assist patients in optimizing their health along with optimal diet and exercise. For patients that have sugar levels greater than 100, I often recommend CardioGT (glucose tolerance) which when used along with the proper diet and exercise regimen, can help maintain a healthy blood sugar level. CardioGT is formulated using natural ingredients which have been identified to have a positive impact on glucose metabolism. These ingredients are chromium, alpha-lipoic acid, magnesium, vanadium and cinnamon. (Click on link for more information regarding these natural ingredients.)

Diabetes, or pre-diabetes, significantly increases your risk for heart disease. If you are one of these individuals with elevated blood sugar levels, CardioGT, when combined with a healthy diet and exercise, may help assist you in improving your long-term health outlook . Click here for further information on CardioGT.

How Many Calories Do You Drink?

2010-05-13T00:32:00.007-05:00

Beverage Serving Size Teaspoons Sugar Calories

Chocolate Milk 8 oz 6 190

Gatorade 8 oz 3 ¼ 63

Gatorade 21 oz 8 150

Sweet Tea 8 oz 5 ½ 91

Coke 12 oz 9 ¾ 155

Orange Juice 8 oz 5 ¾ 130

How Many Calories Make Up 1 Pound?

It takes 3500 extra calories to gain a pound.

Therefore…

500 extra calories a day for one week will cause you to gain one pound.

Or…

500 calories less per day for one week will cause you to lose one pound.

If you drink 2 cans of soda daily for one month, you will have consumed 12.2 cups of sugar & 9300 extra calories.

If you drink 2 cans soda daily for a year, you will have consumed 146 cups of sugar & 111,600 extra calories.

Enough extra calories to gain 31.9 pounds in 1 year!

(If you change to water or unsweetened tea you could lose 31.9 pounds in 1 year!)

Artificial Sweeteners: Blue, Pink, and Yellow Packets

2010-04-16T09:00:00.003-05:00

When I was little, treats or “sugars” in the house were sparse. When they were available all the siblings kept an eye on them to make sure whatever it was-it was evenly distributed. Over time, these sugar products became inexpensive and have infiltrated our homes. We have traded healthy snacks for desserts three plus times per day. And we got bigger and now obese. As smart Americans, we found a way to have this same sweet taste without the calories or sugar spikes that real sugar has. Yep, out of the production lines came diet drinks and those colorful packets-the artificial sweeteners.

We really have enjoyed them. But, as a society, did we get smaller and lose weight with these products? No. In fact, we have gotten bigger and many Americans are not only obese; but more and more Americans are now morbidly obese. Why is that? It’s because we crave the taste of it, not the calories. We crave tasting the sweet stuff. Thus, the more of the sweet taste, the more we crave.

No matter what it is, a diet drink or a coffee with artificial sweetener in it, once we have it – it turns on our craving for more…and the mental agony for the day starts. About every 2 hours or so you are not hungry; but, you physically feel you need something to feel better – or stop your craving. So you feed your withdrawal symptoms so you can go back to work and concentrate on what you were doing. You might get a pretzel, grab a small handful of M&Ms off someone’s desk, pop a peppermint in your mouth, snack on some popcorn, or consume anything that is a simple carbohydrate or sugar to get the craving gone….only to have it again 2 hours later. And each time you complete the mindless nibbling or increased consumption of simple carbs and sugars you are disappointed in yourself and don’t understand why you did it….because after you have fed the craving the urge or craving is resolved and you can once again think rationally. How could you have let yourself do that?

It’s simple. We do not recommend diet drinks, artificial sweeteners or simple sugars. Once you begin consuming these substances the battle begins. You have turned on the craving for the day and for the most part…you will fight it all day long. So avoid the battle, avoid the addiction…concentrate on lean protein and fruits and vegetables at each of your meals and for your snacks. Stay Healthy from the beginning of your day to the end.

Chocolate Bunnies for Easter?

2010-04-03T06:55:00.004-05:00

Happy Easter! For many of you this means going to church to celebrate the meaning of Easter as well as carrying on some of the Easter traditions. Which include eating candy and chocolate bunnies. There is so much information about dark chocolate and it’s benefits that many of the patients we see tell us ….“I have been eating my dark chocolate. You know, it is healthy for you.”

Well, it is true, dark chocolate is a rich source of antioxidants (containing more than milk or white chocolate), and the fat present in dark chocolate is metabolically neutral. Studies have demonstrated a small amount of dark chocolate everyday can reduce blood pressure in individuals with high blood pressure and can reduce LDL cholesterol (bad cholesterol) by up to 10 percent.

Other benefits of dark chocolate aside from protecting your heart include:

It stimulates endorphin (happy hormone) production.

It contains serotonin, which acts as an anti-depressant.

It tastes good.

BUT, this isn’t a free pass to eat all the dark chocolate you can get your hands on. Chocolate is a high calorie, high fat food. Most of the studies done use 3.5 ounces of dark chocolate or less per day to get these benefits. If you are eating dark chocolate and telling yourself it is healthy; while at the same time, gaining 10 pounds, become pre-diabetic, and gaining abdominal fat (bigger waistline)-you aren’t being honest with yourself and you are hurting your own health. Also, if you are addicted to sugar; this keeps you craving for more sugar (see Curbing Your Sweet Tooth).

One bar of dark chocolate can contain up to 400 calories. If you eat half the bar of dark chocolate for the day you still have to balance out those extra 200 calories by eating less of something else.

It’s like life-everything in moderation. Enjoy the present pleasures in such a way that you do not injure future opportunities.

Happy Easter everyone! Hope you spend the day filling up your souls and keeping your body on the healthy track.

Stress and/or Binge Eating

2010-03-27T22:00:00.000-05:00

Perhaps you don’t even know you are stress/binge eating until you have finished or are well into the moment. Here are some tips to assist you in stopping Stress/Binge eating.

Have fewer “treats” around the house/kitchen
Bake less
Wait 15-20 min to eat – drink a cup of water-the urge may pass
If something’s bothering you exercise first
Keep a journal of what you eat and drink everyday
Don’t bring any junk food into the home
Sit down to eat

When you do Over Eat…

Find healthy choices to have available in the future
Do not buy more of the culprit binge item so it is not available to you during the next weak moment.
Please take me for a walk. Don't binge eat again.
Ask yourself why did this happen? What can I change?
Don’t dwell on it. Move on. It’s done. It’s not about where you have been; but, about where you are going.
Exercise more and eat a little less the next day.
Change your routine to avoid this in the future.
Engage in a new activity or hobby. You will eat less when your mind is on a new hobby.

Each day set a nutrtional goal and a physical activity goal. We all must have a goal before we can accomplish it. Stay Healthy.

Curbing Your Sweet Tooth

2010-03-27T00:35:00.001-05:00

Are you beginning to have a hard time with the weight loss? It’s hard to help anyone lose weight if they start their day off with sugar of any kind. And so many people start their day off with sugars. Once one begins the day with sugar…the addiction begins. Every 2-3 hours they will find themselves having to feed the withdrawal symptoms of coming down from their sugar high. One might pick up a pretzel here, sip a soda or a coffee with sugar added to it, eat a peppermint, nibble on chocolate, eat popcorn, etc….until another 2-3 hours occurs again and they’ll either have a meal with more simple carbohydrates (breads, pastas, white rice, soups, crackers, etc) or simple sugars in it to calm down the withdrawal symptoms. And then the cycle repeats. Sound familiar?

I have randomly picked 4 patient charts and I thought I would share with you what their reported breakfasts are:

Chart #1 Frosted mini wheats and orange juice

Chart #2 Instant Oatmeal with raisins, cranberry juice

Chart #3 Starbucks Latte and cookie

Chart #4 Orange Juice, 2 pieces of toast, dried apricots

Do you see a trend here? There is no protein and each breakfast is loaded with sugars. If kids eat this…come 0930 or 10am they aren’t concentrating on a math problem…they are looking to where they can get 10 pieces of gum, a candy bar, soda, or a friend to give them a treat…as they are having withdrawal symptoms which are so strong they can’t concentrate…until the withdrawal symptom is resolved. Same with adults. In our office building, if you go to the vending machines from 3pm-5pm…people do not need dinner. They need to feed their withdrawal from sugar symptoms so they can get back to work and concentrate. The key is do NOT start your day off with sugar. Sugar of any kind. That includes artificial sweetners too! Yes, the blue, pink and yellow packets do not help.

Ask yourself this: Did the people in the world lose weight or gain weight after diet drinks and artificial sweeteners came about? We definitely haven’t gotten any smaller. The reason is, it is not the calories we crave-it’s the taste we crave. If we start our day off with coffee and a colored packet…the sweet taste is turned on and the addiction cycle begins.

So what is a good breakfast? I’ll keep it simple. Each meal should have lean protein and 2 colors (fruits and/or vegetables). Some examples of heart healthy breakfast would consist of apple and celery slices with all natural peanut butter, handful of healthy nuts (walnuts, almonds and pecans) with fruits and/or vegetables, egg whites with fruits and or vegetables, cooked oatmeal (instant is high in sugar-stay away from instant oatmeal) and then add handful of healthy nuts and 2 colors (blueberries, strawberries, apples, peaches, etc), left over meat from the night before with fruits and/or vegetables are all healthy breakfasts. If you need to sweetened a food item – use cinnamon- it helps to reduce your blood sugar levels by assisting your own cells in being more sensitive to your own insulin.

Remember, if you look down at your plate and you do not have lean protein and “2 colors” you are not eating to feed your organs; but, you are eating for pleasure. Feed your organs first and remember, do not begin your day and your most important meal with sugar….breakfast will set your pace for the day.

To those of you trying to lose weight: Keep at it and avoid the sugars. The first 10-14 days will be difficult as your body will be reseting to it’s new normal blood sugar levels. Once this occurs…the sugars will no longer dictate when you eat, nibble or snack…instead you will be back in charge of your body and your health.

Up Front and Personal...When the Rubber Meets the Road

2010-01-30T21:00:00.001-06:00

The other day a patient came to the Cardio Wellness Clinic for an individualized health plan to optimize his health. When I asked how he had heard about the clinic he coldly responded, “I really don’t know why I am here. My physician insisted I come; but, my cholesterol isn’t high and I don’t believe I have any high risks for heart disease-besides I’ve heard all of this before.”

I immediately scanned his chart and looked at the many health risks this young man carried with him. I was quite alarmed that he seemed to have no knowledge of how serious his risks were. He was a male over the age of forty-five, had a sedentary lifestyle, high blood pressure, his bad(LDL) cholesterol was over 150 mg/dL (his goal is less than 100 mg/dL), his good(HDL) cholesterol was too low and his triglycerides (another form of bad cholesterol) were nearly double his targeted goal. His sugar level placed him in the pre-diabetic state and his weight in relation to his height placed him in the obese category with a high and unhealthy waist circumference. As science has proven, one risk factor plus another doesn’t equal a 2 fold increase risk for heart disease; but, can be over a 4 fold increase risk. You see risk factors for heart disease have a multiplicative effect and multiple risks can lead to significant health risks. This patient, whenever I began to speak would immediately stop me to let me know I need not waste my breath as “I’ve heard this all before.”

Each patient is unique with unique risks and unique health plans; but, among them all lies a common thread that in many ways connects them. In this particular case, it wasn’t that he didn’t believe he had risks for heart disease. After all, he drove himself over a hour to come to the appointment. He was fearful of having to change his life and facing the inevitable fact that his current lifestyle was slowly ruining his health. You see as long as no one says it-he doesn’t have to face it. That’s why he was stopping me every time I spoke, yet he drove over 60 miles for the appointment-he knew he needed to hear it-he wanted someone to hold him accountable.

For all of you who have untreated risks or who have let yourself go over the years-don’t be fearful and don’t be hard on yourself. It’s not about where you have been-it’s about where you are going. Most of heart disease can be prevented. For this young man, I informed him of all his risks (quite the list) and told him he was quite fortunate. He hadn’t had any damage to his heart and all the risks I acknowledged with the exception of his age were all modifiable-something he could change. I told him he still had control of his health he just needed to start making changes. He didn’t speak- tears rolled down his face, he understood. The rubber met the road.

What is Heart Disease?

2010-01-19T01:00:00.000-06:00

Heart disease includes a number of problems affecting the heart and blood vessels in the heart. Types of heart disease include coronary artery disease (blockages in the heart arteries), heart failure (problems with the heart not pumping efficiently), or a heart arrhythmia

(changes in the beat of your heart). Coronary artery disease is the most common cause of heart disease. It is a narrowing or blockage of the coronary (heart) arteries. It is the major reason why people have heart attacks.

Check out the video to see how plaque in your heart arteries can lead to a heart attack or sudden death. Many people think it is because it grows slowly over time and eventually it becomes big enough to block enough blood flow to the heart to cause a heart attack or sudden death. We know today plaque will burst to cause that heart attack or sudden death. (See Video)

Heart disease remains the number one killer in both men and women today. But, this doesn’t have to be your fate. Much of heart disease can be prevented or treated with healthy lifestyle choices. That is why it is so important to take action, become aware of risks, minimize them and continually manage them. If you have risks, or have heart disease we encourage you to follow up with your health care provider or through your Cardio Wellness clinic to make sure you have minimized all your risks, stablized your plaque and are on your way to optimal health.

Six Motivational Tips for Exercise

2010-01-10T21:45:00.000-06:00

1) Don’t Count the Calories Burned

One of the ways to keep exercising is not counting the calories burned or weight lost. There are more important things transforming in your workout. Such as new found self esteem, stress reduction, increase endorphin levels (Happy Hormone), improving memory and cognition and adding longevity to your life to name a few.

2) Accountability

Hold yourself accountable. Mark an “X” on your calendar every time you exercise. Seeing your motivation (or lack thereof) in black and white helps to keep you focused on your goal.

3) Join a club, exercise class, or exercise with a buddy

Statistics inform us that we are more consistent with exercise when we do it with a buddy. Just knowing someone is waiting for you to exercise; helps you to show up and get it done.

4) Challenge Yourself

Sign up for a local 5K walk/run or bike trip. It will help you stay focused on your exercise goal while accomplishing a new activity. Not only will you benefit from the exercise; but, from your community involvement too.

5) Reward

Put a dollar or two in the jar every time you complete a workout. When you have enough money, treat yourself to a massage, new CD, workout outfit, session with a personal trainer, or new piece of sport/exercise equipment.

6) Mood Motivation

Often people will say it’s my mood that either motivates me to exercise or not. Regardless of your mood prior to exercise—exercise has been known to improve your mood. Work out your aggressions in the gym instead of at home or work.

Let’s ring in the New Year being active and moving our bodies. Cheers to our Health!

CardioTabs Omega 3 Fish Oils: Blue Ocean to the Green Economy

2010-01-01T17:45:00.000-06:00

CardioTabs continues to update it’s products based upon the latest scientific evidence and what’s best for our environment. The use of marine-derived Omega 3 fatty acids as therapeutic agents have been well established for a wide-range of medical conditions. (Omega 3 fatty acids, are highly concentrated in the brain, eyes, nervous system and other vital organs.) Over the past several years there have been confusion as to which omega 3 fatty acid is most crucial for our health- Docosahexaenoic acid (DHA) or Eicosapentaenoic acid (EPA). Recent studies point to DHA as the number one Omega 3 fatty acid for cardiovascular health. In general, research has demonstrated EPA did not show significant effects on blood pressure reduction and heart rate. However, DHA demonstrated significant effects on enhancing dilation mechanisms through forearm circulation, lowering blood pressure, reduction of heart rate and further triglyceride (type of cholesterol) reduction. Not only is DHA showing superior benefits in the heart health arena but also for overall human health. Recent literature suggests DHA’s health benefits extends past our heart health to other areas such as growth and development, brain function and eye function-particularly in the elderly.

Typically fish oils and fish oil concentrates unfortunately contain much less DHA than EPA. Cardio Tabs has always offered a higher DHA to EPA ratio in their fish oils. In fact the CardioTabs standard Omega 3, burp free, fish oil has a 2.6 to 1 – DHA to EPA ratio. But, what’s more exciting is CardioTabs is now offering us a new product to choose from. It is an Ocean Safe Omega 3 fish oil that has a 10 to 1 – DHA to EPA ratio. This Ocean Safe fish oil not only offers more DHA but it contains 400 iu of Vitamin D3- the vitamin we all seem to be deficient in -and it comes in a citrus berry flavor. If you have heart disease I would recommend 2 of these capsules daily. If you do not have heart disease one capsule should suffice. (You may even chew these fish oils if you like- citrus berry taste.)

So what makes this new product a “green” product? This oil is obtained using safe and sustainable fishing techniques that do not destroy the ocean habitat or deplete the fish stocks. The marine oil is produced from food grade calamari. Calamari has a short life span so they are in plentiful supply and they are naturally high in DHA. CardioTabs fish oil from the Blue Ocean to the Green Economy-protecting our health and the natural habitats of the ocean.

ARBITER 6-HALTS (Big win for Niaspan + Statin Combination)

2009-11-19T21:15:00.001-06:00

The American Heart Association’s 2009 Scientific Sessions released the results of the Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6: HDL and LDL Treatment Strategies in Atherosclerosis (ARBITER 6-HALTs) trial earlier this week. And now medical office phones are ringing. Patients are asking, should I stay on my current cholesterol lowering medication or should I go on Niaspan?

This study consisted of 363 participants who were on statin (90% were on Lipitor (Atorvastatin) and Zocor (Simvastatin))medications for at least 3 months prior to enrollment into the study. The mean statin dosage was 42 mg. These participants were then divided in half. One group received Ezetimibe (Zetia) 10 mg daily while the other half received Niaspan 2000 mg daily (titrated up over 2 months ).

All participants had the following:

-LDL (bad) Cholesterol less than 100 mg/dL

-HDL (good) Cholesterol less than 50 mg/dL

-Known vascular or coronary disease risk equivalents

Baseline Statistics of both groups:

Mean LDL 84mg/dL and Mean HDL 43mg/dL (Ezetimibe group)

Mean LDL 81mg/dL and Mean HDL 42mg/dL (Niacin group)

After 14 months of treatment – the results:

Mean LDL decreased from 84 mg/dL to 66 mg/dL ; HDL decreased from 43 mg/dL to 40 mg/dL; Triglycerides decreased by 7% in Ezetimibe (Zetia) group.

Mean LDL decreased from 81 mg/dL to 71 mg/dL; HDL increased from 42 mg/dL to 50 mg/dL; Triglycerides decreased by 21%: in the Niacin arm.

Primary Endpoint:

Carotid Intima Media Thickness :

-Niaspan (Niacin) arm Statistically significant regression

-Ezetimibe (Zetia) arm Did not have significant regression but did stop progression

Secondary Endpoints Include:

Coronary Heart Disease (CHD) Death, MI(Heart Attack), Coronary Revascularization (heart stent or balloon to open artery or open heart surgery), Unstable Angina (unstable chest pain)

Ezetimibe (Zetia) group had 9 of the secondary endpoint events out of 165 participants. This is 5.5% in the 14 months of the trial.

Niacin group had 2 of the primary endpoint events out of 169 participants. This is 1.2% in the 14 months of the trial.

Dr. James O’Keefe, Cardiologist at the Mid-America Heart Institute in Kansas City, reports “This is a big win for the Niacin + Statin combination treatment. We have had other randomized studies such as HATS and FATS, both of which are smaller studies like ARBITER 6, which although not powered to show event reduction, did find significantly better cardiovascular outcomes with niacin”.

I was able to attend the meeting at the AHA Session earlier this week. The presenter and lead investigator, Dr. Allen Taylor, from Medstar Research Institute, Washington, DC, reported that in 2008 there were 9 million U.S. patients receiving treatment with Zetia and 2.5 million U.S. patients receiving treatment with Niacin. Although niacin isn’t an easy drug to use, due to its’ flushing side effect we should make strong efforts to help our patients tolerate this medication. Over time the flushing becomes less often, less intense and less in duration. In one Niaspan study, participants who took the medication for 6 months had approximately 2 flushes per month. Dr. James O’Keefe reports, “patients should avoid sustained release over the counter (OTC) niacin products, as they are more hepatotoxic (toxic to liver) than the immediate release (IR) OTC niacin or prescription, Niaspan. “

In summary, if you are taking cholesterol medications we recommend you do not stop your medications without speaking with your health care provider. If you are taking an over the counter niacin product make sure it is an immediate release niacin or we recommend taking prescription form Niaspan-which is often more tolerable. “In our experience, which is supported by this recent study, the combination of niacin with a statin such as Simvastatin (Zocor), Rosuvastatin (Crestor), Atorvastatin (Lipitor) is a great way to go both for buffing the cholesterol numbers and improving cardiovascular prognosis,” Dr. James O’Keefe.

Coronary Artery Calcium Scan

2009-11-01T01:16:00.001-05:00

Coronary artery calcium scan is a simple 15 minute, non-invasive heart test that will assist in determining if one has coronary heart disease (plaque in coronary arteries). Coronary artery calcium (CAC) measures “hard” calcified plaque in heart arteries. This scan does not pick up soft plaque that may have formed in coronary arteries. As coronary plaque builds up, so does the threat of heart events. Arteries become more narrowed and blood has a hard time squeezing through; thus, increasing your risk for severe cardiac events (heart attack).

The Multi-Ethnic of Atherosclerosis (MESA) enrolled 6814 asymptomatic patients, of whom over half, 3563, had zero CAC score at baseline (no hard plaque found in coronary arteries). Study participants who went on to have heart catheterization (invasive procedure that visualizes inside heart arteries) due to symptoms, clinical indications, result of the coronary calcium score, abnormal stress test or preoperative risk stratification included 175 of them. In 96% of these cases, the documented baseline calcium score predicted the actual severity or extent of the obstructed coronary artery disease as found per heart catheterization. But, in the remaining 4% there was significant narrowing of heart arteries from soft plaques found via heart catheterization-despite a zero CAC score.

In symptomatic (chest pain or equivalent) or in suspected coronary artery disease (CAD) patients in the Emergency Room-a zero CAC score has a 96% negative predictive value, meaning that 4% of patients with a zero calcium score will have significant CAD, due to soft plaque. People who present with chest pain or equivalent or who are suspected of having CAD, generally need to have functional imaging (stress MPI, stress ECHO, etc.) rather than a screening calcium score.

In asymptomatic (having no symptoms) patients; but, at risk for heart disease, the CAC scan is an excellent choice. As, the main purpose for CAC scoring should be to detect early subclinical stages (before symptoms) of CAD for which specificity is virtually 100% (people w/o significant CAD will not have calcium in their vessels.)

Dr. Harvey Hecht from Lenox Hill Heart and Vascular Institute in New York, New York was quoted: “A strong argument can now be made for requiring coronary calcium screening before stress testing in asymptomatic patients. Also, less aggressive drug therapy is appropriate for zero-score patients, and at the other end of the spectrum, the presence of coronary calcium identifies the higher risk pool of patients in whom 95% to 96% of the events will emerge; it is this group that will benefit from highly targeted aggressive treatment.”

To wrap this up, if patients present to the emergency room with chest pain symptoms a functional imaging study should be recommended versus a coronary artery calcium scan. In asymptomatic patients screening for early signs of heart disease a coronary artery calcium scan would be an excellent choice. Remember, early detection is the key to preventing heart events.

Hospitalization for Heart Disease on the Decline!

2009-10-09T01:21:00.001-05:00

The U.S. Agency for Health Care Research and Quality reported hospitalizations for coronary heart disease (blocked heart arteries) has decreased by 31% from 1997-2007. Additionally, hospitalizations for a heart attack decreased by 15%. No longer is hospital stay for coronary heart disease (blocked heart arteries) the No 1 disease treated in hospitals. It now trails behind pneumonia and heart failure (when your heart isn’t pumping efficiently).

The report included other noteworthy facts.

Congestive heart failure rates were unchanged between 1997-2007.
Admissions for irregular heartbeat were up 28% between 1997-2007.
Heart catheterization (invasive procedure to assess heart arteries) is the second most common procedure among hospitalized men, and the fourth most common in women.
Although hospital stays for blocked arteries have significantly decreased circulatory conditions (combining: congestive heart failure, heart attack, blocked arteries, and irregular heartbeat) were the most frequent major cause of hospital stays in 2007.
High Blood Pressure was a co morbid condition (existing simultaneously with and usually independently of another medical condition) in 35% of all hospital stays in 2007.
When pregnancy and child birth stays were excluded, women still accounted for more hospital stays (59%) than males (41%) in 2007.

We should applaud ourselves for taking better care of our hearts. However, we still have a lot of work to do. Heart disease is still the leading cause of death for both men and women in the United States. Stroke remains the third leading cause of death in the United States. If you haven’t had your heart risk assessment call your local Health Care Provider or visit your local Cardio Wellness Center to do so. Many with heart disease-their first symptom is their last. Don’t let this be you. Most of heart disease can be prevented.

One last note- heart failure hospital stays have not declined since 1997 and stroke remains our 3^rd leading cause death in the United States. High Blood Pressure is often present before heart failure and/or strokes occur. Know your blood pressure number and manage it. One in three of us have high blood pressure….do you know your pressure?

Levit, K., et al. HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2007. Agency for Healthcare Research and quality 2009.

Feel Better Now

2009-09-21T20:00:00.000-05:00

-Sometimes we all get stuck in a rut. With the changing of the seasons now is a good time to change ourselves for the better. Check out these four key topics to better yourself.

Nutrition

Have lean protein & two colors at each of your meals.

Lean protein – healthy nuts, fish, chicken, turkey, edamame, all natural peanut butter

Two colors- fruits and vegetables

Bread- if you must have it, look for fiber content of 5 grams per slice. Remember each slice is 80-100 calories, bread raises blood sugar and contributes to weight gain.

Artificial Sweeteners- Avoid. They make you crave carbs and sugars. Since they have been developed the world has not gotten smaller.

Omega 3 Fish Oils- Helps to promote healthy cells in your body.

Improve Work/Life Balance

Rest/Reflection- schedule in rest and thinking time for yourself. Write it on the calendar.

Keep Connected- initiate daily communication with a relative or friend. Keeps you interested and aware of others.

Compliment- Compliment others on their good deeds, accomplishments, and/or good qualities every day.

Listen To Your Heart- if you want something, pursue it.

Exercise

Get Moving- be active throughout your day. Park farther away, take the stairs, walk the long way around….just because you can.

Half-hour power- walk, cycle, swim, hike 30 minutes everyday

Weights- in addition to aerobic activities, weight train to maintain bone density and add muscle strength.

Sleep Better

Caffeine – avoid caffeine and sugary snacks 12 hours before going to bed. They can cause lots of dreams and restless sleep.

Relax- take a 10-15 minute stroll prior to hitting the sack or take a hot bath

Adequate amount- try to get 7-9 hours of sleep each night.

FDA Approves New Medication to Reduce the Risk of Heart Attack in Angioplasty Patients

2009-09-09T09:09:00.000-05:00

The U.S. Food and Drug Administration approved Effient (Prasugrel) in July 2009. Effient is approved to reduce the risk of blood clots from forming in patients who undergo angioplasty. It is a blood thinning drug that prevents platelets from clumping or sticking together, which can result in clogged arteries and may lead to heart attack or stroke.

A study enrolling 13,608 patients which compared Effient to another blood thinning medication, Plavix (Clopidogrel) was completed. These patients presented with a heart attack or threatened heart attack and were about to undergo angioplasty, a procedure where a balloon is used to open the artery that has been narrowed.

Effient is more efficacious than Clopidogrel in preventing deaths from blood clots, non-fatal heart attacks and nonfatal strokes in patients receiving stents. However, those receiving Effient had a greater risk of bleeding than those taking Clopidogrel. Patients who have a history of stroke were more likely to have another stroke while taking Effient.

Effient appears to be an excellent alternative treatment for preventing dangerous blood clots from forming and causing a heart attack in those patients who present with a heart attack and are in need of stenting.

However, it is recommended to not use Effient in those patients who have active pathological bleeding, history of transient ischemic attacks (TIAs) or strokes. Effient should not be used in patients who are in urgent need for surgery-including open heart surgery. Due to the fact, that when possible, patients should discontinue Effient at least 7 days prior to any surgery (as directed by a physician). In general, patients who are 75 years of age or older it is not recommended to use Effient because of increased risk of fatal and intracranial bleeding and uncertain benefit.

As with any treatment, physicians and patients must carefully analyze the potential benefits and risks associated with the use of Effient – as each individualized case is unique.

How Simple Modifications Can Add Longevity to Your Life

2009-08-25T22:10:00.000-05:00

This was done a couple of years ago. I’m not very good at the interview/video thing…but the story told here is wonderful. I do not believe I have seen higher Triglycerides than this.

UltraViolet Rays and Sunscreens

2009-08-04T21:45:00.000-05:00

Did you know the sun produces 3 types of ultraviolet (UV) Rays? There are UVA, UVB, and UVC rays. The atmosphere completely absorbs the UVC rays. However, both the UVA and UVB rays reach our bodies…but they have a different effect on us.

UVA rays are known to cause wrinkles and at high doses may be the cause of skin cancer-melanoma. UVA radiation does not have the ability to enable us to produce vitamin D. UVB radiation, however, is responsible for sunburns and vitamin D production. Since, UVB radiation can cause sunburns if in the sun too long-UVB radiation may also be part of the cause of skin cancer-melanoma. This is due to the fact that when we develop a sunburn we cause mutation to the skin cells. These skin cells replicate in a mutated state until later they appear in the form of skin cancer. Thus, the key is not to burn.

Sunscreens were first used in the 1940s. What I have found most interesting is up until the late 1990s these sunscreens only blocked UVB radiation (the UV rays that cause sunburns). These sunscreens did not protect against UVA radiation; as they were not thought to be harmful rays, since they did not cause sunburns. Thus, allowing us to absorb mega doses of UVA radiation that we would not normally be able to stay out in the sun and absorb.

Perhaps, this gives us some insight as to why melanoma rates have been increasing by 2% every year over the past thirty years. We now know, UVA radiation at high doses is thought to be one of the causes of skin cancer- melanoma. Therefore, UVB protection only sunscreens have been phased out and broad spectrum sunscreens were developed. This occurred in the late 1990s. These broad-spectrum sunscreens protect us against both UVB and UVA radiation.

Dr. Holick, our nation’s leading expert on vitamin D, completed studies involving sunscreens. His data demonstrates: sunscreens with a SPF 8, reduces vitamin D production by 97.5% and SPF 15, reduces it by 99.9%. Therefore, sunscreens almost completely prevent the body from making any vitamin D from the sun. The point to remember is that it is okay to get “raw” exposure to the sun- 10-15 minutes 2-3 times per week. The key is not to burn. After about 10-15 minutes of “raw” exposure to the sun you should utilize a broad-spectrum sunscreen to protect against having a sunburn.

Lastly, I often get asked, “Can I get a sunburn or UVB radiation from sunshine that warms the skin through a window?” No. UVB radiation from sunlight does not penetrate through glass. Thus, you will not burn and your body will not make vitamin D from sunshine through a window.

So go out in the sun responsibly. Do not burn. Use broad-spectrum sunscreens if you plan to be out in the sun longer than 10-15 minutes to prevent sunburn. Use common sense. Sunshine is not to be feared. Sunlight is the fuel that enables us to manufacture vitamin D. The benefits of vitamin D on human health are many, varied and profound. Just as with oxygen, air, water, our bodies need sunshine. Use it responsibly.

FDA Approves Triple-Drug Polypill for the Treatment of Hypertension

2009-06-23T17:55:00.000-05:00

Do you have high blood pressure? Tired of taking multiple pills to lower your blood pressure? This just might be your solution. The FDA has approved a triple-drug polypill for the treatment of hypertension (high blood pressure). The polypill, called Exforge HCT contains the calcium channel blocker amlodipine (Norvasc), the diuretic hydrocholorothiazide (HCTZ) and the angiotensin receptor blocker valsartan (Diovan). This is the only single tablet that combines three drugs for treatment of high blood pressure in the United States. This drug may be used as add-on/switch therapy for individuals not adequately controlled on any two components of the triple combination.

There have been several studies demonstrating, the less pills one takes the more compliant they are. Three drugs that treat hypertension being contained in one pill should assist us in becoming more compliant in taking our blood pressure lowering medications. The tablet comes in the following dosages:

Tablets: (amlodipine/valsartan/hydrochlorothiazide mg)

5/160/12.5

10/160/12.5

5/160/25

10/160/25

10/320/25

If you are taking these three pills separately; you should consult with your health care provider to see about the possibility of changing over to the polypill. You may find that you miss fewer dosages, becoming more compliant with taking your medications. By doing so will allow for better management of your blood pressure and your health.

High Blood Pressure: Do You Know Your Pressure?

2009-06-19T20:15:00.000-05:00

Many patients who come to the office have high blood pressure. What is alarming is they find excuses for the cause of their high blood pressure. Examples include:

I was running late
I walked in from the parking garage
I didn’t sit long before my blood pressure was taken
I had a disturbing phone call
I ate at a restaurant last evening
I had a busy day at work
I had a hectic schedule
I am under more stress than usual today

Sound familiar?

So many people do not believe they have high blood pressure, even when they come to the office and see their blood pressure is elevated. The other side of the coin is when we treat patients with high blood pressure; patient’s often think it is a disease that can be cured and once their blood pressure is controlled they stop their medications or reduce their current dosage of the medication. Yes, if one is overweight and sedentary they can lower blood pressure by weight loss, decreasing sodium in their diet and exercise—but it is a condition to be managed. For the most part however, once one is on a blood pressure lowering medication you are most likely going to need to stay on the medication.

The facts regarding high blood pressure are: 1 in 3 adult Americans has high blood pressure. Data from the Framingham Heart Study suggest persons 55 y.o. and older have a 90% risk of developing high blood pressure during their lifetime. High blood pressure is associated with:

69% of first heart attacks
74% of heart failure cases
77% of first strokes

In order to prevent these events we must monitor our blood pressures at home and discuss options with our health care provider if our blood pressure is consistently greater than 130/80. As health care consumers, we must know our own blood pressure numbers and seek help if our blood pressure is elevated in order to optimize our health.

So…do you know your numbers?

Stent Patients Advisory: Switch Heartburn Drugs

2009-05-11T01:35:00.001-05:00

WARNING

Anyone taking the clot-preventing drug Clopidogrel (Plavix) after receiving a stent in a coronary artery opening procedure should avoid a type of popular heartburn medications called proton pump inhibitors (PPIs).

PPIs include medications such as Nexium, Prevacid, Protonix, Aciphex and Prilosec.

The Clopidogrel (Plavix) Medco Outcomes Study was recently presented at the Society for Cardiovascular Angiography and Interventions (SCAI)’s annual scientific sessions.

The study reported patients taking both Plavix and PPIs experienced a 50% increase in the combined risk of hospitalization for heart attack, stroke, unstable angina (chest pain), or repeat revascularization. A more in depth review demonstrates patients who received a PPI had a 70% increase in the risk of heart attack or unstable angina; 48% increase risk of stroke or stroke-like symptoms’ and a 35% increase in the need for a repeat coronary procedure.

This study followed 16,690 patients taking Plavix for a full year following coronary stenting. The patients in the study were taking PPIs – Protonix, Nexium, Prilosec, and Prevacid for an average of nine months post stenting. This trial did not look at outcomes in patients on newer PPIs such as Aciphex or Kapidex. The experts report that PPIs decrease the efficacy of Plavix secondary to decreased absorption as compared to the population of patients who used Plavix alone.

Patients who receive a stent are prescribed Plavix to prevent clots from developing. Plavix does increase the risk of bleeding and GI upset; therefore, many providers have routinely given PPIs to patients taking Plavix to prevent gastrointestinal side effects.

The SCAI now suggest providers who are treating post stenting patients on Plavix therapy to consider prescribing histaminergic (H2) blockers such as Zantac or Tagament or antacids instead of a PPIs due to the high risk for adverse events with Plavix and PPI combination as demonstrated in this recent study.

If you are currently taking Plavix and a PPI, I would encourage you to discuss this combination with your health care provider. Perhaps a H2Blocker would be a better treatment for you.

From Sun Worshipers to Sun Phobes

2009-02-19T22:55:00.000-06:00

What happened? One minute we are worshipping the sun, building solariums in our hospitals, gagging down cod liver oil, baking in the sun, and now in the 21st Century we have frightened ourselves out of the daylight. Why is that?

Well, unfortunately, over the past 20 years the relationship between sunlight and skin cancer has been blown out of proportion. AND as per our typical American tradition, we go to extremes when it comes to our health. So from Sun Worshipers to Sun Phobes we went. Wearing long sleeves, long pants, floppy hats, and slathering every inch of our bodies with sunscreen every time we go out in the sun. The cosmetic arena of the pharmaceutical industry helped us in our beliefs, too, as the once anti-sunburn cream turned into the new cancer prevention cream.
So let’s discuss sunburns. A sunburn is much different than a tan. The redness of a sunburn is caused from increased blood flow to the skin so that it can attend to cells that have been damaged by the sun. When damaged enough squamous and basal cells in the skin cannot repair themselves so they die off so they won’t replicate in a mutated state and cause cancers. Severely damaged melanocytes stay alive however. These cells replicate in a mutated way and present themselves later in life as cancer-melanoma. So the key here is not to not go into the sun; but, to go into the sun…just don’t burn.

Let’s look at the Skin Cancer facts (The UV Advantage 2003- Authors Holick and Jenkins)

Non-melanoma- caused by long term sun exposure

Fewer than ½ of 1% die
Claims 1200 lives annually

Melanoma-seen more often in people who do NOT receive regular sun exposure

Comprises 10% of all skin cancers
85% of skin cancer deaths
Kills 7,000 annually

With those facts we need to be cautious about going into the sun and not burn. But, let’s compare the sun risk with diseases that can be prevented by regular sun exposure:

Colon, Breast Cancers 20-65% mortality rate
Kills 138,000 annually.
Osteoporosis affects 25 million Americans.

And every year 1.5 million people with osteoporosis suffer broken bones which can be fatal when the person is elderly.

(Yes, sun exposure reduces the risk of these cancers and osteoporosis)
The risk of sun exposure pales in comparison to the sun’s benefits. Sun exposure can not only result in fewer cases of internal cancers (breast, ovaries, colon, prostate, stomach to name a few) but can reduce fractures from osteoporosis, reduce rates of depression associated with seasonal affective disorder as well.

Look at the maps (above this post). Look where most of the Colon and Breast Cancers are located (red states)…in states with less sun exposure…states away from the equator.

With all the advances we have made in medicine over the past 20 years it is disturbing to know that Vitamin D deficiency and its’ disease states are once again on the rise in the United States. Yes, rickets (weakening of bone in children) and osteomalacia (vague aches, pains and weakening of bones in adults) are back on the rise.

What about fibromyalgia? Let’s shed some light on Fibromyalgia. Is it Fibromyalgia or is it really Osteomalacia? Fibromyalgia was basically unknown until about 15-20 years ago. Fibromyalgia symptoms are muscle pain and weakness. The condition is usually diagnosed when providers can’t find anything else to explain the vague muscle and bone aches. There is no specific test to confirm a fibromyalgia diagnosis. Guess what folks? Check your Vitamin D levels. Dr. Holick reported that between 40-60% of people who came to his clinic with fibromyalgia actually had Osteomalacia due to Vitamin D deficiency. There’s a lot to be learned from this. We all should get about 10-15 minutes of raw exposure to the sun two to three times per week. The key is not to burn. In cities north of Atlanta from November to February the sun’s rays are not strong enough to give us Vitamin D. Therefore, it is important for us to get adequate supplements during these months. I recommend the CardioDaily multivitamin as it is the only multivitamin I know that has 2000 IU of Vitamin D in it.

Most people ask what foods can we get Vitamin D from. An 8 ounce glass of Vitamin D fortified milk is suppose to contain 100 iu of Vitamin D. However, in studies most so-called Vitamin D fortified milks contained less than 20% the amount listed on the label. Although, milk, eggs, and salmon contain Vitamin D, they are in amounts too small to maintain adequate levels for our bodies. So in the winter months here in Kansas City (or any city north of Atlanta for that matter), make sure you take your CardioDaily. If you haven’t had your Vitamin D level checked you might want to have this done…you just might be surprised.

Questions you might have:
Do I advocate Tanning? Not true. I would advocate common sense when it comes to being in the sun.
Do I lie out in the sun for hours w/o protection? Not True.
Do I go out in strong sunshine w/o sunscreen on and does my skin get tanned? Yes. Why? I recognize my body needs a certain amount of sun exposure to be healthy.
Do I put sunscreen on after a certain amount of time? Yes. Why? I understand there are risks as well as benefits with being in the sun

Becky K. Captain, RN, MSN, CLS, BC, FNP-C
Nurse Practitioner

Exercise for Life

2009-01-08T10:44:00.000-06:00

Exercise is your insurance policy. It doesn’t have to cost you any money AND it will give you more time on the clock of life. As an added bonus, exercise will add quality to your life. Close your eyes and picture yourself 10 years from now with your overweight, tired, low self -esteem body lying on a hospital bed with a heart monitor and a nurse constantly checking your blood pressure, blood sugar and heart rate. Your worried family is by your bedside. Open your eyes. Scary, huh? Now close your eyes and picture yourself and family on a sandy beach or out in nature with all the energy you never imagined possible due to the reconditioned body you have carved. Feels good. Doesn’t it? All of us have the ability to change our mindset and choose a different future, or a different past. Becoming fit doesn’t take years—you’ll see the benefit of exercise within a few weeks.

Does the following sound familiar? You know you’ve got to start exercising and you vow to park the car in the furthest parking space, hit the gym after work, sign up for an exercise class, and take the stairs.

But a week passes and before you know it, parking spots are opening up right in front of the stores and buildings, the elevator is already in the lobby and you’ve had an intense week of juggling work, kids and deadlines. How could you have ever thought you could fit in exercise when you have 100 things to do (including your bone density test)? Really, what were you thinking? You still have to organize the sock drawer and Tupperware cabinets. How can you exercise with those items in such chaos?

Been there? Many of us have.

So why does exercise seem so wonderful until we actually have to do it? Lack of motivation? OR is it a misunderstanding that leads us to believe motivation is something that will come to us if we wait long enough…that someday we’ll wake up and finally want to exercise. We must stop living in that fantasy. The reality of motivation—it is something we create—not something we wait for. So, stop waiting for the motivation to come to you—just do it! Make it happen today!

Here are six ways to create your motivation.

1. Don’t Count the Calories Burned
One of the ways to keep exercising is not counting the calories burned or weight lost. There are more important things transforming in your workout, such as new-found self-esteem, stress reduction, increased endorphin levels (happy hormone), improving memory and cognition and adding longevity to your life, to name a few.

2. Be Accountable
Hold yourself accountable. Mark an “X” on your calendar every time you exercise. Seeing your motivation (or lack thereof) in black and white helps to keep you focused on your goal.

3. Join Up!
Join a club, exercise class, or exercise with a buddy or a dog. Statistics tell us that we are more consistent with exercise when we do it with a companion. Just knowing someone is waiting for you to exercise helps you to show up and get it done.

4. Challenge Yourself
Sign up for a local 5K walk/run or bike trip. It will help you stay focused on your exercise goal while accomplishing a new activity. Not only will you benefit from the exercise; but, from your community involvement too.

5. Reward Yourself
Put a dollar or two in the jar every time you complete a workout. When you have enough money, treat yourself to a massage, new CD, workout outfit, session with a personal trainer, or new piece of sport/exercise equipment.

6. Motivate Your Mood
Often people will say it’s my mood that either motivates me to exercise or not. Regardless of your mood prior to exercise—exercise has been known to improve your mood. Work out your aggressions in the gym instead of at home or work. The only obligation in any lifetime is to be true to yourself. So, ask yourself what the secret to YOUR success is. Listen to your answer. Then practice it. See you at the gym or out on the sidewalks and trails!

Full Circle

2008-09-18T01:39:00.001-05:00

I met Mr. Smith in July of 2007. He came to the Preventive Clinic based upon a strong recommendation from a life long friend. Mr. Smith informed me at our first visit that he had come to reduce his risk factors for heart disease. Mr. Smith was full of kindness. He exuded his benevolence at his first Clinic appointment where he started our meeting with kind words for the patient who had referred him to me. Over the past year, Mr. Smith and I have been meeting to optimize his health and reduce his risk for heart disease. During this time, I have come to have a deeper connection with Mr. Smith and have learned more about his life and his kindness. Perhaps this trait, his kindness, will and/or ultimately added just as much quantity and quality to his life as reducing his heart risk factors.

In the book Meaning & Medicine (Bantam Books, 1991) Dr. Larry Dossey states, “Altruism behaves like a miracle drug, and a strange one at that. It has beneficial effects on the person doing the helping-the helper’s high; it benefits the person to whom the help is directed; and it can stimulate healthy responses in persons at a distance who may view it only obliquely.”

Kindness enhances us psychologically as well as physiologically. How is this? Our body manufactures chemicals called endorphins. Endorphins are naturally occurring morphine-like substances that create a feeling of bliss within us. Not only do they provide us with a “feel good experience” but, the endorphins also reduce pain messages being delivered to the brain.

When you choose to become a kinder person, you are not only improving the well being and health of yourself but of those you come into contact with, too. Your kindness has a ripple effect. It has the magical ability of causing even those who have witnessed the act to spontaneously feel good.

Authors Allan Luks and Peggy Payne mention some of the benefits of “doing good” in their book The Healing Power of Doing Good (Fawcett Columbine, 1991). These include a more optimistic and happier outlook on life, sense of exhilaration and euphoria, increase in energy, feeling of being healthy, decreased feelings of loneliness, depression and helplessness, sense of connectedness with others, greater sense of calmness and relaxation, increased longevity, stronger immune system, reduction in pain, reduction of excessive stomach acid, reduction of high blood pressure, and improved circulation to name a few.

It was this past winter during one of our meetings that Mr. Smith was speaking of places in Liberty, Missouri. I told him I was familiar with Liberty and that I visit my grandmother in an assisted living facility there. I was certain he wasn’t aware of this facility as it is a small facility and not well known. I was wrong. Mr. Smith informed me both his parents had lived in that facility and he and his wife visit a few people there on a monthly basis. He immediately added my grandmother’s name to the visit list. What a wonderful act of kindness.

As you see, my grandmother lives for visitors, mail, and outside food. She is 91 years old and quite forgetful. So on my next visit to see grandmother, I placed a note on her table reminding her the Smiths who were friends of mine might be stopping by. Soon, my mother, sees the note. “The Smith’s? That’s Mrs. Smith’s son, the lady who I took piano lessons from. She was a real nice lady.” My mother has fond memories of her piano recitals too. She did a duet with another one of Ms. Smith’s students at a recital. They never practiced together until the day of the recital. Ms. Smith had just played the different part of the duet during their piano lesson and come recital day the two girls who hadn’t met became connected and created a fond memory together. Making this much more than a solo event.

Just recently, I had the opportunity to see Mr. Smith again. He had lost 10 pounds, changed his eating habits, prevented diabetes and subsequently significantly reduced his heart disease risk. Briefly I had mentioned his mother was a piano teacher. His eyes widened and said, “Yes, she was.” I told him my mother’s name and that she had taken lessons from his mother. He went on to inform me that he had visited my grandmother the previous month.

Mr. Smith has made positive lifestyle changes and his physiological risk factors are now minimized. Just as importantly as living a “heart healthy” lifestyle, he continues to deliver random acts of kindness which as we have come to know enhances us both physiologically and psychologically as well. One would only predict his life will continue to be enriched.

It’s interesting that the beneficial effect of helping others holds the power to not only affect our own health, but the health of our entire tension filled society. To better ourselves and our community, not only should we exercise, eat healthy, have our risk factors assessed; but, we should all strive to deliver acts of kindness daily. We meet a lot of people and come across many connections daily. One never knows how our acts of kindness will positively affect others….perhaps for generations to come. With Mr. Smith, this has come Full Circle and it started in the 1950s with his mother teaching my mother piano.

Living Your Priorities

2008-06-19T23:30:00.000-05:00

I saw a patient today who was tearful over her current predicament. She is overweight, has high blood pressure, high cholesterol, and is now pre-diabetic. She broke out in tears stating she felt “she had failed herself.” She felt sad that she had just let herself go over the past several years and now must fight to prevent diabetes and heart disease. How many of you have felt just that way?

In my practice setting, I am often the first person who tells patients they are diabetic, pre-diabetic, have high blood pressure or that they are obese with increased abdominal fat– all of which will lead to diabetes, heart disease and poor health if they continue their current lifestyle. Please note, this isn’t the first patient to become tearful or sad over her current situation. In fact, both grown men and women experience this same emotion. The key point to remember here…and as I tell my patients….this is NOT about where you have been…But it is about where you are going.

Starting right now at this very moment we will make our health a top priority. Yes, this means making changes. Some changes might be a little uncomfortable and you may be on unfamiliar ground at times. But, not only will you add years to your life by making positive lifestyle changes; you may find a better quality of life too. Here are some basic priorities to healthy living and tips to incorporate them into your life.

1) Complete some type of exercise on a daily basis.

You can’t wait for the day to begin because you get a chance to exercise today. (That’s the spirit!) Change your way of thinking. Change your life so this is a priority.

If you are taking your children to baseball practice or piano lessons, etc, put on some walking/jogging clothes and exercise while they are completing their activity.

Instead of meeting your friends to “catch up” over dinner or after work for a few drinks- meet at the local community center, join a class together and see each other weekly. If you can’t afford a class… meet at a park and walk/jog together.

It will not happen unless you MAKE the time.

Additionally, you will surprise yourself how many people will see you as a role model and work exercise into their lives too…all because you did.

2) Choose to eat healthy today.

Get protein for breakfast, lunch and dinner. Eat 4 fruits and 4 vegetables daily. These are the basics of healthy eating. This is your priority for your daily diet. Don’t go for the bagels, English muffins, candy bars, chips, etc…until you have had the basics. In most cases you will not feel the need to eat so much of the other non healthy food choices once you have had the basics. If you are still hungry you can have all the vegetables you want. Then, utilize Joan O’Keefe’s Three Bite Rule from her current blog.

3) Get 6-8 hours of sleep daily.

I know it is difficult some nights to get an adequate amount of sleep due to demanding schedules. But it should be one of your daily priorities, as an adequate amount of sleep contributes to our daily health.

These are 3 basic interventions to healthy living. Make them your priority. Your life and your loved ones are depending on it. My parents often stated, “Don’t lose sight of your goals or priorities.” It is so easy to do in this world today-so much hustle and bustle and so many distractions. It is important that you take the time to make the best decisions for your health on a daily basis. Your health today is a reflection of your past decisions, but your health tomorrow is a reflection of your decisions today.

No matter what our backgrounds are, our troubles, failures or successes in life…we all have the same inner guidance to change our lives and change our health for the better.