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Live Well!

JANUARY 30, 2014

Health • Fitness • Lifestyle

2014 Fearless Fitness Tips for getting back to regular exercise after a heart attack

The Numbers Don't Lie Find out which health indicators are the most important when it comes to your heart

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Simple Ways to Reduce Daily Stress

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Desert Valley Hospital & Medical Group Co-sponsor The High Desert Go Red Shuttle

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Choice Medical Group suggests changes to manage heart attack risks

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Heritage Victor Valley Medical Group offers tips for treating your heart right

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Thursday, January 30, 2014

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Inside

Live Well 3 4 6 8 10 12

State Your Age, Weight and Heart Health...

to Heart Disease

13 14 15

Managing Heart Attack Risks

Takes Women to Heart

Exercise After an Attack From the Mouths of Survivors: Butt Out Five Simple Ways to Reduce Daily Stress Get Smarter, Think Fast for Stroke Awareness Little-Known Dietary Contributors

Exercising Outside of the Box Desert Valley Hospital and Medical Group

16 Amazing Facts About the Human Heart 17 Happy Heart, Happy Life 18 The Numbers Never Lie 20 Ask The Expert: Rip Esselstyn 22 The Nutritive Power of Apples 23 Tips for Yoga Beginners

Live Well! Health s Fitness s Lifestyle

is published and copyrighted 2014 by the Daily Press, 13891 Park Ave., Victorville, Calif. 92392 and the Desert Dispatch, 130 Coolwater Lane, Barstow, Calif. 92311 Freedom Communications Inc. Newspapers. Publisher: Al Frattura Advertising Director: Angie Callahan Project Coordinator: Ray Marien Editor and Page Layout: Micki Brown, Special Sections Editor For Daily Press advertising information, call 1-760-951-6288 For Daily Press subscription information, call 1-760-241-7755 For Desert Dispatch advertising information, call 1-760-256-2257 For Desert Dispatch subscription information, call 1-760-256-8589

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State Your Age, Weight and Heart Health … Gaining weight is especially dangerous as people age, and the effects on the heart can be devastating BY JEFF SCHNAUFER CTW Features

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any think it’s just natural to put on weight as one ages, but some health experts say it may be the worst time in a person’s life to put on weight and get out of shape. Yet unfortunately, more and more seniors are becoming obese. According to Dr. Catherine Loria, nutritional epidemiologist in the National Heart Lung and Blood Institute’s Division of Cardiovascular Sciences in Bethesda, Md., the obesity rate among men greater than 60 years old is 37 percent and women greater than 60 is 42 percent. And data from the 2009-2010 National Health and Nutrition Examination Survey reveals that adults age 60 and over were more likely to be obese than younger adults. Myriad health risks accompany obesity, health experts say. These include hypertension or high blood pressure, high cholesterol and heart disease, cancer, osteoarthritis and diabetes. For the 50-plus crowd, health experts say obesity can increase these risks even further. “Probably one of the main considerations there for the 50-plus population is that the conditions have had longer to do damage to the body,” says Dr. Vance Blackburn, a physician in Birmingham, Ala., who has conducted research for the American Academy of Family Physicians. “Another factor is that people who are overweight tend to have SEE HEART HEALTH • PAGE 27


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After a heart attack or stroke, getting the heart in better shape is important for long-term survival. But how do you overcome the fear of elevating your heart rate? And what is safe to do and what isn’t? BY LINDSEY ROMAIN CTW Features

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Exercise After an Attack

xercise is always an intimidating endeavor, but exercise after the trauma of a heart attack heightens that intimidation tenfold. Heart attacks are, after all, synonymous with increased heart rate, the exact goal one works t owards when they work out. It’s hard to shake the fear of triggering another attack and undoing the hard work of rehabilitation. Luckily, the risk can be minimalized with the help of doctors. “The key is to start very slowly, with gentle and easy activity as tolerated and with caution,” says Dr. Mark Urman, clinical professor of medicine at the David Geffen School of Medicine at UCLA. Post-trauma exercise is case dependent – the severity of the attack and the amount of exercise the patient performed beforehand are determining factors for how to jump back into a routine. Urman suggests starting with “walking on a flat surface for SEE EXERCISE • PAGE 26


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FROM THE MOUTHS OF SURVIVORS:

BUTT OUT! Quitting smoking is one of the best ways to prevent heart disease, but it’s also one of the hardest. Think it can’t be done? Get inspired by these true stories of heart patients who successfully quit smoking and learn how it’s impacted their overall health — and lives — for the better

BY DAWN KLINGENSMITH as little as three years, the risk of heart attack or stroke CTW Features returns down to the level of a s most heart patients nonsmoker,” says Dr. Richard Krasuski, a cardiologist at are well aware, quitting smoking can the Cleveland Clinic in Ohio. What patients may not bring about drastic improveknow is that many smoking ments in cardiovascular health. “Improvement is seen cessation programs “stress comfort” instead of dire almost immediately, and in

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warnings, says Patricia Folan, director of the Center for Tobacco Control at North Shore University Hospital in Long Island, N.Y. “We don’t ask people to quit. We prepare them to quit. We talk about medications and products than can help keep them comfortable.”

Some prefer to quit cold turkey, without the use of nicotine replacement therapies. Here, heart patients who have successfully quit smoking share their experiences — their methods, their challenges and the outcomes that make it all worthwhile. © CTW Features


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Roosevelt Smith, 53, Norfolk, Va. My heart attack played a big part but it wasn’t the deciding factor. What did it was my family and their response to me after having surgery. I slowly, slowly, slowly got back to smoking even after a total of seven heart attacks and bypass surgery at age 45. I remember almost forcing myself to do it even though it was painful, and even though the surgeon told me he felt like he was wasting his time on me because I’d last less than two years if I continued to smoke. It was like something was missing and I needed to get that something back, no matter the cost. What has smoking cost me? My livelihood as a commercial plumber — I can no longer do it. I wound up losing my home, which put a strain on the marriage and cost me that, too. I don’t want to put it all on cigarettes because there were other factors. When I quit for good, I went cold turkey. But by that point, I had reduced the amount I was smoking to two to three cigarettes a day. By degrees, I have started to feel better. And I’m happy to say I outlived that doctor’s prediction. Roosevelt Smith is featured in the CDC’s “Tips From Former Smokers” campaign MORE SURVIVORS • PAGE 24

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FIVE

Thursday, January 30, 2014

SIMPLE WAYS TO REDUCE DAILY STRESS

Dealing with the everyday things isn’t easy, but knowing how to manage life’s ups and downs is an important factor in maintaining a healthy heart BY LINDSEY ROMAIN CTW Features

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tress is more than just frustration at work or exasperation from a packed schedule — in some instances, it’s a precursor to deadly debilitations. Stress is a general term given to the body’s responses to stressors, which “induce activation of the sympathetic nervous system responsible for flight-or-fight response,” says Krishna Tummalapalli, cardiologist at the University of Pittsburgh Medical Center. The sympathetic nervous system releases hormones like adrenaline, cortisol and serotonin, which lead to accelerated heart and lung action, inhibition of digestion and a number of other physiological responses. The human body, while complex and adaptable, isn’t equipped to handle constant sympathetic nervous system activation, Tummalapalli says. It’s not just moments of intense stress — like Tako Tsubo syndrome, which refers to the sudden onset of heart attack or heart failure symptoms due to the sudden deterioration of heart function after a person hears unexpected tragic news

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Thursday, January 30, 2014

LIVE WELL 2014

— that are detrimental to heart health, but prolonged minor stressors, too. Stress is a leading factor in chest pain, strokes, elevated blood pressure and heart attacks. If left unattended, warns Tummalapalli, it can lead to unhealthy coping mechanisms like smoking, poor food choices and a sedentary lifestyle. “Stress also impairs our ability to fight infection, impairs our cognitive abilities — like thinking clearly and remembering accurately — and increases inflammatory markers in the body,” says Catherine M. Stoney, program director for the Division of Prevention and Population Sciences at the National Heart, Lung and Blood Institute in Bethesda, Md. And though, according to Stoney, eliminating stress isn’t always a realistic goal, learning to live and cope with it is the best possible outlook. It’s all about finding what works for you. Here are some suggestions for ways to reduce stress in everyday life: 1) Exercise. It almost goes without saying in this day and age — exercise is a great way to both relax and stay in shape. “This might be the single most important thing you can do

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to improve your health,” Tummalapalli says. 2) Meditation and Yoga. Tummalapalli and Stoney both recommend these soothing activities as a way to center oneself and learn proper deep-breathing techniques, which are helpful in times of panic. 3) Find a hobby. “Tennis, dance, photography — whatever you like!” Tummalapalli says. 4) Take a time out. Similar to a hobby, this involves taking some time out of every day to spend quality time with yourself. “Read, watch a movie, take a relaxing bath or choose another enjoyable activity that provides a quiet time apart from your daily activities,” says Stoney, who also advises turning off electronic devices to truly “commit to the notion that time for yourself is as important as time for work.” 5) Socialize and volunteer. “Humans are social animals,” says Tummalapalli, who notes the importance of being selective about who you choose to interact with: “Socialize with people you genuinely enjoy spending time with.” Keep yourself surrounded by people who love and support you, and “ask for help when you need it,” Stoney says. © CTW Features

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GET SMARTER, THINK FAST FOR STROKE AWARENESS BY LISA IANNUCCI CTW Features

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ccording to American Heart Association statistics, every 45 seconds, someone in the U.S. has a stroke, and 1 out of 18 people will die from it. It’s a startling fact, but the good news is that the National Stroke Association says that 80 percent of strokes can be prevented. A stroke occurs when a blood clot blocks an artery or a blood vessel breaks (called an aneurysm), interrupting blood flow to an area of your brain.  When either of these things happens, brain cells begin to die and brain damage occurs. “Most common strokes are from a hemorrhage or aneurysm,” says Dr. Elliott M. Badder, vascular surgeon at Mercy Medical Center in Baltimore. “Then there are poor circulation strokes, which are more of a limited area of loss and mini strokes, or transient ischemic attacks (TIAs).” Anyone can have a stroke but a person’s risk increases with certain risk factors such as hypertension, high cholesterol and diabetes, all which worsen with age. Risk also increases if you are a smoker, are overweight and aren’t physically active. “Risk factors like high blood pressure, cholesterol and diabetes don’t hurt and my stroke patients in the ER thought they were healthy and wonder why it’s happening to them, but they aren’t healthy,” says Dr. Randall Wright, medical

director of the Stroke Recovery Care Unit, Health South Rehabilitation Hospital in The Woodlands, Texas. Stroke symptoms can be confused for other conditions, such as multiple sclerosis, other neurological problems and even a tumor, which can delay someone from going to the hospital quickly. To prevent a stroke, it’s vital to get your risk factors under control and, if you’re over 55, consider being screened for hardening of the arteries, or Carotid Artery Disease (CAD), especially if you already have heart disease. Otherwise known as the silent disease, because it shows no warning signs and the first symptom may be a stroke, CAD is a narrowing of the neck arteries that blocks blood flow to the brain. "Plaque formation forms in the blood vessels that lead to the brain," explains Dr. Michael H. Yen, who practices cardiology at Vassar Brothers Medical Center in Poughkeepsie, N.Y.

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To prevent a stroke, it’s vital to get your risk factors under control and, if you’re over 55, consider being screened for Carotid Artery Disease.

STROKE WARNING SIGNS (National Stroke Association)

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body. • Sudden confusion, trouble speaking or understanding. • Sudden trouble seeing in one or both eyes. • Sudden trouble walking, dizziness, loss of balance or coordination. • Sudden, severe headache with no known cause. For more information visit: • National Stroke Association: www.stroke.org • American Stroke Association: www.strokeassociation.org • Dr. Wright: www.thewrightchoicerx.com To determine if your arteries are narrowing, doctors will place a stethoscope over your neck’s carotid artery and listen for a lack of blood flow, or a bruit. If they find one, further tests are performed and, depending on the severity of the blockage, you’ll either be monitored or undergo surgery. According to the Society of Vascular Surgery, only 1 percent of adults age 50 to 59 have significantly narrowed carotid arteries, but it increases with age, with men having a higher risk of CAD before age 75 and women having a higher risk after age 75. If you think you’re suffering from a stroke think FAST, which stands for Face, Arm, Slurred Speech and Time. “If you ignore your symptoms you’ve already lost valuable time for us to get a clot-busting drug in your system,” Wright says. © CTW Features

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LITTLE-KNOWN DIETARY CONTRIBUTORS TO HEART DISEASE R

ed meats, hydrogenized oils — these are the foods we associate with heart disease and high cholesterol. But a few other things many people eat rather frequently could be contributing to future heart problems.

White pasta and breads Researchers have found that eating a diet high in refined grains, including those in most store-bought pastas and white breads, can double the risk of heart disease. These foods are those that have a high glycemic index, or GI. Foods with a high GI quickly release sugar into the bloodstream. Doctors have found a correlation between high GI and heart disease, mainly in women, according to research at the University of Milan. The study questioned 32,578 women and 15,171 men. Those who consumed the largest concentration of high GI foods were 2.24 times more likely to develop heart disease than those with the lowest. Nutritionists advise that, when choosing grain products, it is important to select those made from whole grains. Not only do these products provide the nutritional benefits of whole grains, including fiber, they also help reduce cholesterol and the risk for heart disease.

Sugary items While many people associate sugary snacks, beverages and sugar itself with dental decay or unnecessary calories, these items also impact cholesterol levels. The average American eats the equivalent of 21 teaspoons of added sugar a day, which is two to three times the amount they should, according to an article in the Journal of the American Medical Association. Researchers found that individuals who consumed the most sugary products had the lowest HDL, or good cholesterol, and the highest blood triglyceride levels. Eating large amounts of sugar can then be a major risk factor for high cholesterol and heart disease. In its 2010 guidelines, the American Heart Association recommended limiting added sugar in the diet to no more than 100 calories a day for most women and 150 calories for most men. That’s 6 teaspoons for women and 9 for men. To put those guidelines in perspective, consider that a 12-ounce can of soda has between 8 and 10 teaspoons. In addition, many processed foods contain sugar even if sugar’s inclusion seems foolish. Some restaurants and food manufacturers have admitted to adding sugar to foods — especially those geared to children — to make them taste better and be more appealing. Therefore, sauces, readymade dinners and other items may have sugar, and the consumer may not know it without reading the nutrition label. Also, it’s important to note that beverages are the leading supplier of added sugar for many people. Simply reducing the amount of juices, sports drinks and sodas in your diet can greatly reduce sugar consumption. — Metro


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Page 13 The Choice Medical Health and Wellness Center is located at 18564 U.S. Highway 18, Apple Valley Call today to find out about the many programs Choice offers to keep you healthy. (760) 242-9377

Managing heart attack risks

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ou can be a huge help to your heart. Personal and family history affect your risk of heart disease. However, your lifestyle choices have a lot to do with raising or lowering risk factors. Make it a point to visit your Choice Medical Group physician to monitor your cholesterol, blood pressure, weight and other factors that can increase your risk. Learn more below about preventing heart disease, heart attack and stroke. Steps to a healthier heart: • Enjoy a low-fat diet: Better food habits can help you live healthier. The American Heart Association recommends that you eat a wide variety of foods daily from all of the basic food groups, but especially whole grains, vegetables and fruits. Keep fat intake low. • Lower your cholesterol: If results of a blood test show that you have an elevated cholesterol level, you have an increased risk of heart disease. Have your cholesterol checked regularly. • Stop smoking: Smokers have twice the risk of heart disease of non-smokers. Moreover, the risk increases with the number of cigarettes smoked each

day. Cigars, pipes and chewing tobacco also increase risk, although to a lesser degree. Among other things, smoking encourages the development of atherosclerosis (fatty plaque) in the blood vessels. It also decreases the good cholesterol (high density lipoproteins or HDL) and increases the tendency for blood to clot inside blood vessels and cause blockages. • Monitor your blood pressure: When left untreated, high blood pressure causes the heart muscle to weaken because it must constantly work harder against the increased resistance in the blood vessels. Untreated high blood pressure can lead to heart failure. It also increases the risk of strokes, kidney damage and aneurysms. • Exercise: In addition to improving cardiovascular health, regular exercise promotes weight loss, helps lower blood pressure, and enhances the body’s ability to eliminate cholesterol and other fatty substances. It even reduces the lifestyle-limiting effects of osteoporosis and arthritis and improves mental health. — Choice Medical Group


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Simple ways to incorporate exercise into your daily routine

EXERCISING OUTSIDE OF THE BOX

xercise is an essential element of a healthy lifestyle. When coupled with a healthy diet, exercise puts men and women on a path toward optimal health while reducing risk for a host of ailments, some of which can be deadly. But many people find they simply don’t have the time to exercise regularly. Commitments to career and family can be demanding and time-consuming, and exercise is often a casualty of a hectic schedule. Though getting to the gym every day or even making use of exercise equipment at home on a daily basis may not be feasible, that doesn’t mean people still can’t find ways to incorporate a little exercise into their daily routines. The following are a few simple ways to fit more exercise into your day no matter how busy you may be. • Avoid the elevator, and attack the stairs. The elevator may be inviting, but it’s also somewhat of an enabler. Instead of taking the elevator up to your office each day, take the stairs, and take them with more gusto than you’re used to. Rather than taking one step at a time, take the stairs two by two, lifting your legs high as you scale each pair of steps. This helps build your leg muscles and makes the daily climb up the staircase a little more strenuous. • Turn TV time into treadmill time. Watching a little television at night is how many people relax and unwind, but it can be a great time to squeeze in some daily exercise as well. Opinions as to what’s the best time of day to exercise vary, and no definitive study exists to suggest


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Desert Valley Hospital and Medical Group Takes Women to Heart

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o Red For Women is a network of women dedicated to education, support, and research that was formed ten years ago after the American Heart Association discovered that heart disease killed more women than men. In fact, it took more women’s lives than all forms of cancer combined. Since then, in partnership with organizations like Desert Valley Hospital and Desert Valley Medical Group, millions of women have been educated on the dangers of heart disease, and have made major changes in their health care. The High Desert Go Red Shuffle event is scheduled for Saturday, February 22 at the Mall of Victor Valley from 9 a.m. to noon to support awareness, research, education and community programs to benefit women. The goal of the event is to advance women’s understanding about their risk for heart disease and provide tools and motivation to help women reduce their risk to protect their health. This exciting event will consist of a fun Go Red Shuffle fitness walk and a survivor fashion show. Additionally, attendees will be educated through physician and survivor presentations and can visit several health and wellness vendor booths. Desert Valley Hospital and Desert Valley Medical Group, the American Heart Association, Macy’s, and the Mall of

Victor Valley are major sponsors of this important High Desert event which is designed to educate women on the importance of heart health. Attendees will be encouraged to pursue a healthy lifestyle by following an exercise routine, eating healthy, getting regular doctor check-ups and being aware of heart health. Free blood, cholesterol and glucose screenings will also be available. “With the region’s most advanced Heart Center in the High Desert, we are proud to support this important event and help raise the awareness of the dangers of heart disease which has been predominantly associated with men. It is the number one killer of women and we want to help make them aware of the risk factors,” stated Margaret Peterson, CEO of Desert Valley Hospital. The Go Red movement is now saving lives, improving the heart health of women, raising awareness and improving the lifestyles of women across America. Although the event is free and open to the public, women are encouraged to pre-register for this exciting event by sending an email to Laura.kirk@ heart.org, by visiting www. iegoredluncheon.org, or by calling (310) 424-4164. — Desert Valley Medical Group

one time of day is better than another. People who like to relax with a little television time at night should make the most of that time by hitting the treadmill, elliptical machine or exercise bike instead of just plopping down on the couch. Add a television to your home’s exercise room or purchase a gym membership where the cardiovascular machines are connected to televisions. You will still get to enjoy your favorite shows while simultaneously getting the benefit of exercise. • Say “bon voyage” to the conference room. Professionals who spend lots of time in meetings can add a simple twist that incorporates exercise into a typical business meeting. Rather than conducting the meeting in a conference room, propose a walking meeting when possible. A walking meeting is the same as a standard business meeting, but it’s conducted on foot outside of the office. Walking meetings can provide some much-needed energy for you and your fellow staff members, who may appreciate the chance to get out from behind their desks and stretch their legs while still getting work done. Take your smartphones or tablets along to jot down important ideas, just like you would in a more traditional meeting. And make the most of your walk by leaving time for some light stretching before and after the meeting. Chances are you will return to

your desk reenergized and glad you found a way to get some exercise despite of a busy schedule. • Park far away when shopping. It’s tempting and almost human nature to hunt for the parking spot closest to the door when shopping at the mall or even the grocery store. But for those who want to include more exercise in their daily routines, parking far away from the entrance to your favorite store is a great way to incorporate more walking into your life. Walking is a simple yet effective cardiovascular exercise, one that the Mayo Clinic notes can lower your blood pressure and manage your weight while lowering your low-density lipoprotein, which is commonly referred to as “bad” cholesterol. In fact, research has indicated that regular, brisk walking can be just as effective at lowering a person’s risk of heart attack as more vigorous exercise, including jogging. When parking far away from the entrance, just make sure you park in a well-lit area where others can easily see or hear you. Many adults find they simply don’t have the time to commit to routine exercise. But there are several simple ways to incorporate exercise into your existing routine without taking time from your already busy day. — Metro


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Amazing facts about the human heart

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very Valentine’s Day homes and businesses dress up the decor with cupids and hearts to celebrate a day all about love and affection. The heart shape has been used to symbolically represent the human heart as the center of emotion and romantic love. Hearts symbolizing love can be traced back to the Middle Ages. Those familiar with human anatomy realize that an actual heart bares very little resemblance to the ideographic heart shape used in art and imagery. Similarly, the human heart really has nothing to do with human emotions. Despite this, there are many interesting components of the heart, and a man or woman truly cannot love or live without one. The heart as an organ is relatively small in size. It is roughly the size of a fist and weighs only 11 ounces on average. Although diminutive, the heart is responsible for pumping 2,000 gallons of blood through 60,000 miles of blood vessels each day. It accomplishes this by beating 72 times a minute in a healthy adult. All of the cells in the body receive blood except for the corneas in the eye. The heart works harder than any other muscle in the body. In a fetus, it begins beating at four weeks after conception and will not stop until a person’s time of death. Even then, sometimes the heart can be revived. A heart can also continue to beat outside of the body provided it has an adequate oxygen supply. Although many people refer to all of the blood vessels in their body as “veins,” they’re actually a combination of veins and arteries. Veins carry fresh, oxygenated blood to the body through arteries. The main artery leaving the left heart ventricle is called the aorta, while the main artery leaving the right ventricle is known as the pulmonary artery. Blood traveling back to the heart flows through veins after it has passed the lungs to pick up oxygen. The thumping noise that is heard while the heart is beating is actually the chambers of the heart closing and opening as blood flows through.


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Happy Heart, Happy Life

he heart is a muscle that pumps blood throughout our bodies. As we age, this muscle can become weaker, leading to heart disease. You can prevent this from occurring by taking care of your heart and keeping it strong. Here are some helpful tips Fiber helps control your to keep your heart happy for appetite and cleans a lifetime: the blood of unwanted 1. Watch your weight. toxins. Try to cover at Carrying extra pounds puts least half your plate extra pressure on your heart with these delicious vegto pump all that blood. Talk gies and your heart will HOLLY with your doctor to deterthank you for it. Choose HANDORF mine the best weight for you. celery or cucumbers 2. Control your portions. instead of chips. Try Over eating can put a strain mashed cauliflower in not only on your waistline, but also on place of mashed potatoes. Load up on a your heart. Eating small, nutrient-rich green leafy salad. meals will not only help your figure, but 4. Stay hydrated. Drinking at least will save wear and tear on your heart. two liters of water a day gets your blood 3. Eat more veggies. New research flowing, making it easier for your heart to shows that loading up on nutrient-rich pump it through your body. Drinking pure non-starchy vegetables can help prevent water is best. Coffees, teas, and sodas can heart disease. Examples of non-starchy be dehydrating, leading to sticky blood veggies include carrots, cucumbers, cel- making it hard for your heart to pump the ery, spinach, all types of lettuce, broccoli, blood to vital organs. Add a splash of fresh cauliflower, zucchini, all types of mush- lemon or lime juice for an extra treat. rooms, and tomatoes. These vegetable 5. Get fit. Participating in 150 minutes are also loaded with heart-healthy fiber. of aerobic activity a week has been shown

to keep hearts strong and healthy. That breaks down to 30 minutes, five days a week. That’s the length of a sitcom. It can be as simple as a walk around the block, a bike ride with a friend, or a game of tag with your kids. So, get out and get moving! 6. Skip the smoke. Cigarette smoke is very damaging to the heart muscle. Even second-hand smoke can damage your heart. If you smoke, quit. You can get help by calling 1-800-NO-BUTTS. If you don’t smoke, don’t start. 7. Chill out. Stress can put quite a strain on your heart. Sometimes stress can’t be avoided. What’s more important is how we handle the stress we have. Finding ways to release stress will allow your heart the chance to relax. Try yoga, meditation, having a good laugh, enjoying a good movie, or just spending time with the people you love. Our heart is one of our most important organs. It is also the one we most neglect. Treating your heart right now will have it loving you for a lifetime. Happy Heart Health Month! — Holly Handorf, RN, BSN Health Educator, Heritage Victor Valley Medical Group

While the heart may not be the cornerstone of emotions, it can be affected by feelings. Studies have shown that a “broken heart” is a real occurrence, according to Live Science. Bad news or a breakup with a loved one can put a person at increased risk for heart attack. This type of trauma releases stress hormones into the body that can stun the heart. Chest pain and shortness of breath ensue but can be remedied after some rest. Conversely, laughter and positive feelings can be beneficial for the heart. Research has shown that a good laughing fit can cause the lining of the

Being intimate can provide a physical workout, in some instances doubling a person’s heart rate and burning up to 200 calories. That’s the equivalent of a brisk 15-minute run. Also, a study of 2,500 men aged 49 to 54 found having an orgasm at least three times a week can cut the likelihood of death from coronary disease in half, according to The New England Journal of Medicine. The heart is an amazing organ responsible for sustaining life. Although it is not directly tied to love and emotions, without the heart such feelings wouldn’t be possible. — Metro

blood vessel walls — called the endothelium — to relax. This helps increase blood flow for up to 45 minutes afterward. Although having a big heart colloquially means that a person is loving and goes out of their way for others, physically speaking, a big heart is unhealthy. An enlarged heart can be a sign of heart disease and compromise the heart’s ability to pump blood effectively. Left untreated, it can lead to heart failure. There is good reason to get a morous with a loved one on Valentine’s Day or other times during the month.


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MIN. OF EXERCISE

Thursday, January 30, 2014

BLOOD SUGAR

AGE

SMOKING

BLOOD PRESSURE

WEIGHT

WAISTLINE

BY BEV BENNETT CTW Features

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nowing your cholesterol numbers says you’re in charge; you’re the master of your heart health. What more do you need to track? Plenty. Your age, race, gender, weight, diet and exercise habits and whether you have diabetes could determine

your potential for a heart attack or stroke, according to new guidelines to assess and reduce atherosclerotic cardiovascular risk from the American College of Cardiology and the American Heart Association. With these guidelines comes a different approach than in the past, according to Dr. Reena L. Pande, a cardiologist at Brigham and Women’s Hospital in Boston and an instructor at Harvard

CHOLESTEROL

Medical School. You’ll find there’s more emphasis on your collective risk factors, according to Pande. It’s more important to know your personal health history, not just your cholesterol numbers. You’ll want to discuss your risks with your physician so you can determine whether you need to make lifestyle changes and whether you’d benefit from medications. Don’t ignore your choles-

terol readings, however. You still need those. But you should also be aware of the other numbers linked to your health, according to Dr. Joel K. Kahn, clinical professor of medicine, Wayne State University School of Medicine, Detroit. These include: • Your blood pressure. • Your waistline circumference. You’re at greater risk for heart disease if you’re a man with a waistline that’s more than 40 inches or a


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LIVE WELL 2014

THE UMBERS NEVER LIE Tracking vital health statistics is vital to a maintaining a healthy heart. Here’s what you need to know about your own body woman measuring more than 35 inches around the waist (measure around your bare abdomen, just above your hipbone). • Your fasting blood sugar. “You can have elevated blood sugar for years before you have a diabetes diagnosis,” says Kahn, also director of cardiac wellness at Michigan Healthcare Professionals. Having diabetes increases your risk of heart disease,

according to Kahn. • The number of first-degree relatives with heart disease before age 50. • The number of minutes a week you exercise. • The amount you’re smoking. Along with a profile of your health numbers, talk to your physician about any irregularities in your well-being. “Do you get short of breath on exertion? Has your physical fitness deteriorated so you

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ADD IT UP You can figure out your 10-year risk for cardiovascular disease using an online calculator from the American Heart Association and the American College of Cardiology. However, the calculator isn’t without controversy. Some suggest that the data used to determine risk is too old to be useful. Dr. William A. Zoghbi argues the merits of the calculator. “It’s like a weather forecast: rain in four days. There’s no certainty, but a warning, a higher chance that rain will happen, ” says Dr. Zoghbi, immediate past president of the American College of Cardiology. The calculator has a similar function to alert you to a higher risk for heart disease. “If you see risk you have to do something to reduce it,” Dr. Zoghbi says. For more information, visit the website of the American Heart Association at: http://www.heart. org/HEARTORG/ Conditions/Heart Attack/Heart AttackToolsResources/ Heart-Attack-Risk Assessment_UCM_ 303944_Article.jsp

can’t do regular things?” asks Kahn. Learn how your race could affect your heart health. African-Americans have a greater risk for developing heart disease and stroke. If you have concerns based on your personal history, ask about further tests to diagnose your heart health. “I see a zillion people who want to be checked out. People come in without symptoms, see the [heart]

guidelines and want to be checked out,” Kahn says. Advanced tests include lipoprotein testing, which shows whether you have a specific type of lipoprotein, and a coronary calcium scan, which looks for specks of calcium on the walls of the coronary arteries. Positive results on either test could indicate that you’re at risk for a heart attack. SEE NUMBERS • PAGE 25


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ASK THE EXPERT: RIP ESSELSTYN

Love Thy Fruits & Veggies BY RACHEL GRAF CTW Features

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he definition of “healthy eating” is constantly evolving. The paleo diet advocates eating meat but no carbohydrates, a vegetarian diet includes carbohydrates but no meat and a Mediterranean diet is a mixture of the two. However, author Rip Esselstyn says the only way to live a truly healthful life is to eat a strictly plant-based diet. Esselstyn, a former firefighter, explains the benefits of a plant-based diet in his most recent book “My Beef with Meat.”

How can eating a plant-based diet benefit heart health specifically? We’re in a bit of a quagmire right now when it comes to the health of this country, and the number one killer of Americans is heart disease. A lot of people think it’s hereditary when the reality is something completely different. Animal products and animal byproducts, as well as processed and refined foods, are the building blocks for plaque in our bodies. Animal products contain an abundance of saturated fat, dietary cholesterol and problematic animal protein; these are sources that promote inflammation and increase plaque formations in the arteries.

What if someone has been eating red meat and dairy products for 50 years? At what point is it too late to switch to a plant-based diet? The good news is it’s never too late to start eating this way. Something like 65 percent of the people who have a heart attack are over the age of 55. Plant-based foods can not only stop but also reverse heart disease by metabolizing away

Rip Esselstyn, a former firefighter and author of “My Beef With Meat: The Healthiest Argument for Eating a Plant-Strong Diet” (Grand Central Life & Style, 2013) reveals why he believes plant-based diets are best for the heart. plaque formations. The human body wants to be healthy, and if you take care of it and feed it plants exclusively, the sky is the limit in terms of reversing the disease.

By eliminating meat from their diet, do people run the risk of deficiencies in protein and other essential nutrients? They can get everything they need from plants. People need to put the protein myth to rest. You only need somewhere between 5 and 10 percent of your total calories from protein, and it’s impossible not to get that much eating a plant-based diet. As for other nutrients, 11 of the earth’s 13 vitamins come from plants. The two that don’t are B12 and Vitamin D, which come from soil and the sun respectively. So, B12 is the only supplement that anyone on a plant-based diet should ever need to take.

Is there a healthy middle ground for people who are intimidated by the idea of completely eliminating meat and dairy products from their diet? A lot of people don’t know that chicken has the same amount of cholesterol as red meat. Similarly, most fish have more cholesterol than red meat or chicken. Egg yolk has the same amount of cholesterol as two Burger King “Whopper” sandwiches. Taking baby steps is not gonna do it. That’s why I tell people you gotta lose the moderation mentality. Heart disease and obesity laugh and snicker and ridicule moderation.

Often, friends or neighbors will invite people to dinner parties. Could you share advice on how to refuse food that is not part of a plant-based diet without seeming rude? It’s so funny that, somehow, by declining animal products


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and animal byproducts we come across as rude when the reality is we’re being compassionate toward animals, protecting our own health and doing the number one thing to protect the environment and the climate. So, you should let your friends or family know that this is an experiment and you’d really appreciate their support. It’s also always nice to bring a couple dishes — whether it’s root veggies or salads or tofu. It’s a spread that anyone would love.

You mentioned that eating a plant-based diet has environmental benefits, in addition to health benefits. Would you explain what these are? Meat production is the number one driver of climate change. It exploits 90 percent more water than plants do. We have a population of over 7 billion people. We have to connect the dots and realize if we want to save the health of the planet, and ourselves, we need to start moving toward an exclusively plant-based diet and we need to do it fast. © CTW Features

KALE CEVICHE SALAD

Excerpted from “My Beef With Meat” by Rip Esselstyn (Grand Central Life & Style, 2013)

Ingredients: 1 bunch Kale, stripped and chopped 1 large (or 2 small) avocados OR 1⁄4 cup oil free hummus 1⁄2 lemon, juiced 1⁄4-1⁄2 teaspoon salt 1⁄2 teaspoon, red chili flakes 1⁄2 red bell pepper, finely chopped 1 small carrot, grated 1⁄2 purple onion, diced 11 oz. mandarin oranges (about 3 oranges)

Instructions:  1. Throw stripped and chopped Kale leaves in a large bowl with avocado, lemon juice, salt, and red chili flakes 2. Mash and massage the avocado (or hummus) into the Kale with your hands until the avocado is spread evenly — like a dressing — throughout the Kale 3. Stir in red bell pepper, carrot, purple onion, and mandarin oranges 4. If you can, let the salad sit for 30 minutes before serving, if not, dive in!


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Whether gala, golden delicious, granny Smith or braeburn, apples make for a nutritious snack.

The nutritive power of apples

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ho has not heard the old adage, “an apple a day keeps the doctor away”? It may seem unlikely that one fruit could be so effective at maintaining good health, but apples really are a super food. Apples are a member of the Rose family and are related to pears, peaches, apricots and plums. Though considered a fall fruit, apples can be enjoyed year-round thanks to commercial food production and importing. Apart from being sweet, sometimes sour and refreshingly crisp, apples pack a number of nutritional benefits. Research has shown that apples can help to reduce a person’s risk of heart disease and help those with diabetes. In addition, apples can help fight cancer and prevent dental problems. According to new information from long-running studies published in the British Medical Journal, eating at least two servings a week of whole fruit, particularly apples, blueberries or grapes, reduces a person’s risk for type 2 diabetes by around 23 percent. Apples are high in many antioxidants and, as a result, this makes them especially valuable at fighting illness. For example, the disease-fighting compounds in antioxidants have been shown to reduce the risk of certain cancers by neutralizing free radicals. Apples also are very high in fiber. Fiber is needed to help a person feel full and can also regulate digestive function.

Fiber also can help reduce cholesterol by preventing the buildup of cholesterol-causing plaques in the blood vessels, improving cardiovascular function and possibly reducing risk of a stroke as a result. In addition to working their magic inside of the body, apples can have a noticeable impact on physical appearance as well. Apples are sometimes referred to as “nature’s toothbrushes” because they can brighten and clean the teeth. The crisp, abrasive texture stimulates the gums and removes debris from the teeth. What’s more, the natural mild acidity of apples helps to stimulate saliva production that can rinse away germs that lead to plaque. An apple weighs in at under 100 calories per serving, making them a low-fat and ideal snack any time of the day. Because they are low in calories and full of fiber, apples can help men and women maintain a healthy weight. Because apples can be plagued by insects and parasites, some growers repeatedly spray the trees with pesticides. It is adviseable to buy organic apples to avoid many of the pesticide dangers and to be able to safely eat the apples raw. There are more than 7,000 varieties of apples on the market today. With such variety, availability and health benefits, apples make a convenient and nutritious snack. — Metro


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TIPS FOR YOGA BEGINNERS

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hough it might once have been considered a trend, yoga has long since moved on from trendy territory to become a more widely accepted discipline that is practiced by millions for its positive impact on mental and physical health. Though yoga is an ancient practice, only recently has it become so popular in the western hemisphere, where Sports Marketing Surveys found that roughly 20 million Americans over the age of 18 practiced yoga in 2012. That’s a considerable increase from just four years earlier, when just under 16 million Americans admitted to practicing yoga. The growing popularity of yoga likely comes as no surprise to its many practitioners, who often credit yoga with relieving stress and improving overall fitness. In addition, yoga can also help alleviate chronic pain and, according to the Mayo Clinic, reduce risk factors for chronic conditions such as heart disease and high blood pressure. While yoga is beneficial in many ways, it’s important that men and women not mistake yoga for medical treatment. Though yoga may be part of an individual’s treatment plan, it’s still necessary that men and women with medical conditions rely on their health care providers for treatment. For example, doctors may recommend yoga to individuals dealing with elevated stress levels, but doctors also may want their patients to take certain medications in order to lower those stress levels. Yoga on its own may be effective, but men and women should still seek professional medical treatment when dealing with health problems. It’s also important that men and women beginning a yoga regimen not take it lightly. Though the atmosphere in a typical yoga studio tends to be serene, yoga is a physically demanding discipline, and those unprepared to deal with such demands often find themselves suffering from injuries.

According to the American Academy of Orthopaedic Surgeons, injuries to the neck, shoulders, spine, legs, and knees are possible when practitioners of yoga do not exercise proper technique and caution. So it pays for beginners to heed the following warnings when beginning a yoga regimen. • Work with a professional. No matter how long your neighbor insists he or she has practiced yoga, it’s still best that you learn the discipline from a certified instructor. Your neighbor might know all of the poses, but an instructor with credentials can help men and women with preexisting medical conditions avoid poses that can exacerbate such conditions. Novices might not know that certain poses can increase injury risk for sufferers of osteoporosis, spinal problems and high or low blood pressure. When trying yoga for the first time, always work with a professional, making sure to discuss any preexisting medical conditions before your initial session. • Take things slowly. Its

reputation as a calming discipline often gives beginners the mistaken impression that yoga is an easy discipline to grasp. However, it’s best for beginners to take things slowly before attempting to perform difficult stretches and poses. Yoga is not a competition, so give yourself adequate time to learn proper breathing techniques and figure out ways to maintain your balance. Once you have mastered such techniques, you can then begin to try your hand at more advanced poses. • Warm up before each session. Men and women should warm up before beginning any exercise regimen, and yoga is no exception. Stiff, cold muscles can lead to serious injury whether you’re playing basketball or stretching into a yoga pose. Warm up your muscles with a few minutes of light cardiovascular exercise before beginning a yoga session to reduce your risk of muscle tears or pain when you start stretching or posing. • Dress appropriately. Flexibility is essential when practicing yoga, so make sure your clothing is not restrictive. Women can buy pants made specifically for yoga that stretch easily, making it easier to perform various poses and stretches. Men may also be able to find pants made specifically for yoga, but if not, athletic shorts or track pants can work just as well. • Stop if you feel any physical problems. It is not uncommon, especially for beginners, to experience feelings of dizziness or feel as if your body is becoming overheated during yoga. In such instances, stop immediately, as yoga is supposed to be a pain-free discipline. Ask the instructor for help the moment you start to feel faint, dizzy, overheated, or injured. Physical problems during yoga may be a byproduct of dehydration, so be sure to begin your session fully hydrated and remain so throughout your workout. — Metro


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Thursday, January 30, 2014

TOMMY PIVER, 61, NAPLES, FLA. I’d already lost a kidney to cancer, but my initial motivation to quit was financial. My insurance rates as a smoker were sky-high. I didn’t quit in time for my heart. In 2012 I had a quadruple bypass. The surgeon said my lungs were still pretty black. But I believe quitting did save my life. Now, at 61, I’m much healthier physically than I was at 51. My quit day was January first, 2010. I’m one of those rare New Year’s resolution quitters who made it. The first 30 days you can really run on motivation — you can rah-rah yourself through. The next one hundred days are the no-man’s land where most ‘quits’ are lost. You need support from people who’ve been there. People who have never smoked — they want you to be successful, but their support wanes after the first month and they expect you to be over it. On the eighth day of my quit, I saw a commercial for the website (BecomeAnEx.org), and I was skeptical. I actually went on the site to fight with them. Through the site, I have lifelong friends that I’ve never laid eyes on. And I’ve learned ‘collateral kindness’ — helping myself by helping others.

MARC LAWRENCE, 51, LONG ISLAND, N.Y. That morning, I got up and had a cup of coffee, and I couldn’t get through my second cup. I had a dull pain in my chest. As the day wore on, I continued to smoke throughout the whole episode — through the shoulder pain and the numbness in my left arm. However, I did not take cigarettes when I packed my bag to go to the hospital — I knew by then I was having a heart attack. I had a blockage in my right coronary artery and needed a stent. A nurse told me in a very nonthreatening, nonjudgmental manner about the hospital’s smoking cessation program (North Shore-LIJ Health System’s Center for Tobacco Control). It’s free, and they give you free products. I used the patch mainly, but it was the support group that helped the most. I continue to go now almost as kind of a ‘pay it forward’ to help others along. What I learned from my group and my experience is you have to want to quit — for yourself. Three months before my heart attack, my mother died of lung cancer and still I smoked. When I decided to quit, I had 25 cartons of cigarettes in my apartment and I gave them all to my siblings. But I kept one pack of cigarettes on the coffee table. If I wanted to smoke, I could — they were right there. But I chose not to. It reinforced that it was my decision to quit and stay quit. One year later, I brought them to the center and we had a little ceremony out front and destroyed that last pack of cigarettes.

MARIANO ZERMENO, 56, CHICAGO The doctor said, ‘You have a big problem. Your blood pressure is very high.’ He told me, ‘You have to stop — the problem you have is from smoking.’ I smoked for 35 years and had never tried to quit. But after open-heart surgery, God gave me a second chance and I had to take it. I just said, ‘No more cigarettes’ and that was all. I should have quit smoking years ago and probably could have avoided all these problems. I still pay the price — medicine and needles and all that stuff for the rest of my life. But it leaves me no time to think about cigarettes. I have more energy and can ride a bike for two or three hours. Before, I could not do these things. I can also taste all the different flavors in all the foods. When I see someone who smokes, I show them my scar. Maybe they won’t need to go through what I did. Not everyone is lucky like me and gets a second chance. Mariano Zermeno is featured in CDC’s “Tips From Former Smokers” campaign .


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STATINS QUO?

I

f you have certain risk factors for atherosclerotic cardiovascular disease (ASCVD), your physician will most likely discuss statins, a family of medications recommended for heart disease or stroke prevention. In writing the new guidelines, experts from the American Heart Association and the American College of Cardiology identified four groups of individuals who could benefit from using statins. These include adults who have some clinical history of heart disease or stroke, such as unstable angina or peripheral artery disease. The second category includes adults those who have very high LDL (bad) cholesterol levels. Statins are also recommended for adults, ages 40 to 75, with diabetes. Adults ages 40 to 75 who don’t have cardiovascular disease but who have a 7.5 percent or greater risk for heart attack or stroke in the next 10 years should also consider statins. Risk is based on race, gender, age, total cholesterol, HDL (good) cholesterol, blood pressure, use of blood pressure medication, having diabetes and/or smoking. Before accepting a prescription talk to your physician about potential side effects. Memory loss, confusion, increased blood sugar levels and muscle damage have all been reported, according to the U.S. Food and Drug Administration. “I’m not a statin basher. There are side effects patients should know,” says Dr. Joel K. Kahn, author of the upcoming book, “The Holistic Heart Book: A Preventive Cardiologist’s Guide to Halt Heart Disease Now” (Reader’s Digest, 2014). Dr. Kahn recommends taking the lowest statin dose possible for you to achieve good results.

NUMBERS FROM PAGE 19

If you do have heart disease, you need to act, says Dr. William A. Zoghbi, immediate past president of the American College of Cardiology. You need to make lifestyle changes and you need to start a drug regimen (see sidebar on statins), he says. “It’s very important to have medication. It’s not controversial. We know it saves lives; we know it improves the quality of life,” says Zoghbi, also director of the Cardiovascular Imaging Institute at the Methodist Hospital in Houston. If you don’t have heart disease, you’ll want to take the necessary steps to reduce your risk. This means making a serious commitment to change your lifestyle, says Zoghbi. Get more exercise, lose weight and eat healthier foods. If you smoke, stop. The good news is that only 25 percent of the risk of heart disease comes from genetic factors that can’t be changed. The remainder — 75 percent — comes from risk factors you can reduce, says Dr. Pande.

“I see a zillion people who want to be checked out. People come in without symptoms, see the [heart] guidelines and want to be checked out.” — Dr. Joel K. Kahn “People with a genetic risk for heart disease can change their risk as well,” she says. “Take care of yourself and your outlook will be better,” says Zoghbi. © CTW Features


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Thursday, January 30, 2014

pulling or straining in the first six weeks after a heart attack, Urman says. He also says no jogging or running until the patient gradually works into it, usually with the help of a FROM PAGE 4 cardiac rehabilitation team. A cardiac rehabilitation program is the best way to safely a few minutes at a time, doing light housework and increase exercise while being monitored, Urman says. gardening” in the first few days. “Cardiac rehab is a customized program of exercise and “If tolerated, then we generally want our patients to education that has been shown to save lives and improve gradually do more aerobic activity and increase it every few outcomes after heart attacks,” Urman says. days,” he continues. Some other tips to consider when exercising after an That might mean walking on a treadmill and cycling on attack, according to Zeller: a stationary bike, ultimately building toward the level of • Warm up at an easy pace and cool down before strenuous activity the patient is comfortable with or used to stopping completely. perform regularly. • Avoid exercise in temperature extremes – like heat Laura Zeller, clinical psychologist with the University of indexes above 85 degrees F or wind chill less than zero. Wisconsin-Madison Health Preventive Cardiology Program, • If prescribed nitroglycerin, carry if with you when you says that instead of using heart rate as a guide for intensity, exercise. heart patients should instead focus on breathing or perceived • Do not exercise to the point of chest pain – if you exertion since heart medications can decrease heart rates. develop it, stop exercising and take nitroglycerin as “Most heart patients will be recommended to work up to prescribed, or call 911. a minimum of 150 minutes per week of a moderate • Stop exercise and let your health care providers know intensity aerobic exercise – or more, especially if weight loss if you experience unusual shortness of breath, dizziness, is desired,” Zeller says. nausea or irregular heartbeats. If the patient was active before the heart attack, they It’s also helpful to keep in mind that exercise has may require higher intensity workouts. “Some patients countless health benefits – and that easing back into a are told not to exercise vigorously at all, while others are routine can be a matter of life or death. advised to include it as part of their programs,” Zeller says. “Research shows the long-term benefits of exercise in “Also, some patients are recommended to begin strength heart patients outweigh the short-term risks,” Zeller says. training while others are restricted.” Generally, patients are to avoid heavy lifting, © CTW Features

EXERCISE


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HEART HEALTH FROM PAGE 3

multiple problems, like high blood pressure or hypertension and diabetes. As you start adding all of those things together then the health risks significantly increase. Probably one of the main factors is that the body’s metabolism slows down as we age. I often have people say they are eating the same things they were eating before but they are gaining weight. And for those who are obese over 50, they are less likely because of fatigue or joint pain to be active. They’re more sedentary. That definitely intensifies problems.” Among the trouble areas:

High Triglycerides and Cholesterol “Obesity definitely increases the rates of high triglycerides in the blood and that’s a component of the cholesterol levels. It also tends to lower the good cholesterol,” Blackburn says. “Those things are part of the risk factors that can increase heart disease.”

Heart Disease In addition to the risks of high triglycerides and dangerous cholesterol levels, Dr. Robert H. Eckel, former president of the American Heart Association, encourages people who may be obese to be tested for obstructive sleep apnea. “This can lead to a greater risk of heart disease,” Eckel says. “This can be treated. This is an important area that is underestimated.”

Diabetes “The risk of diabetes almost exponentially increases with weight gain as we become older,” says Dr. Jack Dersarkissian, regional lead for Adult Weight Management for the Southern California Permanente Group. “As we all get older, we lose our lean muscle mass, so we may stay the same weight, but it is fat. And it’s fat in the visceral area, which is inside the belly. That’s the most dangerous type of fat. Diabetes in and by itself really cascades into a lot of other diseases, like heart attacks and kidney failure and increase of stroke.”

High Blood Pressure or Hypertension “With hypertension, as we gain weight, our blood pressure can go up by 10 to 20 points,” Dersarkissian says. “If you are 200 pounds and you lose 20 pounds, that can improve diabetes and blood pressure risks and reduce the amount of blood pressure medication your are on.” Fortunately, there is a remedy for obesity for many people, including the 50-plus crowd. While it may not reverse an existing medical condition, the remedy may help prevent the onset of certain conditions. The treatment: lose weight and keep the weight off. © CTW Features


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January 2014