Heart Health

Researchers Found a Problem with the Research Supporting the Mediterranean Diet - What Does This Mean For You?

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You may have seen articles in the news this week that a major study supporting the Mediterranean Diet has been retracted.  And you may have questions about what this means and whether or not you should consider following the Mediterranean Diet.

First of all, let's start with a little background.

Over 50 years ago, a research study by Ancel Keys, PhD, the Seven Countries Study, found that middle-aged men living in the Mediterranean region of the world, specifically the island of Crete, experienced lower cardiovascular disease rates than middle-aged men in other parts of the world.  This outcomes was attributed to their diet - specifically a traditional diet comprised of fruits, vegetables, whole grains, beans, and fish.

Subsequent studies found that people in the Mediterranean region following this diet experienced an array of health benefits, including increased lifespan, less obesity, lower cholesterol, lower rates of heart disease, stroke, and diabetes, improved brain function and lower rates of Alzheimer's disease.

In 2013, results from a landmark study called the PREDIMED trial were published in the prestigious New England Journal of Medicine.  This large multi-site trial was touted as a randomized study comparing the Mediterranean Diet against the low-fat diet promoted by the American Heart Association.  The results were impressive:  A Mediterranean diet that included nuts reduced the risk of cardiovascular disease by 30% and risk of stroke by 49% when compared to the American Heart Association low-fat diet.

This week, the researchers acknowledged that there were serious problems with their methodology in the PREDIMED study - specifically, not all of the supposedly randomized participants were, in fact, separated into groups randomly.  The researchers re-analyzed their results, retracted the original study, and replaced the study with the new results - which came to the same conclusion as the original study.

In other words, even though the original study design was flawed, once the data were corrected to account for the flaws, the results were the same.  The Mediterranean Diet does lower the risk of cardiovascular disease and stroke.  In addition to all the benefits noted in other studies of the diet.

So, if you follow, or are considering following, the Mediterranean Diet as your way of eating, should you throw it out?  Absolutely not!

The Mediterranean Diet with its emphasis on plant-based, locally sourced, whole and natural foods remains a very healthy way of eating with many health benefits. 

The Mediterranean Diet with its emphasis on plant-based, locally sourced, whole and natural foods remains a very healthy way of eating with many health benefits.  When you are eating the Mediterranean way, your diet will focus on a variety of fruits and vegetables, legumes, lean protein, nuts, healthy fats, and whole grains, all in moderation, and washed down with a bit of red wine if you so choose.  It is a diet that is loaded with the vitamins, minerals, phytochemicals, and antioxidants your body needs, with little of the highly processed, low-nutrition foods so common in the standard American diet.  And it is a way of eating that is reasonably easy to follow, filled as it is with a tasty variety of mostly easy to find foods.  So eat up with a clear conscience - and don't forget the red wine! 

Book Review: Women Fit at Fifty: A Guide for Living Long by Mary Kathryn Macklin, MSN

Mary Kathryn Macklin, MSN, is a cardiac nurse practitioner who works daily with people who are at high risk for heart disease.  Many of her patients have been inactive and sedentary for years, are overweight, short of breath, and deconditioned.  Many have been told they need to do more to stay healthy, but they don't know where to start.  Ms. Macklin wrote this book to  help women in their fifties or nearing their fifties take simple steps to remain, or to become, healthier.

Ms. Macklin starts with a chapter on mindset, excuses and procrastination.  I think that perhaps the most common limiting belief that we have is that we are "too old" to start now, that it's too late to reverse years of unhealthy habits.  In this first chapter, Ms. Macklin encourages us to think about what our excuses are, confront the fears and excuses that cause us to procrastinate taking steps to improve our health, and develop strategies for overcoming our excuses and fears.  With this chapter, she helps us set the stage for success in developing new healthy habits.  

Ms. Macklin goes on to provide an overview of the scientific research supporting the health benefits of exercise in older adults, and in the next few chapters, she talks about heart health and blood pressure, weight, diabetes, arthritis, diet, and fibromyalgia.  Throughout these chapters, she weaves the stories of patients she has worked with over the years.  

This book does not actually lay out a step by step strategy for diet or exercise, but it does provide a good foundation for understanding why diet and exercise is so important for women in midlife, and how diet and exercise impacts our overall health and wellbeing.  She helps us to understand the reasons we need to take steps to better health, and how we can get started.  She lays our excuses out in front of us, and knocks them down, one by one.  

The book is short at 120 pages and easily readable in an afternoon.  Ms. Macklin writes with the knowledgeable warmth of many years of experience caring for patients in midlife who need both a supportive, empathetic coach and a gentle kick in the butt to get started.  If you are just starting your journey toward health in midlife, or if you are struggling with excuses and procrastination, this book will ease you into believing that it is not too late for you to develop healthy habits.  

Three to Thrive: Three Behaviors That Change Everything

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The American Heart Association recommends the "Simple Seven" - seven steps to reduce your risk of heart disease, stroke, and diabetes. 

I'm going to make it even more simple.  There are really only three main things you need to focus on to improve your health and well-being, and if you get these three things right, it follows naturally that you greatly increase your chances of achieving the rest of the Simple Seven.

Three to Thrive

  • Be Physically Active
  • Eat a Healthy Diet
  • Don't Smoke

Sounds simple, right?  Common sense?  Yes and yes.  But not so easy in a sedentary world filled with unhealthy but delicious food choices and seemingly endless binge-worthy shows to watch, along with work that is all to frequently done sitting at a desk. 

Perhaps the easiest habit (if you never take it up) is the third - don't smoke.  But anyone who has ever come under the nicotine spell knows how hard the chains are to break.

But you can take control by making changes in your habits in each of these areas that will lead to lifelong and life-prolonging improvements in your health.  Start small, make one little change, and keep at it until that change becomes a new, healthy habit.  Then make another small change.  Small improvements over time really add up!

National Nutrition Month

Welcome to March which is National Nutrition Month.  This month, I will be sharing tips for healthy eating.  And since we are just coming off of Heart Month in February, the first tip is to eat 10 fruits and vegetables a day for your heart.

Eating 5 servings of vegetables and 5 servings of fruit a day helps to lower your blood pressure.  Look for a variety of colorful fruits and vegetables for a great mix of vitamins and nutrients.


Women and Heart Disease - Lose Just a Few Pounds for Big Improvements

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You won't believe how little weight you need to lose to improve your heart health...

But first, I have to preface this article by stating that I am an obese woman.  According to CDC guidelines for the BMI (body mass index), I have shot past overweight to obese. 

I didn't start out this way.  There was a time when I was slim and trim.  Over the years, childbearing, a sedentary lifestyle, age, and bad eating habits caught up with me. 

As an obese middle-aged woman, I will make this statement without compromise:  Obesity does not equal healthy. 

There is no getting around it - being overweight or obese increases your risk of cardiovascular disease, high blood pressure and stroke, as well as diabetes and some cancers.  According to the journal Circulation, obesity predicts coronary artery disease and congestive heart failure is common in obese patients. 

Almost 70% of American adults are overweight or obese.  Obesity is ranked in the top three health problems in the United States.

If you are told you are "obese", that means you have a body mass index (BMI) of 30 or higher.  BMI measures the ratio of your height and your weight.

Overweight people have a BMI of 25-29.9.

Waist circumference and where you carry fat on your body affects your risk for heart disease.  If you carry most of your extra weight around your belly, you have a higher risk than someone who carries fat on their thighs and buttocks.

A study which was conducted on over 116,000 nurses and published in the Journal of the American Medical Association showed that women who were moderately overweight (BMI between 25 and 28.9) were twice as likely as slender women (BMI less than 21) to develop coronary artery disease (the type of heart disease responsible for heart attacks).  

Women with a BMI over 29 had four times the risk of coronary artery disease.

Research by the National Heart, Lung and Blood Institute adds more evidence that extra weight is bad for your heart:

In a study of over 5,000 participants, the risk of heart failure increased with each additional point of a participant's BMI (about 4 to 8 pounds).   Researchers found that the risk of heart failure was 34 percent higher for overweight individuals and 104 percent higher for people who are obese.

But there is good news...

Studies have shown that losing even a little weight can improve heart health and reduce your risk of death from heart attack.  The National Institutes of Diabetes and Digestive and Kidney Diseases states that losing just 5-10% of your weight can significantly reduce your risk of cardiovascular disease.  For a 200 lb woman, that would mean losing just 10 to 20 pounds.

Losing just 5-10% of your weight can significantly reduce your risk of heart disease

If you are at risk for heart disease because of overweight or obesity, make small changes now to keep your ticker healthy and ticking.