heart health

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.

DASH Diet Challenge - Week 1

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Week 1 of the DASH Diet Challenge is complete and I want to share with you how it went.  Below, I will break down what I ate, results for the week, and what I learned.  If you are considering trying out the DASH Diet for weight loss, to lower your blood pressure, or for heart health, I hope this information will be helpful to you.

For this challenge, I set my daily calorie goal at 1,800 calories, based on the calorie needs chart provided by the National Heart, Lung, and Blood Institute, the creator of the DASH Diet Plan.  I wrote a previous post on the DASH Diet recommended food groups and serving sizes.

I started off the week tracking my food intake using my Fitbit app.  While this app does a good job of calculating total calories, sorting out percentages of carbs, proteins, and fats, and it is easy to enter the data, I couldn't track the sodium intake.  So, midweek, I switched over to tracking in MyFitnessPal.  The free version was adequate for my needs, but a premium version is available.  This app can track your food diary, and you can also track your water intake and exercise and generate printable reports (which is a great extra if you are keeping a food diary to share with your physician or dietician).  It has the functionality to provide nutrition information on imported recipes and help you with meal planning.  There is also a community forum, and MyFitnessPal syncs with lots of trackers, including the FitBit.

Week 1 Results:

1.  My starting weight was 219.5.  Weight on Friday was 217.8 - down a little over a pound, and that is within my goal plan for the year.

2.  Blood pressure.  I knew my blood pressure has been running high for several years.  I decided should get a reading for a baseline for this challenge.  Before I left my office Friday afternoon, I checked it, and it was a freaking scary 183/94.  I checked it 2 more times on different machines, and the results were similar.  Not good!  And here is where I have to admit that I did not do what I would tell any one of you to do:  I did not immediately take myself off to see the doctor.  I did what a lot of women do.  I waited. 

Luckily, when I went to my local pharmacy and checked my blood pressure the next morning, it was much more in line with what I expected at 144/87.  That reading is still way too high, though.  I will be putting a visit with my physician on my calendar this week for sure!

3.  Exercise.  I only exercised one morning this week.  Since the weather has remained frightfully cold, I did a walk-jog video on YouTube.  Gotta love all the workout video options on the internet.  

4.  The Diet.  Once I put everything I ate this week into the food diary, I categorized each food into the appropriate food group categories.  And here is what I found:

  • I had a really hard time eating the recommended amount of grains, and I did not achieve the recommended amount on any day of the first week.  I'm not used to eating a lot of grains, and even consciously incorporating them into my daily mail plan was hard.  They also have a relatively high calorie count for small portions and aren't very filling.
  • It was fairly easy to get in the right amount of vegetables every day.  My lunch is usually 3 cups of leafy power greens and lettuces, sprinkled with lemon juice, with a serving each of meat, cheese and fruit. 
  • I had to consciously add fruits, just as I had to consciously add grains.  I only got the recommended amount on 1 day.  I went for apples (studies have shown that women who regularly eat apples have lower blood pressure), and low sugar fruits like berries.  I did add bananas to smoothies on a couple of days, for the potassium and sweetening.
  • Dairy was easy.  Just a cup of yogurt or kefir or fat free milk and a cheese stick and this one is taken care of.
  • Lean meat, fish, poultry - This was another easy category.  I focused more on lean meats and fish like tuna and turkey, bison, and lean beef stew meat.
  • Because of my addiction to hummus, I went overboard on the nuts, seeds, legumes category this week.  Enough said.
  • Using just a bit of avocado oil was enough for the fat category - another easy category to meet, but I had to be careful of the portion so that I wouldn't exceed the allowance. 
  • I don't usually eat a lot of sweets anyway, having weaned myself off most sugar over a year ago, but I did have a Halo top ice cream pint that lasted through three days, and one night, I indulged in two cinnamon twists from Dominos.  The nice thing about this diet is that it does allow for those little indulgences once in a while.
  • Speaking of Dominos, yes, my favorite pizza place does have health(ier) options.  When the fam decided that Friday should be pizza night, I chose the plain bone-in chicken wings and the Apple Pecan Chicken Salad with the Lite Balsamic Vinaigrette Dressing.  But I should probably find another option for the hot wing sauce - it is way high in sodium.
  • Keeping the sodium levels low was also a challenge.  I admit it, I like the salt shaker.  Tracking it is making me mindful of how much is in what we eat everyday.
  • On only two days did I go over my calorie allowance, and not by much.  Most days were under the allowance, so I consider that a success.
  • Tracking my food intake made me really mindful of the portion sizes on the DASH Diet.  This is an area where I have struggled to get control and it is probably the area that has most contributed to my lack of progress in losing weight.  
  • There were a few things that I ate during the week that I have had to scratch my head about where to fit them in the plan:  the half and half in my morning coffee, a little snack bag of potato chips (are those a vegetable lol?), EAS Advantage Low Carb Shakes (to stave off a hunger attack mid-morning), a Zone Perfect Chocolate Peanut Butter Bar (does that go under "Sweets" or "Nuts"?), and chicken/vegetable broth that I used in soups.  
  • Although I did feel hunger on most days as lunch or dinner approached (hence, a shake or protein bar - and I'm not sure a little bit of hunger is necessarily a bad thing), I did not feel deprived.  There really was no food that was absolutely prohibited, and I could eat a large variety of foods.  
  • Planning meals through the week helped to keep me on track.
  • This whole challenge is not necessarily about following the diet perfectly.  It is about learning to be mindful about what I am eating and improving my eating habits and portion control.  Tracking my calories and portions right now is very helpful to me so that I can see exactly what and how much I'm eating and where I need to make adjustments.  

I've copied my chart and food diaries below to help you with your own meal planning on the DASH Diet.  I've color coded the top chart in green (met the goal) and red (did not meet goal), so I can more easily see where I can improve.  Please note that the charts show exactly what I ate in the first week of the challenge.  Obviously, from the chart below, if you wanted to follow the diet perfectly, some adjustments would need to be made to the meals.  Feel free to use this information as a starting point to create your own meal plan.

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Follow my progress on the 30-Day DASH Diet Challenge!

Learn to Love Your Heart in this series on Midlife Women and Heart Health

DASH Diet Challenge - Food Groups and Serving Sizes

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As I wrote in my DASH Diet Challenge Post, for the next 30 days, I will be following the DASH Diet.  

As with most diets, one must start by figuring out what you can eat.  The NIH National Heart, Lung and Blood Institute includes several charts to help us decide an appropriate calorie intake and servings of various food groups.  Based on the calorie chart, I should take in 1,600 - 1,800 calories a day.

It's the next step that often stumps people.  What exactly does that mean in terms of what I can eat?  According to the chart, I can have:

  • 6 servings of grains per day
  • 3-5 servings of vegetables per day
  • 4-5 servings of fruits per day
  • 2-3 servings of fat free or low-fat dairy products per day
  • 3-6 servings of lean meats, poultry or fish per day
  • 3-4 servings of nuts, seeds, and legumes per week
  • 2-3 servings of healthy fats and oils per day
  • 3-5 servings OR LESS of sweets per week
  • Maximum sodium intake of 2,300 mg per day

Hmm, sounds like a lot of food, right?  But now, I need to know just what a serving is for each type of food.  So, on to the next chart.

Grains.  In the grains category, a serving size is 1 slice of bread, an ounce of dry cereal, a 1/2 cup of cooked rice, pasta, or cereal.  The slice of bread is easy enough to visualize.  For the other items, I will have to use a measuring cup.  Accurate portion control is going to be important, especially for the grains, as they are high in carbohydrates.  For a visual reference, a 1/2 cup of rice is a lot less than you think - about the size of a half of a fist.

Vegetables.  The vegetables category is my favorite, since I especially like green, leafy vegetables and my lunch is usually a salad made from mixed lettuces and power greens.  A serving size of leafy vegetables is a cup (a good handful), or a half cup of cut up raw or cooked vegetables.  Starchy vegetables like potatoes should be eaten sparingly.

Fruits.  To be honest, I have not been eating a lot of fruit, since many are high in sugar, and I do seem to be very sugar sensitive.  However.  In the fruit category, a serving size would be a medium size fruit (think a medium size apple), or a 1/4 cup of dried fruit (about the size of an egg for visual reference - no scarfing down a whole bag of dried mangos!), or 1/2 cup of fresh, frozen, or canned fruit.  You may notice I haven't mentioned fruit or vegetable juice.  I don't particularly like either one, but if you do, a serving size would be 1/2 a cup.  I'll be going for lower sugar fruits such as berries and Granny Smith apples (delicious sliced and sprinkled with a bit of cinnamon).  

Dairy.  A serving size is 1 cup of milk or yogurt, or 1-1/2 oz of cheese.  People who are lactose intolerant (I am not) can drink lactose-free milk.  I've found that milk from grass fed cows seems to taste better, even when it's fat free, and I like Kroger's Simple Truth version.  If you are following this diet, or any others that allow dairy, be especially aware that Greek yogurts, although higher in protein, often have a lot of sugar in them. I've been choosing lower sugar yogurts like Siggis since I started eating breakfast every day.  You can also make your own yogurt so that you can control the sugar content.  For a visual reference for the cheese serving size, it would be the size of a 9 volt battery.

Lean Meats, Poultry, Fish.  A serving size is 1 oz of cooked meat, poultry or fish (for visual reference, 3 ounces is the size of a deck of cards or the palm of your hand).  One egg would also be a serving in this category.  That's way less meat than I am used to eating, so this will require me to manage my portions.

Nuts, Seeds, Legumes.  A serving size is 1/3 cup or 1-1/2 oz of nuts (much smaller portion than we are used to thinking about - I can easily scarf down a bag of pistachios at one go).  For nut butters, a serving size would be 2 tablespoons, and for seeds, the serving size is also 2 tablespoons or 1/2 ounce.  The serving size for cooked peas, lentils, legumes is 1/2 cup (the same as a serving size of rice).  Note that this category is 3-4 servings per week, not per day.

Fats and Oils.  A serving size is 1 tsp of margarine, butter, or oil, or a tablespoon of light mayonnaise or salad dressing.  (This one will be hard - I love my healthy fats!  But for the purposes of this challenge, I will do my best to follow the guidelines).  

Sweets and added sugars.  I'm pretty sure this category was added in so that people don't feel deprived by having to give up their sugar.  You are allowed a few servings a week of jelly or jam (1 tablespoon) or syrup, 1/2 cup sorbet or gelatin dessert, or a piece of hard candy.  

So that's the breakdown of what is allowed and how much.  Now, on to meal planning!

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Learn more about Women and Heart Health in my Love Your Heart series.

The DASH Diet Challenge

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As part of my series of Heart Health Month articles, I will be experimenting with the DASH Diet in the form of a 30-day DASH Diet challenge.

As you may know from reading my previous blog articles, losing 52 pounds is one of my goals for 2018.  As a general rule, I do not promote any particular diet.  It's my opinion that there are many good diet plans out there, focusing on eating healthy and nutrition-dense foods that will promote weight loss and good health if followed.  The hard part is picking one and sticking to it.

However, the DASH Diet, which originated in research conducted by the NIH National Heart, Lung, and Blood Institute, consistently gets high marks for improving cardiovascular health, especially in lowering blood pressure.  The DASH Diet has been ranked as the best diet for the past eight years by the National Institutes of Health according to US News and World Report.  The study's original author, Dr. Stephen Jurasche, an adjunct assistant professor at Johns Hopkins University, has stated that in people with higher blood pressure, the diet is "comparable to anti-hypertensive medication." Since my blood pressure has run high for the past few years, and since I would prefer not to have to go on medication, this sounds like a great benefit to me.

Free guides and recipes are available from the National Heart Lung and Blood Institute.  The diet emphasizes fruits, vegetables, lean protein, low fats and whole grains, and decreases sugar, sodium, and high fat foods.  No real surprises there.  The diet does provide calorie goals for different age/activity groups, and for my goal of 52 pounds in a year at moderate activity, my suggested daily caloric intake is 2,000 calories.  The plan also suggests increasing physical activity levels (no surprises there either).

Now, I know some readers will immediately exclaim in horror, "But the carbs!"  Yes, I know.  I tend toward the lower carb theories myself.  However, this is an experiment on myself to see what happens if I follow this diet for 30 days.  Up until now, I have not really "followed" any particular diet plan; rather, I have just tried to eat healthy foods while cutting out sugar.  But I have not been good at managing my portions or focusing on specific foods for a specific result.  

After I have 30 days worth of results from following the DASH diet, I can then decide if it is working for me or not, and how or if I would tweak it for me personally.  I already have my baseline of my current state (an important step in the 2018 Success Planner - click the link to download and build your own plan for success in 2018).  Now, I need the next piece, which is to follow the part of my action plan that is "eat a healthy diet", and share and record the results (the accountability piece), and then change or continue as the results dictate.  And maybe what I learn by experimenting on myself will help you too.

So for the next 30 days, I will be following the DASH Diet and posting up my results, both here and in the Yes I Can Health Facebook group.  

I would love to have you follow along, since I will be updating this blog post throughout the month. 

And you can learn more about Women and Heart Health in my Love Your Heart series.

Women and Heart Disease - Signs of a Heart Attack

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Would you recognize the signs if you or someone you know were having a heart attack?

As you learned in Part 2 of this Women and Heart Disease series, a heart attack occurs when an artery supplying the heart muscle is blocked by plaque or a clot.  The muscle supplied by the artery begins to die from lack of oxygen.  If blood flow is not quickly restored, significant damage to the heart muscle, and even death, can occur.  A heart attack is a medical emergency.

We've all watched a television show where a guy, usually in his midlife or older, suddenly clutches his chest, cries out in pain, and collapses to the floor.  TV shows and movies usually show the most common signs and symptoms of a heart attack, so that's what we are familiar with, and that's what we look for ourselves.  If we saw someone clutching her chest, crying out, and fainting, we would immediately assume "heart attack."  And in fact, in both men and women, chest pain is the most common symptom of a heart attack.

But, in women, and especially women in midlife, the signs and symptoms of a heart attack may be different.  A woman may not even experience chest pain.  Rather, she might have one or more of a group of vague, subtle symptoms that she might not associate with heart attack at all.  These symptoms include:

Shortness of breath, with or without chest discomfort.  A woman may begin to experience shortness of breath several weeks prior to a heart attack, and it may occur at random times.  She could be sitting at her desk and suddenly experience severe difficulty breathing, or find herself short of breath while walking up a flight of stairs that usually presents no problem.  Feeling short of breath right after waking up is also a sign something could be wrong.

Chest discomfort or pressure.  The most common phrase is "like an elephant sitting on my chest," but the discomfort may be more vague than that.  It may feel like squeezing, fullness, or pain in the center of the chest.  It may even radiate to the arms, back, neck, jaw, or stomach.  The woman may experience pain in the back or the neck or the jaw, but not in the chest.  

Nausea.  A woman may experience nausea and vomiting and believe she has the flu.  Nausea may occur days or weeks before the heart attack.

Breaking out in a cold sweat.  Women in midlife may associate this symptom with perimenopausal symptoms.

Dizziness, lightheadedness or fainting.  In both women and men, this symptom can be a sign of a heart attack or cardiac arrest.  Bob Harper, a fitness trainer, experienced spells of dizziness and even fainting at the gym before he had a cardiac arrest.

Any of these symptoms should prompt a call to 9-1-1 for transport to an emergency room.  Women in particular may wait to call, thinking (hoping) it's not serious, but delay can put you in a life-threatening situation.  Making the 9-1-1 call early, as soon as you experience symptoms, can save your life.

Even More Vague Symptoms - The Silent Heart Attack

Women sometimes experience a heart attack and don't even know it has happened!  But the result is the same - heart damage has occurred.  This is the so-called "silent heart attack."  However, there are some signs.

Prolonged or Excessive Fatigue.  Either before or after a heart attack, a woman may feel excessively exhausted and unable to carry out her usual activities, as the heart muscle is deprived of blood and oxygen.

Indigestion that women may think is the flu, heartburn, an upset tummy, or gastric reflux.

And again, women may experience soreness or pain in the chest or upper back, neck, arm, or jaw that they attribute to a muscle pull.

Because the symptoms can be so vague, women (and their doctors) may think a silent heart attack is just caused by anxiety.  Studies indicate that women may experience more silent heart attacks than men, and the silent heart attack causes damage to the heart muscle that may be more dangerous because it is not detected early on.

Feeling of Doom - Many patients experience a feeling of "impending doom," that something is just not right.  If you are feeling any of these symptoms, see your physician and request a cardiac asssessment.

Learn more about Women and Heart Health in the Love Your Heart series.