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Personal trainer and her client with dumbbells

Metabolic Syndrome: A New Focus for Lifestyle Modification

Personal trainers have the opportunity to do more than just help people they train become more active. We need to be prepared to also help our clients implement lifestyle behavior changes related to stress, family history of coronary heart disease, obesity, smoking, high blood pressure and high cholesterol.

A look at what is called metabolic syndrome will help you understand why, even though increasing physical activity levels is the overall best thing you can do for any client, there are additional ways to guide them to a healthier lifestyle. Sometimes you may be able to help them make the changes yourself; and, sometimes you will need to refer them to another health professional like a doctor or dietitian for guidance. Either way, knowing how to help them or when to direct them to someone who is more knowledgeable than you is important. So, first let’s become familiar with the syndrome and the clinical criteria that the doctor uses to diagnose it. Your goal is then to help your clients understand and make the necessary changes so that they don’t progress to cardiovascular disease and the almost certain heart attack heart that will be the end result.

Cardiovascular disease is still the number one cause of morbidity and mortality in the United States and much of this burden of disease can be linked to poor nutrition and a dramatic increase in sedentary lifestyles, leading to overweight and obesity. This increase in weight leads to an increase in the incidence of type 2 diabetes, and blood pressure and cholesterol problems, which are all well-established cardiovascular disease risk factors. The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III has updated the recommendations for the evaluation and management of adults dealing with high cholesterol, renewing its emphasis on the importance of lifestyle modifications for improving cardiovascular risk. The NCEP has coined the term “therapeutic lifestyle changes” (TLC) to reinforce both dietary intake and physical activity as crucial components of weight control and cardiovascular risk management.

As well as focusing attention on the LDL cholesterol (also called bad cholesterol) levels, the NCEP also identified metabolic syndrome as a secondary target of therapy. Metabolic syndrome (also called insulin resistance syndrome and syndrome X) is characterized by decreased tissue sensitivity to the action of insulin (pre-diabetes), resulting in a compensatory increase in insulin secretion. This metabolic disorder predisposes individuals to a cluster of abnormalities that can lead to such problems as type 2 diabetes, coronary heart disease and stroke. The prevalence of the syndrome has increased 61% in the last decade. It is crucial for medical professionals to identify patients at risk and follow these patients closely and counsel them about making lifestyle changes to lower the risk of type 2 diabetes and cardiovascular disease.

GUIDELINE: According to the NCEP, the criteria for metabolic syndrome includes at least 3 of the following 5 clinical factors

Risk factor Defining level
Abdominal obesity
Men
Women
Waist circumference
>40 in (>102 cm)
>35 in (>88 cm)
Fasting triglyceride level >150 mg/dL
HDL cholesterol level
Men
Women
 
<40 mg/dL
<50 mg/dL
BP >130/>85 mm Hg
or taking antihypertensive medication
Fasting glucose level >100 mg/dL or diabetes

Source: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, Md: National Institutes of Health; 2001. NIH publication 01-3670.

Millions of Americans at risk for metabolic syndrome can sharply lower their chances of getting this disease by adopting a healthy lifestyle (stop smoking, low-fat diet, weight loss/maintenance and increased physical activity). Without diet and exercise modifications, most patients will eventually fail and progress to type 2 diabetes within a decade and experience a heart attack about 10 years later. Experts recommend a diet reduced in saturated fats (<7%), low in cholesterol (<200 mg/day), high in fiber (20-30gm/day) and reduced in simple sugars. Weight loss of only 5-7% (less than 15 pounds) can make a big difference in health markers like cholesterol and blood pressure. A program that includes daily exercise reaching 85% of heart rate for age is reported to be of benefit too. However, any exercise is better than none, and a target of 30 minutes every other day is a reasonable level for most people.

As a fitness professional reading this, hopefully you are not asking yourself “so what?” but are instead seeing an opportunity to educate and motivate your current clients and to use your knowledge to help attract future clients. The medical community is good at diagnosing this syndrome, but not necessarily equipped to provide patients with the tools to be successful with the lifestyle changes they recommend. There exists a wonderful opportunity to build a partnership with physicians in your area. Most physicians will gladly refer patients to you for help with the all-important exercise and nutrition portion of the treatment program. In many cases, you have more knowledge in this area than the physician who has been trained in tertiary, not preventative, (i.e. most MD’s know very little about diet and exercise since this is not a focus in medical school) medicine.  Often times all that you will need to get a referral is for the doctor to be aware of your existence and to give them an easy way to get the patient to you. A short introduction letter outlining your qualifications and showing your desire to help people make lifestyle changes is a good start. A personal visit to your primary care doctor and others in your area is even better. But, be prepared to take up just a few minutes of their time to introduce yourself, your idea, and leave your letter and cards.


Tammy Petersen, MSE, is the Founder and Managing Partner for the American Academy of Health and Fitness (AAHF). She’s written a book on older adult fitness and designed corresponding training programs. SrFit Mature Adult Specialty Certification is used nationwide as the textbook for a college based course for personal trainers who wish to work with mature adults. SrFit is also the basis for a specialty certification home study course that qualifies for up to 22 hours of continuing education credit with the major personal trainer certification organizations.

References

  1. Centers for Disease Control and Prevention. Early release of selected estimates based on data from the January-June 2003 National Health Interview Survey. URL: cdc.gov/nchs/about/major/nhis/released200312.htm.
  2. Summary Health Statistics Tables for the U.S. Population: National Health Interview Survey, 2016 https://www.cdc.gov/nchs/nhis/SHS/tables.htm 16 Apr. 2018.
  3. Centers for Disease Control and Prevention. Prevalence of health care providers asking older adults about their physical activity levels—United States, 1998. Morbidity and Mortality Weekly Report. 51(19):412-4, 2002.
  4. Huang, Paul L. “A Comprehensive Definition for Metabolic Syndrome.” Disease Models & Mechanisms5-6 (2009): 231–237. PMC. Web. 16 Apr. 2018.
heart-stethoscope

Body Fat Promotes Heart Disease

Risk factors for heart disease – elevated LDL cholesterol, hypertension, elevated triglycerides, inflammation, and blood glucose – are all exacerbated by excess body fat, and overweight/obesity itself is considered a risk factor.1-3

Is it beneficial to be a little overweight?

However, there has been controversy about a potential “obesity paradox” in heart disease: the idea that some amount of excess weight either does not pose any risk or is even protective. Unfortunately, the studies that suggest there may be a protective effect of body fat are often the ones that get more news coverage; but this does a disservice to an already overweight and nutritionally misguided public, allowing them to believe that excess body fat won’t harm their health.

Is there really an obesity paradox? Or is it just that BMI is not a good measure of body fat?

Many of these studies have used body mass index (BMI), however BMI, which only takes into account height and weight, is not an accurate indicator of body fatness. BMI does not distinguish between fat mass and lean mass, nor does it take into account fat distribution (visceral fat vs. subcutaneous fat). Many people whose weights are within the “normal” BMI range are still carrying excess fat.

There has been no evidence providing a convincing explanation of how excess fat could possibly provide a cardiovascular advantage.  Plus, there are numerous medical conditions may cause unintentional weight loss, including depression, anxiety, autoimmune diseases, cancers, and digestive disorders. In the elderly especially, a low BMI may be an indicator of muscle loss and frailty rather than an indicator of a healthy low level of body fat. In short, people who are thinner are not necessarily healthier.

Relationship between body fat and heart disease: using better measures than BMI

A new study  is helping to clear this issue up,4 in a cohort of almost 300,000 people in the UK (age 40-69) who were followed for an average of 5 years. Their first analysis puts the optimal range of BMI for heart disease prevention at 22-23 kg/m2. It was a “J-shaped” association, meaning risk rose both above and below the 22-23 range. But the researchers went further. They used multiple measures of body fatness to get a more accurate picture: waist circumference, waist-to-hip ratio, waist-to-height ratio, and percent body fat.

Ultimately, what the researchers found was that using BMI produces different results than the other indicators. BMI was the only one that showed an increase in risk at the low end (<18.5 kg/m2). When they excluded smokers and participants with pre-existing diseases, the increase in risk associated with low BMI almost disappeared.  The more accurate measures of body fatness – body fat percentage, waist circumference, waist-to-hip-ratio, and waist-to-height ratio – showed a clear trend: more body fat, greater risk.4

More body fat, greater cardiovascular risk

The researchers concluded that the obesity paradox observation mainly occurs due to confounding effects of disease and other factors on BMI, and that the “public misconception of a potential ‘protective’ effect of fat on CVD risk should be challenged.”4

As discussed above, a low BMI is often an indicator of disease, rather than an indicator of a healthy weight resulting from healthful eating. The standard American diet (SAD) is fattening. If someone is eating the SAD and is not overweight, there is likely something wrong.

Lose weight permanently on a Nutritarian diet

The dramatic weight loss-promoting effect of the Nutritarian diet contributes to cardiovascular protection. A 2015 study published in the American Journal of Lifestyle Medicine analyzed and reported weight loss results provided by 75 obese patients who had switched to a Nutritiarian diet. The average weight loss was 55 pounds, and very importantly, they kept the weight off. None of these respondents had gained back the lost weight after three years.5

Reprinted with permission from Dr. Fuhrman.


Dr. Fuhrman is a board-certified family physician specializing in nutritional medicine. He is President of the Nutritional Research Foundation and the author of 6 NY Times bestselling books, including The End of Heart Disease.  Visit him at DrFuhrman.com

References

  1. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci 2013, 9:191-200.
  2. Tchernof A, Despres JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013, 93:359-404.
  3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017, 135:e146-e603.
  4. Iliodromiti S, Celis-Morales CA, Lyall DM, et al. The impact of confounding on the associations of different adiposity measures with the incidence of cardiovascular disease: a cohort study of 296 535 adults of white European descent. Eur Heart J 2018:ehy057-ehy057.
  5. Fuhrman J, Singer M. Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style: A Patient Survey With Illustrative Cases. Am J Lifestyle Med 2015.
Therapist doing massage releasing tension by pressing chest on p

I have heart disease. Is massage right for me?

Senior man having a massageAccording to the Heart Foundation.org about 80 million Americans have heart disease or high blood pressure. The 2010 Heart Disease and Stroke Statistics update of the American Heart Association reported that 17.6 million persons in the United States have heart disease, including 8.5 million with a history of heart attack and 10.2 million with chest pain. The prevalence of heart disease increases with age for both women and men.

Heart disease requires a variety of possible treatments, including various medications and procedures. Some people with heart disease may benefit from regular massage, but there are certain types of massage that can possibly cause serious damage. You need to be sure you’re in a knowledgeable practitioner’s hands to make sure you are safe.

Can Massage Help?

A hypothetical example:

Alex is a 59-year old tax preparer who has moderately High Blood Pressure that is easily controlled with a healthy lifestyle and medications. He is married, enjoys golfing, shooting, and watching football. As Alex’s work becomes busier during tax season, he gets headaches that are frequent and intense.  And when he works too much, he doesn’t have time to take care of himself like he should.

Alex’s doctor recommended that massage could help compliment his treatment plan to stabilize his blood pressure. His doctor referred him to a therapist who is experienced in working with cardiovascular patients. The doctor and therapist agreed that a relaxation massage with some trigger point and stretch techniques mixed in would be safe and beneficial for him.

After a few massage sessions, his headaches decreased. The doctor recommended a massage twice every month, but during busy season, Alex likes to go every week. The routine gives him peace of mind in knowing he’s doing everything he can to take good care of himself. For him, massage is a great antidote to the hours at his desk, and he finds himself less “grumpy” when he gets home after a hard day. When work is less busy, and Alex has more time for golf, he finds that massage gives him great relief for his low back tension, which helps his swing. Alex considers massage as part of his prescribed health routine, just like eating carefully and exercising.

What should you be careful of?

Because there are so many different types of cardiovascular conditions, there is no one-size-fits-all approach. The type of massage that you have seen on TV is not the only kind out there, and in fact, may not be right for you. Your complete health history must be considered before making a decision. You must always talk to your doctor before deciding to embark on a personal massage program:

Blood thinning drugs: Cause the body to be more sensitive and in some cases, even fragile. Deep tissue done on someone taking blood thinners can cause inflammation, bruising, and tissue or organ damage.  Like the wise man said, more is not always better.

High Blood Pressure (Hypertension): Massage may be just the thing to help you manage stress and subsequently your high blood pressure (just like the example above). Low blood pressure is also a concern, and because massage lowers one’s blood pressure slightly, it is not uncommon for individuals taking medication to lower their blood pressure.  This would cause them to get a bit lightheaded just after receiving a massage, until the blood pressure returns to normal.

Blood Clot: Individuals with a history of blood clots (aka Thrombosis) should avoid Swedish Massage. Swedish massage techniques on someone who has a risk of blood clotting could possibly dislodge a clot and release it into the blood stream. In a worst-case scenario, this can induce a stroke or heart attack, or a lung blockage.

Pacemaker: If an individual has a pacemaker, stent, or any kind of apparatus implanted into a vein/artery which is superficial (in the neck and leg would be considered superficial, but inside the rib cage is not), the therapist must avoid pressing over that area so as not to dislodge or damage it or surrounding tissues. But massage can usually be safely done on the rest of the body.

Massage can usually be great for someone who has Arrhythmia or a disruption in the heart rate, if that is the only health concern.

An individual with any signs of Congestive Heart Failure should avoid vigorous Swedish massage or limit Swedish massage to less than 15-20 minutes.  Gentle Massage on head, feet and hands is not a problem.

Close-up of a physiotherapist massaging a senior woman's back in the medical officeYou must find a therapist who is experienced and knows how to keep you safe. If they don’t ask about your medications or medical history, you’re not in the right office. Interview them on the phone before you go, and check their credentials. You probably want to ask your doctor to consult with your therapist so they can discuss your options. You probably CAN have massage, but it may be different from what you imagined, or what you see on TV.

How do you choose a practitioner?

If you are seeing a cardiologist, you should definitely get medical clearance before you have a massage. You should also get guidance on what kind of massage is best, and what the risks are. You should call your therapist before your appointment to make sure they have a good understanding of what it takes to keep you safe and comfortable. Most Certified or Licensed massage therapists get instruction on working with individuals with heart disease as part of their entry level massage education. However, there are additional classes available, and each therapist has varying levels of awareness and experience. Don’t be afraid to ask questions about the therapist qualifications, and what they’re going to do during the massage. While you’re receiving massage, continue to ask questions as they come up. If at any time during the massage it feels worse than a “hurts good” sensation, then it’s too much, and you should speak up. Your therapist should never encourage you to suffer through anything you don’t like during a session.

The MedFit Network can help you find a reliable, educated massage practitioner in your area. In the right hands, you are sure to relax and find comfort through skilled touch. Search Now.


Kathy Flippin’s passion is to offer excellent therapeutic massage, and educate her clients on how they can take the best care possible of themselves. Kathy is the owner of Dynamic Touch Massage and has been a Sports Massage Therapist since 1997. Her clients include everyone from professional athletes to active grandmothers.

Senior Man On Cross Trainer In Gym

Exercise and Cardiovascular Disease

Senior Man On Cross Trainer In GymRegular exercise has a favorable effect on many of the established risk factors for cardiovascular disease. For example, exercise promotes weight reduction and can help reduce blood pressure. Exercise can reduce “bad” cholesterol levels in the blood (the low-density lipoprotein [LDL] level), as well as total cholesterol, and can raise the “good” cholesterol (the high-density lipoprotein level [HDL]). In diabetic patients, regular activity favorably affects the body’s ability to use insulin to control glucose levels in the blood. Although the effect of an exercise program on any single risk factor may generally be small, the effect of continued, moderate exercise on overall cardiovascular risk, when combined with other lifestyle modifications (such as proper nutrition, smoking cessation, and medication use), can be dramatic.

Benefits of regular exercise

  • Increase in aerobic capacity
  • Decrease in blood pressure at rest
  • Decrease in blood pressure while exercising
  • Reduction in weight and body fat
  • Reduction in total cholesterol
  • Reduction in LDL (bad) cholesterol
  • Increase in HDL (good) cholesterol
  • Increased insulin sensitivity (lower blood glucose)
  • Improved self-esteem

Physiological Effects of Exercise

There are a number of physiological benefits of exercise. Regular aerobic exercise causes improvements in muscular function and strength and improvement in the body’s ability to take in and use oxygen (maximal oxygen consumption or aerobic capacity). As one’s ability to transport and use oxygen improves, regular daily activities can be performed with less fatigue. This is particularly important for patients with cardiovascular disease, whose exercise capacity is typically lower than that of healthy individuals. There is also evidence that exercise training improves the capacity of the blood vessels to dilate in response to exercise or hormones, consistent with better vascular wall function and an improved ability to provide oxygen to the muscles during exercise. Studies measuring muscular strength and flexibility before and after exercise programs suggest that there are improvements in bone health and ability to perform daily activities, as well as a lower likelihood of developing back pain and of disability, particularly in older age groups.

Patients with newly diagnosed heart disease who participate in an exercise program report an earlier return to work and improvements in other measures of quality of life, such as more self-confidence, lower stress, and less anxiety. Importantly, by combining controlled studies, researchers have found that for heart attack patients who participated in a formal exercise program, the death rate is reduced by 20% to 25%. This is strong evidence in support of physical activity for patients with heart disease.

How Much Exercise is Enough?

Unfortunately, most Americans do not meet the minimum recommended guidelines for daily exercise. In 1996, the release of the Surgeon General’s Report on Physical Activity and Health provided a springboard for the largest government effort to date to promote physical activity among Americans. This redefined exercise as a key component to health promotion and disease prevention, and on the basis of this report, the Federal government mounted a multi-year educational campaign. The Surgeon General’s Report, a joint CDC/ACSM consensus statement, and a National Institutes of Health report agreed that the benefits mentioned above will generally occur by engaging in at least 30 minutes of modest activity on most, if not all, days of the week. Modest activity is defined as any activity that is similar in intensity to brisk walking at a rate of about 3 to 4 miles per hour.

These activities can include any other form of occupational or recreational activity that is dynamic in nature and of similar intensity, such as cycling, yard work, and swimming. This amount of exercise equates to approximately five to seven 30-minute sessions per week at an intensity equivalent to 3 to 6 METs (multiples of the resting metabolic rate*), or approximately 600 to 1200 calories expended per week.

How Can a Personal Trainer Help?

If you have cardiovascular disease or are at risk for developing disease, you may be apprehensive at starting an exercise program. You may have questions such as:

  • Is exercise safe for me?
  • How long should I exercise?
  • How frequently should I exercise?
  • Do I stretch before or after exercise?
  • Can I do strength training and lift weights?
  • How do I know if I’m exercising at the right intensity?
  •  What if I develop symptoms such as dizziness, light-headedness, or nausea?

A personal trainer or exercise professional can answer all of these questions for you and establish a well-rounded exercise program that is safe and effective.

A personal trainer will tell you what types of aerobic exercise are most appropriate for you and devise an exercise program tailored towards your needs. This will include guidelines for frequency (how many times per week), intensity (how hard you should exercise), and duration (how long each exercise session should last). A well-designed exercise routine will start with a warm-up that includes dynamic movements designed to raise the heart rate, increase core temperature, mobilize the major joints in the body, and prepare the body for more intense exercise. Warm-up can be followed by either aerobic exercise or weight training. Your trainer can monitor your heart rate and blood pressure during both activities to make sure you are exercising at the proper intensity. If heart rate and blood pressure get too high, your trainer will have you decrease the intensity of exercise or stop. If you develop any symptoms while exercising, your trainer will be right there to advise you and check your vital signs. Weight training is very safe as long as it is performed with proper supervision. Your trainer will recommend the most appropriate exercises for you to do and emphasize proper breathing and technique. Under the guidance of an exercise professional, you can help to improve aerobic capacity, decrease blood pressure and cholesterol, improve good cholesterol, lower blood glucose, improve muscular strength, increase joint range of motion, and lower weight and body fat. All of these will result in a lower risk for developing cardiovascular disease or if you already have disease, it will decrease the chances of subsequent cardiovascular events. Most importantly, working with an exercise professional will extend your lifespan and greatly improve the quality of your life.


Eric Lemkin is a certified personal trainer, strength & conditioning specialist, corrective exercise specialist and founder of Functionally Active Fitness. Lemkin has been a certified personal trainer for 17 years and has helped people ages 8-80 reach their fitness goals through customized personal training – specializing in exercise for the elderly or handicapped. 

References

Kochanek KD, Xu JQ, Murphy SL, Miniño AM, Kung HC. Deaths: final data for 2009 [PDF-2M]. National vital statistics reports. 2011;60(3).

Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update: a report from the American Heart Association . Circulation. 2012;125(1):e2–220.

Heron M. Deaths: Leading causes for 2008 [PDF-2.7M]. National vital statistics reports. 2012;60(6).

Heidenriech PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123(8):933–44.

CDC. Million Hearts™: strategies to reduce the prevalence of leading cardiovascular disease risk factors. United States, 2011. MMWR 2011;60(36):1248–51.

Senior Man On Cross Trainer In Gym

Where to Begin When You Are Working Out With a Health Condition

The gym can be a confusing place especially for individuals with health concerns. Many times, these clients are trying to navigate their workouts by themselves because they are unsure of the appropriate questions that they need to ask.

First of all, there are two different types of trainers. There are trainers who have a four year degree and certifications. These trainers are sometimes called Fitness Specialists and have had many hours of study related to a wide variety of diseases and injuries. They are used to modifying exercises and programs based on any specific condition you may have. Fitness Specialists are usually found in a medically based fitness facility affiliated with a hospital. Please note that some Fitness Specialist’s will specialize in a certain area. Some work with individuals with diseases and disabilities and some don’t.

Personal Trainer, Gym, Pull Down Machine, Exercising, AssistanceWhen you finally narrow down who you might like to hire you will want to ask some questions. Please don’t be afraid to ask these questions as they will help you to decide which trainer is right for you. It is also recommended that you observe Fitness Specialists training clients.

First you want to make sure that the trainer has had experience with your condition. If not, they should be willing to research it and or speak with your doctor with your permission. There are exercise guidelines that all Fitness Specialists should follow when working with clients who have health conditions.

You will also want to ask about the trainers background. It is alright to ask about education, certifications, and years of experience. You also want to hire someone who is patient with you. This is extremely important as you figure out which exercises work best for your body. I would also like to add that you need to be patient with yourself as well. Try to relax and enjoy your training session.

Asking the questions from above help to keep you feeling confident. Exercise can seem frustrating in the beginning but you have to keep a positive mindset. In the beginning, set small goals and do the best you can during each training session.


Robyn Caruso is the Founder of The Stress Management Institute for Health and Fitness Professionals. She has 15 years of experience in medical based fitness.

heart with heartbeat

Skip these 5 Foods for Better Heart Health

There’s no shortage of marketing messages about what’s best for heart health and some of it is well, just plain wrong. Here’s my top 5 offenders – don’t believe their hype, choose my real deals instead.

1) The”Oat” cereals

AKA the Sugar & chem lab project bombs – cereals like Honey nut cheerios & Honey bunches of oats or getting “fully loaded” oatmeal with added sugar & dried fruit – my heart just skipped a beat – not in a good way. AKA better: choose organic oats and add spices, nut butter and / or hemp seeds. We are loving Natures Path’s new plain Qi’a oatmeal

2) Fat-free dairy

Mooooove away from this stuff – research shows full-fat dairy is associated with lower risk of obesity (which means lower heart disease risk too) and likely due to the hormone profile change when the fat is removed, as well as the fact that without the fat it’s harder to feel full which means you fill up on other calories. AKA better: choose organic whole milk or skip the dairy and choose full fat coconut or cashew etc.

3) Pieces, Parts and Puffs

While potatoes pack in heart healthy potassium and rice provides vitamins, minerals and antioxidants – when we over process them and then add salt and other chemistry lab projects we end up with a heartbreak. AKA better: whole bean or potato chips with added spices not loads of salt.

4) Soy sauce or soy protein isolate in bars or protein powders

We hear soy and think heart health but the truth is these are heart failures. Highly processed parts of soy contain none of the good stuff – fiber, omegas, antioxidants that we find in whole organic soybeans. AKA better: whole organic soybeans or organic tofu or organic tempeh – and “protein” powders and bars that contain them or other whole quality plant sources like hemp and quinoa.

5) Heart shaped candies

They look so love-ly and even have such sweet quotes on them. But they aren’t the sweet friend for heart health that you think – artificial dyes and chemistry lab corn syrup are not the basis of a lasting love affair. AKA better: choose a little heart-healthy organic dark chocolate (that’s >65%) and if you do want candy try authentic sweets – organic, free of artificial dyes etc – like those from our friends at TruSweets.

Originally printed on ashleykoffapproved.com. Reprinted with permission.


Ashley Koff RD is your better health enabler. For decades, Koff has helped thousands get and keep better health by learning to make their better not perfect nutrition choices more often. A go-to nutrition expert for the country’s leading doctors, media, companies and non-profit organizations, Koff regularly shares her Better Nutrition message with millions on national and local television, magazines and newspapers. Visit her website at ashleykoffapproved.com.

Healthy human health care symbol

Why do Yoga if you have Heart Disease or have had a Stroke?

Psychological stress has been shown to increase activation of the sympathetic nervous system and the hypothalamic pituitary adrenal axis. This increased activation releases adrenaline, noradrenaline, and cortisol, which lead to faster heart rate, increased cardiac output, and narrower arteries. These changes, in turn, create increased blood pressure. Activation of these systems also accelerates the progress of atherosclerosis and can lead to acute plaque rupture, which results in ischemia of the heart (angina) and coronary heart disease and stroke.

heart-graphic

The Role Anger Plays in Heart Attack Prevention

Everybody knows that if you want to prevent heart disease, you should exercise and eat a healthy diet, right? Well, that may not be true in every single case. While aerobic exercise can certainly lower blood pressure, reduce bad cholesterol in the body, and control weight gain, research shows that working out while angry or upset may increase your risk of heart attack.