Top 5 Heart Healthy Gift Ideas from CCNM

It's that time of the year when we stress about, er, take joy in, buying gifts for others. But what to get for those trying so hard to develop good healthy habits? Fret not! We have procured a list of healthy, good habit-forming gifts that are safe and doctor-approved. Let's get to it:

1. What's healthier (and tastier) then a basket of fruit? Not much. Keeping it local,  Denville mainstay for the past 70 years, J&M Gourmet Foods, has a great selection of fruit baskets that will deliver locally on the same day or ship it overnight. The Famous J&M Fruit Basket for $49.95 is our go-to selection but there are numerous others from which to choose.

2. Did you know that gardening can burn up to 1,260 kJ an hour while also working those core muscles? Once the winter snow thaws and the green begins to show its time to get out there and get healthy. So why not do it with some new tools. For the guys who do the heavy lifting, cutting, pruning there are plenty of power tools to satisfy even the manliest of gardeners. Check out Home Depot or Lowe's for the latest deals on cordless hedge trimmers, lawn mowers, etc. And for the ladies, new gloves, gardening tools and even plants/seeds ordered online are an awesomely healthy way to get spring started. Check out White Flower Farms  for the best online plant selection.

3. This device that looks like its from 2021 is worn like a watch and does actually tell time. However, it tells much more than that. The Nike Fuelband also monitors your daily activity and translates that into energy spent. It counts your steps and uses an accelerometer to calculate your level of exertion. It then syncs with your mobile device wirelessly and can give you daily reports about how you've done. If you also want to keep an eye on your shut-eye the Fitbit One Wireless Activity and Sleep Tracker also monitors your sleep cycle and can actually be set to wake you at the optimal point in the cycle so that you'll srise feeling well-rested and ready to go.

4. Full disclosure: I want this gift! We are finally at the point in our technological advancement where we no longer have to be impeded by annoying swinging wires while we run or connection points that no longer connect well. Welcome to the wonderful world of wireless accessories. They connect to any iPod, iPad, iPhone, Android, or any other Bluetooth enabled device, so you can listen and control your music play, advancing or rewinding the track and pausing from up to 32-ft. away. It even has a microphone that lets you make or take calls on your cell phone — the music stops when a call is in progress, and resumes playing when you hang up. So good.

5. Finally, from Circulation, the journal of the American Heart Association, it was previously reported that moderate intake of alcoholic beverages (1 to 2 drinks per day) is associated with a reduced risk of coronary heart disease in populations. That's good! We can use that evidence-based data for a great gift idea. Why not support the local wineries of NJ and grab 2007 Unionville Red Montage Big O, which has won multiple national awards and the distinction of Best Wine in NJ from the Star Ledger and Tastings.com. Or, go to your local store and pick up a bottle of red wine for a friend. Remember though, the benefits only exist in moderate intake!





From all of us at CCNM, have a Happy Chanukah, Merry Christmas, and a Healthy New Year!!

So many of us lead busy lives and eating healthy is a challenge when you're in the run. I hear from patients so often that time is a limiting factor, particularly when it comes to breakfast. The temptation to grab something quickly and get on with the day is usually stronger than the desire to find something good for you. However, there are options available that are markedly more heartsmart than the sausage and egg coronary killer. WebMD has done the work for us in sorting out the bad from the not as bad and we've posted their slideshow below. Take a look and get your day started in a better way:

http://on.webmd.com/T6w67Y

Does Work Stress Lead to Heart Disease?

It seems logical that stress, and in particular job-related stress, where we spend so much of our time and effort, would contribute to health issues. So many of my patients report that they have had "a lot of issues at work" in the same breath as their description of chest pain-type symptoms. And there is that urban myth about people working so hard that it resulted in their demise. But most of these myths often have a kernel of truth and recently, a group of British researchers performed an analysis of 13 studies performed between 1985-2006 assessing job strain as a risk factor for coronary heart disease, i.e. heart attacks.

Of the nearly 200,000 patients analyzed, 15% reported significant job strain and after some savvy statistical analysis that involves terms like hazard ratios and reverse causality, these smart guys found that job stress does indeed appear to be linked with higher rates of heart attacks. Their interpretation as described in the published abstract stated the following:

Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking.

 

So, those of you smoking to deal with a tough day of work - cut it out! The smoking will hurt you way more than your distasteful boss.

 

The American Heart Association is not as confident in linking stress to heart disease and bluntly states on their website that...  "although stress is not a confirmed risk factor for either high blood pressure or heart disease, and has not been proven to cause heart disease, scientists continue to study how stress relates to our health. And while blood pressure may increase temporarily when you're stressed, stress has not been proven to cause chronic high blood pressure."

 

The AHA then goes on to give several recommendations for how to manage stress in your life (some good, some not that good) which you can find here:

 

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp

 

In my opinion, stress contributes more to mental anguish and anxiety than anything else and often triggers our coping mechanisms - which may be good (e.g. exercise, reading, yoga, etc) or more often bad (smoking, drinking, festering, etc). The key is to try to minimize the bad coping mechanisms, avoid situations that are stressful if possible, and enjoy life.

 

The Lancet, Volume 380, Issue 9852, Pages 1491 - 1497, 27 October 2012

Carry Your ECG With You Forever

Next time you have an electrocardiogram (ECG) done, take it with you forever by snapping a pic of it with your phone. If you are lucky enough to have an iPhone or Droid (or any phone with a decent camera) the quality of the ECG image will be very decent.

This could come in very handy if you were to ever end up in an ER or doctor's office who wanted one for comparison. And that happens more commonly than you might think.

This is a quick, cheap an easy way to answer what potentially may be a very important question: is this finding on your ECG new?

This may be particularly important in those patients with chronically abnormal ECGs at baseline. Certain findings on an ECG, such a left bundle branch block, can prompt fairly aggressive courses of action if they ate thought to be a new finding. Obviate that by carrying yours on your phone.

Check Your Blood Sugar With Your iPhone or iTouch

It seems like this should be something that's more theoretical than realistic but technology seems to be not only catching up to medicine, but outpacing it.

The iBGStar Blood Glucose Monitoring System is now being sold at Walgreens for $74.99 and the Apple Stroe for $99.99 and the article below summarizes all the benefits of checking, recording and even managing your blood sugar with the assistance of this peripheral device and accompanying app.

Mobile medicine getting more impressive all the time...

http://www.imedicalapps.com/2012/05/doctors-prescribing-iphone-ibgstar-blood-glucose-peripheral/

Article: Medical Tests | Unnecessary Medical Tests & Treatments

Medical Tests | Unnecessary Medical Tests & Treatments
http://www.consumerreports.org/cro/magazine/2012/06/many-common-medical-tests-and-treatments-are-unnecessary/index.htm

(Sent from Flipboard)

App for atrial fib

http://www.imedicalapps.com/2011/12/pharmaceutical-sanofi-aventis-useful-medicalapp-patients-heart-arrhythmia/

Transradial in the Spotlight

As some of you know, the transradial approach to cardiac cathterization is a specialty of CCNM's Dr. Jordan Safirstein. The use of the wrist to access the heart, instead of the groin, has now moved beyond niche procedure and is growing in frequency every year. The lack of associated bleeding complications and improved patient comfort have begun to wear down even the most staunch femoral supporters. While Europe and Asia have zoomed ahead of us in their utilization of the radial artery for cath, the U.S. has begun to catch on. The NJ Star-Ledger recently published a great article along with an online pictoral display of the entire procedure from beginning to end. Check it out here:

• Pictures of transradial cardiac catheterization
• NJ Star-Ledger's A second opinion on unclogging arteries: Catheters through wrist, not groin

Super Goal Monday

With the big game on Sunday, and the big food that goes along with it, many of us (or maybe just me) are still  on our "Holiday" will-power hiatus and looking for an excuse to start serious food restriction.

Well, the gig is up and thanks to my awesome office staff, I have an excuse to get my BMI closer to where it should be. The women have initiated a Super Goal Monday Weight Loss Challenge.

After gorging on offensively hot wings, a plastic football full of pretzels and (hopefully) the sweet taste of a Giants victory, we will begin a 3 month competition to see who can best reverse the damage of the above. Weekly weigh-ins and a financial incentive will keep us honest and aqt the end of 90 days, we will all be better for it.

For privacy and safety reasons (mine in particular), I am not allowed to post results of any of the weigh-ins although I'd really like to. Unfortuantely, I'll just have to give vague, non-numerical updates. These types of weight loss challenges are wonderful ways to help you and your colleagues/friends/neighbors/family members to get healthier, using a team approach and exchanging ideas about what works and what doesnt. There are also several online options to facilitate a group weight loss challenge and I've provided a few below. Check it out if you feel so inspired. And fo course, GO GIANTS!!!

Ideas for a Weight Loss Challenge at LiveStrong

WeightLossWars

Healthier School Lunches Are on the Menu

After 15 years, the school lunch ladies will be dishing over some healthier grub to our children, says the National School Lunch Program.

With an additional six cents per meal, the schools could hardly figure out where to spend first. Fortunately, most of the improvements come in the form of omissions, including smaller portions, calorie limits, less fats and zero trans fat. There are some increases too, such as those in "dark green vegetables", whole grains, and fruits.

Despite an attempt to discount tomato paste (and thus pizza) as a vegetable Congress was able to successfully reverse that and maintain its status as equal to one veggie serving.

"It was a bit unfortunate that some groups had powerful friends in Congress and basically tried to sort of short-change [kids] and create some confusion with these standards," said Agriculture Secretary Tom Vilsack.

"Our response was to set up minimum requirements. You have to have a minimum level of dark green vegetables, you've got to have a minimum level of red or orange or yellow vegetables."

And coming on the heels of these changes will be laws affecting school vending machines.

Here are the quick bullet points:

• Offer a minimum of 8 to 10 ounces of whole grains. No more than two desserts a week may be used to meet this minimum
• Offer at least a half cup per week of dark green vegetables
• Offer at least 3/4 cup red/orange vegetables for grades K-8, and at least 1 1/4 cups in grades 9-12
• Offer at least a half cup of beans or peas
• Offer at least a half cup of starchy vegetables. There is no limit on starchy vegetables
• Offer at least a half cup of fruit in grades K-8 and at least 1 cup of fruit in grades 9-12
• Offer at least a half cup (grades K-8) or 3/4 cup (grades 9-12) of "other vegetables," which may be met with any of the above vegetables except for starchy vegetables
• Allow tofu as a meat alternative
• Get federal reimbursement only if they offer at least a half cup of a fruit or vegetable
• Contain no fewer than 550 calories for grades K-5, 600 calories for grades 6-8, and 750 calories for grades 9-12
• Contain no more than 650 calories for grades K-5, 700 calories for grades 6-8, and 850 calories for grades 9-12
• Obtain less than 10% of total calories from saturated fat
• Have zero trans fat
• Limit salt according to grade level
• Offer at least a cup of low-fat or skim milk

Read the whole article on WebMD 

The Future Is Here

When I asked my patient yesterday of he had been recording his blood pressures he cooly whipped out his Droid and showed me his recorded and graphed BP - which had a very reassuring negative slope to it. He used The HeartLite app for the Droid and all of you with SmartPhones can do the same.

The Truth About Shoveling Snow

With the snowiest weeks ahead, we thought it would be good to uncover the truth about shoveling snow. Slips and falls, not cardiac catastrophes, are the most commonly seen winter-related injuries - but heart problems account for almost every recorded death in reported studies.

It is quite possible that you have heard about the risks of shoveling snow on the news, or possibly from your doctor, and most likely from your spouse. However, it is very unlikely that anyonw has shown you the proof that it can be deleterious to your cardiac health.

 "It's a dangerous activity. People who are middle aged or older with a history of heart problems simply should not shovel snow," said Barry Franklin, director of Cardiac Rehabilitation and Exercise Laboratories at William Beaumont Hospital in Royal Oak, Mich.

But why? In an ABC News report, Franklin lays it out fairly well explaining that many people may not realize that a shovel full of wet snow can weigh as much as 15 to 16 pounds. So he said that if someone is shoveling snow at a rate of 12 shovelfuls per minute, they will have moved nearly a ton of snow if shoveling their driveway in just 10 minutes.

"So the physical demands are really, really substantial," said Franklin. When you couple that with the cold air that they are breathing, which causes the coronary arteries to constrict, in many respects you've got a perfect storm for heart trouble," said Franklin.

"Being out in the cold, some of the warning signs may be camouflaged," he added.

Cold weather and hard work can mask those symptoms, delaying people's responses and sometimes leading them into more trouble.

"We really encourage people beyond the age of 50 to try to hire a neighborhood kid to do it," he added.

Not everyone is at risk for a heart attack while shoveling, of course and people in cold climates often have "conditioning," according to Dr. Randal Thomas, director of the Mayo Cardiovascular Health Clinic in Rochester, Minn.

Studies published in the Lancet and the American Journal of Cardiology show that the incidence of heart failure goes up in the week after a blizzard. The Lancet study, based on death certificates in eastern Massachusetts after six blizzards from 1974-78, demonstrated that coronary artery disease-related deaths rose by 22 percent during the blizzard week and stayed elevated for the subsequent eight days, suggesting that the effect was related to storm-related activities, like shoveling, rather than the storm itself.

Similarly, the AJC article, based on medical examiner records from three Michigan counties, found that there were more exertion-related sudden cardiac deaths in the weeks during and after blizzards, and that 36 of the 43 total exertion-related deaths occurred during or shortly after snow removal.

Here are some tips from Brigham and Women's Hospital cardiologist, Daniel Forman M.D.,director of Exercise Testing Laboratory and Cardiac Rehabilitation.

Certain individuals should consult their doctor before shoveling snow:

• People who have previously had a heart attack or other cardiovascular disease.
• People with a history of chest pain or angina.
• People with medical histories of high blood pressure, diabetes or high cholesterol levels.
• People who smoke or who have other cardiovascular risk factors.
• People who do not exercise regularly.

For those who wish to shovel snow, follow these general tips to help stay healthy:

• Dress warmly and be sure to protect extremities such as your nose, ears, hands and feet. This is important because cold weather can reduce circulation, aggravating heart disease.
• Stretch your arm and leg muscles as you would before any exercise; this minimizes musculoskeletal injury and strain.
• Also warm up your cardiovascular system with a light activity such as marching in place or walking before shoveling. Warming up is an important means of modifying cardiovascular strain.
• Don’t eat a heavy meal or drink alcohol prior to shoveling (this is not a good way to work off a big meal!). Avoid stimulants such as caffeine or nicotine, which increase heart rate and cause blood vessels to constrict.
• Use a shovel with a small blade. It is safer for your heart as well as your back and joints to lift smaller and more frequent amounts of snow than to haul a few huge shovelfuls. Likewise, it is important to have a shovel that is suited for your height.
• Pace yourself. Start out shoveling slowly, and don’t try to clear the entire area at once.
• Take frequent breaks to give your heart a rest. Use the time off to drink plenty of water and stay hydrated. Also make sure you are eating normally and taking your routine medications. Push the snow rather than lifting and throwing it.
• If you must lift, do it properly. Spread your hands along the handle for more leverage, stand with your feet hip-width apart, and bend at the knees (not at the back).
• Do not twist or throw snow over your shoulder. Scoop in a forward motion and step in the direction you throw the snow to avoid lower back pain the day after shoveling.
• Know the warning signs of a heart attack. Stop immediately and seek emergency medical help if you experience heart attack symptoms such as chest pain, shoulder, neck or arm pain, shortness of breath, dizziness, fainting, sweating or nausea.