The ABCs of Eating Right & Exercising

Depsite the advancements in medical therapy for diseases like hypertension (high blood pressure), high cholesterol, and diabetes, very few treatments are as effective, or as longlasting, as weight loss, exercise and proper nutrition - and of course, smoking cessation in those that smoke. However, I also realize that exercising every day and eating "right" can be challenging on many levels, not the least of which is understanding how to eat right and what type of exercise is best. These type of lifestyle changes also require us to change our habits, our schedules, and most frustratingly, the comfort-giving routines that we have been entrenched in for weeks, months and sometimes years.

The DASH diet. DASH actually stands for Dietary Approach to Stop Hypertension. The basics: eat lots of fruits, vegetables, whole grain, low-fat dairy foods, as well as poultry, fish, meat, nuts and beans. The amounts of added fats, red meat, and sugary drinks and foods are limited - as is salt.
So how good is this diet? the NIH studied patients on the DASH diet as if they were studying a new medicine and found that:

• Patients with pre-hypertension who followed the DASH eating plan experienced an average drop of 6 mm Hg in systolic blood pressure and 3 mm Hg in diastolic blood pressure.
• Patients with hypertension experienced reductions of 11 mm Hg in systolic blood pressure and 6 mm Hg in diastolic blood pressure.

Not too shabby for changing the food that you eat. Most pharmaceutical companies would brag about this type of data if they could reliably produce it.

Furthermore, a recent study published in Circulation: Cardiovascular Quality and Outcomes pointed out that the DASH diet decreases the 10-year risk of heart attack..

You need more reasons you say? How about the fact that U.S. News & World Report just ranked the DASH diet as Best Overall Diet. A panel of experts in diet, nutrition, obesity, heart disease, diabetes and food psychology reviewed 29 diets and ranked them according to safety, short-term and long-term weight loss, how easy they were to follow, nutritional completeness, diabetes prevention and management, and heart disease prevention.

The diets were ranked according to a star system, with five stars being the best score. Below are the diets which ranked best:

• DASH diet - 4.1 stars. Nutritionally complete, safe, can prevent and control diabetes, also promotes heart health.
  
• TLC diet - 4 stars. TLC stands for Therapeutic Lifestyle Changes. This diet was created by the National Institutes of Health (NIH) to reduce levels of cholesterol. The panel said it is a healthy, well rounded diet. However, the dieter is left very much on his/her own.
  
• Mayo Clinic diet - 3.9 stars. Experts say it is safe and nutritious, and moderately effective for those aiming to lose weight. How can you go wrong with the Mayo?
  
• Mediterranean diet - 3.9 stars. The diet is rich in vegetables, fruits, olive oil, and other healthy nutrients. It was criticized for being too different to what Americans are used to and may consequently be hard to keep up.
  
• Weight Watchers - 3.9 stars. This diet was praised for the emotional support dieters receive, as well as being an easy one to stick to.

Above you will find links to where you can find and download the DASH Diet (YOU DO NOT HAVE TO BUY THE BOOK BECAUSE ALL THE INFO IS PUBLISHED FREE HERE) and all the other Top 5 diets. The best of them are free but others come with a fee and for some, that is a motivating factor, i.e. 'I payed for it, I better do it' phenomenon.  Each of the above diets are good for you and often times the one that seems most appealing and realistic for you will be the best one. At the very least, if you are not a structured diet person, here's a few simple tips on how to lose weight:

1. Limit your portion size. A good rule of thumb is that each portion should be no bigger than your fist.
2. Limit your intake of rice, pasta, potatoes and bread. These complex carbohydrates are heavy in calories, low in protein, and all eventually are converted to sugars. Replace the starchy sides with vegetables, e.g. curry roasted or pureed cauliflower (tastes like mashed potatoes), quinoa, string beans, etc
3. Eliminate all sugary drinks from your diet - particularly sodas. Empty calories with no nutritional benefit.
4. Exercise 4-6 days per week. Even 30 mins of walking on the treadmill with a modest incline would be greatly beneficial to you in the longterm. '

Here's to a healthier, thinner, you in 2013!

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