February is all Heart — Prevent Heart Disease

For most of us February means Valentine’s Day, a time for couples to celebrate their love and commitment by sharing hearts of candy. But February is also American Heart Health month, a time to spread the word and encourage people to maintain a healthy heart. Heart disease is still the number one cause of death for both men and women.

With the exception of heredity or other contributing health conditions, it is well-known that cardiovascular disease has a strong correlation to lifestyle. We know that smoking, being overweight or obese; consuming too much unhealthy fats and sodium, and high blood pressure can increase the risk of this disease. In addition, a sedentary lifestyle with minimal activity in front of a TV or computer most hours of the day can also contribute largely to heart attack and stroke.

A lifetime of simple choices in what foods we eat, the amount of exercise we participate in and whether or not we chose smoke can make a big difference in the outcome of the health of our hearts and cardiovascular system. This February, make a commitment to be more mindful of heart healthy choices.

Here are some ways to begin a strategy to plan for prevention. Visit your doctor every year. Most health insurance policies will cover an annual physical 100%, which is an easy way to monitor blood pressure and check for other conditions that can raise the risk of CVD. Have cholesterol checked at least every 5 years or more frequently if you have a family history of heart disease or if you have diabetes or kidney issues.

Include more fruits and vegetables, and lean protein low in unhealthy fat, cholesterol and sodium in your diet. Use oils higher in healthy Omega 3 fatty acids, eat fish twice a week, and add flaxseed or walnuts to oatmeal. Look for more whole grain foods that are high in fiber with reduced or no added sugars. Drink more water and unsweetened beverages. Limit caffeine and alcohol.

Maintain a healthy weight and exercise regularly at least 150 minutes per week. Walking 30 minutes a day at a moderate-intensity can significantly reduce risk of CVD and other diseases including diabetes.

It’s easier said than done, but if you smoke find a way to quit. There’s substantial evidence to support quitting smoking as one of the best ways to protect your health including the health of your heart and lungs — the number one cause of preventable death — smoking not only harms your health but harms the health of others around you who breathe in cigarette smoke.

Get high blood pressure and diabetes under control and reduce high cholesterol. Take any medicines as prescribed, and talk to your doctor about any side effects that you may have.

Make the commitment to the prevention of heart disease for you and for your family. Become a role model for your children and pass-on heart healthy habits that they can continue into adulthood to keep their hearts healthy for an entire life time.

References

February is American Heart Month. (2014, February 12). Retrieved February 7, 2015, from http://www.cdc.gov/features/heartmonth/

Getting Healthy. (n.d.). Retrieved February 9, 2015, from http://www.heart.org/HEARTORG/GettingHealthy/GettingHealthy_UCM_001078_SubHomePage.jsp

Heart Disease and Stroke Statistics-2014 Update. (n.d.). Retrieved February 7, 2015, from http://circ.ahajournals.org/content/early/2013/12/18/01.cir.0000441139.02102.80.citation#cited-by

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The Detox Diet, a Mulligan for Poor Lifestyle Choices?

The popularity of detox diets may simply be about what they represent rather than what they claim to do. The idea of undoing poor lifestyle choices by flushing away toxins in the body and starting clean is hard to resist. A do over, a second chance — but do these diets cause us to underestimate what our bodies already do for us every day by leading us to believe anecdotal claims and promises?

Three organs work together to keep our system clean of wastes and toxins, the liver, kidneys and the colon. Everything we consume is first broken down and absorbed into the bloodstream by the small intestine, then is processed through the liver. The liver detoxifies our blood and metabolizes the food we eat for use or storage. The kidneys filter out the blood and expel urine to dispose of toxic waste while balancing fluids in the body. Whatever is not absorbed by the small intestine is eliminated through the large intestine. Gastroenterologists will attest that colon cleansing is not necessary and that the large intestine is very efficient at elimination. Normal bowel movements ensure that fecal matter is removed on a regular basis. In a healthy person, these organs do an excellent job to keep harmful substances from damaging our bodies without any help from other sources. There is no magic herb or pill that will detoxify the body any more efficiently or melt away any so-called toxic fat from our cells.

But there is a way to feel cleansed and more rejuvenated. Consume more fresh fruits and vegetables close to their original form. Prepare them raw or steamed. Eat healthy lean protein, like roasted chicken breast or salmon with seasonings and herbs. Reduce the amount of sodium, unhealthy fats and added sugars from your diet while increasing fiber intake from whole grain sources. Drink more water and less sugary, caffeinated or alcoholic beverages, which in excess can may you feel sluggish and tired. Exercise for a minimum of 30 minutes a day for most days of the week to increase energy and improve mood.

By practicing this more “clean” way of eating while increasing physical activity, you will maintain a healthy immune system, and your body’s peak efficiency to detox and filter out, and eliminate any harmful substances on its own for years to come. This way is by far the healthiest and safest way to undo poor lifestyle choices while regaining a positive outlook for the future.

References

Nutrition and healthy eating. (n.d.). Retrieved February 9, 2015, from http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-answers/detox-diets/faq-20058040

Wanjek, B. (2013, May 29). Detox Diets & Cleansing: Facts & Fallacies. Retrieved February 9, 2015, from http://www.livescience.com/34845-detox-cleansing-facts-fallacies.html

Mahan, K. L., Escott-Stump, S., Raymond, J. L., (2012). Krause’s food and the nutrition care process. St. Louis, Missouri: Elsevier Saunders

Antacids with Calcium: Are You Consuming too Much of a Good Thing?

You just finished eating dinner and once again you feel the heartburn coming on and immediately reach for an antacid. A little while later you take a few more tablets— anything to stop that burning sensation in your chest. On the back of the bottle, the manufacturer warns, “Do not take any more than 15 tablets within a 24 hour period, or the maximum dosage for more than 2 weeks without a doctor’s supervision.” You also notice that the antacid contains calcium, which is good for you, right?

Our bodies use calcium for strong bones and teeth, and to help muscles and blood vessels contract. The recommended dietary allowance states that adults 19 to 50 years of age require 1000 mg of dietary calcium per day. One tablet of Tums® Antacid Assorted Fruit, regular strength, provides 500 mg of calcium carbonate which helps neutralize heartburn. But 40% of the calcium carbonate is the dietary calcium, which equates to 200 mg per tablet. Taking 15 tablets over a single 24-hour period, equals a consumption of 3000 mg of calcium. Continuing with this dosage for longer than a two-week period can elevate levels of calcium in the blood which can cause hypercalcemia.

Hypercalcemia can occur in someone with conditions such as hyperthyroidism or uses of certain medicines that cause an increase in serum calcium. Taking high doses of dietary calcium from an antacid without direction from a doctor can worsen this condition. Hypercalcemia can affect the GI tract, kidney and brain function. Symptoms include constipation, nausea, decreased appetite and abdominal pain, in addition to, frequent urination and kidney stones, confusion, memory loss and depression. High serum calcium can also put individuals more at risk for bone fractures. Instead of munching on antacids when heartburn occurs, there may be ways to prevent it from happening in the first place.

Consider some dietary and lifestyle changes to reduce heartburn and relieve symptoms. Avoid foods that are fatty, fried, spicy or acidic, chocolate, peppermint and spearmint, whole milk, oils, creamed foods or soup. Beverages to avoid include alcohol, citrus juices, coffee, tea, sodas and other liquids with caffeine. Try to eliminate some of these foods and beverages one-at-a-time to see if the heartburn starts to go away. Pinpointing your trigger foods can help you feel better. If you smoke consider finding a way to quit for your overall health. Nicotine weakens the lower esophageal muscle that leads to the stomach, which can cause stomach acids to propel up the esophagus causing the burning sensation. Avoid late evening snacks or lying down immediately after eating. Eat smaller more frequent portions rather than large meals. If you experience reflux while sleeping, elevate your head six to eight inches to help keep stomach acids from moving up into your esophagus.

If you find that your heartburn is a daily occurrence and your dosage of antacids is steadily increasing, it may be time to talk to your doctor. He or she can check to see if your heartburn is due to something serious or if simple modifications or a medication can bring more long-lasting relief and help you kick the antacid habit.

References

TUMS® Regular Strength. (n.d.). Retrieved January 30, 2015, from https://www.tums.com/products/regular/

Nutrition and healthy eating. (n.d.). Retrieved January 30, 2015, from http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097?pg=2

Calcium carbonate (Caltrate 600): Side Effects and Dosing. (n.d.). Retrieved January 30, 2015, from http://www.medicinenet.com/calcium_carbonate/page2.htm

Hypercalcemia: Read About Symptoms and Treatment. (n.d.). Retrieved January 30, 2015, from http://www.medicinenet.com/hypercalcemia/article.htm

Gastroesophageal Reflux Disease Diet. (n.d.). Retrieved January 30, 2015, from http://gicare.com/diets/gerd/

For Relief of Antibiotic-Associated Diarrhea — Consider Probiotics

A recent bacterial infection has landed you in the doctor’s office. In order to treat the infection your doctor prescribes an antibiotic. Unfortunately, you recall the last time you had to take an antibiotic you experienced a bad side-effect that caused you to miss a couple of days of work. That side-effect was antibiotic-associated diarrhea or AAD.

The antibiotics that kill infection-causing bacteria may also eliminate the good bacteria in your digestive tract. When this happens, the natural balance of bacteria in the intestine is disrupted, which can lead to AAD. This is common among 10% to 30% of patients taking an antibiotic.

Though temporary, AAD can disrupt daily activities, and raise the risk for a more serious form of bacterial infection called C. difficile. This infection has the ability to cause life-threatening diarrhea and inflammation of the colon. Though healthy individuals are at a lower risk for developing this infection, long-term doses of antibiotics can begin to eliminate the healthy bacterium that keeps C. difficile from overgrowing in the GI tract. If you’ll be taking antibiotics for a certain period of time, and have experienced AAD in the past, there are ways to reduce symptoms and reduce the risk of contracting C. difficile.

For antibiotic-associated diarrhea, it’s important to stay hydrated. Replenish fluid, sodium and potassium by consuming a sugar-free juice, sports drink, soup or broth. Thicken stool by consuming potatoes without the skin, bananas, applesauce, oatmeal, bread, peanut butter, white rice or pasta. Limit foods that are mainly saturated fat and/or fried, along with foods that produce gas, like broccoli, Brussel sprouts or cabbage. Avoid beverages with a lot of sugar, lactose or caffeine as they can also aggravate your symptoms.

In addition, consider taking a probiotic. Probiotics are organisms such as yeast or bacteria that are beneficial in restoring the natural bacterial balance in the intestine. By increasing the numbers of good bacteria, probiotics compete with the harmful bacteria in your GI and begin to replenish what has been lost. Though further research is needed about different probiotic strands and their usefulness, some randomized control trials have shown promising results with strains of Lactobacillus rhamnosus and Saccharomyces boulardii. They may help to reduce AAD and reduce the risk of C. difficile overgrowth in the GI tract. Probiotics come in pill form and are found in yogurt. Use caution and talk to your doctor if you have a weakened immune system, yeast allergies, are pregnant, or are taking medications for other conditions. Probiotics make cause gas in some people who take them, but they are generally safe if used as directed.

To prevent the spread of C. difficile, it’s important to always wash your hands after touching any potentially contaminated surfaces. Use warm water and soap for at least 30 seconds; pay special attention to between the fingers, underneath the fingernails and the wrists.

Always stay in contact with your doctor and make him or her aware of any other symptoms you experience. The doctor may be able to give you another kind of antibiotic that may be more tolerable, but always remember to finish prescriptions as directed to ensure that the bacterial infection your doctor is treating is completely gone.

References

Antibiotic-associated diarrhea. (n.d.). Retrieved January 26, 2015, from http://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/basics/lifestyle-home-remedies/con-20023556

Probiotics for Diarrhea: Types, Uses, Side Effects, Benefits. (n.d.). Retrieved January 26, 2015, from http://www.webmd.com/digestive-disorders/probiotics-diarrhea#2

C.diff: Causes, Symptoms, and Treatments. (n.d.). Retrieved January 26, 2015, from http://www.webmd.com/digestive-disorders/clostridium-difficile-colitis#2

Nutrition Tips for Diarrhea. (n.d.). Retrieved January 26, 2015, from https://stanfordhealthcare.org/programs-services/nutrition-services/resources/nutrition-tips-diarrhea.html

Saccharomyces boulardii: MedlinePlus Supplements. (n.d.). Retrieved January 27, 2015, from http://www.nlm.nih.gov/medlineplus/druginfo/natural/332.html#Safety

Lactobacillus: MedlinePlus Supplements. (n.d.). Retrieved January 27, 2015, from http://www.nlm.nih.gov/medlineplus/druginfo/natural/790.html

Stop the Destruction, the Importance of Early Diagnosis: Celiac Disease

The road leading to a diagnosis of celiac disease can prove to be an arduous journey. The symptoms are similar to a long list of other possible causes. It is estimated that about 1% percent of the US population has the disease, and about 83% of Americans who have celiac disease, go undiagnosed or are misdiagnosed. It’s also believed that it takes, on average, about 6 to 10 years for an accurate diagnosis— not reassuring, when time is of the essence for a destructive disease that can harm the human body in many ways.

Celiac disease is an autoimmune disease. The body has an abnormal sensitivity to Gluten. When gluten is present in the small intestine, the immune system responds and tries to destroy it, but instead, the antibodies destroy the villi along the walls of the small intestine by shortening or flattening them. Healthy villi are necessary for absorbing nutrients from food as it passes through the intestine, while damaged villi lose the ability to absorb these nutrients. If left untreated, celiac disease can raise the risk for malabsorption, malnutrition, bone density and neurological disorders. It is also associated with other autoimmune diseases and infertility. The sooner the disease is discovered, symptoms can be eliminated and health can be restored.

Symptoms of celiac disease include, but are not limited to, stomach pain, diarrhea, join pain, weight loss, and an itchy skin rash called dermatitis herpetiformis. Other symptoms can include slowed growth in children, extreme tiredness, and change in mood. A path towards diagnosis starts with a blood test after all symptoms are evaluated. While the patient is still on a gluten-containing diet, blood is drawn to test for certain antibodies. If the test is positive, the doctor may order a biopsy to confirm the disease which means a tiny amount of the small intestine is obtained and examined for any damage to the villi. If it is celiac disease, the patient can be on the road to recovery with a one important change to the diet, the avoidance of gluten. There is no known cure for the disease, but the elimination of gluten in the diet has been proven to drastically improve the health of individuals with this disease. It must be a lifelong commitment to prevent damage to the small intestine and keep it healthy.

There are three main sources of gluten people with celiac disease should be aware of: First, gluten is found in wheat, rye and barley. In addition to bread and pasta, processed foods may also contain these three ingredients which can show up on an ingredient list as “natural flavorings” but will not be listed individually. Eating out can also be a challenge as servers may not have full knowledge of all the ingredients in a menu item. Second, there are non-food sources of gluten which include medications, toothpaste, makeup, art and craft materials and pet foods. Third, is contamination, gluten can be found in a toaster or other kitchen appliances at home or in restaurants where gluten-foods are prepared. Restaurants selling gluten-free items must ensure that those items are prepared away from gluten items to avoid contamination, which can be easily overlooked, but unfortunately may still potentially cause harm to the small intestine in a person with celiac disease.

If you were recently diagnosed, getting a handle on gluten-free information can certainly be confusing and daunting, but there is help and you’re not alone. A registered dietitian can help put together a meal plan and provide a list of foods that contain gluten-free grains, seeds and starches. He or she can also teach you what to look for on a food ingredient label to find the hidden gluten. With time, it’ll become easier to get on the path to a gluten-free lifestyle that will help you heal, be healthy and symptom free for years to come.

Click on the links below, to access reputable resources for celiac disease.

References

What I need to know about Celiac Disease. (n.d.). Retrieved January 23, 2015, from http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/ez.aspx

Understanding Celiac Disease. (n.d.). Retrieved January 23, 2015, from http://www.eatright.org/Public/content.aspx?id=5542

Celiac Disease Antibody Tests. (n.d.). Retrieved January 23, 2015, from http://labtestsonline.org/understanding/analytes/celiac-disease/tab/test/

U.S. Food and Drug Administration. (n.d.). Retrieved January 24, 2015, from http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/Allergens/ucm362880.htm

Celiac Disease Foundation -. (n.d.). Retrieved January 24, 2015, from http://celiac.org/

Home – The Gluten Intolerance Group. (n.d.). Retrieved January 24, 2015, from https://www.gluten.net/

National Foundation for Celiac Disease Awareness. (n.d.). Retrieved January 24, 2015, from http://www.celiaccentral.org/celiac-disease/facts-and-figures/

Are You Getting Enough Vitamin D During the Winter Months?

Depending upon where you live in the world, winter time means that the sun may not shine for days or even weeks at a time. Cloud coverage in the sky seems to hang around forever. Spending more time indoors every week due to colder temperatures can reduce the amount of sunshine we are exposed to. Vitamin D, known as the sunshine vitamin, is synthesized by our bodies when our skin is exposed to the sun’s UV rays for a certain period of time. Without enough sun, we need to rely on our diet in order to take in sufficient amounts. If we don’t consume enough, we can develop low levels or become deficient.

There are two types, vitamin D2 and D3. Studies have shown that consuming either form is adequate. The exception is with a supplement. A vitamin D3 supplement is recommended for higher potency. D2 is usually found in fortified foods such as cow’s and plant-based milk, cereal, orange juice, yogurt and margarine. Vitamin D3 fortified cow’s milk is becoming more readily available. Though not many, some foods contain D3 naturally, like salmon, mackerel, tuna and sardines. Small amounts of vitamin D are also present in beef liver, cheese and eggs. Cod liver oil provides the highest amount of vitamin D (340% of the Daily Value) but is not recommended. It’s also high in vitamin A which can build up to toxic levels with regular use.

Although limited sun exposure is on the top of the list, there are other factors that can cause low levels of vitamin D. People of color have greater amounts of melanin in their skin which reduces their ability to synthesize it from sunlight. Reduced sun exposure, and low intake, compounds their risk of vitamin D inadequacy. In addition, replacing milk with sugary soft drinks that don’t contain any calcium or vitamin D has been increasing among older children and teens.

Since milk has been fortified with vitamin D since the 1930s, rickets is extremely rare among children in the US. Yet there have been cases seen in children who were breast fed as infants. Human breast milk doesn’t supply adequate amounts of vitamin D. The CDC recommends vitamin D fortified formula or a supplement of 400 IU.

Deficiency in healthy people is rare but can occur in people who have inflammatory bowel disease when the ability to absorb nutrients in the small intestine is compromised. Kidney disease can prohibit the kidneys from converting vitamin D to its active form. Osteomalacia and osteoporosis is common among older adults. As we age we lose the ability to make vitamin D efficiently. We are more likely to spend time indoors, have inadequate intakes, or take medications that interfere with nutrient absorption.

Vitamin D is important for healthy bones by helping the body insure adequate amounts of calcium are absorbed into the blood stream. Though inconclusive, research that suggests that low levels of vitamin D may be associated with higher incidences of breast cancer, depression, osteoporosis, hip fractures and chronic disease.

Vitamin D supplements are recommended by many health practitioners, yet there’s conflicting evidence that supplements are effective at all. A cup of milk (dairy or plant-based) at each meal may still be, by far, the best way to get most of the recommended daily intake of vitamin D along with some good quality sunshine.

References

Vitamin D. (n.d.). Retrieved January 17, 2015, from http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Feature, D. (n.d.). Vitamin D FAQ: Vitamin D Sources, Deficiency, and Intake. Retrieved January 17, 2015, from http://www.webmd.com/osteoporosis/features/the-truth-about-vitamin-d

Vitamin D Supplementation. (2009, October 20). Retrieved January 18, 2015, from http://www.cdc.gov/breastfeeding/recommendations/vitamin_d.htm

Healthy Fats — How Can Fats be Healthy?

There are many types of fats, like a fiction novel of good vs evil, there are good guys and bad guys. Both good and bad fats are high in calories, consuming too many can cause weight gain. But in moderation the good guys can support our health, brain growth and reduce inflammation that can cause chronic disease.

Two of the bad guys we are already familiar with are saturated fat and trans-fat. Most of us know that we should limit consuming these types of fats because of the increased risk of cardiovascular disease because they tend to raise the amount LDL, the bad cholesterol, in our bodies. Trans-fat is considered more harmful when consuming large amounts they also have a tendency to lower HDL, the good cholesterol.

Two of the good guys are monounsaturated fat and a polyunsaturated fat called Omega 3. These heroes help protect our heart and maintain our body’s cells. They also help our bodies use vitamins A, D, E and K. They help to lower bad cholesterol in our bodies and reduce inflammation.

Omega 3, more specifically DHA, possibly has many health benefits for expectant mothers. DHA supports baby’s brain growth and development. Research is promising for DHA’s role in cognitive performance in children whose mothers consumed enough during pregnancy.

How do we find these good guys and avoid too much of the bad guys? One of their characteristics is that they are liquid at room temperature while saturated fats and trans-fats are solid at room temperature. Oils such as olive, canola, peanut, safflower and sesame oil are rich in monounsaturated fat. Use these oils in moderation while cooking instead of butter. Peanut butter, avocado, nuts and seeds are also good sources.

Cold water fish such as mackerel, salmon and tuna provide omega 3 fatty acids. Pregnant women should watch for mercury levels in fish and could benefit from taking a supplement that includes DHA.

References

http://www.webmd.com/baby/news/20040716/pregnant-omega-3-essential-for-babys-brain

http://www.nlm.nih.gov/medlineplus/ency/imagepages/19302.htm

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Monounsaturated-Fats_UCM_301460_Article.jsp

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/Polyunsaturated-Fats_UCM_301461_Article.jsp

http://www.cdc.gov/nutrition/everyone/basics/fat/transfat.html