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Instructions & Questions Here you are able to raise your hand, or request the speaker to speak louder/softer. This area allows you to comment or ask the presenter questions. If you cannot currently hear the audio, please start a private chat with Leah Kaiser. To start a private chat
Will You be My Valentine? Taking Care of Your Heart The Center for Wellness and Prevention
Heart Healthy Nutrition Angela Blackstone, RD, LD Staff Dietitian The OSU Center for Wellness and Prevention
The American Heart Association states that: “a healthy diet and lifestyle are your best weapons in the fight against heart disease.” www.heart.org
What Can You Do? Eat more fiber-rich foods. Eat at least 4.5 cups of fruits and vegetables per day. Eat two 3.5oz servings of oily fish (salmon, trout, herring)per week. Eat four 1.5oz servings of nuts per week. www.heart.org
What Can You Do? Limit sodium to <1500mg per day. Limit sugary beverages to < 36oz (450 calories) per week. Limit total fat to < 35% of total calories. Saturated fat < 7% of total calories Trans fat < 1% of total calories Cholesterol < 200mg www.heart.org
Keys to Making Changes Focus on gradual changes. Track what you eat and drink. Keep moving forward. Reward yourself. Seek out support. www.heart.org
Activity and Exercise for Heart Health Ellen S Aberegg, MA, LD, RD
Exercise and Heart Health We all know we should exercise First we need to know why. Then, how do we start?
What regular exercise “buys” us Lower blood pressure. Lower blood sugar levels. Calories burned, which helps reduce weight. Improved blood fat profile. Improved circulation in leg arteries Increased energy. It gets easier when you exercise regularly! Lower stress levels. Lower the risk of having another cardiovascular event if have already had one.
Starting an Exercise Program Guidelines for healthy adults under age 65 with no apparent chronic disease or condition If you could answer – yes to any of these questions on the next slide or – are older than 65 or – if have a chronic disease or condition, check in with your physician FIRST
Answer these questions: Yes No Has your health care provider ever said that you have a heart condition and that you should only do physical activity recommended by a health care provider? Yes No Do you feel pain in your chest when you do physical activity? Yes No In the past month, have you had chest pain when you were not doing physical activity? Yes No Do you lose your balance because of dizziness or do you ever lose consciousness? Yes No Do you have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity? Yes No Is your health care provider currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? Yes No Do you know of any other reason why you should not do physical activity?
Starting an Exercise Program STEP 1 - Set aside time each day to exercise. STEP 2 - Choose cardiovascular activities you enjoy STEP 3 - Start with 10 to 15 min of cardiovascular exercise daily. Each week, add five minutes STEP 4 - Incorporate strength training
Resources for exercise information https://patienteducation.osumc.edu/Pages/search.aspx?k=exercise Patient Education Search Patient Education Health Information Learn more about your health care The Do's and Don'ts of Exercise Diabetes and Exercise Exercise Log - Oncology Rehabilitation Using Exercise to Fight Cancer-Related Fatigue Diabetes Class Series - Benefits of Exercise to Manage Diabetes My Exercise Plan (Pulmonary Rehab) Exercise Induced Asthma Exercise for People with Lung Disease and many more!!!
Resources for exercise information Your Prescription for Health Series Information and recommendations for exercising safely with a variety of health conditions. Click here to download the full Your Prescription for Health flier series, or choose a flier below. Click here Exercising and Alzheimer's Exercising with Amyotrophic Lateral Sclerosis Exercising with Anemia Exercising with an Aneurysm Exercising with Angina Exercising with Anxiety and Depression Exercising with Arthritis Exercising with Asthma Exercising with Atrial Fibrillation Exercising Following a Brain Injury Exercising with Cancer And many more!!!!!
Stress Management for Heart Health Katharine Feister, ABD, PC Health Coach OSUMC Center for Wellness and Prevention
What Can You Do? Develop healthy habits that will help you prevent and manage stress. “Healthy habits can protect you from the harmful effects of stress.” -American Heart Association
Habits to Fight Stress Talk with family and friends Engage in daily physical activity Accept the things you cannot change Remember to laugh Give up the bad habits American Heart Association at http://www.heart.org/
Habits to Fight Stress Slow down Get enough sleep Get organized Practice giving back Try not to worry American Heart Association at http://www.heart.org/
Quick Stress Relievers Take a walk and change your environment Take a few deep breaths Listen to music Journal Say no—even if it is difficult Use humor Prayer or meditation
Quick Stress Relievers Ask for help Say “thank you” and/or “I’m sorry” Look at pictures of loved ones and places with positive memories Take a mini-vacation through guided imagery (examples available on Youtube or other sites such as: osuhealthplan.com/online/guidedimagery/)
Quick Stress Relievers Progressive Muscle Relaxation – Cycle of tensing and relaxing muscles – Tense muscles for 10 to 15 seconds, then notice the contrast of relaxation – Start at forehead and move all the way to your toes – If any muscles still feel tight, go back and repeat
For More Information, Contact: The OSU Center for Wellness and Prevention at: http://medicalcenter.osu.edu/patientc are/healthcare_services/center_for_we llness_prevention/Pages/index.aspx OSU Wellness Services and Health Coaching at: www.osuhealthplan.com/wellness
Medical Approaches for Heart Health Martha Gulati MD, MS, FACC, FAHA Associate Professor of Medicine (Cardiology) Sarah Ross Soter Chair in Women’s Cardiovascular Health Section Director for Women’s Cardiovascular Health and Preventive Cardiology
2011 Heart and Stroke Statistical Update. Roger V et al. Circ 2011 Cardiovascular Disease Mortality Trends for Males and Females in the United States 1979-2007
Myth : fat deposits at old age! It starts from 2 years of age Foam Cells Fatty Streak Intermediate LesionAtheroma Fibrous Plaque Complicated Lesion/ Rupture Adapted from Pepine CJ. Am J Cardiol. 1998;82(suppl 104). From First Decade From Third Decade From Fourth Decade
… NOT an inevitable part of life We have effective means to reduce heart disease 90% of heart disease is preventable We don ’ t use them enough or effectively – especially in women and minorities Heart Disease is Preventable!
What Increases Risk for Heart Disease Grundy SM, et al, Circulation, 1998; Grundy SM, Circulation, 1999; Braunwald E, N Engl J Med, 1997; Grundy SM, et al, J Am Coll Cardiol, 1999 Non-Modifiable Risk Factors (Things You Can’t Change): Age Gender Family History Race Modifiable Risk Factors (Things You Can Change!): Abnormal cholesterol levels Obesity Cigarette smoking Hypertension Diabetes/Metabolic Syndrome Physical Inactivity Alcohol
Roger VL et al. Published online in Circulation Dec. 15, 2010 Where Are We Now: Estimates for USA for Ideal Heart Health based on AHA 2020 Goals: NHANES 2005-06
Start By Knowing Your Numbers BMI<25 kg/m2 Waist circumference<35 inches BP<120/80 Total cholesterol<200 Triglycerides<150 LDL<100 HDL>50 women/>40 men Fasting Glucose<100
Hypertension BP > 180/110 mm Hg evaluate and treat immediately or within one week depending on the clinical situation BP > 160/100 mm Hg evaluate and treat or refer within one month BP ≥ 140/90 mm Hg recheck within 2 months, if confirmed, evaluate and treat or refer BP ≥ 120/80 mm Hg counsel regarding lifestyle factors, recheck within one year and monitor Initial evaluation of the hypertensive patient should include 12-lead EKG, urinalysis, hematocrit, serum glucose, creatinine, calcium, and potassium measurement and a lipid profile Source: Seventh Report of the Joint National Committee on Prevention, Evaluation, and Treatment of High Blood Pressure 2004.
Hypertension Treatment: Encourage an optimal blood pressure of < 120/80 mm Hg through lifestyle approaches Pharmacologic therapy is necessary when blood pressure is ≥ 140/90 mm Hg or an even lower blood pressure in the setting of diabetes (≥ 130/80 mm Hg) Thiazide diuretics should be part of the drug regimen for most patients unless contraindicated, or unless compelling indications exist for other agents
Lifestyle Approaches to Reduce Hypertension Maintain ideal body weight -Weight loss of as little as 10 lbs. reduces blood pressure DASH (Dietary Approaches to Stop Hypertension) eating plan (low sodium) -Even without weight loss, a low fat diet that is rich in fruits, vegetables, and low fat dairy products can reduce blood pressure Sodium restriction to 1500 mg per day Increase physical activity Limit Alcohol: <1 drink/day for women, <2 drinks/day for men -Alcohol raises blood pressure -One drink = 12 oz. beer, 5 oz. wine, or 1.5 oz. liquor Source: Seventh Report of the Joint National Committee on Prevention, Evaluation, and Treatment of High Blood Pressure 2004, Sacks 2001, Mosca 2011
Dietary Approaches to Stop Hypertension (DASH) Plan 7–8 servings of grains, grain products daily 4–5 servings of vegetables daily 4–5 servings of fruits daily 2–3 servings of low-fat or nonfat dairy foods daily ≤ 2 servings of meats, poultry, fish daily 4–5 servings of nuts, seeds, legumes weekly Limited intake of fats, sweets Source: National Heart, Lung, and Blood Institute 1998, Sacks 2001.
DASH Study 48% women ( BP 133/85) 60% African Americans > 60% obese BP Results: 6.4/2.9 mmHg overall Greater drop in African Americans and higher baseline BP Svetkey, Archives Int Med, 1999
DASH + Sodium + Wt. Loss Na+ restriction (<1.5 gm/d) additive to DASH ( ↓ ~4mmHg) More effective: women, age > 45, AA’s, hypertensives Magnitude = single drug Rx (11/6mmHg) Add exercise & wt. loss – = ↓ 16/10 mmHg Sacks, NEJM 2001; Bray, AJC 2004; Blumenthal, Arch Int med, 2010
Effects of Lifestyle on Blood Pressure ModificationRecommendationAvg SBP Reduction WeightNormal body wt 5-20 mm Hg/10 kg reduction(BMI 18-5-24.9 kg/m 2 ) DASH eating fruits, vegetables, and 8-14 mm Hg planlow-fat diary saturated and total fat Dietary Na + sodium intake to2-8 mm Hg sodium 100 mmol per day reduction(2.4 g Na + or 6 g NaCI) AerobicRegular aerobic physical4-9 mm Hg physicalactivity (eg, brisk walking) activityat least 30 min/d, most days of the week ModerateMen: Limit to 2 drinks/day2-4 mm Hg alcoholWomen and lighter weight consumptionpersons: Limit to 1 drink/day 21-55 mm Hg JNC VII
LDL cholesterol is known as bad cholesterol. It has a tendency to increase risk of heart disease LDL cholesterol is a major component of the plaque that clogs arteries HDL cholesterol is known as the good cholesterol. Higher in women, increases with exercise and when quit smoking HDL cholesterol helps carry some of the bad cholesterol out of arteries. Good vs. BAD Cholesterol
Know your Numbers! Desirable numbers Total cholesterol < 200; LDL < 100 HDL > 40 (men) >50 (women) Triglycerides < 150 Get the levels tested routinely and keep them under control The only thing worse than finding out that you have one of these conditions is…….NOT finding out that you have it!!
Cholesterol/Lipids Key is to Know your numbers Optimal levels of cholesterol (lipids) are as follows: – LDL-C < 100 mg/dL – HDL-C > 50 mg/dL for women, >40 in men – Triglycerides < 150 mg/dL – Non-HDL-C < 130 mg/dL (Non-HDL-C equals total cholesterol minus HDL-C)
Approximate and Cumulative LDL Cholesterol Reduction Achievable By Diet and Weight Loss Modifications Dietary Component Dietary Change Approximate LDL Reduction Major Saturated fat< 7% of calories8-10% Dietary cholesterol*< 200 mg/day3-5% Weight reductionLose 10 lbs.5-8% Other LDL-lowering options Viscous fiber5-10 g/day3-5% Plant/sterol2 g/day6-15% stanol esters Cumulative estimate20-30% * NOTE: New cholesterol guideline recommends <150mg/day Source: Adapted from National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) 2002.
Treatment for Cholesterol/Lipids Drugs to lower LDL is recommended simultaneously with lifestyle therapy in those with heart disease to achieve an LDL-C 20% A reduction to < 70 mg/dL is reasonable in very-high-risk
People who are overweight (10- 30% more than their normal body weight) Obese have 2 to 6 times the risk of developing heart disease Waist measurement >35 inches for women; >40 inches for men Pears or apples? Obesity and Weight