Cardiac Associates, P.C.

A Few Words On…Diet

Now that summer is here with cool mornings and pleasantly warm evenings we often start (or restart) our diet and exercise programs that unfortunately fell casualty to the cold winter and heavy snow burden.  As we embark on this adventure many of us are saddened to see that we are a few pounds heavier than this time last year.  This undoubtedly prompts us to want to wipe the slate clean and go on a diet.  Truth be told, this probably is not a bad idea for many of us.  According to a recent study from the National Health and Nutrition Examination Survey (NHANES)[i], over 30% of the entire US population are considered obese (body mass index [BMI] >30) and 68% are considered overweight (BMI >25).  Given the fact that obesity is associated with a number of detrimental health conditions (e.g., high blood pressure, elevated cholesterol, diabetes, heart disease, stroke, certain cancers and arthritis), it would be in our best interest from a personal as well as public health standpoint to pay a little more attention to our weight.  So, what diet do you choose?  A quick search on Google will unfortunately not be much help.  With over 20 million hits on diets ranging for the legitimate to the questionable, it is no wonder many people give up before even starting.  My recommendation for safe and effective weight loss involves 5 simple steps:

1)  Estimate how many calories your body requires to maintain your current body weight, then subtract 500 calories.  This represents your new total caloric intake per day.  A variety of calorie calculators are available for free on the internet (see the end of the newsletter for some recommendations).  

2)  Start reading nutrition labels for all foods purchased at the grocery store (or at some chain restaurants).  This process will start to make you more aware of portions, calories, and nutrient content of various foods. 

3)  Measure portions at home and keep a food diary for 3 days of everything you eat.  While quite annoying and labor-intensive, it is important to get a sense of what you are eating, how much, and how frequently.  In essence, it puts steps 1 and 2 into action. 

4)  Eat fresh.  This is NOT a plug for a popular sandwich chain, but rather a principle.  Instead of trying to eliminate entire foods and food groups, focus more on eating fresh fruits and vegetables, lean fresh meats, and low fat/non-fat diary.  That being said, however, if you enjoy a little ice cream on a warm weekend night, or a cocktail at the end of a long day, go for it.  Just remember though to include it in your total calorie count for the day. 

5)  Exercise.  As I have alluded to in an earlier newsletter, you do not have to train for a marathon to be healthy or lose weight. 

While exercising regularly (30 minutes per day, 5 or more days per week) would be great, just being more physically active in your everyday lives is a good place to start.  In summary, there is no miracle diet, magic pill, or surgery for that matter, that will completely, safely and effectively address the obesity/overweight epidemic in the U.S.  Instead, we as a society need to look inward for the personal strength and determination to make the important lifestyle changes today so that we may be around for a healthier tomorrow. 

Definition of the Month: Angina

Angina is the medical term for chest pain that occurs as a direct result of the heart muscle not getting enough oxygen.  This typically happens when an artery supplying blood to the heart becomes clogged with plaque, thereby depriving the heart muscle of important oxygen and nutrients.  Typical anginal chest pain is located behind or to the left of the breast bone, occurs with exertion (physical – such as walking; or emotional – such as intense stress), and is relieved by rest within 5-10 minutes.  That being said, there are definitely variations on this presentation.  Sometimes the anginal pains occur at rest (usually in very severe presentations of coronary artery disease), radiate to the left arm, neck or jaw, and are only relieved by anti-anginal medications such as nitroglycerin.  In any case, if you experience symptoms such as these you should contact your cardiologist for an urgent office appointment.  If the above noted symptoms persist without relief with rest (or nitroglycerin), you should call 911 and go to your local hospital emergency room.           

Test of the Month:

What is…a Stress Test? A stress test is a cardiac test commonly ordered to determine if symptoms of chest pain (or shortness of breath on exertion) are due to some underlying heart problem such as coronary artery disease.  Typically a patient will be asked to walk on a treadmill while attached to cardiac monitors (e.g., ECG and blood pressure machines).  The purpose is to place the heart into a state of controlled stress (i.e., exercise with elevations in the pulse rate and blood pressure) and monitor for symptoms of chest pain or abnormal readings on the blood pressure or ECG monitor.  If specific changes do occur on the ECG, with or without the provocation of chest pain, this may represent a potential blockage.  Frequently this treadmill test will be paired with some imaging (pictures) of the heart to increase the accuracy of the study.  These pictures may be in the form of ultrasound (stress echocardiogram) or nuclear imaging (nuclear stress test).  In the event that someone cannot walk on the treadmill, or reach a certain predetermined peak pulse rate, a “chemical” stress test may be performed in lieu of walking on the treadmill.  Imaging of the heart (echo or nuclear) is mandatory with chemical stress tests.   

Health Quiz (answers are below) 

1.        How many calories should the “average” adult consume in one day? 

2.        How many grams of fiber should be consumed per day as a part of a well-balanced diet?

3.        Name 3 foods which contain healthy fats?  

Helpful Resources

 ·         http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/BodyMassIndex/Body-Mass-Index-BMI-Calculator_UCM_307849_Article.jsp#bmiswf 

·         American Heart Association website which calculates body mass index and provides information of how to interpret the results. 

·         http://www.heart.org/HEARTORG/GettingHealthy/FatsAndOils/Fats101/Monounsaturated-Fats_UCM_301460_Article.jsp 

·         American Heart Association website with information on dietary fats – the good ones, the bad ones, and which foods contain which fats. 

·         http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HeartSmartShopping/Heart-Smart-Shopping_UCM_001179_SubHomePage.jsp 

·         American heart association website with information on how to properly read nutrition labels and create a heart-healthy grocery shopping list.  

·         http://www.myfooddiary.com 

·         Great website for helping you to track food intake, count calories, research nutrient content of foods, and monitor exercise activities.  Also contains on-line support groups and mobile resources to count calories on-the-go from your PDA/phone. 

·         http://www.americanheart.org/presenter.jhtml?identifier=3040366 

·         American heart association website which helps you determine how many calories you need to consume per day to maintain your current weight. 

·         www.cardiacassociates.org

·         Website for Cardiac Associates, P.C.