There’s always a lot of talk about the different components of food and, everyone seems to have an opinion about what is right and what is wrong. But face it, whether you’re consuming carbohydrates, fats, or proteins all of them contain calories. If your diet focus is on any one of these alone, you’re missing the bigger picture. Thus, if you want avoid looking similar to the photo above, you want to know the facts about basic health and what you need to do to stay as healthy as you can, particularly with food and lifestyle.

Energy In less Energy Out: The Caloric Balance Equation
We all want to lose weight, well, at least those who are overweight. But, you don’t want to go up and down in your weight like a yo-yo. Ideally, you want to maintain a healthy weight and you want to do it long term.

When it comes to maintaining a healthy weight for a lifetime – calories count!
Weight management is all about balance—this means balancing the number of calories you consume with the number of calories your body uses or “burns off.” Think of it this way; food is energy. Thus, the equation is: energy in – energy out = your weight.

• A calorie is a unit of energy supplied by food. It doesn’t matter what food type the calorie comes from because a calorie is a calorie regardless of its source. Carbohydrates, fats, sugars, and proteins, all contain calories.

• Caloric balance is like a scale. To remain in balance and maintain your body weight, the calories consumed (from foods – energy in) must be balanced by the calories used (in normal body functions, daily activities, and exercise – energy out).

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Therefore, there are three simple scenarios when balancing the energy in minus energy out (caloric balance):

1. Maintaining Weight: you must eat about the same number of calories that your body uses each day. Doing so will result in a stable weight;

2. Gaining Weight: you are eating more calories each day than your body burns and this is the general case for a great many people, which results in being overweight or obese and can lead to serious health problems. In other words you store the excess calories as fat; and

3. Losing Weight: you are eating fewer calories than your body uses each day. Doing this uses fat storage cells for energy thereby, decreasing your weight. This is the step you need to be at to begin losing weight.

Let’s talk about step 3. To lose weight, you need to watch portion control and eat less energy than your body burns daily. You can compound or multiply fat loss by both eating less and exercising regularly. And, believe it or not, there is a lot of science behind this.
Thus, regardless of your fitness, training, and health goals, if you are maintaining your current body weight, you are in caloric balance. If you need to gain weight or to lose weight, you’ll need to tip the balance scale in one direction or another to achieve your goals.

To be able to do this there’s just a couple of things you need to know. First, it’s all about the energy balance; food is energy. How much energy do food have? Alcohol carbs have 7 calories per gram; carbohydrates and proteins have 4 calories per gram; and fat has 9 calories per gram. Second, it’s all about the math; you need to figure out the number of calories you need, how much your meal plan is giving you, and balance it out – this means eat more, less or the same depending on your weight goals.

Also, it takes about 3,500 calories below your calorie needs to lose a pound of body fat. While this can vary from person to person and your exercise regimen, this is the average and a good base to work from. Therefore, to lose about 1 to 2 pounds per week, you need to reduce your caloric intake by 500—1000 calories per day. There’s also the food choices you make, exercises you perform and a host of related factors. Keep reading the website to educate yourself. Regardless, this is an excellent start.

To learn how many calories you are currently eating you will need to be a calorie counter for a little bit though, you must not get into the habit of doing it all the time. Begin by writing down the foods you eat and the beverages you drink each day and have a daily total. This will help you become more aware of everything you are consuming. By the end of the week you’ll know how well you have been doing. At this point, you’re not trying to change anything, you’re trying to get a handle on your energy use so, eat normal and record it. At the same time, begin writing down the physical activity you do each day and the length of time you do it. You will be able to look up the exercises and determine how much energy you burned and compare that to the total amount of energy from food, in calories, that you ate for the week.

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Amber tried this experiment. Her total food in calories was about 1,400 calories each day, but on two days, the weekend, she ate almost 1,800 calories. Her total consumed calories for the week was 10,400 calories. She exercised 3.5 hours for the week and burning 875 calories. Thus, we have some numbers to work from.

Amber,s goal weight is 120 pounds. With no activity, she would need to eat her body weight x 10 + 200 or 1,400 calories per day for a total of 9,800 calories per week. How did she do in terms of weight loss or gain? Well, she ate 10,400 calories and burned 875 for net calories of 10,400-875 = 9,525 calories. Considering she needs 9,800 calories to maintain her weight, she had a negative caloric balance of 9,800 – 9,525 = 275 calories. Potentially, she lost about 1/10 pound.

You can see right away that exercise and physical activities (both daily activities and exercise) help tip the balance scale by increasing the calories you expend each day.

Recommended Physical Activity Levels
The recommended amount of exercise includes 30 minutes per day for 5 days per week (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking), as well as muscle-strengthening activities for 2 or more of those days. The muscle strengthening activities should ideally include exercises that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

However, the above recommended amount of activity is essentially to maintain your current fitness and health level.

If you wish to truly improve and have a better caloric balance, increasing the intensity and or the amount of time that you exercise or are active can have even greater health benefits and may be needed for some to control body weight.

If you have children, encourage both children and teenagers to be physically active for at least 60 minutes each day, almost every day.

Remember that each person’s body is unique and may have different caloric needs. A healthy lifestyle requires balance in several areas: the foods you eat; beverages you consume; the way you carry out your daily activities; and the amount of physical activity or exercise you perform each day.

Although counting calories is not necessary, it can initially help you to gain an awareness of your eating habits so you can achieve a stable caloric balance. Of course, this balance is determined by whether you are gaining, maintaining, or losing weight.

Many middle-aged adults are just hearing about this term and have sent questions asking what he or she should look for. Symptoms of the somatopause are weight-gain, especially around the middle; loss of bone density; and declining energy and sex drive, as well as an increase in bad cholesterol, decrease in good cholesterol, and the skin begins to wrinkle.

Phil Campbell, the author of a new book on anti-MIDDLE-aging, health and fitness says the somatopause is the ultimate baby-boomer bummer, because millions of dollars are spent by middle-age adults on healthcare, medicine, plastic surgery, health food, and gym memberships attempting to reverse the impact of the somatopause.

While the somatopause slowly creeps up on you as you age, there are two proven cures: 1) growth hormone injections that can cost as much or more than $1000 per month and 2) exercise.

One can readily see the dramatic difference in cost, especially since the latter, a specific recommended type of exercise, does not even require a gym membership, it’s free.

There is a specific type of exercise that makes the body release a particular hormone that reverses the somatopause. These exercises are targeted at releasing the body’s anti-middle-aging hormone and doesn’t take a lot of time. These exercises are anaerobic and are therefore of short duration. These exercises are sprinting and other forms of a short-burst, get-you-out-of-breath exercises. This shortness of breath will generally occur in only a few seconds.

Researchers show that the somatopause is related directly to the decline of growth hormone (a natural substance produced by the body) during aging. In fact, biomedical research shows that increasing growth hormone can produce an average response of a 14 percent loss in body fat and an 8 percent gain in muscle. This is very significant since we lose muscle due to sarcopenia as we age. Researchers also report improvements in skin, bone density, and cholesterol.

It’s widely reported that several well-known actors take growth hormone injections for its anti-aging, youth rejuvenating properties. And growth hormone injections have been banned for athletes because of their ability to improve performance. Growth hormone is given to children with clinical stature growth problems to help them grow normally. However, growth hormone therapy does not make adults grow taller, but does reverse several measurable clinical factors of the somatopause.

Other than exercise and sprinting type exercises, some inexpensive nutritional supplements, and adequate deep sleep, will do the job naturally. Other exercises to perform include high-intensity cycling , interval running, swimming, interval biking, and almost any anaerobic exercise that you can do for 20 seconds as fast as you can, get out of breath, recover after about 30 seconds and repeat the process. Perform these exercises for 2-3 times per week for about 20 minutes of total exercise time, do not count recovery time. Thus, total workout time will be about 40-45 minuts. These exercises are explained in detail in our fitness section.

Most people want to feel good, lose weight, and restore their energy and appearance to youthful levels, as well as desiring a lean, muscular, sprinter’s physique. You’ll be happy to know that even at age 50 and above, that’s what increasing growth hormone naturally can do if you follow the right type of fitness program.

On a more scientific note, what happens to cause the somatopause? The more you know about it, the better off you’ll be. First, we’ll look at the specific hormone in the body (lack thereof) that is responsible.

Somatotropin, the human growth hormone, is secreted by the pituitary gland under the influence of growth hormone releasing hormone. This secretion falls with age from 500 ug at 20 years to 200 ug at 40 years, and 25ug at 80 years with a concomitant fall of IGF-I (Insulin Like Growth Factor I or Somatomedin C), levels from 240 ng/ml at 30 years, 200 ng/ml at 40 years, and 40 ng/ml at 80 years. IGF -1 is the main effector of growth hormone activity.

IGF-I or Somatomedin C is the major member of a family of proteins synthesized by the liver in response to growth hormone stimulus. It circulates in the peripheral blood bound on a tertiary complex with IGFBP-3 and acid labile subunit (ALS). In this form Somatomedin C (IGF-1) cannot leave circulation. An increase in the ratio of Somatomedin C (IGF-1) to either IGFBP-3 or ALS has been reported to increase the bioavailability of the Insulin Like Growth Factors. However, this would only be true if the total Somatomedin C (IGF-1) and IGF-II exceeded the binding capacity of IGFBP-3. This has yet to be demonstrated. The measurement of IGFB-3 clinically has yet to be proved of value in either diagnosing or monitoring therapy of growth hormone deficiency.

The increasing incidence of Somatomedin C (IGF-1) reduction with age, results in a clinical hyposomatotropin deficiency syndrome. The symptoms are: sagging cheeks, deep and large wrinkles, thinned hair, lips, jaw bones and skin, pseudogynecomastia, an obese floppy belly, general muscle loss, fatigue, somnolence, lack of self assurance and esteem, anxiety, and low sociability. The laboratory changes seen in this syndrome include: a decrease in Somatomedin C (IGF-1) level below youthful levels, an increase in cholesterol levels with altered lipoproteins, low thyroid hormone levels, high fibrinogen, and an increase in osteocalcin levels. These changes are often accompanied by an increase in atherosclerosis and an increase in cardiovascular mortality.

The measurement of random human growth hormone in serum is of very little diagnostic value because levels change dramatically in response to various stimuli. Dynamic tests of pituitary function such as the Arginine infusion test or insulin hypoglycemia both with measurements of growth hormone levels are valuable but not practical in an outpatient environment. Therefore, the measurement of Somatomedin C (IGF-1) is the best indicator of adult growth hormone deficiency in the outpatient setting, and the test of choice to monitor growth hormone therapy.

The diagnosis of adult human growth hormone deficiency should be considered in every adult patient who presents with suggestive symptoms. The diagnosis should be confirmed by measurement of Somatomedin C (IGF-1).

The FDA has now approved the use of synthetic or recombinant human growth hormone for the treatment of Adult Onset Growth Hormone Deficiency, as well as: dwarfism due to growth hormone deficiency, Turner’s syndrome and wasting due to AIDS.

However, fighting this problem with exercise is should be your first challenge. If you are not able to perform such exercises as described you should consult your physician regarding growth hormone injections. Also, is you attempt any of the described type exercises, please consult your doctor first because they are fairly intense and taxing on the body.

Question: I’ve been reading your site and enjoying the great information, but can’t find what I’m looking for. I’m a baby boomer and have heard that there are specific areas I should be concerned about called physical fitness components. Can you tell me what these are?

Answer: You would be referring to health-related physical fitness. Due to you age, these are very important. They are:

• Cardiovascular (aerobic fitness)
• Abdominal muscular strength and endurance
• Flexibility of the lower back and ham-strings
• Body composition (lean-to-fat ratio)

These areas are considered of significant importance for both young and old. The better performance you can show in each is an indication of overall health status. Because one tends to decrease in performance in each of these areas as he or she ages, the more active you are, the more functional you’ll be with age and the ability to lead an active and healthy lifestyle will be enhanced.

To improve yourself, begin an exercise program that has aerobic, strength, stretching, and general fitness components included. Begin at your own fitness level and strive to improve with time. But, as always, check with your doctor before beginning any exercise program. Please see other areas of the My Health and Fitness web site for additional information. Also, match your calorie intake to your exercise program and be persistent in your goals.

Question: I’m currently 52 years old and want to live to see my grandchildren graduate from college and enjoy some time with my great grandchildren. To do this, I need to live until I’m 75-80 years old. What are my chances of doing this?

Answer: Currently, for the average American, your probability of living to that age range is 88% to 79% for youngest to oldest years. However, these are statistics for someone beginning at age 65 and, at an average fitness level. By increasing your fitness level and staying active, an average of 10 years could be added to this barring any unforeseen accidents or chronic diseases. Thus, it’s likely you’ll be able to spend the time you wish with your loved ones.

Question: I’ve been having sore knees and ankles lately, am very overweight and have a difficult time trying to exercise because I don’t like lifting weights or riding bikes at the gym. I also eat lots of sweets due to my wife’s cooking. I had a physical from my doctor and he said the soreness is due to too much weight on the joints. Do you have any suggestions?

Answer: Recently an My Health and Fitness client in Denver, Gregg B., had the same problem. Here is what is likely happening. Being overweight is causing undue stress on your joints and muscles, making them sore, i.e., they just cannot handle the weight load comfortably. By both reducing weight and increasing strength, these symptoms will generally disappear. Since you do not like to exercise, it will be more difficult to reduce your weight, but at the same time, since you are inactive, you must also be careful with the intensity at which you begin to exercise. Compounding this problem is the amount of sweets you eat since too much sugar is the enemy, both from a diabetes standpoint and the fact that it produces triglycerides causing an increase in cholesterol in the blood, and is a major factor in weight gain. Consequently, you need to solve your problem with a dual-pronged attack: 1) Ease into exercising, and 2) Watch your diet; reduce both sugar and caloric intake.

First I’ve begin walking 15 minutes per day for at least five days per week, six days per week if at all possible. Begin with a leisurely stroll, i.e., about 20-25 minutes per mile. You can use the time to think about important issues in your life, listen to music or inspirational messages via cassette or CD and headphones, or spend time with a friend or loved one as a workout partner. After the first week, increase walking time to 25 minutes per day. For the third week, increase walking time to about 40 minutes per day. You can gradually increase walking speed as well on a weekly basis. If you feel like it, try adding a few push-ups and sit ups to your daily regimen. Begin slowly.

Second – Resist overeating. Gregg had a problem doing this so, before each meal, he was required to drink 1-2, 8-ounce glasses of water, which would make him feel full so that he physically couldn’t consume as much food as normal without feeling uncomfortable. Combined with this, reduce your calorie intake about 500 kcalories per day (kcal is the same as calories, it’s just the scientific term we use to express calories). This kcal per day reduction will allow you to lose about one pound per week. If you’re walking too, you would expend about 4 kcal/minute per 100 pounds of body weight during the exercise. For example a 110 pound person would burn 4.1 kcal/minute and a 210 pound person would burn 7.9 kcal/minute at an average pace of 3 mph or 20 minutes per mile. Thus, for 20 minutes of exercise the range would be 82-158 kcalories burned during the walk. If you don’t count the calories expended during the exercise of such low intensity, then you’d wind up losing about 1.2-1.3 pounds per week, which would be acceptable. However, if you begin to exercise at a higher intensity and continually lose weight, you must make up for the calories expended during exercise to maintain a good health level.

Third – Limit sugar intake to twice per week only. This means you cannot eat any treats on other days. For example, have a slice of pie or something else you like on Wednesday and another treat such as ice cream on Saturday or Sunday. The portion of the treat you choose should be one serving; do not over consume! The treat is a reward for your hard effort; use moderation.

Fourth – at the end of 12 weeks, reassess your goals and your program and start over until you obtain the weight you desire.

After 12 weeks following this simple program, Gregg lost 19 pounds and felt better each day. He is more active, livelier, and looks very healthy and has done so without super intense exercise although, the time will come when he will have to increase exercise intensity to increase his fitness and health level. Gregg began at 234 pounds and is now (12/1/02) at 215 pounds. Assuming he loses one pound per week since reassessment, he will weigh about 200 pounds by the end of March 2003. His goal weight is 190 pounds. Realistically, he’ll reach that weight in about mid June 2003. More importantly, he’s much healthier and happier and has become so without dieting.

This requires making a few simple choices, eating in moderation, reducing intake of high fat foods to nominal levels, and having variety in your diet. As an example, if you find yourself going to fast food restaurants, make better choices. Instead of eating fries and hamburgers, opt for grilled chicken or fish and consume water or diet drinks to reduce both sugar and fat intake. Such a simple choice for one meal will account for a significant calorie reduction on a daily basis.

Let us use Burger King as an example. A typical choice would be the whopper with cheese, medium fries, and a coke for a total kcal intake of 1228 kcal. There are 64 grams of fat in this meal, which has a calorie value of 576, i.e., 47% of this meal is fat! The ideal would be 20-30% of your daily calories from fat. As an alternative, let us choose a BK Broiler, water or diet drink, and no fries. The calorie value is 380 kcal with only 18 grams of fat. Notice that there is a huge difference. By simply making an optional choice, you have reduced your calorie intake by 848 calories. That’s a major accomplishment and also allows you to spread calorie intake throughout the day into a more even amount, which allows the body to burn fat and calories more efficiently.

As a note, calorie intake of 1228 calories per day would be the amount required for a 100 pound person that is not doing any exercise. Even if you were 200 pounds in weight, this number would be more than half of your required daily caloric intake.

Please read the diet and nutrition section on the web site for more information concerning this topic. Also, you may wish to attend one of Dr. Tindall’s weight loss and control clinics.

Sarcopenia strongly influences muscle strength and mobility and is a factor in the occurrence of frailty and likelihood of falls and fractures in the elderly and loss of energy and strength in the middle aged. Research with animals (in-vitro), experimental systems, on healthy humans and in those with diseases known to accelerate muscle mass loss, has shown repeatedly the safety and effectiveness of progressive resistance (strength) training in reversing sarcopenia and frailty in both the elderly and increasing vigor among the middle aged. Though we say elderly here, sarcopenia constantly progresses with age. In simple terms, again, about age 30, your body will lose about 1/3 to 1 pound of muscle mass per year. The unfortunate circumstance is that you tend to maintain the same diet and eating habits and thus, your weight remains the same. Therefore, instead of being composed of more lean muscle mass, your body actually adds more adipose tissue (fat cells) and at the same time, has less lean muscle. This is not beneficial for long-term health. The more you know about sarcopenia and its effects with age, the better you are able to combat it, which is actually as simple as having a persistent strength-training program combined with a cardiovascular program.

New methods are being developed to reverse and prevent the loss of muscle mass due to sarcopenia and new research may shed additional light on the mechanisms causing sarcopenia, including age-related alterations in hormones and in the immune system, and on the potential of exercise and diet to improve or prevent this situation. Until then, stick to the basics of exercise as the best method to combat it.

As a summary, currently we know several major factors concerning sarcopenia:

• Normal age-related changes in muscle mass loss include a loss of primarily fast-twitch muscle fibers, decreased protein synthesis and a deinnervation of motor units.
• Severe sarcopenia can lead to disability and can impair daily functioning.
• Both men and women are at risk of sarcopenia as testosterone and estrogen (hormones that help maintain muscle mass) decrease with age.
• Sedentary individuals and those suffering from debilitating or chronic diseases are at greatest risks of sarcopenia.
• Exercise via resistance training and cardiovascular training will dramatically reduce muscle loss with age due to sarcopenia.

There are many proposed treatments for sarcopenia, such as hormone replacement and diet modification. However, the only known treatment to reverse sarcopenia is EXERCISE, specifically resistance training. And, the best type of exercise training are those that work the fast-twitch muscle fibers such as sprinting, speed-strength full-body lifts, and stop and go anaerobic exercises. We have some of the best specialist in the world at My Health and Fitness that excel in both teaching the right exercises and creating individual programs to combat sarcopenia.

If you feel that sarcopenia is an issue due to age or training, please contact us at My Health and Fitness. We’ll help you on the right path. If you are over 50, please see our Seniors Fitness category for additional information.

What Is High Blood Pressure?

Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure or hypertension. Blood pressure is typically recorded as two numbers the systolic pressure (as the heart beats, i.e., contracts to pump blood) over the diastolic pressure (as the heart relaxes between beats). A consistent blood pressure reading of 140/90 mm Hg or higher is considered high blood pressure, another term for hypertension.

What is systolic blood pressure?

Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure. Diastolic pressure does not need to be high for you to have high blood pressure. When that happens, the condition is called “isolated systolic hypertension,” or ISH.

Is isolated systolic high blood pressure common?

Yes. It is the most common form of high blood pressure for older Americans. For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines. About 65 percent of hypertensives over age 60 have ISH. You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH or any type of high blood pressure see your doctor and have a blood pressure test. The test is quick and painless.

Is isolated systolic high blood pressure dangerous?

Any form of high blood pressure is dangerous if not properly treated. Both numbers in a blood pressure test are important, but, for some, the systolic is especially meaningful. That’s because, for those persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure.

If left uncontrolled, high systolic pressure can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

Clinical studies have proven that treating a high systolic pressure saves lives, greatly reduces illness, and improves the quality of life. Yet, most Americans do not have their high systolic pressure under control.

Does high blood pressure require special treatment?

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. ISH is treated with lifestyle changes and/or medications. The key for any high blood pressure treatment is to bring the condition under proper control. Blood pressure should be controlled to less than 140/90 mm Hg. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt in your diet or adding a second medication.

What is diastolic blood pressure?

Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It’s shown as the bottom number in a blood pressure reading. The diastolic blood pressure has been and remains, especially for younger people, an important hypertension number. The higher the diastolic blood pressure the greater the risk for heart attacks, strokes and kidney failure. As people become older, the diastolic pressure will begin to decrease and the systolic blood pressure begins to rise and becomes more important. A rise in systolic blood pressure will also increase the chance for heart attacks, strokes, and kidney failure. Your physician will use both the systolic and the diastolic blood pressure to determine your blood pressure category and appropriate prevention and treatment activities.

Why Is High Blood Pressure Important?

High blood pressure is dangerous because it makes the heart work too hard. It also makes the walls of the arteries hard. High blood pressure increases the risk for heart disease and stroke, the first- and third-leading causes of death for Americans. High blood pressure can also cause other problems, such as heart failure, kidney disease, and blindness.

What Causes High Blood Pressure?

The causes of high blood pressure vary. Causes may include narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions will cause increased pressure against the artery walls. High blood pressure might also be caused by another medical problem. Most of the time, the cause is not known. Although high blood pressure usually cannot be cured, in most cases it can be prevented and controlled.

Who Can Develop High Blood Pressure?

High blood pressure is common. More than 50 million American adults – 1 in 4 – have high blood pressure. It is very common in African Americans, who may get it earlier in life and more often than whites. Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. About 60% of all Americans age 60 and older have high blood pressure. Others at risk for developing high blood pressure are the overweight, those with a family history of high blood pressure, and those with high-normal blood pressure (130-139/85-89 mm Hg).

African Americans

High blood pressure occurs more often among African Americans than whites. It begins at an earlier age and is usually more severe. Further, African Americans have a higher death rate from stroke and kidney disease than whites. The good news is, treatment can control high blood pressure. In addition, lifestyle changes can prevent and control high blood pressure. These include losing weight if overweight (losing 10 lbs can help), increasing physical activity (walking 30 minutes per day can help), following a healthy eating plan, that emphasizes fruits, vegetables, and low-fat dairy foods, choosing and preparing foods with less salt and sodium, and if you drink alcoholic beverages, drinking in moderation. If lifestyle changes alone are not effective in keeping your blood pressure controlled, there are many blood pressure medications to help you.

A diet that has been found to be effective in lowering blood pressure is called Dietary Approaches to Stop Hypertension (DASH). In January 2016 the DASH diet was ranked the best diet for the 6th year in a row by U.S. News and World Report. It is not only good for lowering blood pressure, but effective for weight loss, lowering cholesterol and managing/preventing diabetes.

How Does Cholesterol Cause Heart Disease?

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes “hardening of the arteries” so that arteries become narrowed and blood flow to the heart is slowed or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone–younger, middle age, and older adults; women and men; and people with or without heart disease.

What Do Your Cholesterol Numbers Mean?

Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a “lipoprotein profile” to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:

• Total cholesterol
• LDL (bad) cholesterol-the main source of cholesterol buildup and blockage in the arteries
• HDL (good) cholesterol-helps keep cholesterol from building up in the arteries
• Triglycerides-another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done.

See how your cholesterol numbers compare to those below.

Total Cholesterol Level Category Less than :

• 200 mg/dL Desirable
• 200-239 mg/dL Borderline High
• 240 mg/dL and above High

* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

DL Cholesterol Level LDL-Cholesterol Category

• Less than 100 mg/dL Optimal
• 100-129 mg/dL Near optimal/above optimal
• 130-159 mg/dL Borderline high
• 160-189 mg/dL High
• 190 mg/dL and above Very high

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people. This is why lots of sugar is not good for you because sugar consumption raises cholesterol levels in the blood.

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

Diet

Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.

Weight

Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.

Physical Activity

Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.

Things you cannot do anything about also can affect cholesterol levels. These include:

Age and Gender

As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women’s LDL levels tend to rise.

Heredity

Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

What Is Your Risk of Developing Heart Disease or Having a Heart Attack?

In general, the higher your LDL level and the more risk factors such as being overweight (other than LDL), the greater your chances of developing heart disease or having a heart attack. Some people are at high risk for a heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes (which is a strong risk factor) or a combination of risk factors for heart disease. Follow these steps to find out your risk for developing heart disease.

Step 1: Check below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal.

Major Risk Factors That Affect Your LDL Goal

• Cigarette smoking
• High Blood Pressure (140/90 mmHg or higher or on blood pressure medication)
• Low HDL cholesterol (less than 40 mg/dL)*
• Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
• Age (men 45 years or older; women 55 years or older)

If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count.

Even though obesity and physical inactivity are not counted in this list, they are conditions that need to be corrected.

Step 2: How many major risk factors do you have?

If you have 2 or more the risk factors listed above, use the attached risk scoring tables (which include your cholesterol levels) to find your risk score. Risk score refers to the chance of having a heart attack in the next 10 years, given as a percentage. My risk score is ________%.

Step 3: Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack below.

Your risk factors determine your category.

• Heart disease, diabetes, or risk score more than 20%*, I. Highest Risk
• 2 or more risk factors and risk score 10-20%, II. Next Highest Risk
• 2 or more risk factors and risk score less than 10%, III. Moderate Risk
• 0 or 1 risk factor, IV. Low-to-Moderate Risk

* Means that more than 20 out of 100 people in this category will have a heart attack within 10 years.

My risk category is ______________________.

Treating High Cholesterol

The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. To find your LDL goal, see the boxes below for your risk category.

There are two main ways to lower your cholesterol:

Therapeutic Lifestyle Changes (TLC)–includes a cholesterol-lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.
Drug Treatment–if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.

If you are in…

Category I, Highest Risk, your LDL goal is less than 100 mg/dL. If your LDL is 100 or above, you will need to begin the TLC diet. If your LDL is 130 or higher, you will need to start drug treatment at the same time as the TLC diet. If your LDL is 100 to 129, you may also need to start drug treatment together with the TLC diet. Even if your LDL is below 100, you should follow the TLC diet on your own to keep your LDL as low as possible.

Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart-healthy diet for all Americans, which allows a little more saturated fat and cholesterol than the TLC diet.

Category III, Moderate Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart-healthy diet for all Americans.

Category IV, Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet. If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet to lower your LDL, especially if your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will need to follow the heart-healthy diet for all Americans.

To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have such as high blood pressure and smoking.

Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC)

TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarine and salad dressings) can also be added to the TLC diet to boost its LDL-lowering power.

Weight Management – Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).

Physical Activity – Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat free or 1% dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarine (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

Drug Treatment

Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, and fibric acids. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels.

Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting

Diabetes is a disorder of metabolism, the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in your blood. Glucose is the main source of fuel for the body. After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas is supposed to automatically produce the right amount of insulin to move glucose from blood into our cells. In people with diabetes however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

Millions of people have diabetes mellitus, commonly called diabetes. You may be surprised to know that many of these people don’t even know they have it. Diabetes is a serious disease and should not be ignored. If you have it, correct treatment can help you live a long and healthy life.

If you have diabetes, your body can’t make or use insulin. Insulin helps change sugar into energy to keep you alive. There are different kinds of diabetes, but the main ones are Type 1 and Type 2.

Type 1 Diabetes

This type of diabetes is mostly found in children and young adults. If you have type 1 diabetes, your body does not make insulin and you must take insulin shots every day.

You May:

• urinate often
• be very thirst
• be very hungry
• lose a lot of weight
• be very tired
• be irritable
• have blurred vision
• have trouble seeing

Type 2 Diabetes

Most people with diabetes have this form of the disease. Type 2 is usually found in people over 45, who have diabetes in their family, who are overweight, who don’t exercise and who have cholesterol problems. It is also common in certain racial and ethnic groups (African Americans, American Indians, Hispanics) and in women who had diabetes when they were pregnant. If you have type 2 diabetes, your body cannot make enough insulin or correctly use it. Treatment is diabetes pills and sometimes insulin injections, as well as diet and exercise.

You May Have:

• any of the symptoms of type 1 diabetes
• a lot of infections
• cuts or bruises that heal slowly
• tingling or numbness in the hands or feet
• skin, gum or bladder infections that keep coming back

Controlling Diabetes:

Daily monitoring and careful control of blood sugar levels are the most important steps to take for people with diabetes. If not treated, diabetes can cause:

High blood sugar (which could make you thirsty, tired, lose weight, urinate often, give you infections that won’t go away)
Many serious health problems (which could injure your eyes, kidneys, nerves, heart)

Warning: Low Blood Sugar People with diabetes may develop low blood sugar because their blood has too much insulin or other blood sugar-lowering medication or from not eating enough food. It is important to follow the eating and medication schedule your doctor has prescribed to avoid low blood sugar. Low blood sugar could make you shaky, dizzy, sweaty, hungry, have a headache, have pale skin color, have sudden mood or behavior changes, have clumsy or jerky movements, have difficulty paying attention, feel confused, or have tingling sensations around the mouth. Taking Care Of Your Diabetes

The best way to take care of your diabetes is to make sure the levels or amount of sugar in your blood are near the normal range. This will make you feel better and help you stay healthy. Your doctor will tell you how often to check your blood sugar level. To do this you will need to take a drop of your blood and place it on a special test strip. Then a device called a blood glucose meter, which measures the amount of sugar in your blood, reads the strip. Writing down this level, along with the time and date, will help you see how well your treatment plan is working.

Remember:

A person’s blood sugar level rises after eating any meal that contains carbohydrates or protein. Table sugar (also called sucrose) counts as a carbohydrate. Artificial sweeteners, such as saccharin and aspartame (NutraSweet), do not count as carbohydrates or fats. They make food taste sweet, but they do not raise blood sugar levels and have little or no calories.

To Help Control Diabetes

Eat well-balanced meals-healthy foods in the right amounts, will keep your weight under control and help manage your diabetes.

Your body needs foods from the four main food groups every day:

1. Fruits and vegetables (oranges, apples, bananas, carrots, and spinach)
2. Whole grains, cereals, and bread (wheat, rice, oats, bran, and barley)
3. Dairy products (whole or skim milk, cream, and yogurt)
4. Meats, fish, poultry, eggs, dried beans, and nuts.

Note:

Too much fat and cholesterol in your diet can be very harmful to people with diabetes. Foods that are high in fat include red meat, dairy products (whole milk, cream, cheese and ice cream), egg yolks, butter, salad dressings, vegetable oils and many desserts.

Can You Do Anything Else?

Exercise-is important for good diabetes control and usually lowers blood sugar and may help insulin work better. Exercise and a healthy diet can also help you take off extra pounds if you are overweight.

Warning:

Check with your doctor before starting any exercise program. You may need a snack before or during the activity to avoid having low blood sugar while you exercise.