Category Archives: Exercise

Type II Diabetes Epidemic

Diabetes Increases Risk for Heart Disease

Obesity ConceptMillions of people have Type II diabetes and the number is growing with the obesity epidemic. At first, as blood sugars rise, Type II diabetes is a silent disease without recognized symptoms, but behind-the-scenes, excess sugar molecules in the blood are causing harm.

Diabetes occurs when inadequate insulin is available for sugar metabolism. Instead of being used by cells for energy, the sugar molecules increase in the blood and interfere with cell function. This leads to heart disease, high blood pressure, strokes, vision impairment and kidney damage.

Type II diabetes is a complex metabolic problem. Although the body produces enough insulin at first, it isn’t being used properly because at the cellular level, insulin resistance develops. This stimulating the pancreas to produce more and more insulin, until the cells become distressed and die off, leaving the body unable to maintain proper insulin production. The disease worsens.

Treatment for diabetes is variable. It can be very complex, requiring numerous medications, self testing and the addition of insulin injections. Some people do very well for years in a pre-diabetic state. If a fasting blood sugar is minimally elevated, just taking the oral medication metformin, may reduce progression. But if the sugar continues to rise, additional treatment must be started as soon as possible to normalize the sugar.

If someone you know is overweight, particularly if the weight is carried around the waistline, blood sugar levels should be monitored and treated if elevated. Losing weight will help, but weight loss is not easy.

Best results occur with reduced caloric intake and healthful food choices, combined Family exercisewith exercise. Even walking thirty minutes a day, helps lower blood sugar, burns calories and improves longevity.

Type I diabetes is different from Type II. Type I is usually seen in young often thin people, including infants and children. Cells in the pancreas that make insulin are destroyed and are unable to produce insulin, a hormone essential for sugar metabolism. Insulin cannot be taken orally. It must be injected or taken as a nasal spray.

obesityType II diabetes had been a disease of aging people until recent years when overweight children began developing this serious problem. Like adults, children are at risk for serious cardiovascular disease. Elevated blood glucose levels damage arteries throughout the body. Over time the vessels become so narrowed they cannot carry an adequate supply of oxygen-rich blood and nutrients to vital organs. As more children become obese, more of them develop diabetes and are at risk for early heart disease.

So, what should we do? First, understand that Type II diabetes is a serious health risk even when no symptoms are apparent. The American Diabetes Association recommends having a fasting blood sugar test performed at least annually. Blood is taken after having nothing to eat or drink for at least eight hours. A fasting blood sugar above 100 is abnormal.

Another blood test, the hemoglobin A1C, measures red blood cell glucose attachment. This test correlates directly with the blood glucose levels over preceding weeks/months. If the A1C is 8, the glucose average has been 183mg/dl. Until more information becomes available, specialists believe an A1C goal of <7% is valuable in reducing health risks.

Symptoms of High Blood Sugar:
Excess urination (Ex.-Getting up at night repeatedly.)
Excess water consumption (Ex.-Drinking water during the night.)
Increased appetite, blurred vision, low energy
Neuropathy (burning pain and numb feelings in hands and feet)

Additional information regarding diabetes, healthful eating and weight control can be found on the following websites:
www.realage.com, www.diabetes.orgDiabetes Health in your handsBetty Kuffel, MD

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HEART ATTACK RISKS

Understand your risk factors and take action … before you have a heart attack.

Your Heart Book Cover- Final FINALThe American College of Cardiology reported young women with heart attacks are more likely to die than men. Part of this scenario is because many women do not experience the classic symptoms of chest pressure, arm, or jaw pain. Women are also more likely to report stomach symptoms, fatigue or shortness of breath instead of chest pressure when a coronary artery is closing. Without the proper diagnosis, life-saving interventions including stents to open a closing artery are delayed or not performed.

In a study evaluating women under age 55, Yale researchers found half the women believed they were healthy prior to a heart attack. Fewer women than men in the study had not received education from their care providers regarding risks for heart disease. Many of the women had modifiable risks and only 22% of them received information about heart disease and how to reduce their risks.

Nearly half of women in a 2012 survey did not report heart disease as a leading cause of death, yet they considered themselves well-informed on female health issues. Read a quick take on statistics and how you can identify and reduce your risks.

Excerpt from Your Heart book:

Women and Heart Disease

Many women do not realize they are at high risk for heart disease and early death. Under age 50, heart attacks in women are twice as likely to be fatal as in men. Each year more than 250,000 women die of heart attacks. Six times the number of women die from heart disease than from breast cancer. Many factors weigh into these statistics including hormones.

♥ Research reported in the National Institutes of Health bulletin, The Heart Truth for Women, states that by leading a healthy lifestyle, women can lower risks by 82%. You are in charge. This means: regular exercise, healthy weight and not smoking. Also take medications to control other risk factors such as high blood pressure and high cholesterol. What you choose to do and what you eat can improve health and prolong life.

♥♥♥♥♥

Five risk factors both men and women can modify and reduce their risk for dying from a heart attack:
• High cholesterol
• Smoking, tobacco use
• Diabetes
• Obesity
• High blood pressure

What to do about these risks: See your physician for an evaluation

  • Check your cholesterol and blood pressure.
  • Treat cholesterol and blood pressure abnormalities with diet modification and medication.
  • Stop all tobacco use.
  • Keep blood glucose normal with diet and medication.
  • Eat a Mediterranean diet and control your calorie intake. Consider the 5/2 diet for weight reduction (discussed in previous blogs on this website)
  • Exercise at least 30 minutes each day.

Betty Kuffel, MD

Statin Treatment for Cardiovascular Disease

Primary Prevention and Treatment in Women

More women die of heart disease than of breast cancer.
Women are also more likely to die from a heart attack than men.

vitruvian-woman-sm1.jpgIf you have risk factors for, or have already had, a cardiovascular event such as a heart attack or stroke, taking a statin medication to alter abnormal cholesterol can be life-saving.

Common Risk Factors:
High blood pressure
High LDL cholesterol
High triglycerides
Low HDL cholesterol
Family history of early heart disease
Diabetes
Obesity
Smoking
Sedentary life style

Lowering LDL cholesterol with statins can prevent cardiovascular disease.

A recent study analyzed the effects of 27 trials including 174,000 people and found women gain the same benefits from statins as men. Prior to this study the value of treating healthy women with risk factors to prevent heart disease was not clear.

We have known lowering cholesterol after a heart attack or stroke is beneficial in both men and women, but this new study confirms statin drugs are also valuable in preventing cardiovascular disease in women. Statin treatment improves overall survival by reducing the liver’s production of cholesterol.

Men develop heart disease at a younger age than women, likely because estrogen in women is protective. Following menopause, risk for heart disease in women climbs especially in those who smoke.

People with diabetes have an increased risk for cardiovascular disease affecting the coronary arteries in the heart, arteries in the brain, and small arteries in the eyes and kidneys. Last summer, another study important to women showed diabetic women had a 30% reduction in the risk of dying of heart attack or stroke when treated with another cholesterol modifying drug, fenofibrate.

Many scientific studies over decades have shown the benefit of lowering low-density lipoprotein LDL cholesterol to prevent heart attacks and strokes. LDL is the “bad” cholesterol, (think “L” for Lard as a way to remember LDL as the bad cholesterol) and that you want it Low. This is the cholesterol that clogs arteries similar to the way lard solidifies if poured down a drain.

Triglycerides, another form of cholesterol often elevated in diabetics, obesity, and as a familial disorder, contribute to heart and vascular disease. This must also be lowered to reduce risk.

The high-density lipoprotein (HDL) is the transport molecule that moves LDL out of the arteries. The HDL is the “good” cholesterol you want High.

Assess and lower risks for heart disease:
• See your doctor. Discuss risk factors and how to modify them.
• Have blood tests: lipid panel and hemoglobin A1c (check for diabetes)
• Assess your cholesterol levels and discuss treatment needs and options
• Reduce saturated fat intake, fried foods – no more than 35% of your daily calories should come from fat
• Attain ideal weight
• Exercise at least thirty minutes a day – If you’re healthy but not physically active, starting an aerobic exercise program could increase your good cholesterol by 5% in the first two months. Regular exercise also lowers bad cholesterol.

Remember, high cholesterol does not cause symptoms. It is a silent disease that slowly narrows arteries throughout your body.

For more information on modifying risk factors read additional posts on this site. At www.lipsticklogic.com you will also find articles on women’s health.

Best wishes for good health in 2015.

Betty Kuffel, MD and Bev Erickson

Actions to Improve Heart Health

Actions to Improve Heart Health

Vegetable heartLifestyle and diet impact health and longevity. This concept was once again substantiated by a medical study presented at the recent American Heart Association Scientific Sessions meeting. Researchers at Allina Health and the Minneapolis Heart Institute Foundation shared information from their ten year joint study based in New Ulm, MN. This study examined modifying cardiovascular disease risk factors in a rural community.

Interventions impacting improved health of participants in the study included:
♥Health coaching
♥Heart health screening
♥Work site health improvement
♥Better food choices in restaurants
♥Encouraging farmer market shopping
♥Increasing physical activity in the community

Researchers looked at changes in heart disease risk factors over the first five years. In an additional study, they examined whether short-term lifestyle changes had any effect on HDL, high density lipoprotein, often termed the “good cholesterol” – the one you want high. With the Total Cholesterol/HDL ratio, heart disease risk prediction can be calculated. (These tests are included on standard lipid blood panels.) Researchers found weight loss the strongest lifestyle predictor for increasing HDL.

Findings included improvements in:
Blood pressure control
Cholesterol levels

In the studies, improving lifestyle choices, health care access, and environment changes in the community and workplaces, resulted in overall reduction of cardiovascular risks. Lack of exercise increased heart risk.

To calculate your personal heart risks, complete the survey at the Harvard School of Public Health: https://healthyheartscore.sph.harvard.edu/

WEIGHT CONTROL THROUGH THE 5/2 EATING PLAN

The Five/Two Eating Plan

As a method of weight loss and weight control, this easy solution of five/two pertains to a 7 day eating plan. Once you have reached your ideal weight, you transition to healthy baseline calorie intake every day. If you gain a pound, then you can transition back to the 5/2 plan. This is how it works:

·         For 5 days a week, you eat a healthy diet based primarily on fruits, vegetables, a few nuts, a little olive oil, limiting pasta or rice to twice a week. Add limited whole grains tokabob veg the mix, with low-fat meat, including salmon or other similar fish. Mirror your food selections with the Mediterranean diet like people who live along the southern Italian coast and Greek islands. Eating primarily fresh fruits, vegetables, and little saturated fat, they tend to live longer, in better health and with lower heart disease.

·          For two days a week, eat very few calories, only 500-600. The two days must not be consecutive. Instead separate them such as Monday and Thursday.

 Why not do the low calorie days together? Harsh calorie restriction can trigger what researchers call the starvation response. With starvation, the body revs up to store calories by lowering the metabolic rate and packing on calories when food becomes available. It is a natural process to maintain life.

Even though the two low calorie days are not true fasting, if they are consecutive such as Monday and Tuesday, your metabolic rate may be affected. Separating the days, combined with daily exercise such as walking is known to increase metabolic rate and calorie burn. — And, with exercise, you are unlikely to stimulate a starvation response. In fact, with a marked reduction in calorie intake and consistent exercise, you will lose weight.

 British physician Michael Mosley, described the 5/2 diet in his book FastDiet in 2012. In a follow up study done at the Aston University in the UK, they found intermittent fasting (very low calorie days) more effective than daily calorie restriction and calorie counting. Favorable findings included:

  • Reduced weight
  • Reduced inflammation
  • Reduced blood glucose
  • Reduced lipids (cholesterol)
  • Reduced blood pressure

True fasting (consuming no nutrition) has been shown to lower weight, prolong life, lower blood glucose and lower cholesterol levels. However, fasting also lowers metabolic rate, something you do not want, because your body becomes very efficient at storing excess calories and weight returns.

Eating two low calorie days per week is usually safe for Type 2 diabetics. Those taking medications and insulin must consult their medical provider for advice and to help manage medication dosages when reducing calorie intake. In the end, with weight loss, some Type 2 diabetics can reduce or stop some of their medications. Or, for those with borderline glucose elevations, weight loss and the drug Metformin, may help ward off the development of full-blown Type 2 diabetes. Without interventions, most people with borderline elevation of blood glucose will evolve to Type 2 diabetes within ten years.

 Pay special attention to your daily intake:

  • Choose fruits over sweets for desserts.
  • Exercise portion control. Avoid second helpings. Wait 30 minutes and see if you are really still hungry.
  • Do your best to prepare low calorie meals such as turkey breast instead of hot wings or steak.
  • Forget potatoes, pasta, gravy, cheese sauce and fattening salad dressing.
  • If you are preparing meals, serve light calorie recipes and fruit for dessert.
  • Take time to exercise

 Note: If you are, pregnant, breast feeding or a Type 1 diabetic, following a Mediterranean-type cuisine is healthy but do not follow the very low calorie day recommendations. However, this is a heart-healthy approach for those with high blood pressure and heart disease, even those who have had bypass and stent procedures.

 Betty Kuffel, MD

Follow: yourheartbook.com blog for additional updates

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FAST HEALTHY FOOD CHOICES FOR 2014

If you are a fast food junkie or frequently eat in restaurants, healthier options are becoming available but it is still up to you to make the choice. Forget the bread; choose baked or grilled options and a salad with low fat dressing.

Guidelines for heart health and weight reduction are everywhere but take a look at shopper’s grocery carts. How many of them are filled with fresh fruits and vegetables? Not many.

Some processed foods may be healthy, but you must read labels carefully and then decide. I WmSonoma hot chocolaterecently wanted to purchase a hot chocolate mix to serve during winter holiday activities. Many products on the shelves contained many ingredients I couldn’t identify as safe, even after years of studying chemistry. I left without making a purchase. Most mixes contained unpronounceable chemicals, plus significant fat and sugar.

 Later I found a hot chocolate powder at Williams-Sonoma made with bittersweet chocolate, sugar and peppermint oil that looked a bit healthier. But, if it’s that difficult to buy a hot chocolate mix, it may take you all day to read all packaged food labels of the items you want to purchase. On the other hand, if you avoid the center isles of the grocery and purchase fresh and frozen products, you will save time and money and have a better chance of improving your health.

Fast Healthy Choices to Consider:

Fat Free Yogurt, raw oatmeal with flax seed is quick and heart healthy

Fresh fruits and vegetables require little preparation – many can be eaten raw.

Fresh meats – wash, season and grill – avoid frying or adding gravy or sauces

Fresh or frozen cold water fish like salmon, cod or trout – marinade and grill in minutes

Avoid sweets, fats and breads (except hearty whole wheat or multi-grains)

Limit your portions

Exercise

Choose unprocessed grains: oatmeal, steel cut oats, rice, wild rice, barley, whole grain breads. Avoid sugar-rich granola, sugary cereals and white breads.

Choose fresh fruits and vegetables: you’ll save money by purchasing whole or bulk fruits and Saladveggies like bags of potatoes, apples, full sized carrots, heads of lettuce, celery, cauliflower and broccoli – wash and cut them as you need them.

Choose fish and lean meat; boil/bake/broil – no frying. Avoid all fried foods for a healthier heart and weight.

 Med.FoodExercise a minimum of 30 minutes three times a week.

TAKE CONTROL OF YOUR HEALTH

cropped-vitruvian-heart-woman1.jpgSome of my friends believe they can make better choices to attain maximum health and yet I see them regularly exercising and eating wisely. These are two very important actions in the scheme of health and living longer. After seeing parents and relatives die young from smoking, heart disease, diabetes and obesity, they vowed to make personal choices that correlate with better health.

 Other people I know do not exercise and eat wantonly. A common breakfast choice by one particular person is a bacon/sausage omelet with a side of pancakes. This person is more than 100 pounds overweight, has high blood pressure, out-of-control diabetes and has had a heart attack. His choices and health issues provide a view of factors seen in many who contribute to current world statistics placing heart disease as the leading cause of death in women and men.

Coronary artery disease, also called atherosclerosis is a disease in which arteries narrow because of metabolic abnormalities related to lifestyle choices. In the United States, 18% of all deaths are from coronary artery disease. Inflammation is a large component of this disease in conjunction with the accumulation of LDL-cholesterol fat inside blood vessels. Increasing weight leads to Type 2 diabetes and diabetes contributes to the disease process.

You have probably read or heard this scenario so many times you find it boring. Some people say they have tried everything and can’t lose weight. Losing weight is not magical. It doesn’t matter what time of day you eat, whether you drink water before, during or after meals. It doesn’t matter whether your largest meal is in the evening, whether you graze all day, or eat one meal per day. What matters is how much you eat and what you eat. In other words, it is important to balance your food intake with your energy output.

We all need to eat for energy. Without proper food, our body processes are impaired. But when we eat more food than we burn off each day, the body stores that extra food as fat. If the stored fat isn’t burned, it continues to accumulate — that is how the body evolved to survive during times of sparse food.

 Consider these examples:

If you eat one scoop of ice cream (about 400 calories) in addition to your daily calorie needs, you must walk one hour just to burn off that extra 400 calories. If you don’t exercise to burn the extra fuel, your body will store the calories as fat.

Even eating one extra little banana per day (about 100 calories) can add up. In one month you will have consumed 3100 more calories than you needed to maintain your energy needs. At the end of one year, your scale will show you are up by 10 pounds.

One weekly meal that includes a bacon cheeseburger, fries and a shake (about 1500 calories) can put you on the road to obesity. Over a year, without significant additional exercise, that daily fast food meal alone can add up to a 20 pound weight gain per year.

The first step in taking control of your health is to learn how. Making a healthy lifestyle change is within your power. By making healthy changes in your diet and adding exercise to your daily routine, you will begin the road to better health and possibly even extend your life. Just like adults, obese children show signs of early heart disease. Teaching kids to eat right and exercise can also reverse the negative effects of their overeating.

Your Heart is a health guide. Scientific studies over many years support healthy food choices like the Mediterranean diet and vegetarian eating, too. Choose to eat healthy.

Make 2014 the year for better health choices for you and your family. Don’t smoke. Avoid sweets and all fried and fatty foods. Eat fresh fruits and vegetables and add exercise to your day.

Beginning today Your Heart is available at a reduced price in both paperback and Kindle through December 24th. To purchase, click on Kindle Heart book or Paperback Heart book

Happy Holidays