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Tuesday, October 29, 2013

Low Fiber Intake Linked to Increase Diabetes and CV Risk

A recent trial from Brigham and Women's Hospital reports that there is a significant association between low dietary fiber intake and cardiometabolic risks, including metabolic syndrome, cardiovascular inflammation, and obesity.
The Institute of Medicine (IOM) recommends the following adequate intake levels for total fiber: 38 g per day for men aged 19-50 years, 30 g per day for men older than 50 years, 25 g per day for women aged 19-50 years, and 21 g per day for women older than 50 years.
In the above mentioned study, the authors found that on average, individuals only consumed 16.2 g per day, well below the IOM total recommended levels. 
Therefore, to lower your cardiometabolic risk (and your waist line too), consider consuming more dietary fiber.

Saturday, October 26, 2013

Almonds For Skinny Snackers? Yes, They Help Curb Your Appetite : The Salt : NPR

Almonds For Skinny Snackers? Yes, They Help Curb Your Appetite

The protein, unsaturated fat composition and fiber in almonds all very likely play a role in helping to curb appetites.
Americans seem to have a love affair with snacking.
As a society, we eat twice as many snacks as we did a generation ago. Women, on average, nosh on upwards of 400 snack calories per day, according to federal survey data. And men consume almost 600 calories a day in between meals.
So, if nibbling is our new pastime, researchers have a suggestion for one satiating snack that seems to help control our appetites: almonds.
According to the findings of fresh research published in the European Journal of Clinical Nutrition, people who added 1.5 ounces of almonds to their diet each day reported reduced hunger, and they compensated for the extra calories from nuts by eating less at other times of the day.
"This research suggests that almonds may be a good snack option, especially for those concerned about weight," says Richard Mattes, a professor of nutrition science at Purdue University. "Despite adding 250 calories to the diet, there was no change in total energy intake."
And after a month of eating almonds each day, the participants did not gain weight.
If you listen to my story on All Things Considered, you'll hear how Glenn Reed of East Orange, N.J., manages to stay slim. We met up with him at Union Station, in Washington, D.C., during the late afternoon commuting rush.
"There's a lot of junk and sugar here [at the train station]," Reed noted, "so I always look for something with nuts in it."
As he munched on trail mix that included almonds and dried cranberries, he says nuts may be calorie dense and full of fat — which many Americans are wary of — but for him, nuts are the perfect snack.
"I love the crunchiness, and this is a snack that will definitely ... hold you over [until dinner]," Reed told me.
So what is it about nuts that can help curb our appetites? It's most likely a combination of factors, explains Mattes.
"The protein, the unsaturated fat composition, the fiber" all very likely play a role, he says. And almonds are low in carbohydrates, which tend to stimulate our appetites.
One other factor? Chewing. As we've reported, research has shown that if we don't chew our almonds thoroughly, some of the calories move right through us — undigested.
Prior research has already shown that almonds help increase satiety, both in people of normal weight and those prone to being overweight.
The new observation here, according to Mattes, is that almonds are even "better at controlling appetite when consumed as snacks."
His team found that eating almonds in between meals tended to blunt the rise in hunger, compared with when people ate the nuts as part of a meal.
It's not clear whether all nuts have this effect. This study was funded by the almond industry, and researchers didn't evaluate other types of nuts.
Mattes explains that industry-funded studies are becoming more common, especially as government funding becomes harder to obtain. But he emphasizes that the research is carried out completely independently and is peer-reviewed before being published.
"So it does have the checks and balances," Mattes concludes.

Good Heart Healthy Tips from the AHA


Let me know if you agree...

We will never forget

While on the anniversary of Super Storm Sandy we here in Fairfield, CT have bright blue skies and the first frost of the season, we will never forget those who suffered and are still suffering from the ravaging effects of Super Storm Sandy.

Wednesday, October 23, 2013

Flu vaccines are not only safe but they reduce major cardiovascular events

In a recently published report, the Flu vaccine has been shown to be associated with impressive reduction in major cardiovascular events. ]
The study examined 6735 patients (mean age 67 years-old, 36.2% with a cardiac history). The trial showed a significant lowering of risk of the composite endpoint of CardioVascular death, hospitalization for heart attack, unstable angina, stroke, heart failure and need for urgent coronary intervention. The number needed to treat was 58. This means that for every 58 patients that received the flu vaccine, one major cardiovascular event was prevented. This is a powerful effect. 
I would encourage all patients to discuss the Flu vaccine with their physician. For older patients and those with known heart disease, I would strongly recommend that you receive a Flu vaccine

Tis the season... To exercise

While there are some seasons that are perfect for celebrating and caroling, some for swimming and barbecuing and some for skiing and making snowmen, now (especially here in the NorthEast) it's the perfect time to get outside and exercise. I been hitting the trails for runs in the woods and enjoying soaking up the foliage on walks/hikes with my family. If you've been wanting to get outside and start exercising - now's the time.

Monday, October 14, 2013

A picture is worth a thousand words

One of the most common complaints patients come into my office with is palpitations or irregular heart beats.

There are many different reasons why patients feel palpitations. Some are totally benign (not serious) and others are dangerous and need to be actively worked-up and treated. 

The first step in diagnosing a palpitation is trying to determine exactly what the heart is doing while a patients is feeling the palpitations. We have many different types of monitors to do this with - depending on the frequency and duration of the patient's symptoms.

Now I have a new weapon and its as simple as an app on an iPhone The iPhone carries a powerful device to help monitor your heartbeat – the camera. By detecting changes in color while illuminating your finger with the built-in flash, the camera can detect the pulse in your arteries at the tip of your finger. 

Cardiograph is one app that does this. As you can see from the photo below, the first few pulses seem a little inaccurate but after that I had a fairly steady pulse at a rate 62bpm.

Although it is not entirely accurate and the app carries warnings on it that the app should not be used for medical purposes, I think for some patients it may be a wonderful way to cheaply and easily start work-up of their symptoms

Friday, October 11, 2013

Caffeine and Atrial Fibrillation


As I lover of coffee, I read a recent report of the lack of connection between atrial fibrillation and caffeine with much relief. Atrial fibrillation is the most prevalent sustained malignant heart rhythm in adults and a leading cause of stroke. 

2 recent studies were published evaluating over 115,000 patients. In the end it was found that caffeine exposure is not associated with increased risk of atrial fibrillation. In fact, low-dose caffeine may even have a protective effect.

I would discuss this finding with your physician but for now, I will continue to drink my beloved dark roast with more reassurance that it is not increasing my risk of atrial fibrillation.

Tuesday, October 8, 2013

Could your sleep be hurting your heart?

For many, snoring is not just an annoying habit that drives your loved ones crazy, it is a symptom of sleep apnea. Other signs of sleep apnea include sleepiness during the day and headaches in the morning.

Sleep apnea is a serious breathing issue.

This condition has be shown to seriously impact the heart. Studies have shown that sleep apnea is linked to hypertension, abnormal heart rhtyhms, heart attacks, heart failure and death. 

Continuous positive airway pressure machine (CPAP) is an effective treatment. CPAP can greatly reduced the frequency and severity of apneic episodes. Two recent studies have shown that using a CPAP can reduce the development of high blood pressure and actually reduce the risk of developing a heart attack. Patients who use CPAP also feel much better during the day with much more energy and less headaches. 

If you or your loved one is a chronic snorer, I suggest you talk to your physician

Thursday, October 3, 2013

Depression and Heart Failure - Another Reason to Exercise

It has long been known that depression occurs frequently in patients suffering from heart failure (HF). Recent trial data has shown that ~ 40% of patients with HF can be classified as having symptoms consistent with depression or severe depression. Patients with HF and depression symptoms more frequently have worse scores on quality of life symptoms (fatigue, lack of energy, listlessness ...).

Do drugs for depression work? A recent trial showed that when sertraline (a classic SSRI anti-depression medication) or placebo was administered to patients, there was difference in symptoms or outcomes.

What does work? A recent trial of HF patients showed that patients who were depressed had less exercise tolerance than the patients who were not depressed. However, when placed on an exercise program, patients depression status improved. Not only that, the more patients exercised, the better they felt.

If you have HF and depression symptoms, please discuss this with you physician. Also try and use consistent exercise - the evidence tells us that it will not only make you feel better but also lead to better outcomes.

Tuesday, October 1, 2013

Positive Attitude Boosts Exercise, Longevity Among Heart Disease Patients, Study Suggests

Here's an excellent article on the benefits of trying to keep a positive attitude. While life can be very stressful, those who keep a positive attitude not only are happy but exercise more and are healthier. 

Therefore, try and smile more ;-)

Positive Attitude Boosts Exercise, Longevity Among Heart Disease Patients, Study Suggests

Sep 11, 2013
Attitude is everything, at least for people with heart disease, a new study suggests.
The research, published in the journal Circulation: Cardiovascular Quality and Outcomes, shows that having a positive attitude is tied to a longer life and greater likelihood of exercising among coronary artery disease patients.
"We should focus not only on increasing positive attitude in cardiac rehabilitation, but also make sure that patients perform exercise on a regular basis, as exercise is associated with both increased levels of optimism and better health," study researcher Susanne S. Pedersen, Ph.D., professor of cardiac psychology at Tilburg University in the Netherlands, said in a statement. Pederson is also an adjunct professor of cardiac psychology at the University of Southern Denmark and Odense University Hospital in Denmark.
The study included 600 people with coronary artery disease who were being treated at a hospital in Denmark. Researchers followed up with them over five years to find an association between positive mood and likelihood of exercising, as well as positive mood and risk of dying over that five-year period.
Specifically, people with positive attitudes who exercised had a 42 percent decreased chance of dying over the study period. Meanwhile, 16.5 percent of those with more negative attitudes died over the study period.
Past studies have also shown a link between having a positive attitude and good health. A study earlier this year in the American Journal of Cardiology shows that having a cheerful disposition could help to lower your risk of experiencing a heart attack. And last year, a study from Duke University Medical Center researchers found that positive thinking about the future was linked with a lower risk of dying from heart disease, the Chicago Tribune reported.
For more health benefits of optimism, click through the slideshow:

Sent from my iPhone