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Unbreak My Heart


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My February (heart month) community lecture from Advocate Sherman Hospital

Published in: Health & Medicine
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Unbreak My Heart

  1. 1. Un break my heart? DrRic Saguil
  2. 2. I feel fine? AHA says at 40, 1 in 5 in a lifetime will not be fine.
  3. 3. stats AHA • 750,000 people had a heart attack -2013 • 116,000 people with MI died -2013 • 1 in 3 report no physical activity outside work -2014 • proportion on ideal diet from 0.7 -1.5 -2004 to 2012 • 13 mill adults obese (17%) -2009 to 2012 • 80 mill adults HBP (33%) -2009 to 2012 • 43% adults total cholesterol >200 -2009 to 2012
  4. 4. • Family history • Sedentary / Sitting • Smoking • Diabetes • High cholesterol • High blood pressure • Waist line
  5. 5. Eat healthy? Exercise? Mind your weight?
  6. 6. “…when I have a heart attack, don’t revive me, I’m ready to meet the Lord”
  7. 7. Tools • Cholesterol level (+ the fancy one) • C reactive protein • Coronary calcium • Ankle brachial index • Intimal thickness
  8. 8. Calcium Score • when in doubt (unsure about risk) • to reclassify risk • avoid adverse outcomes • establish subclinical disease
  9. 9. Questionnaires •Framingham •Heart of 29 • RealAge
  10. 10. carotid intimal medial thickness
  11. 11. BMI
  12. 12. Standard of Care • Control Total Chol LDL • Control Glucose • Control Blood Pressure • Control Weight+/- Gastric Bypass • Control Sleep (CPAP) • Control Mood (DON’T FEEL BAD / FEEL INSPIRED)
  13. 13. Diet • limit saturated and trans fats • eat food containing omega 3 fatty acids • reduce salt
  14. 14. Limit Saturated and Trans Fat Select lean cuts of beef and pork, especially cuts with "loin" or "round" in their name. Cut back on processed meats high in saturated fat, such as hot dogs, salami and bacon. Bake, broil, roast, stew or stir-fry lean meats, fish or poultry. Drain the fat off of cooked, ground meat. When you make a stew or soup, refrigerate leftovers and skim off the fat with a spoon before reheating and serving. Eat fish regularly. Try different ways of cooking such as baking, broiling, grilling and poaching to add variety. Include plant foods as sources of protein, including soybeans, pinto beans, lentils and nuts. Replace higher-fat cheeses with lower-fat options such as reduced-fat feta and part-skim mozzarella. Thicken sauces with evaporated fat-free milk instead of whole milk. Move toward using lower-fat milk and yogurt. Start with 2-percent products, then move to 1-percent and finally to fat-free to adjust to the new taste. Use liquid vegetable oils and soft margarine instead of stick margarine or shortening. Limit trans fats often found in foods such as cakes, cookies, crackers, pastries, pies, muffins, doughnuts and French fries. Many food manufacturers Use a small amount of oils such as canola, olive and soybean in recipes and for sautéing. Make salad dressings with olive, walnut or pecan oil. Eat Foods Containing Omega-3 Fatty Acids Select oils that provide omega-3 fatty acids, such as canola, flaxseed or soybean oil. Add walnuts to cereal, salads or muffins. Try walnut oil in salad dressings, too. Eat two 4-ounce portions of fatty fish each week, such as salmon, lake trout, albacore tuna (in water, if canned), mackerel and sardines. Some chickens are given feed that is high in omega-3s so their eggs will contain more as well. When buying eggs, check the package label. Reduce Salt (Sodium) Prepare foods at home so you can control the amount of salt in your meals. Use as little salt in cooking as possible. You can cut at least half the salt from most recipes. Add no additional salt to food at the table. Select reduced-sodium or no-salt-added canned soups and vegetables. Check the Nutrition Facts panel for sodium and choose products with lower sodium content. Season foods with herbs, spices, garlic, onions, peppers and lemon or lime juice to add flavor.
  15. 15. Supplements • omega 3 oils • red yeast rice (RYR) • plant sterol • fiber
  16. 16. RYR • Thorne Research Choleast • Natures Plus Herbal Active RYR • Whole Foods RYR • Now Foods RYR inhibit HMGCoA reductase (inhibit cholesterol production)
  17. 17. Plant Sterols • Andrew Lessman ProCaps Laboratories CholestaCare • Enzymatic Therapy Cholesterol Shield • Nature Made CholestOff Plus • Pure Encapsulations CholestePure • Shaklee Cholesterol Reduction Complex • Source Naturals Cholesterol Rescue decrease absorption of dietary cholesterol in the gut/resoprtion
  18. 18. Fiber • 25-35grams daily
  19. 19. …the others • niacin • asa 81mg • plants in a bottle
  20. 20. Activity • 30min 5days a week moderate • 30 min 3 days a week intense
  21. 21. Relaxation Practice non RX decrease in: -anxiousness -insomnia -carb hunting -blood pressure • 10-20minutes RPM • 10-20minutes night
  22. 22. Standard of Care • Control Total Chol LDL • Control Glucose • Control Blood Pressure • Control Weight+/- Gastric Bypass • Control Sleep (CPAP) • Control Mood (DON’T FEEL BAD / FEEL INSPIRED)
  23. 23. Lifestyle changes are more impacting than any RX alone!!! • Lyon Diet Heart Study = 70% reduction in heart • Dart Study = 29% decrease in repeat MI • Scandinavian Simivstatin Survival Study 37% reduction in repeat procedure <fat/>fish/>fiber mediterranean type diet no info on survival change
  24. 24. Till next February • Monthly goals • Seasonal rewards (pampering the new you) • RX Holidays? • Quarterly MD visits • Team reassessment new clothes new equipment massage/trainer hire enrollment fee coaches eyes
  25. 25. Invite to monthly yoga meditation class Local Appearances May = Fibromyalgia Summit