Weight Reduction Can Reduce Atrial Fibrillation

As provided by the American College of Cardiology:  Weight management is associated with a reduction in atrial fibrillation (AF) symptom burden. 

In the LEGACY (Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort) trial, 335 patients with BMI >29 kg/m2 were offered weight management assistance and followed for 5 years. 

Weight loss of ≥10% of body weight resulted in a sixfold greater probability of arrhythmia-free survival at 5 years. 

A More Active Lifestyle Lowers the Risk of Death

This NOT new news - the more active you are, the healthier you are.  Most recently I posted an article about decreased rates of dementia in people who exercise.  Another study published recently in the British Medical Journal looked at activity and how it correlates to the risks of death.  The researchers found in people who are more active, the risk of death from cardiovascular events is reduced 29%!  Even the chance of dying due to cancer drops 11%!

How much exercise do you need? 

The ultimate goal of exercise is either 2 and 1/2 hours of moderate exercise, or 1 and 1/2 hours of vigorous exercise (these are the minimums).  Said another way, this is about 20 minutes of daily walking.  Of course - you can always do MORE!

>>Read the summary here on MedicalNewsToday.com

>> Read the original article here.

6 Ways to Reduce the Chance of Dementia

We are learning more and more about how to prevent dementia as we age.  More than issues with our joints, or cardiovascular system, most people fear the deterioration of their mind as they age.  Here are the 6 things recommended by Caroline Muggia to slow dementia (Read the original article here):

1. Get regular exercise
2. Stop smoking
3. Avoid heavy alcohol consumption
4. Keep your weight under control
5. Eat a healthy diet
6. Control your risk factors (blood sugar / glucose / blood pressure)

In addition to those things mentioned above, other experts have recommended constantly learning new tasks, reading books that make you laugh, and meditation ... as proven ways to slow down dementia.

All About Fiber!

I really encourage everyone to read this article by Lyle McDonald posted to Bodyrecomposition.com.

We all know that a diet high in fiber is healthy for us and has the following benefits (from the article):

1. Promoting fullness/satiety
2. Slowing gastric emptying
3. Decreasing nutrient absorption
4. Improved glycemic control, secondary to delayed gastric emptying and impaired nutrient absorption
5. Decreasing blood cholesterol
6. Decreasing mineral absorption
7. Effects on insulin sensitivity via fermentation to short-chain fatty acids
8. A number of effects relevant to colon cancer
9. Helps with poopin’

The article is excellent and provides some excellent information.  In general, try to eat as many vegetables as you can with each meal!

Is red meat that bad? Is white meat that healthy?

By now you have certainly come across information suggesting a strong link between eating red meat and poor cardiovascular outcomes. Largely, we believe this is due to the saturated fat content of many cuts of red meat, but a recent study in the American Journal Of Clinical Nutrition looks at whether eating white meat is truly any better.

Wait... steaks have saturated fat?? Lets take a quick look at different cuts of red meat (in their usual serving size), their calorie, fat and saturated fat content.

• Ribeye (10oz) - 873 calories - 65 grams fat (27 saturated)
• T-bone (10oz) - 741 calories - 47.7 grams fat (17 saturated)
• Filet (7oz) - 426 calories - 22.2 grams fat (14 saturated)
• Grilled Chicken Breast (7oz) - 327 calories - 7.1 grams fat (2 saturated)

You can easily see from the numbers above that a typical 10oz ribeye would give you twice the saturated fat as the typical 7oz filet. Chicken in comparison, however, appears to have half of the total fat content, and an even smaller fraction of saturated fat.

To investigate whether white meat may have the same deleterious effects as read meat, researchers decided they would analyze cholesterol levels after 4 weeks of an assigned diet. The study compared the changes in cholesterol between a diet of red meat, white meat, or a "non-meat" diet.

Large LDL particles were increased in both the red meat and white meat groups, WITHOUT a significant difference. The plant based diet did the best, with the lowest cholesterol levels.

Does this mean chicken is as bad as steak for you health? Alternatively, does it mean steak is as healthy as chicken? The only real conclusion here is that they may be more similar than previously thought, and that a meat in general, raises your cholesterol.

Read the abstract here <<<

Just a Little Exercise Keeps Your Brain from Shrinking

A recently published report from the long running Framingham Heart Study, suggests that even a little bit of exercise will keep your brain from shrinking.

How little? 

It is estimated that 1 hour of light exercise a week, would avoid 1.1 years of normal brain shrinkage (.22% volume). 

“We observed that people who are doing just a little bit more activity, even light-intensity activity, have larger brains than those doing very little,” said lead author Nicole Spartano, PhD.

>> Original Article Here

Pick Healthy Condiments!

As we are all attempting to eat healthier foods and grilling or baking our chicken, fish, or meat... a common question many of us have is how to flavor the food. A pinch of salt, pepper, and spices is the safest and most healthy way, but many of us love ketchup, mustard, or other sauces.

Even "fat-free" sauces can be high in sugar. And because fat actually lowers the glycemic index of a meal (the likelihood it will be stored as fat), they may not be the best choice.

I found a great article on HealthLine that picks the top 20 most healthy condiments - read on, and enjoy!

"20 Healthy Condiments" - HealthLine.com

A Bad Diet Could be Worse than Smoking!

Royers, Round Top Texas

In a new study published by the Lancet looking at 195 different countries, they found that 11 million people die each year, at least in part due to certain foods, or lack of nutritious foods.

From the Washington Post article, "Lead author Ashkan Afshin, an epidemiologist at the University of Washington, said the researchers estimated that, overall, poor diets are responsible for more deaths around the world than any other risk factor, including cigarette smoking"

The study estimated that globally: 

• 3 million deaths were due to excessive sodium
• 3 million deaths were due to lack of adequate whole grains
• 2 million deaths were due to lack of adequate fruit

What about the "Mediterranean Diet"?   That diet is known for being high in heart-healthy fats and fiber... and scored the best with the researchers.  This diet was defined as a high intake of fruits, vegetables, nuts, and healthy oils - like olive oil.

>> Read the original article in the Washington Post here.

Fast Food over the Last 30 years: More Calories and Salt

So many of us are still eating at "fast food" restaurants on a regular basis. When I ask about this in the office the most common response is because of "convenience." Fast food, aka McDonalds, Burger Kind, KFC, Taco Bell, etc..., grew into a regular food source for many people by providing calorie-dense, cheap, and readily available food at nearly every street corner. 

Over the years these restaurants have tried to incorporate more healthy items into the menu like salads or even oatmeal for breakfast. However, per a recent article in the New York Times by Tiffany Hsu, we can see that portion sizes and overall calorie content over the last 30 years has gone up sharply!

Portion Size and Calories of Entrees

Portion Size and Calories of Desserts

Portion Size and Calories of Side Items

The above data is adapted from her article where she notes "[Entrees + sides eaten] together as a single meal... account for nearly 40 percent of a 2,000-calorie daily diet."

>>> Read the original article here.

Do you exercise? "Yes, I walk the dog." That's N.E.A.T.!

N.E.A.T. stands for Non Exercise Activity Thermogenesis and comprises all the activities you perform during that day that are not sitting or sleeping.  These activities include:  walking the dog, going to the grocery store, doing yard work, etc...  We often talking about being "active" during the day and at work, and many patients who work in construction, or on their feet every day tell me that they don't exercise because they're so "busy at work."

Sadly, that kind of activity is not a replacement for exercise, BUT it is still very important to our overall fitness and health!   This is taken from Vanessa Bennington's online article and is so well written, I will just include it here:

Your basal metabolic rate (BMR), plus the thermic effect of the foods you eat, added to something often referred to as Non-Exercise Activity Thermogenesis (NEAT) or Non-Exercise Physical Activity (NEPA) makes up your energy requirements for each day. NEAT or NEPA is a huge part of that equation and I’ll explain how. 

BMR + thermic effect of food + NEAT/NEPA = daily energy requirement

BMR, or Resting Metabolic Rate (RMR), is the energy requirement of your body either without any activity or while lying motionless. BMR/RMR accounts for about 60% of your total daily energy requirements. The thermic effect of food (the amount of calories needed to digest food) accounts for about 10-15% of your energy requirements. The rest of your energy requirements are dependent on how active you are in both intentional exercise and NEAT/NEPA activities (normal life activities like cleaning, shopping, walking, etc.).

NEAT/NEPA can account for as little as 15% of energy expenditure in the very sedentary and up to 50% in very active individuals. If a woman has a BMR of around 1,000 calories (we’ll use that nice even number for simplicity’s sake), she’ll burn about 150 calories digesting the food she eats each day. She may also burn anywhere from 150 to 500 calories more per day depending on whether she has a day full of walking around, shopping, and cleaning or if she spends the day sitting and working on the computer.

We’re also going to say our person didn’t engage in any intentional exercise on this particular day. So, on the low end of things, she is going to burn 1,300 calories. If her NEAT activities are on the higher end, she’s going to burn 1,650. That’s a 350-calorie per day difference between those activity levels. Now, I don’t know many people who eat only 1,300 calories per day, but I know plenty of people who have office jobs and don’t workout. Couple a sedentary lifestyle with a daily surplus of calories beyond your basic energy requirements and over time you have weight gain.

So, made simple, the little activities that we can fit in during the day really do matter.  Walking the dog, taking a walk around the office, or maybe doing a couple of laps in the office parking lot at lunch time will make a difference in how active you are OVERALL and if you can add that to a regular exercise routine, you're on the way to a faster metabolism and being in better shape!

Men: can you do 40 push-ups?

Rick Manivong, Personal Trainer - adding something extra to the push-up

Harvard school of public heath recently asked an excellent question... we all know that better fitness is associated with better health... but is there a simple, easy test that a patient could perform in the office to determine their fitness level that could predict their future cardiovascular issues?

Push-ups.

The authors studied 1,104 men over a 10 year follow up. At baseline, patients who could do 40 push-ups had a significant reduction in cardiovascular disease over the next 10 years, compared to patients who could do less than 10.

>> Read the study here in JAMA

Your "Cardio Fitness" Level May Predict Heart Disease

Good data keeps being published about daily exercise.  In nearly all studies, doing some sort of physical activity every day is associated with lower rates of disease.  Recently data was published in the European Heart Journal looking at cardiovascular aerobic fitness, and heart disease.

Per Jordan Smith at Bicycling, "...they discovered that people in the top 25 percent of cardio fitness levels had a nearly 50 percent lower risk of heart attack ... This remained true even after researchers adjusted for those other factors that may influence heart risk.

That means that even people who were deemed “healthy” in other aspects—say, their blood pressure was in the normal range, and they were nonsmokers—were still at greater heart risk if their cardio fitness levels were poor."

>> Read the original article here

Healthy Fats May Help You Lose Weight

There is so much research on diets that it becomes confusing what to eat, and what NOT to eat. This is especially true with fats. There are 4 types of fats:

Mono-UNSATURATED
Poly-UNSATURATED
SATURATED
TRANS fats

The "bad" ones that raise your LDL (low density lipoprotein) cholesterol are the SATURATED and the TRANS fats. Which foods contain those fats? Cookies, Ice Cream, Chips, Fried Foods, High Fat Dairy and some cuts of Red Meat (that's for you Dr. Awar).

Check out his article on Popsugar that looks at why the "healthy fats" can help you loose weight. In essence, healthy fats can help you naturally reduce your calorie intake, because they take longer to burn... meaning you feel full, longer. 

 
It's like we discuss in the office: protein is like "lighter fluid" for the metabolism, it speeds everything up, but you will likely be hungry soon afterward. Healthy fats keep that hunger craving somewhat a bay. Its why the best diet combines the best of all categories: lean protein, healthy fats, and small amounts of complex carbohydrates.

How Far is 10,000 Steps a Day... ??

So many of us have Fitbits and Apple Watches these days... or other wearables that track our steps. I always have heard that we should walk 10,000 steps a day. It wasn't until I read this article by Caitlyn Fitzpatrick on PopSugar that I really thought about the distance of 10,000 steps.

Before I give you the (somewhat depressing) statistics, we will first assume the 10,000 steps measured by your device are actually true walking steps. Sadly, we know these devices count arm oscillations, wrist movements, and other body movements as "steps" when we are not even moving (don't cheat). That said, let's look at the numbers!

10,000 steps = 5 miles

100 calories are burned every 1 mile of walking

10,000 steps = 5 miles of walking = 500 calories

Doing 10,000 steps, 7 days a week = 3500 calories = 1 pound of fat

All things being equal that means if you get your 10,000 steps in EVERY day, then you could potentially lose 1 pound of fat per week.   Even if you are doing other forms of cardio / workouts and are able to capture your burned calories - you need almost 3500 burned a week to lose one single pound.  Its now even more clear why it's so hard to lose weight!  But don't let that discourage you - keep moving and get walking!

Diet Review: An Excellent Look at Intermittent Fasting

It seems like every season there is a new diet trend:  low carb, keto, paleo, Atkins, on and on... One of the more fascinating eating methods that has shown some promising results is "Intermittent Fasting" or restricting calories from 12 - 24 hours (sometimes even longer).  

Intermittent fasting comes in different forms and there is an excellent article by Julia Belluz on Vox that I would highly recommend that explains the different types.

Studies like the one by Valter Longo and associates,  have shown that intermittent fasting helps people lose weight and fight disease, but sticking to the method can be difficult, and so the long term results are variable.

>> Read the whole article here.

Daily Fiber May Prevent Early Death, Heart Attacks, Strokes, Diabetes, and Colon Cancer

A study was recently published online by the Lancet looking at dietary fiber and health.  The findings are startling...! 

This study analyzed nearly 135 million person-years of data from 185 prospective studies and 58 clinical trials.  When they compared people who ate the lowest amount of fiber to people who at 25-30 grams of fiber each day:  dying from any cause,  heart disease, stroke, diabetes and colon cancer was reduced by 15-30%!

"The more dietary fiber people ate, the lower their risk. For every additional 8 grams of fiber consumed daily, the risk of heart disease, type 2 diabetes and colon cancer dropped by an additional 5% to 27%", per TIME magazine.

In this study, dietary fiber consumption was more significant than whole grains, or even concentrating on low glycemic index foods.

The best sources of fiber from WebMD are:

1. Beans: Think three-bean salad, bean burritos, chili, soup.
2. Whole grains: That means whole-wheat bread, pasta, etc.
3. Brown rice: White rice doesn't offer much fiber.
4. Popcorn: It's a great source of fiber.
5. Nuts: Almonds, pecans, and walnuts have more fiber than other nuts.
6. Baked potato with skin: It's the skin that's important here.
7. Berries: All those seeds, plus the skin, give great fiber to any berry.
8. Bran cereal: Any cereal that has 5 grams of fiber or more in a serving counts as high fiber.
9. Oatmeal:  Whether its microwaved or stove-cooked, oatmeal is good fiber.
10. Vegetables:  The crunchier, the better.

>>> Covered here in Time Magazine.

>>> Read the article from the Lancet here.

A Hormone Made During Exercise May Protect Against Alzheimer's

Every day patients ask what they can do to improve their memory... it turns out going back to the basics of eating well and getting regular exercise can go a long way! 

A hormone (FNDC5/irisin) is produced during exercise which may protect brains against Alzheimer's disease by improving synaptic plasticity (mental sharpness) and memory.

>>> Read a summary here

>>> Read the original paper in Nature

Exercise is Keeping Us Alive

"A 2015 report by the Academy of Medical Royal Colleges called Exercise – the Miracle Cure said that regular exercise can assist in the prevention of strokes, some cancers, depression, heart disease and dementia, reducing risk by at least 30%. With regular exercise, the risk of bowel cancer drops by 45%, and of osteoarthritis, high blood pressure and type 2 diabetes by a whopping 50%.

Exercise, in these terms, is not a fad, or an option, or an add-on to our busy lifestyles: it is keeping us alive."

>>> Read more from the Guardian Here

Cholesterol Rises with the Holidays

The New York Times (Bakalar) reports that research published in Atherosclerosis suggests that “the holiday season may confer an unwanted gift: higher cholesterol.”

>> Read more here.

HealthDay (Reinberg) reports that “after Christmas, cholesterol levels jumped 20 percent from summer levels among the 25,000 people studied.” 

An individual’s “risk of having high cholesterol becomes six times higher after the Christmas break, the scientists said.”

>>> Read more here.

Low Cardio Fitness In Men Tied To Higher Risk Of Stroke

Reuters (Dec 31, 2018 Crist) reported researchers found that men with low cardiorespiratory fitness are more likely to have a stroke than those with higher fitness.

Investigators “in Norway followed 2,014 middle-aged men for more than 20 years.” The researchers found that “those who were unfit for the whole study period, or who started out fit but became less so, were twice as likely to have a stroke as those who stayed fit or became fit.”

>>> The findings were published in Stroke.

Learn to Love Exercise

Depositphotos

So many of our patients struggle with "starting exercise".  I make it a special point to ask people if they have made good on their promise to start walking (like they promised) or using their home exercise equipment.   Often the weather is to blame ("its too cold") or maybe a recent back or knee injury.  A lot of the time, however, I think its simply hard to begin something new.

This is an excellent article to hopefully motivate you to begin getting healthy!

"How to make exercise a regular part of your life.  Learn to stop worrying and love working out," by Dan Seitz.

>>> Read more here

Fit Seniors Have Younger Hearts (NPR)

David Trood/Getty Images

"The people who got caught up in the exercise boom of the 1970s and stuck with it into their senior years now have significantly healthier hearts and muscles than their sedentary counterparts."

"...people in their 70s who have been exercising regularly for decades seem to have put a brake on the aging process, maintaining the heart, lung and muscle fitness of healthy people at least 30 years younger."  - Patti Neighmond.


>>> Read more on NPR Here.