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As blood circulates the body, it presses against the walls of the blood vessels putting varying degrees of pressure on them. We call it blood pressure, and our blood pressure is indicated in a pair of numbers: systolic and diastolic. When the heart pumps, pressure in the arteries temporarily increases, and we get the systolic number. This reading shows the blood pressure at its highest. When the heart relaxes between the beats pressure in the arteries temporarily decreases, and we get the diastolic number which shows us the pressure at its lowest.

According to the statistics, more than 60 million people in the United States affected by hypertension – high blood pressure (140/90 or higher). Since high blood pressure doesn’t have symptoms unless it’s advanced and already made damage to the body, many might just don’t know about the danger their body faces. One of the most important things someone can do – have the blood pressure checked during regular doctor visits.

The level of our blood pressure affects our health.  People with normal blood pressure are at the lowest danger of developing heart disease and stroke problems.  The higher your numbers go – the greater risk you are facing to develop cardiovascular and other diseases.

 

Understanding blood pressure measurements

Category	Systolic blood pressure (mm  hg)	Diastolic blood pressure (mm  hg)
Normal	Less than 120	Less than 80
Prehypertension	120-139	80-89
Stage 1 hypertension	140-159	90-99
Stage 2 hypertension	Over 160	Over 100

 

Blood pressure usually goes up and down during the day depending on your stress level or physical exertion. That’s why doctors usually take the average of several measurements to determine the average blood pressure.  Sometimes, there is so called “white coat hypertension” takes place. It happens when somebody’s blood pressure rises up from the anxiety of being in the doctor’s office. In this case, doctors recommend checking your blood pressure at home while relaxed and unstressed.

Damage to the body that might be done by the hypertension:

• Heart damage. Since the heart has to work harder to pump the blood against higher than normal pressure, the muscular wall of the heart grows thicker, but unlike the muscles in your arms the thicker muscle in your heart doesn’t mean it’s stronger. On the contrary, it gets wicker after few years of high blood pressure which might lead to the heart failure.
• Atherosclerosis. High blood pressure damages the inner lining of the arteries making little cracks in it. These cracks are likely to build up with fat which can block the arteries after awhile, and interfere with the ability of the blood to carry oxygen and nutrients to the muscles they serve.
• Kidney damage. Arteries supplying different organs of the body narrow as the result of high blood pressure starving the organs of the oxygen and nutrients. When blood supply to the kidneys is reduced, the hormone rennin is produced which affects the body in a way that the arterioles clamp down farther which leads to even higher blood pressure.
• Stroke. Atherosclerosis which affects the arteries supplying brain might limit the blood flow to the brain and starve a part of it of the oxygen and nutrients it needs. High pressure also weakens the blood vessels and might rupture them in the brain causing a brain hemorrhage.

The majority of high blood pressure cases (95%) have no known explanation. Nevertheless, there are risk factors identified: cigarette smoking, obesity, stress, drug abuse, excessive use of stimulants like coffee and tea, high sodium intake.  Primary high blood pressure may run in families, and also might be affected by a race. Black Afro-Americans are at the greater risk of developing high blood pressure than Hispanics.  For some unknown reason women are at slightly greater risk than men are.

5% of high blood pressure sufferers have as called secondary high blood pressure which means their elevated numbers are the result of their underlying medical condition.

Diet plays a big role in preventing hypertension, as well as helping treating it without using drugs for people who didn’t developed Stages 1 and 2 hypertension:

• Limit your salt intake. Experts recommend not more than 2,400 mg of sodium each day for healthy people. For individuals with hypertension it’s better to exclude salt completely from their diet. Stop adding salt while preparing food, avoid salty foods and snacks. Check the labels carefully while buying food and look for the terms “sodium”, “soda”, “salt”, or the symbol “Na” on the label to find hidden salt. Avoid monosodium glutamate, baking soda, canned vegetables (unless they are sodium and salt free), commercially prepared food, diet soft drinks, meat tenderizers, softened water, soy souse, over-the-counter medications containing ibuprofen, any pickles.
• Eat more vegetables and fruits, such as apples, asparagus, bananas, broccoli, cabbage, cantaloupe, eggplant, prunes, raisins, squash, and sweet potatoes. Such diet contains lots of fiber, potassium, magnesium, and calcium, and all of them protect against high blood pressure.
• Eat high-fiber products and take supplemental fiber. Oat bran is very rich on fiber. Grains like brown rice, buckwheat, millet are a good choice.
• Drink fresh juices like beet, carrot, celery, currant, cranberry, citrus, parsley, spinach, watermelon.
• Avoid animal fat. This means cutting back on margarine, butter, as well as on meat products. Meat intake should be strongly restricted. If you can’t avoid meat choose only lean cuts (preferably skinless turkey and chicken), or white fish, and switch to low-fat cooking methods like broiling. Switch to low-fat dairies. Avoid processed meats.
• Eat potassium and magnesium reach food like apricots, figs, dates, bananas, grapefruits, kiwi, melon, raisins, pineapples, mango, baked potatoes with skin, broccoli, low-fat yogurt, baked beans.  Potassium helps maintain the body’s balance of salt and fluids thus helping normalize blood pressure.
• Eat calcium-rich food. Some studies linked calcium deficiency to hypertension. Have two-three servings of low-fat milk products a day.
• Take enough of essential fatty acids to improve circulation of blood and to lower blood pressure. You can find them in flaxseed oil, black currant seed oil, olive oil, primrose oil.
• Limit your intake of alcohol and caffeine. There is some evidence showing that one alcoholic drink a day may reduce your blood pressure, but drinking more than two alcoholic beverages a day raises your chances to develop hypertension.
• Fasting from three to five days a month can be beneficial for high blood pressure. Fast on live juices diluting them with water (1 part of the water for 3 parts of the juice), distilled water (at least ten 8-ounce glasses a day) and up to 2 cups of herbal tea a day. The best juice is lemon juice (juice of 1 lemon to a cup of warm water). Green juices made from green leafy vegetables are great detoxifiers. To prepare for the fast eat only raw vegetables and fruits for two days. Follow the fast by two days of eating raw vegetables and fruits as well.

Other lifestyle changes can be recommended to people in order to prevent hypertension or help treat it:

• Loose weight. The bigger you are, the harder your heart has to work to supply all your body needs with blood. Being even slightly overweight is a contributing factor to hypertension especially if you have an apple-shaped body carrying extra pounds around your waist line. Loosing extra pounds has a great effect on the blood pressure even if you didn’t reach your best weight.
• Exercise. Aerobic exercise (jogging, biking, brisk walking) from three to five times a day for 30 minutes can reduce the blood pressure. There is a theory that aerobic exercise widens arterioles in the body reducing their resistance to a blood flow. Don’t overstretch yourself, especially in hot and humid weather.
• Sleep well.
• As much as possible avoid stress.
• Certain colors may be beneficial for high blood pressure some research says.  Blue, green, and violet tend to relax the body and thus lower blood pressure, while red and yellow might rise it up. Music can reduce the stress also.
• Check your blood pressure with the doctor. If you have stages 1 or 2 of hypertension you need to take medications to lower your blood pressure along with the diet and lifestyle changes.

Cholesterol is one of a group of fats that serve the body as material for building cells, and as an energy source.  It’s needed for proper brain and nerve function, and it’s used by the body to produce sex hormones. However, the excess of serum cholesterol leads to plaque building up in the arteries which might be one of primary causes of heart disease.  

If an artery supplying blood to your heart becomes blocked, the heart attack might happen. If the blockage happens in an artery supplying your brain, a stroke may occur.  

Cholesterol is produced in the liver and transported through the bloodstream to the sides where it’s needed. To travel through the blood stream cholesterol molecules attach themselves to lipid-carrying proteins – lipoproteins. Low-density lipoproteins (LDLs) carry two-thirds of all cholesterol, and tend to deposit cholesterol in the artery walls leading to atherosclerosis. That’s why LDL cholesterol is called “bad” cholesterol. High-density lipoproteins (HDLs) called “good” cholesterol carry unneeded cholesterol away from the artery walls and other tissues back to the liver to be metabolized and removed from the body. High levels of a third type of fat, triglycerides also worsen atherosclerosis.

Unfortunately, high level of cholesterol doesn’t have any symptoms. Many people are diagnosed by their physicians after doing a cholesterol test.  Results of cholesterol test might be expressed in two ways: milligrams (mg) of cholesterol per deciliter, or millimoles (mmol)  of cholesterol per liter. To get the millimole system you need to multiply milligrams to 0.026.

 LDL levels should be below 130 mg/dl (3.5 mmol/l). 130 to 159 (3.5-3.9) is considered as a borderline high, and over 160 (4) is classified as high risk for coronary artery disease and heart attack.

HDL level should be 45-50 mg/dl for men and 50-60 mg/dl       for women.

It is suggested that higher level of HDL cholesterol might protect you from the heart disease.  The ratio between LDL and HDL is calculated by dividing total cholesterol by the HDL figure. The desirable numbers should be less than 4.5.

 

It is important to distinguish between serum cholesterol (cholesterol in the bloodstream) and dietary (cholesterol that is present in food). When eating food rich in cholesterol we can increase the level of our serum cholesterol, but that’s not the only source of our serum cholesterol. Cholesterol level is greatly affected by our heredity, so same food would act differently on different bodies.

If you have high cholesterol level in your blood,
you have to start by changing your diet.

Foods that may raise cholesterol

•          Hard margarine and vegetable shortening which are high in saturated fats and trans fatty acids
•          Cookies, candies, pastries, which are made by using saturated tropical oils (coconut, palm, palm kernel) and partially hydrogenated oils.
•         Full-fat dairy products. Chesses, butter and whole milk are very high in saturated fats.
•        Fatty meats and meat products. All animal products contain saturated fat.  You can consume nonfat milk, low fat cottage cheese, skinless white poultry (preferably turkey), but only in moderation.
•        Coffee. In large amounts coffee might elevate cholesterol level, according to The New England Journal of Medicine.
•        Coconut, palm, palm kernel oils. These are the only plant oils that contain saturated fat.
•        Fast food. Many restaurants use beef fat to make their hamburgers, fish, chicken, and French-fries. Food may not only contain the high amount of cholesterol, but fat used in deep frying process results in oxidation and formation of free radicals harmful for the body.
•       Tobacco. Tobacco smoke encourages the immune system to increase LDLs as well as cause a drop in health promoting antioxidants such as vitamin C.

Food that may lower cholesterol

•           Whole-grain food which has plenty of fiber. Water soluble dietary fiber is important to lower serum cholesterol. It is found in barley, beans, brown rice, oats. Oat bran and brown rice bran are the best for lowering cholesterol.
•           Fresh juices such as carrot, celery, and beet. Carrot juice helps to flash out the fat from the liver.
•           Unrefined cold-or expeller-pressed oils. Monounsaturated fat found in olive and canola oils, some nuts and avocados has been shown to reduce bad LDL cholesterol while rising up good HDL cholesterol. Polyunsaturated fat found in corn, cottonseed, safflower and sunflower oils reduces the bad LDL cholesterol. The bad part, it also reduces the good HDL cholesterol.
•           Nonhydrogenated soft margarine containing plant sterols is relatively healthy option. When consumes as a part of a heart-healthy diet it has been shown to lower cholesterol level.
•           Fruits, such as oranges, apples, pears, bananas, grapes, grapefruit, and dried fruits as apricots, figs, prunes.
•           Vegetables, such as sweet corn, onion, garlic, all kind of beans and other legumes.
•           Nuts, such as almonds, walnuts, pecans; seeds, such as sesame, and sunflower seeds.
•           Cold water fish, such as salmon, sardines. Eat two-tree servings a week.
•           Flavonoid-rich foods showed good results in lowering cholesterol level. Among them citrus fruits, onions. Pectin in apples and other fruits also lowers cholesterol.
•            Soy products. Adding soy protein to low-fat diet helps to lower cholesterol level.
•           Cayenne, hawthorn berries, cinnamon, spirulina help to lower cholesterol.

 

Increased exercise, weight loss, and stress management  are very important to lower cholesterol level as well. Regular exercise for a minimum of 30 min a day at least three times a week can raise the levels of HDL. If diet and exercise do not lower your cholesterol level, your doctor may prescribe drugs.

Stress is defined as any condition that places undue strain on the body.

Stress can be physical (stress of exercise, or stress after hard disease), or emotional (separating from your partners, loosing job, paying bills, etc.).  Some people handle stress well, while the others get frustrated, and depressed.

 

Common symptoms of stress:

Physical:

•           Palpitations, shortness of breath, chest pain and other signs of heart disease (don’t assume it’s a stress, check with the doctor!);

•          Light-headedness, dizziness;

•          Backache (might be chronic as wee as recurring);

•          Tingling sensations in the fingers or toes;

•          Headaches;

•          Digestive problems.

Psychological:

•         Sleep problems;

•          Problems with concentration;

•          Fatigue even after rest;

•          Change in appetite, and reliance on stimulants (drugs, alcohol, cigarettes);

•          Feeling of anxiety;

•          Decreased enjoyment of usually pleasurable things;

•          Increased irritability.

80 percent of all major illnesses might be related to stress such as cardiovascular disease, cancer, endocrine and metabolic disease, skin disorders, infections, back problems, blood pressure, increased blood sugar.

When one experiences stress, his or her body reacts immediately by increasing secretion of adrenalin, elevation of blood pressure, acceleration of heartbeat, and greater tension in the muscles. As a result, digestion slows or even stops, fats and sugars are released from stores in the body, cholesterol levels rises and even the blood changes to more prone to clotting which increases the risk of heart attack or stroke. These responses are made by body to react on stress and called “fight or flight” reaction, and they suppose to prepare one to face an immediate danger.  It’s the same reaction our ancestors had while living in caves, hunting for food, and running from danger.

Most of the symptoms correlated with stress are the result of increased production of hormone called adrenalin. Increased adrenalin level causes the body to step up its metabolism of proteins, fat and carbohydrates to quickly produce energy. As a result, amino acids, potassium and phosphorus are excreted, magnesium stored in muscle tissue is depleted, and not enough calcium is stored in the body. Stress triggers the release of cortisol, as well, an adrenal hormone that regulates carbohydrate metabolism and blood pressure. It also ages brain cells, and builds fat around the body’s midsection.  Also stress increases the level of interleukin-6 – immune system protein, which has direct effects on most of the cells in the body and therefore associated with many disorders like diabetes, arthritis, cancer, osteoporosis, Alzheimer, periodontal disease, cardiovascular disease.  As a result of stress especially a long-term stress, the body experiences the nutrients deficiency and needs help. A long-term stress wears out the body.

 

Nutrients your body needs

while you are stressed out:

 

•         Gamma-amino-butyric acid (GABA) acts as a tranquilizer. Important for brain function.

•          Glutathione is an antioxidant that protects the cells against damage.

•          Nicotinamide adenine dinucleotide (NADH) is important in the creation and transfer of chemical energy during breathing.

•         Taurine is essential for brain and heart protection.

•          Vitamin B complex is necessary for health of the nervous system.

•          Vitamin C is essential for adrenal gland function.

•          Anti-Stress enzymes remove toxic wastes and restore balance in the system.

•          Calcium and magnesium are lost during stress which can lead to anxiety, fear, and hallucinations.

•          Zink is needed for immune function and to protect the cells from free radical damage.

 

Some herbs are helpful during stress:

Bilberry (prevents distraction, mutation, and premature death of cells of the body), ginkgo biloba (helps brain function and good circulation), milk thistle (protects the liver), catnip in moderation (can cause drowsiness), chamomile (good relaxant and nerve tonic), hopes (easy nervousness, restlessness, decreases the desire for alcohol), passionflower (calming effect), skullcap (helpful for headaches), valerian (for nervous system and good sleep).

 

Eating tips during stressful periods:

 

•          Your diet should be composed of 50-75 percent of raw food. Fresh fruits and vegetables are rich on minerals and vitamins, as well as on flavonoids many of which neutralize dangerous free radicals. Don’t deprive yourself from food. Changing eating habits is stressful by itself.

•          Eat breakfast. If you skip it, the stress is more difficult to handle.

•          Eat slowly. Stress slows down the digestion, so by eating fast you will make food even more difficult to digest.

•          Eat regular. Six small meals a day will do better that three regular big.

•          Limit your intake of alcohol and caffeine. Mood-altering substances may bring temporarily relief from stress, but they do nothing to address the problem.

•         Avoid processed foods and foods that create stress on the system like an artificial sweeteners, carbonated soft drinks, eggs, chocolate, fried food, junk food, pork, red meat, sugar, products from refined white flour, food that contain hot spices, chips.

•          Eliminate dairy products for three weeks. Then reintroduce them slowly watching for returning symptoms of your “nervous” condition.

•          Listen to your body and avoid foods that cause you discomfort.

 

If you want to deal with the stress,

you better do some changes to your life style:

 

•         Exercise regularly to increase the production of endorphins, brain chemicals that lift the mood. Any type of exercise will work as long as they are regular.

•         Learn to relax. For a few minutes each day sit quietly with your eyes closed. Learn a relaxation technique, such as yoga, meditation.  Meditation doesn’t have to have a religious connotation. You can meditate on a pleasant person, event, place, idea. It works the best when done regularly on a daily basis.

•          Practice deep breathing which is good for relieving your stress. Inhale deeply with your mouth closed, hold the breath for a few seconds, and then exhale slowly through your mouth with your tongue touching the top of your tips next to the gum line. Do this for few times until the tension passes.

•          Listen to your favorite music. It increases the endorphin level as well.

•          Try to control your internal conversations. The way we talk to ourselves affects how we feel about ourselves and our environment. The words like “I should have done it better”, “It’s always my fault” are not helping the stress.

•          Identify the reason of your stress and try to view it as positive as you can.

•          Find a hobby, or do the things you enjoy. Don’t feel guilty when doing something for yourself. Your health is worth it.

•         Do not deny your emotions. Trying to repress them just compounds the stress. Keeping strong feelings bottled up causes them to resurface later as illness.  Don’t be afraid of cry.

•          Learn to laugh. Try to take the life easier.

•          Consider having a pet. Stroking an animal can help you relax.

•          Share your problems with the family member or friend.

•          If you feel you cannot handle your stress seek the help of a qualified practitioner.

Stress in young people should never be underestimated. Young people have fewer mechanisms to deal with the stress situations.

 

Diabetes is the disease when the body can’t produce or properly use insulin, the hormone produced by our pancreas to control the glucose (sugar) level in the blood stream and the rate at which glucose is absorbed into the cells.

Every cell in the body needs sugar as a source of energy.  The level of glucose might be maintained at a certain minimum for the brain to function normally, since the brain’s only food is glucose. After eating food which contains carbohydrates or protein, the blood sugar normally rises which leads to release of insulin by cells in the pancreas. Release of insulin helps body cells extract glucose from the blood. In the diabetes, either the pancreas doesn’t make enough insulin, or the body cells develop a resistance to the action of insulin. As a result, glucose doesn’t enter the body cells, and stays elevated in the blood stream.

Because all human body tissues need a steady supply of glucose, diabetes can affect every organ. If it’s not controlled, diabetes can lead to heart disease, kidney disease, edema, nerve damage, and infections of the mouth, gums, lungs, skin, feet, bladder, and genital areas. Adults with diabetes have strokes and fatal heart attacks two to four times as often as people with no diabetes. Diabetes is a leading cause of kidney failure and blindness.

More than 18 million Americans have diabetes, according to the American Diabetes Association (ADA).

There are 2 major types of diabetes: type 1 (insulin dependent diabetes mellitus {IDDM}), and type 2 (non-insulin-dependent diabetes mellitus {NIDDM}).

Type 1 is autoimmune disease in which immune system attacks the insulin-producing cells of the pancreas which leads to low amount of produced insulin. It affects 5 to 10 percent of people with diabetes and usually starts at an early age.

Type 2 is more common and develops usually in later years. In this form, the body’s cells become less responsive to insulin, which causes blood sugar level to go up. This leads the pancreas to produce even more insulin. By years, the insulin resistance grows stronger exhausting the pancreas from making extra insulin. At this time, blood sugar levels rise well above normal and symptoms begin.¦

The risk factors for type 2 diabetes:

◊          Age (risk increases with the age);

◊           Overweight;

◊          High blood pressure;

◊          High level of triglycerides;

◊          Family history;

◊          Ethnicity (African-Americans, American Indians, Alaska natives, Asian-Americans, Pacific Islanders and Hispanics have higher risk than Caucasians);

◊          Birth weight of less than 5.5 pounds or more than 9 pounds;

◊          History of diabetes in pregnancy, or giving birth to a baby weighing more than 9 pounds;

◊          Inactivity (exercising less than 3 times a week).

Unfortunately, the early symptoms of type 2 diabetes may not be noticeable. It’s estimated that almost 6 million North Americans may have type 2 diabetes, but don’t know about it. Adults over the age of 50 should have their blood sugar levels tested at least every 2 years, or much often if they ‘re overweight or have a family history.

The home test can help you detest an impaired disability to taste sweets (dosage is measured for adults):

1. Avoid taking any stimulants (coffee, tea, soda, sweets) one hour before the test;
2. Fill up 7 identical glasses with 8 ounces of water each, label the glasses as having no sugar, ¼ teaspoon sugar, ½ teaspoon sugar, 1 teaspoon sugar, 1 ½ teaspoon sugar, 2 teaspoons sugar, 3 teaspoons, and add sugar to the glasses according to labels. Ask somebody else to rearrange the glasses and hide the labels.
3. Using a straw sip from each glass and write down your suggestions about amount of sugar you think is added to the glass. Rinse your mouth with pure water between sips. Healthy people usually notice less than 1 teaspoon of sugar added to the glass of water; people with type 2 diabetes most likely to notice sweetness not unless 1 ½ or 2 teaspoons have been added to the glass.

 

Preventing Type 2 diabetes:

–          Exercise Exercising helps reduce body needs for insulin by keeping excess weight in check and increases the efficiency of insulin action on the cells. Exercised muscles use glucose to make energy naturally helping lower the sugar level in your body. Select an exercise you like and try to do it at least once a day. It is important to get the same amount of exercise every day. Even modest physical activity improves blood sugar control.

–          Maintain a healthy weight Obesity is a significant risk factor for type 2 diabetes. If you weigh 10 percent more than is recommended for your build, you need to start a weight –loss program under your doctor supervision. Researchers found that those who lost modest amount of weight cut their diabetes risk by 58 percent. People over the age of 60 cut their risk even more. Losing just 5 percent of body weight enough to make a difference.

–          Eat well Consuming 20 to 25 grams of dietary fiber will reduce your chance of getting type 2 diabetes. As important as what you eat is how much you eat and when. Avoid eating large meals or skipping meals.

 

Recommendations for people with type 2 diabetes:

◊ Eat a low-fat high fiber diet including raw vegetables and fruits, as well as fresh vegetable juices. For snacks, eat oat or rice bran crackers with nut butter or cheese. Legumes, root vegetables, and whole grains are good also. The types of carbohydrates are important. Some carbohydrates are digested and absorbed into your blood stream quickly, while others are digested and converted to blood glucose more slowly. The glycemic index (GI) measures the effect on blood glucose of a carbohydrate food. Prefer low-glycemic food over the high- glycemic. Carbohydrates found in low-GI foods such as asparagus, broccoli, cabbage, green beans, and low-starch vegetables and fruits like apples, pears, and oranges convert into blood glucose more slowly which raises insulin level gradually. Examples of high-GI food: white rice, white flour products, pasta, starchy vegetables, and many processed foods. They are quickly converted into blood sugar and cause insulin level to go up quickly.

 Choosing Low-GI over Hi-GI

◊ Foods that help normalize blood sugar include spirulina, berries, brewer’s yeast, dairy products (especially cheese), egg yolks, fish, garlic, kelp, sauerkraut, soybeans, and vegetables. According to the herbal medicine, those might be helpful for diabetes: bilberry, dandelion root (don’t take large amounts if you have gallbladder problems), juniper berries, ginseng tea (it’s not for people with high blood pressure), cedar berries, fenugreek seeds. Beanpod tea, made up of kidney, lima, white, navy beans, might be helpful with diabetes because it detoxifies the pancreas. Cinnamon capsules may be a possible and pleasant treatment for diabetes. In a small study, it was shown that taking 1-2 teaspoons a day in a capsule form may reduce blood sugar level, triglycerides, and cholesterol. The continuous ingestion of table cinnamon, however, may be not advisable because of potential toxic buildup of certain cinnamon compounds.

◊ Get your protein from vegetable sources, such as grains and legumes, as well as from fish and low-fat dairy sources. Soy protein helps people with diabetes improve kidney function.

◊ Avoid saturated fats, trans-fats, and partially hydrogenated oils, and simple sugars. Beneficial fats and oils include extra virgin olive oil, fish oil, almond oil and butter, nuts, and seed oils such as sesame, flax, sunflower and pumpkin.

◊ Eat more complex carbohydrates or reduce your insulin dosage before exercising. Exercise produces an insulin-like reaction in the body.

◊ Avoid tobacco in any form. It constricts the vessels and inhibits the circulation.

◊ Cut back on soft drinks that contain sugar. Even when other risk factors were factored in, researchers still found that the soft-drink group was 1.3 times more likely to develop the disease.

◊ Chromium deficiency was associated with reduced glucose tolerance. Chromium is found in foods like whole bran, whole grains, chicken breast, and mushrooms. Processed and refined foods such as white bread, white rice, pasta, and sugar and sweets contain very little chromium.

◊ A higher magnesium intake can lower the risk of getting type 2 diabetes. A diet rich in nuts, whole grains, and vegetables may be beneficial.

◊ It is vital for people with diabetes to take care of their feet. Keep your feet clean, dry and warm, and wear only white cotton socks and well-fitting shoes.

◊ People with diabetes should be careful about their blood fat and cholesterol. LDL cholesterol (“bad” cholesterol) should be less than 130. HDL (“good” cholesterol) should be 60 or above. Triglycerides – 150, or under.  Check it with your doctor who can give you individual recommendations.

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Despite years of research and copious studies, cardiovascular disease (CDV) is still a major concern in the United States. Cardiovascular disorders include hypertension, CHD, stroke, congenital cardiovascular defects, and congestive heart failure. Almost 325,000 people die each year either out of the hospital or in hospital emergency departments because of CVD. Heart disease and stroke remain the number one and three causes of death in the USA.

Hyperlipidemia, or increased plasma cholesterol and LDL levels, seems to be a major risk factor in CHD. Continual scientific research provides more information allowing refinement of recommendations on detection and management of established risk factors. Most cardiovascular disease is preventable by helping people adopt healthy diet and lifestyle.

The AHA and NCEP encourage a fasting lipoprotein profile (total cholesterol, LDL and HDL cholesterol, and triglycerides) for all adults older than 20 years old every 5 years along with assessment for risk factors. LDL cholesterol levels less than 100 mg/dL throughout are associated with a very low risk for CHD. LDL cholesterol greater than 100 mg/dL is the primary target of therapy.

Maintaining a healthy diet and lifestyle offers the greatest potential of all known approaches for reducing the risk for CVD in the general public. For all individuals without CHD adoption of healthy life habits, including avoidance or cessation of cigarette smoking, a healthy diet, weight control, and increased physical activity, is recommended as well as routine medical check ups for blood pressure and cholesterol. These general recommendations also can be applied to patient with or at risk of CHD. Patients at high risk may need more intense therapy.

With implementation of the therapeutic lifestyle changes, it is estimated that LDL cholesterol can decrease 20% to 30%. Natural food sources generally are recommended for most of the nutrients rather than supplements.  Although antioxidants seem to prevent CVD, antioxidant vitamin supplements or other supplements such as selenium are not recommended to prevent CVD. Rather, foods containing antioxidants from a variety of fruits and vegetables, whole grains, and vegetable oils are recommended. Phytochemicals found in fruits and vegetables may be important in reducing the risk of atherosclerosis.

 

Plant sterols are bioactive compounds, found in all vegetable foods, which inhibit cholesterol absorption. Consumption of soy protein-rich foods, a source of plant sterols, may indirectly reduce CVD risk if they replace animal and diary products that contain saturated fat and cholesterol. Small quantities of sterols are present in q variety of foods, including fruits, vegetables, nuts, seeds, cereals, and legumes. Plant sterols are absorbed at the same sites in the small intestine as cholesterol, and interfere with cholesterol absorption resulting in a 15% reduction of LDL cholesterol. An intake of 2 g is needed to produce maximum effect. To sustain LDL reduction from sterols, daily intake is needed as with medications.

The AHA recommends patients without CHD eat a variety of fish, preferably oily fish, at least twice a week. Individuals who already have CHD are advised to consume at least 1 g of EPA and DHA daily, preferably from oily fish, but the healthcare provider may recommend supplement.

Average cholesterol intake in the USA is 341 mg daily. The body synthesizes approximately two to four times more cholesterol than it obtains from exogenous sources. Of all the dietary changes recommended, cholesterol intake probably has the least effect on plasma cholesterol concentration in most individuals because of less endogenous cholesterol production in response to cholesterol absorption. The AHA recommendations do not limit the number of eggs as long as total dietary cholesterol is limited to about 200 mg per day. One large egg contains 212 mg of cholesterol.

Most studies have found that reduction in total dietary fat reduce serum cholesterol. Because fat consumption generally coincides with decreased saturated fat intake, changes in blood lipids may be related more to type of fat consumed rather than to total fat. However, a low-cholesterol, low-fat diet rarely reduces cholesterol more than 15%, and medications may be needed to reduce blood lipids further. By replacing some SFAs with MUFAs and some PUFAs, and decreasing total fat, LDL is lowered without decreasing HDL concentration. These changes result in a more palatable diet that is better received by Americans.

Nutritional Directions:

◊ Advise patients 10% of the total calorie intake should come from linoleic acid. Serum cholesterol can be reduced by a diet low in total fat and higher in MUFAs and PUFAs.

◊ Reduce dietary cholesterol intake to less than 300 mg daily by limiting meats, whole milk, cheese, and eggs.

◊ “Low cholesterol” on a food label can be misleading. A cholesterol-free product, such as stick margarine, can still be high in saturated and trans fatty acids, which elevates blood cholesterol.

◊ Dietary saturated and trans fatty acids have a grater effect on serum cholesterol than dietary cholesterol.

◊ The consumption of soluble fibers may decrease serum cholesterol.

◊ Wise food choices to prevent heart disease are unsaturated fats found in liquid vegetable oils, nuts, and seeds, and omega 3 unsaturated fats found in fatty fish such as sardines, salmon, and shellfish.

◊ Saturated and trans fats can increase total cholesterol and LDL cholesterol. Both types should be limited.

◊ Interesterified fat may be listed on food labels as fully hydrogenated oil.