60 Minutes a day!

Salt: Change Your Salty Ways

Lower Your Risk of Heart Disease

Returning to exercise after flu or illness

If you are coming down with an illness, it is best not to strenuously exercise. Your body needs to use it’s energy to overcome the illness.  Exercising strenuously is like burning the candle at both ends.  The body doesn't have the energy to fight illness, so the illness takes longer to overcome.

 Never exercise if feverish.  A fever indicates your body is fighting an infection.  Exercise can cause your body temperature to rise dangerously high and lead to  heatstroke. This can also  lead to dangerous dehydration and even heart failure. Good advice is when returning to exercise, work out one day at a low intensity for every two days you were ill. I tell patients to cut their intensity to 50% of what they normally do, and start back with a short duration say 20 minutes or so.  Use the two hour rule. You should feel fully recovered two hours after exercise. If you are exhausted for the remainder of the day it is too much on your body. It should take at least two full weeks to build build back up following a nasty cold or flu bug.  Drink plenty of water during this time to help thin any mucus secretions from the lungs, this helps your body to expel these. Be aware that some antibiotics   –  Cipro and Levaquin –  are known to increase the likelihood of muscle rupture, therefore go slow and stretch. 

There is no such thing as “sweating out” toxins, germs or viruses. so put all your energy towards resting and getting well.

Nausea Vomiting / Diarrhea  These can cause dehydration and electrolyte imbalances. Wait to exercise until the symptoms have stopped completely and you are re hydrated. One way to know if properly re hydrated is looking at the color of your urine. If the urine is bright yellow you are not hydrated. The color should be a very pale yellow. Also look at the skin on the back of your hand and give it a pinch. Does the skin stay up for several seconds, or does it quickly go back down. It should quickly go back down.  Electrolyte depletion can be very serious in heart patients, especially those on diuretics.  If in doubt or concerned ask your physician to draw electrolytes.  A weak 50%water to 50% electrolyte drink such as Power aid, or Gator Aid might be advisable.  Of course eating a banana which is easier on the belly than something like orange juice, also helps.  

Most importantly listen to your body, go slow, give yourself the time to heal. Stop exercise if you notice your heart racing, shortness of breath, chest discomfort, weakness.

Eat healthy

Be the leader

Setting a healthy example involves mothers and fathers who can encourage children to leave the couch
. 


What’s happening to our kids that makes them quit wanting to play?
http://www.letsmove.gov/learn-facts/epidemic-childhood-obesity

Getting children to be more physically active seems as if it should be so simple. Do you play with your children? When is the last time you threw the Frisbee  played catch, had a snowball fight, played tag, raced around the block, had a pillow fight, wrestled, arm wrestled, challenged each other with a yoga pose, or weight lifting. Even your teens will enjoy these activities. You could enroll them in classes and programs during school or afterward that are filled with games, sports and other activities. 
i
As parents we need to be role models, make it a lifestyle, teach it not just preach it. Be the mentor, be the instigator, keep it lifelong.

Healthy Snack Ideas

How Healthy is Your Holiday Meal?

With the holidays being upon us in no time this is  a good time to remind heart patients of being acutely aware of the sodium content in foods. The holiday meal contributes to many heart patients having increased symptoms of  high blood pressure, congestive heart failure, fluid retention, shortness of breath. The holiday meals  can be the culprit. Traditional foods like the turkey are often injected with  approximately 8% solution sodium to enhance moistness and flavor. If you read the ingredients you will often note: turkey broth, salt, sodium phosphates, sugar & flavoring. Then many a cook will soak the already salt injected turkey in a brine solution or salt it well, prior to cooking. The turkey alone gets many into trouble, then you add pre-packaged stuffing, broth, or use canned mushroom soups in casseroles. Did I mention the relish tray with pickled foods?                                                           

A little extra salt in or on your holiday foods makes a difference.

1 teaspoon salt = 2131 mg sodium                                          1/2 teaspoon salt = 1066 mg sodium

1/4 teaspoon salt = 533 mg sodium                                        1/8 teaspoon salt = 266 mg sodium

75 mg—the average sodium content of 3 ounces fresh, unsalted beef, turkey, chicken, pork

240 mg sodium in 3 ounces self-basting frozen turkey, cooked (that’s without the gravy!)

580 mg sodium in 3 ounces frozen fully cooked baked turkey

820 mg sodium in 3 ounces honey baked ham

Bread is a major sodium contributor if you eat more than a couple of pieces a day unless you buy special low sodium bread. A slice (1 ounce) of loaf bread has 150 to 200 mg sodium—not including salted butter or other spreads or toppings. Consider using a bread maker to make a low sodium recipe.

Skip the gravy! But if you must go for low or reduced sodium gravy instead of regular salted gravy which has more than 300 mg sodium for 1/4 cup.                                                                                                                                                              

Measurements and labels of sodium

•  1/4 teaspoon salt= 600 mg sodium
• 1/2 teaspoon salt= 1,200 mg sodium
• 3/4 teaspoon salt=1,800 mg sodium
• 1 teaspoon salt= 2,300 mg sodium
• 1 teaspoon baking soda =1,000 mg sodium

• Sodium-free: Less than 5 milligrams of sodium per serving
• Very low-sodium: 35 milligrams or less per serving
• Low-sodium: Less than 140 milligrams per serving
• Reduced sodium: Sodium level reduced by 25%
• Unsalted, no salt added, or without added salt: Made without the salt that's normally used, but still contains the sodium that's a natural part of the food itself.

Names for salt

• sodium alginate
• sodium ascorbate
• sodium bicarbonate (baking soda)
• sodium benzoate
• sodium caseinate
• sodium chloride
• sodium citrate
• sodium hydroxide
• sodium saccharin
• sodium stearoyl lactylate
• sodium sulfite
• disodium phosphate
• monosodium glutamate (MSG)
• trisodium phosphate
• Na

Some drugs contain high amounts of sodium.

Need an antacid after that holiday meal?  Watch out there is excess sodium there too. Carefully read the labels on all over-the-counter drugs. Look at the ingredient list and warning statement to see if the product has sodium. A statement of sodium content must be on labels of antacids that have 5 mg or more per dosage unit (tablet, teaspoon, etc.). Some companies are now producing low-sodium over-the-counter products. If in doubt, ask your healthcare practitioner or pharmacist if the drug is OK for you.

How Sodium causes fluid retention

The job of the kidneys is to filter the excess sodium into the urine so that the body can get rid of it. Many with heart disease and diabetes kidneys cannot handle all the extra work. The kidneys become less efficient at filtering the blood stream. This causes excess sodium to enter the bloodstream. Sodium attracts water to it and effect known as being osmotic. Water follows the sodium  and is drawn into the bloodstream. Excessive salt keeps the circulatory volume higher than it should be, creating and increased pressure in the blood stream and pressing on the blood vessel walls. The stress of the pressure on the walls creates thickening and narrowing of the vessel, leaving less space for the fluid in the blood vessels and raising resistance.  The body then requires higher pressure to move blood to the organs. The heart has to pump against this high pressure system.

I equate it to trying to blow up one of those kids balloons that is turned into animal shapes. They are really tough to blow air into, your cheeks get really sore - this is the resistance of air, similar to the resistance pressure of blood in the arteries. If you stretch the balloon (relax the arteries) then there is less resistance in blowing up the balloon (filling the artery with blood). Twenty percent  of the blood pumped from the heart goes  first to the kidneys.  High blood pressure within the kidneys cause  damage to the heart and to the vascular system in the kidneys. Salt makes you thirsty so limit salty foods, especially if on a fluid restriction.

I once had a patient who lost 45 lbs simply from adhering to low sodium diet. He had a very weak heart with only 10% ejection fraction meaning very limited pumping ability. So a weak heart and sodium in the diet made him retain fluid more than most. He began to measure and count sodium with every meal for a few months and was shocked by how much sodium he consumed even though he thought he ate pretty healthy. By reading labels, doing the math every day and making changes such as eating out less, ordering special, reviewing his medication he lost the fluid and added years to his life, not to mention the improved quality of life with less shortness of breath and fatigue by easing the workload of the heart.                                                   

According to the American Heart Association, eating more than the recommended 1500 milligrams a day puts you at direct risk of high blood pressure. Yet in America we consume an average of 3400 milligrams a day; more than twice what we should. While people with hypertension, heart and kidney disease are always advised by doctors to eat less salt, the AHA wants all of us to do this, whether or not our blood pressure is currently in the normal range. So if you are cooking or know the cook for pass this info on! 

The unhappy meal

Fast Food Facts

America's Nutrition Evolution