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Mr. Heart, Who’s Your Daddy?

February is meant to be a fun month. We have Valentine’s Day and Family Day. Children have reading week. Many families make use of this time to take a holiday. Put real meaning to what family means. This is the month when many people find their life partner and make life-long commitment.

Then there are people who are born on February 29. You wonder whether it would have been better to be born on February 28 or Mar 1. February is also Heart Month. Every day you hear and read about heart disease and how it is going to kill you or paralyze you. You say, “Enough of this. Life is too short. Let me have my fun. Leave me and my heart alone.”

Your heart belongs to you. It has only one daddy. That is you. Same thing applies to me. I am responsible for my heart’s well being. We should all take as much responsibility as we are able for our own health. An editorial in the Canadian Medical Association Journal (CMAJ Jan 31, 2006) says, “…we know that people who are likely to live longer eat less, exercise more and are unlikely to smoke tobacco…” I call this simple and basic personal responsibility for taking care of our health.

The WHO research has shown that high proportion of the world’s illness can be attributed to relatively small number (20 or so) modifiable risk factors. In affluent countries like Canada, we talk about lifestyle factors in diseases like obesity, hypertension, cardiovascular disease, diabetes and cancer. Remember, we are talking about modifiable risks factors.

Lifestyle changes mean any activity of an individual, family or community, with the intention of improving or restoring health, or treating or preventing disease. Lifestyle changes can result in large reductions in premature death and increase national productivity, says the CMAJ editorial. These changes can be made slowly in incremental fashion to achieve your goal. When it comes to eating, replace bad fats with good fats. Eat more fruits and vegetables. Do not forget little bit of red wine, almonds, garlic and dark chocolate. Who said making lifestyle changes was dull and uninspiring?

You can go dancing, swimming, make love, pray, meditate, laugh and go for a walk. Be involved in your community. There are lots of fun things you can do to stay healthy. You are only limited by your imagination.

In the last three columns, we have covered most of the areas you need to work on and be heart smart. Heart Month is almost over. Weather is still lousy. Snow is still on the ground. But don’t get depressed. Go out and have some fun.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Heart Disease and Your Enemy #3

Yesterday was Valentine’s Day. It must have been an evening of love and chocolates for you. That is good. Love and happiness are good for your heart. As they say, “Make love, not funeral plans.” And there is science behind that. It keeps your life active. People who have more sex live longer than those you don’t. Married people and people in healthy relationships live longer than lonely people.

Chocolates are good for your heart. But they are high in calories so if you are going to eat chocolates then you have to make adjustments to your calorie intake for that day. Evidence based recipe for a perfect meal (called polymeal) include wine, fish, dark chocolate, fruits, vegetables, garlic and almonds. Dark chocolates daily (100 grams) reduce blood pressure and cardiovascular diseases by 21 per cent.

Let us go back to our enemy No. 3 – inactivity.

Being a couch potato is hazardous to your health. Being active is good for your health. That is obvious, right? Am I insulting your intelligence by writing such simple and obvious facts?

We have couch potatoes in all age groups. They watch too much TV or spend too much time on the Internet. While they do that they eat junk food. Inactivity plus junk food equals bad news for your heart as you get older. Regular physical activity makes your heart strong.

In sedentary people or couch potatoes, the risk of heart attack was seven times higher in a German study and more than 100 times greater in a U.S. study during vigorous exertion than during lighter activity or no activity. If you compare this to among people who exercised regularly, there was almost no increased risk. Another beneficial effect of regular exercise is that it increases the blood level of HDL (good cholesterol). HDL is another line of defense against heart attack.

The type and amount of exercise required to be fit and healthy depends on your age, your health and your current state of physical fitness. There are three types of exercises: aerobic, weight lifting (resistance training) and stretching. A good exercise program should benefit all three aspects of fitness: stamina, flexibility and strength.

A study found that 150 minutes a week (two and a half hours) of a moderate exercise such as walking and 75 minutes per week (an hour and 15 minutes) of activity like easy jogging provides good health benefits.

It has been estimated that people who are physically active for approximately seven hours a week have a 40 percent lower risk of dying early than those who are active for less than 30 minutes a week.

Be active, do whatever you can and have fun. If it is not fun then don’t do it. Find a partner, join a group, get a dog and just go for a walk. You can celebrate Valentine’s Day every day. Who cares, as long as you are having fun…right?

Ok, get moving now.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Heart Disease and Your Enemy’s Best Friend – Triglycerides

In the last column, we discussed about the harmful effects of bad cholesterol (LDL) on your cardiovascular system. I call LDL enemy number one. Today, we move on to our enemy number two – triglycerides.

Triglyceride is another type of lipoprotein which carries harmful fat-carrying particles. That means it is a bad one. It is the main constituent of vegetable oil and animal fats. It is a major component of chylomicrons and very-low-density lipoprotein (VLDL).

Chylomicron is one of the microscopic particles of fat occurring in a ‘milky’ fluid composed of fat and lymph formed in the intestine during digestion. Next, VLDL is produced in the liver and later becomes the bad LDL.

Triglycerides are the most common form of fat in the body. In fact, almost all the excess calories you consume, whether from fats or carbohydrates, are converted to triglycerides and stored in your fat cells. Once at capacity these cells divide. If you ‘lose weight’ these cells decrease in fat content but never in number. This makes it easier to get fat again.

High levels of triglycerides in the bloodstream have been linked to atherosclerosis (hardening of the arteries), and the risk of heart disease and stroke. High triglyceride levels can
cause pancreatitis, a painful and potentially dangerous inflammation of the pancreas.

What causes elevated triglycerides?

Elevated triglyceride levels can be related to your diet (high in bad fats, carbohydrates and alcohol) and your genetic makeup. In addition, high triglyceride levels can be produced by several medical conditions including: obesity, diabetes, metabolic syndrome and hypothyroidism (low thyroid).

How can we manage high triglyceride levels and reduce the risk of CAD, stroke and death?

It starts with lifestyle modification. Your diet has to change. The key is to replace bad fats with good fats in your diet.

Bad fats are: saturated fats (found in meat and dairy products, some plant foods such as coconut oil, palm oil and palm kernel oil) and trans fats (found in commercially packaged foods and fried foods).

Good fats are: monounsaturated fats (found in nuts, almonds, pistachios, avocado, canola and olive oil) and polyunsaturated fats (found in seafood, fish oil, omega-3, corn, soy, safflower and sunflower oils). Monounsaturated fats have also been found to help in weight loss, particularly in reducing body fat.

Eat plenty of fruits and vegetables. Avoid alcohol, lose weight, exercise, do not smoke, and control your blood sugar and blood pressure. Wow, sounds easy! Well, sort of. There is plenty of help around to achieve your goals. You and your doctor should work together. But you have to have the motivation to start the ball rolling.

This plan will help reduce LDL bad cholesterol, the bad triglycerides (friend of enemy number one) and increase HDL good cholesterol. Next week, look for more fodder for your healthy heart besides love and chocolates on Valentine’s Day. Who is your enemy number three?

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Is Dietary Cholesterol Really Bad for You?

February is Heart Month. This month brings back memories of my father. It was twenty years ago, on February 4, my father passed away from a massive heart attack due to coronary artery disease.

Heart disease kills people. How can we stop this killer?

Healthy diet and healthy lifestyle are two weapons we can use.

When we talk about healthy diet, we mean diet low in saturated fats and trans-fats. Saturated fat is present in full fat dairy products, animal fats and several types of oil. Trans-fat is most often encountered in margarine and hydrogenated vegetable fat, many fast foods, snack foods and fried or baked goods.

Over the years, studies in humans have not provided convincing evidence for an impact of cholesterol intake on coronary artery disease (CAD). Rather, these studies have consistently established a close association between a certain eating pattern and the risk of CAD.

This eating pattern has usually been characterized by a high intake of total fat, low intake of fiber and polyunsaturated fatty acids found mainly in fish (omega-3), corn, soybean and safflower oil (rich in omega-3).

So, is dietary cholesterol really bad for your heart?

The body produces enough cholesterol for our needs. Cholesterol is essential for all animal life. It’s an important part of a healthy body because it’s used to form cell membranes, some hormones and is needed for other functions. It has to travel to different cells to meet its cholesterol demand. In order to travel in the blood, cholesterol is carried by two kinds of lipoproteins – low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL cholesterol is referred to as “bad cholesterol,” because it contributes to atherosclerosis, which is a build-up of cholesterol in the arteries and it leads to heart disease. If too much LDL cholesterol circulates in the blood, it can slowly build up in the walls of the arteries feeding the heart and brain. Together with other substances it can form plaque, a thick, hard deposit that can clog those arteries. This condition is known as atherosclerosis.

HDL cholesterol is often called “good cholesterol,” because it carries cholesterol from other parts of the body back to the liver to be removed from the body.

When you get a fasting blood test for cholesterol profile, which parameter is the most important? As the pundits say, “In politics, it is the economy, stupid.” When it comes to heart disease it is the blood level of LDL which is important……stupid. Did I just say that?

Ok, I said that. Because we worry too much about eating low cholesterol diet but forget that our real enemy is LDL. Experts have proved that total fat intake; especially saturated fat and trans-fats are the major players in the LDL synthesis in blood. Data indicate that dietary cholesterol has little effect on the blood LDL.

Eat right and exercise regularly and get control of your real enemy: LDL. In the next few articles we will continue our discussion on how to defend our blood vessels against this killer.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!