Category Archives: Health & Wellness
Heart Smarts: Preventing Cardiovascular Disease
Dr. David Jackson, MPCP Columbia Cardiology
The Centers for Disease Control reports that heart disease is the leading cause of death among Americans. You aren’t able to change some risk factors ─ such as family history, sex or age – but heart disease is often linked to lifestyle, and you can significantly reduce your risk by making healthy choices. February is National Heart Month, so now’s a good time to get started.
1. Keep an eye on your plate. A diet rich in fruits, vegetables and whole grains can help protect your heart. Beans, other low-fat sources of protein and certain types of fish also can reduce your risk of heart disease. Two examples of heart-healthy food plans include the Dietary Approaches to Stop Hypertension (DASH) eating plan and the Mediterranean diet.
2. Get moving. Regular exercise helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes.
Try getting at least 30 to 60 minutes of moderately intense physical activity most days of the week. But if you can’t make it to the gym, activities such as housekeeping, taking the stairs and walking the dog count toward your total.
3. Kick the habit. Most people know smoking causes cancer, but it can also damage your heart and blood vessels, causing narrowing of the arteries (atherosclerosis) and ultimately leading to a heart attack. The good news is it’s never too late to stop smoking, and when you quit, your risk of heart disease drops almost to that of a nonsmoker in about five years.
4. Get on the scale. Being overweight can lead to conditions that increase your chances of heart disease, such as high blood pressure, high cholesterol and diabetes. One way to see if your weight is healthy is to calculate your body mass index (BMI), which uses your height and weight to find your percentage of body fat. Try this online BMI calculator.
If you’re overweight, even a small weight loss will help you. Reducing your weight by just 5 to 10 percent can help decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes.
5. Get enough quality sleep. It may surprise you to learn that people who don’t get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes and depression. If you wake up without your alarm clock and you feel refreshed, you’re getting enough sleep. But, if you’re constantly reaching for the snooze button and it’s a struggle to get out of bed, you need more sleep each night.
6. Get screened. High blood pressure and high cholesterol can damage your heart and blood vessels, but without testing for them, you probably won’t know whether you have them. If you have high risk for these diseases, such as obesity and family history, check with your doctor to see if you need these screenings.
Additionally, Maryland Primary Care Physicians offers a new testing method, called Carotid Intima-Media Thickness (CIMT), which can help identify people who may be at risk for developing cardiovascular disease. CIMT uses ultrasound to detect thickening in the inner lining of the carotid arteries in the neck, a risk factor for developing atherosclerosis, which often leads to a heart attack or stroke. Having this information can help you and your doctor devise a plan to lower your risk and prevent future problems.
Dr. David Jackson is board-certified in cardiology with extensive experience in all aspects of cardiovascular disease. He is is available for office consultations to assess patients’ cardiovascular risk factors. The Columbia Cardiology office provides high-quality, on-site cardiac stress testing and cardiac ultrasound testing. Contact us at 410-740-0789 or visit our site page.Heartburn, Acid reflux…How do I get relief?
A Q&A with Loraine Dailey, M.D.
Q: I’ve heard acid reflux can be serious. Is that true?
A: If you’ve been taking antacids and refraining from eating lots of different foods, but you still have acid reflux- or “heartburn”- you may have what doctors term GERD. GERD stands for GastroEsophageal Reflux Disease. And yes, while the symptoms are annoying, GERD can also be serious and cause long-term damage if left untreated.
Q: What causes GERD?
A: At the entrance to your stomach is a valve called the lower esophageal sphincter (LES.) Normally, the LES closes as soon as food passes through it. If it doesn’t close all the way, acid in your stomach can move up into the esophagus, irritating the lining. Symptoms can include burning chest pain/heartburn, a sour taste in the mouth, nausea and other pain. If you have symptoms more than twice a week, you should talk with your doctor. We know that untreated GERD can cause damage, such as esophageal bleeding and increase a person’s risk of esophageal cancer. Plus, newer treatments and lifestyle changes can make you feel better fairly quickly.
Q: What are the latest treatments?
A: If the GERD is not serious, the first course of treatment should focus on lifestyle changes. Patients should avoid or reduce foods that trigger symptoms or weaken the LES—common culprits include chocolate, fried or fatty foods, coffee, alcohol and peppermint. Other changes include losing weight, not snacking several hours before bedtime, quitting smoking and evaluating any medications that could make GERD worse. Some people benefit from raising the head of their bed by six inches or sleeping on a wedge to prevent acid from moving up into the esophagus.
For some, treatment may also require medication. We have an effective class of medications called proton pump inhibitors. They are sometimes combined with over the counter medications, such as antacids or foaming agents to coat the stomach. Other drugs, such as H2 blockers, help some people. If medications don’t work, there are surgical options but they are being used much less today. Talk with your doctor if you have persistent heartburn or think you have GERD. Together, you can come up with an effective treatment plan.
Diet After 50: Food Choices & Exercise Prove Critical
For adults age 50 and over, making healthy food choices and staying active are crucial lifestyle habits. Recent studies show that a good diet can not only help you resist illness and prevent certain diseases, but also defy or delay some of the common effects of aging.
“We need fewer daily calories as we age because our metabolism naturally begins to slow,” says MPCP Arnold physician, Amanda Malone, M.D. “Since you don’t need as many calories, those calories you do consume become very important. Your diet after age 50 should include a variety of healthy, nutrient-dense foods. Add in daily exercise and you’re on the path to a higher quality of life and enhanced independence as you age,” she adds.
Body Changes & Diet Needs
As we all know, our body changes with age. There is a reduction in muscle, an increase in body fat, and your total body water decreases by up to 20 percent. You need fewer calories than you did at a younger age since your basal metabolic rate decreases as muscle mass declines.
The good news is that moderate exercise helps preserve muscle mass and can slow the rate of this process. Of course, regular exercise has other benefits, including cardiovascular fitness, bone strength, better mobility and balance, as well as feelings of well-being. Dr. Malone adds, “Try to include exercise that increases lean muscle mass, like weight training. And consider yoga or pilates, which are great for flexibility and boosting your metabolism.”
Another effect of aging is that the body becomes less efficient at absorbing vital nutrients and minerals from our diet– including calcium, vitamin B and folate. Certain medications can also affect appetite, or block absorption of some vitamins and nutrients.
So, what should we “over 50s” do?
1. Make calories count.
“When patients ask ‘How many daily calories do I need?,’ I tell them it depends on how active they are and where their calories are coming from,” says Dr. Malone. Just counting calories isn’t enough for making smart food choices, but here are some general guidelines for maintaining (not losing) weight:
A woman over 50 who is:
-not physically active needs about 1600 calories a day
-somewhat active (housework, yard work, etc.) needs about 1800 calories a day
-very active (exercises regularly 30 mins. or more most days) needs about 2000 calories a day
A man over 50 who is:
-not physically active needs about 2000 calories a day
-somewhat active needs 2200-2400 calories per day
-very active needs 2400-2800 calories daily
These calories should come from a variety of fresh fruits and vegetables (5 a day when possible), unprocessed grains, and good sources of protein. To include more high quality protein in your diet, try replacing red meat and processed meat with fish, skinless chicken and turkey, low-fat dairy, and plant-based protein like beans, nuts and seeds.
“A variety of foods is best because you’ll have several sources of required vitamins and you won’t get bored by the same foods. Also, the more ‘whole’ unprocessed foods you can eat, the better. Go for the whole fruit, not fruit juices. Go for fresh, grilled or baked chicken, not processed lunch meat,” says Nurse Practitioner, Rachel Sweeney, of MPCP Arnold.
Also, if you are trying to maintain- or lose weight- keep track of daily calories with a food diary or a free app, such as myfitnesspal.com.
2. Drink water & eat more natural fiber.
As we age, we can become more prone to dehydration. Post a note in your kitchen reminding you to sip water throughout the day and to drink water with meals. Nutritionists say in general that 3-5 large glasses of water a day is adequate after age 50…you don’t need to go for 8-10 as we often hear. Make drinking more water a daily habit and you will help keep your mind sharp, and body regular. Staying hydrated keeps skin looking younger too!
Dietary fiber also helps keep the body and bowels regular, but can do much more, such as lower your risk of heart disease, diabetes, and certain cancers. Women over 50 should aim to eat at least 21 grams of fiber a day, and men over 50 at least 30 grams per day. Good sources of fiber include whole grains, oatmeal, beans, and uncooked fruits and vegetables like carrots, apples and berries.
3. Don’t skip meals.
While it’s okay to skip meals occasionally, regularly missing meals or heavily restricting calories is unhealthy. Nutritionists advise those over 50 to eat three meals a day, or to break meals up into 5 smaller meals.
“Skipping meals causes our metabolism to slow down, which affects energy level and usually doesn’t help with weight loss,” says Rachel Sweeney, CRNP. “When we skip eating, our blood sugar levels drop, but they can surge again when we eat a big meal. This yo-yo effect is unhealthy and it’s much better to keep our blood sugar levels more even throughout the day with regular, healthy meals.”
Starting the day with a healthy breakfast gets your body going and is a good way to get some fruit, fiber and protein in your diet. Try yogurt topped with bran cereal and berries, or a veggie-packed omlette, peanut butter on whole grain toast or old-fashioned oatmeal with walnuts and fruit.
Snacking is okay as well to tide you over and keep your energy up during the day. Choose healthy options like almonds over chips and fruit instead of cookies. Other good snacks are a slice of cheese and whole grain crackers, veggies and hummus, and even a small cup of soup.
4. Read labels, and cut added sugar and sodium.
While it takes a bit more work, reading food labels can definitely help you make better food choices. Labels break down how much protein, carbohydrates, fats, sodium, key vitamins and minerals, and calories are in a specific serving.
Each label also has an ingredients list, which lists the ingredients from largest amount to smallest. Once you start reading labels you’ll be surprised how many foods list sugar or high fructose corn syrup as the first (largest) ingredient! Sugar is added to many of our foods to enhance the flavor, but many are crediting all the sugar in our diet to the obesity epidemic. Sugar may also cause inflammation in the body, so limiting it is good not only for weight control, but also possible disease prevention.
Reducing sodium (salt) will help prevent water retention and high blood pressure. Look for “low-sodium” options when shopping or try to season meals with herbs and spices other than salt.
5. Be cautious about supplements.
If you are over 50, some of the key vitamins and minerals you should get enough of are vitamin B12, vitamin D, folate and calcium. It is better to meet your needs through diet, but these are so important that you might want to consider taking supplements. Talk to your doctor about which, if any, supplements you need and don’t overdo it. High doses of certain supplements can be harmful, especially if you are on medications.
6. Stay Active!!
The benefits of exercise throughout your life can’t be over-stated. But as you age, even moderate exercise has been proven to add years to your life—and to make those years more enjoyable and independent.
“Regular exercise slows the effects of aging and many age-related disorders such as diabetes, stroke, cardiovascular disease and osteoporosis,” says Dr. Malone. “But that’s only the tip of the iceberg. We know that exercise reduces the risk and seriousness of falls and fractures, keeps our minds sharp, and encourages social interaction,” she adds.
It’s never too late to start exercising either. Start slow– take the stairs instead of the elevator, keep carrying your groceries, and try a new exercise class. As always, talk to your doctor about an exercise plan, and which activities you should consider given your age and current health status.
Teen Stress: Tips for Parents
By: Lisa Meade, PA-C
A recent study by the American Psychological Association (APA) confirms what I see weekly in my practice: Teens feel a great deal of stress and anxiety, but often don’t have the proper coping strategies to deal with these feelings.
The APA report “Stress in America” included data on American youth (teens ages 13-17) for the first time this year. The report found that teens feel higher levels of stress than they think is healthy, but don’t necessarily try to adopt healthy coping strategies, or don’t know what those strategies are.
When I talk to my teen patients, they say trying to juggle school, their social life, and home life can be overwhelming. Expectations and pressure about college are particularly tough for older teens. Plus, we can all remember how important friends and “fitting-in” are at this age– which makes all of the social media and online chatter an extra stressor.
Parents can be a huge help in teaching teens healthy coping strategies and how to keep things in perspective. Here are some suggestions:
1. Know the signs of stress overload in your child. Common results of teen stress can be: Increased physical illness (headaches, stomachaches, chronic fatigue, muscle pain); “shutting down” or withdraw from people and activities; increased anger or irritability; difficulty sleeping or eating; increased tearfulness or feelings of worry; difficulty concentrating.
2. Be willing to listen and model stress coping skills. It’s important for teens to know that stress is part of life and sometimes admitting you are “stressed out” helps. Try to help your child identify what’s really giving them anxiety and then come up with some coping strategies together.
3. Encourage healthy lifestyle habits and reinforce those at home. Here are the things I tell my teen patients to try:
– Get enough sleep! Teens still need 8-10 hours of sleep a night, especially during the school week. Prioritize homework, social or sports activities, phone/TV time. You may not be able to do it all.
– Focus on your strengths. Think about the things you are really good at- or that make you happy- and find ways to spend time doing those things. It will build your confidence and you will find people with like interests.
– Get some exercise. Physical activity is a proven stress reducer. If you’re not on a sports team, find any activity that you enjoy and try to do it at least 30 minutes a day.
– Eat right! Skipping meals or drinking energy drinks will make you feel more stressed in the long run. Try to eat three healthy meals a day and don’t rely on caffeine to keep you going.
– Don’t try to be perfect! Remember that we all make mistakes and a bad choice now and then. Try to keep things in perspective and not focus on the negative. The ability to learn from mistakes and move on is a sign of maturity.
– Talk to someone. It’s much easier to manage stress with a helping hand. Talk to a parent, teacher, doctor, or other trusted adult. They may be able to help you find a way to manage a problem, such as practicing a response to a social situation, getting a tutor in a class, or dealing with a difficult transition such as moving or divorce.
If you feel that your stress is making you depressed, or you find yourself using drugs or alcohol to cope, please tell someone. It might be time to talk to a psychologist or trained professional.
Helping your teen learn healthy ways to cope with stress now will prepare them for a healthier adulthood. Part of the great challenge- and reward- of parenting!
