Amy Hirsch, founder and owner of Precision Pilates and Wellness, LLC, a boutique Pilates Studio, invites the community to celebrate the grand opening of their new location at 110 Lake Avenue South, Suite #45, Nesconset on April 9 from 11 a.m. to 1 p.m. The newly renovated Precision Pilates and Wellness is located in the Lake Industrial Park at 110 Lake Ave South, Suite #45, Nesconset.
The studio will be offering tours, unveiling new equipment and fitness amenities. Attendees will enjoy refreshments and nibbles, along with raffles, giveaways, and sale of up to 20% off fitness wear and more. Special discounts on intro packages and individual Pilates sessions will also be offered at the event.
“We are thrilled to introduce and share our new state of the art Pilates Health and Wellness Facility,” said Hirsch.
“For the past 9 years, we have truly enjoyed helping our clients energize their lives and improve their overall health and wellness, strength, posture, and flexibility by offering affordable, personalized Classical Pilates instruction. Now with our expansion and the opening of Precision Pilates, we are excited to offer many mor class options, beyond Reformer Pilates, including Tower, Equipment, Mat and Privates based on the original work of Joseph Pilates.”
The event is FREE to the public and all ages and fitness levels are welcome. Attendees are encouraged to wear fitness attire and be ready to try out the new space. RSVP via email at [email protected] or visit https://smithtownpilates.com/open-house/ to schedule a tour. For more information, class schedules, or to reserve classes online visit www.SmithtownPilates.com.
Most of us know we need to lower our sodium intake. Still, more than 90 percent of us consume far too much sodium (1). Even if we don’t have hypertension, the impact of sodium on our health can be dramatic.
Sodium is insidious; it’s in foods that don’t even taste salty. Bread products are among the primary offenders. Other foods with substantial amounts of sodium include cold cuts and cured meats, cheeses, pizza, poultry, soups, pastas, sauces and, of course, snack foods. Processed foods and those prepared by restaurants are where most of our consumption occurs (2).
On the flip side, only about two percent of people get enough potassium from their diets (3).
Why is it important to reduce sodium and increase potassium? A high sodium-to-potassium ratio increases the risk of cardiovascular disease by 46 percent, according to the study, which looked at more than 12,000 Americans over almost 15 years (4). In addition, both may have significant impacts on blood pressure and cardiovascular disease.
To improve our overall health, we need to shift the sodium-to-potassium balance so that we consume more potassium and less sodium. And if you struggle with high blood pressure, this approach could help you win the battle. Let’s look at the evidence.
Why do we always harp on sodium?
Two studies illustrate the benefits of reducing sodium in high blood pressure and normotensive (normal blood pressure) patients, ultimately preventing cardiovascular disease, including heart disease and stroke.
The first used the prestigious Cochrane review to demonstrate that blood pressure is reduced by a significant mean of −4.18 mm Hg systolic (top number) and −2.06 mm Hg diastolic (bottom number) involving both normotensive and hypertensive participants (5). When looking solely at hypertensive patients, the reduction was even greater, with a systolic blood pressure reduction of −5.39 mm Hg and a diastolic blood pressure reduction of −2.82 mm Hg.
This was a meta-analysis (a group of studies) that evaluated data from 34 randomized clinical trials, totaling more than 3,200 participants. Salt reduction from 9 to 12 grams per day to 5 to 6 grams per day, determined using 24-hour urine tests, had a dramatic effect. The researchers believe there is a direct linear effect with salt reduction. In other words, the more we reduce the salt intake, the greater the effect of reducing blood pressure.
The authors recommend further reduction to 3 grams per day as a long-term target for the population and concluded that the effects on blood pressure will most likely result in a decrease in cardiovascular disease.
In the second study, a meta-analysis of 42 clinical trials, there was a similarly significant reduction in both systolic and diastolic blood pressures (6). This study included both adults and children. Both demographics saw a reduction in blood pressure, though the effect was greater in adults. Interestingly, an increase in sodium caused a 24 percent increased risk of stroke incidence but, more importantly, a 63 percent increased risk of stroke mortality. The risk of mortality from heart disease was increased alongside an increase in sodium, as well, by 32 percent.
In an epidemiology modeling study, the researchers projected that either a gradual or instantaneous reduction in sodium would save lives (7). For instance, a modest 40 percent reduction over 10 years in sodium consumed could prevent 280,000 premature deaths. These are only projections, but in combination with the above studies, they may be telling.
Why is potassium important?
When we think of blood pressure, not enough attention is given to potassium. The typical American diet doesn’t contain enough of this mineral.
In a meta-analysis involving 32 studies, results showed that as the amount of potassium was increased, systolic blood pressure decreased significantly (8). When foods containing 3.5 to 4.7 grams of potassium were consumed, there was an impressive −7.16 mm Hg reduction in systolic blood pressure with high blood pressure patients. Anything more than this amount of potassium did not have any additional benefit. Increased potassium intake also reduced the risk of stroke by 24 percent. This effect was important.
The reduction in blood pressure was greater with increased potassium consumption than with sodium restriction, although this was not a head-to-head comparison. The good news is that potassium is easily attainable in the diet. Foods that are potassium-rich include bananas, almonds, raisins, sweet potato and green leafy vegetables such as Swiss chard.
The bottom line: decrease your sodium intake by almost half and increase potassium intake from foods. Lowering sodium intake may have far-reaching benefits, and it is certainly achievable. First, consume less and give yourself a brief period to adapt — it takes about six weeks to retrain your taste buds, once you cut your sodium. You can also improve your odds by increasing your dietary potassium intake, which also has a substantial beneficial effect, striking a better sodium-to-potassium balance.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
Mather Hospital in Port Jefferson has been awarded a $25,000 Innovation Grant Award from the Katz Institute for Women’s Health (KIWH) to pilot an Integrative Oncology Program that will focus on both the physical and mental pain of cancer patients.
“Pain management is cited by the American Cancer Society as a top priority for oncology patients, as the physical attributes of the diagnosis and treatment of cancer are amplified by emotional and spiritual suffering,” KIWH stated in awarding the grant.
The Community Integrative Care Oncology program aims to expand community access to evidence-based integrative care modalities for women with an oncology/hematology diagnosis.
“We will be providing acupuncture, meditation, reiki, nurse coaching, aromatherapy, etc. to women with an active cancer diagnosis or women who are survivors of cancer,” said Marie O’Brien, NP, Coordinator and Nurse Practitioner for Mather Hospital’s Integrative Pain Management Program. Nurses in the program include Patricia Dodd, NP, Maria Rubino, NP, and Margaret Scharback, RN.
Patients will register through Patient Access for the services, which will be offered at the hospital. The services will be offered free of charge to participants.
O’Brien said the staff has received additional training and plans to launch the clinic in April.
Suffolk County Legislator Sarah Anker visited three local supermarket stores in March to distribute COVID-19 at-home test kits to their employees. She met with managers and employees of the Stop and Shops in Rocky Point and Miller Place, as well as the King Kullen in Middle Island, where she distributed over 700 test kits between the three stores.
This effort follows Legislator Anker’s recent Drive-Thru Test Kit Distribution event which was open to all residents, as well as the dissemination of boxes of test kit to the various senior communities and day care centers in the area.
“I want to thank the essential workers of our local supermarkets, who worked tirelessly throughout the worst days of the COVID-19 pandemic. It is my hope that these COVID-19 test-kits will help to keep the stores’ workers and patrons safe and healthy as we start to work our way back to a sense of normalcy,” said Legislator Anker.
“I also want to express my appreciation for our Local Unions 338 and 1500, who represent the workers of Stop and Shop and King Kullen. Through these challenging times, our local unions have continued to dedicate themselves to ensuring workers and their families are protected and supported,” she said.
If you are one of the 32.5 million in the U.S. who suffers from osteoarthritis, you know it can make it painful to perform daily tasks. Osteoarthritis (OA) most often affects the knees, hips and hands and can affect sleep quality and mood, in addition to mobility.
Common first-line medications for arthritis pain are acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen. Unfortunately, while medications treat the immediate symptoms of pain and inflammation, they don’t slow osteoarthritis’ progression, and they do have side effects, especially with long-term use.
Here, we’ll focus on approaches you can use to ease pain without reaching for the medicine cabinet. Some may slow worsening — or even reverse symptoms — of your osteoarthritis.
Does dairy help or hurt?
With dairy, specifically milk, there is conflicting information. Some studies show benefits, while others show that it may contribute to the inflammation that makes osteoarthritis pain feel worse.
In the Osteoarthritis Initiative study, researchers looked specifically at joint space narrowing that occurs in those with affected knee joints (1). Results showed that low-fat (1 percent) and nonfat milk may slow the progression of osteoarthritis in women. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space over a 48-month period.
The result curve was interesting, however. For those who drank from fewer than three glasses a week up to 10 glasses a week, the progression of joint space narrowing was slowed. However, for those who drank more than 10 glasses per week, there was less beneficial effect. There was no benefit seen in men or with the consumption of higher fat products, such as cheese or yogurt.
However, the study was observational and had significant flaws. First, the 2100 patients were only asked about their milk intake at the study’s start. Second, patients were asked to recall their weekly milk consumption for the previous 12 months before the study began — a challenging task.
On the flip side, a study of almost 39,000 participants from the Melbourne Collaborative Cohort Study found that increases in dairy consumption were associated with increased risk of total hip replacements for men with osteoarthritis (2).
Getting more specific, a published analysis of the Framingham Offspring Study found that those who consumed yogurt had statistically significant lower levels of interleukin-6 (IL-6), a marker for inflammation, than those who didn’t eat yogurt, but that this was not true with milk or cheese consumption (3).
We are left with more questions than answers. Would I recommend consuming low-fat or nonfat milk or yogurt? Not necessarily, but I may not dissuade osteoarthritis patients from yogurt.
Does vitamin D help?
Over the last decade, the medical community has gone from believing that vitamin D was potentially the solution to many diseases to wondering whether, in some cases, low levels were indicative of disease, but repletion was not a change-maker. Well, in a randomized controlled trial (RCT), the gold standard of studies, vitamin D had no beneficial symptom relief, nor any disease-modifying effects (4). This two-year study of almost 150 men and women raised blood levels of vitamin D on average to 36 ng/ml, which is considered respectable. Researchers used MRI and X-rays to track their results.
The role of weight
Weight management is a crucial component of any OA pain management strategy. In a study involving 112 obese patients, those who lost weight reported a reduction of knee symptoms. Even more exciting, there was also disease modification, with reduction in the loss of cartilage volume around the medial tibia (5).
On the other hand, those who gained weight saw the inverse effect. A reduction of tibial cartilage is potentially associated with the need for knee replacement. The relationship was almost one-to-one; for every 1 percent of weight lost, there was a 1.2 mm3 preservation of medial tibial cartilage volume, while the exact opposite was true with weight gain.
Exercise and diet for the win!
Diet and exercise trumped the effects of diet or exercise alone in a well-designed study (6). Patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant improvements in function and a 50 percent reduction in pain, as well as reduction in inflammation, compared to those who lost 5 to 10 percent and those who lost less than 5 percent. This study was a randomized controlled single-blinded study with a duration of 18 months.
Researchers used biomarker IL6 to measure inflammation. The diet and exercise group and the diet-only group lost significantly more weight than the exercise-only group, 23.3 pounds and 19.6 pounds versus 4 pounds. The diet portion consisted of a meal replacement shake for breakfast and lunch and then a vegetable-rich, low-fat dinner. Low-calorie meals replaced the shakes after six months. The exercise regimen included one hour of a combination of weight training and walking with alacrity three times a week.
Therefore, concentrate on lifestyle modifications to reduce pain and potentially disease-modifying effects. The best effects shown are with weight loss and with a vegetable-rich diet. In terms of low-fat or nonfat milk, the results are controversial at best. For yogurt, the results suggest it may be beneficial for osteoarthritis, but stay on the low end of consumption, since dairy can increase inflammation.
References:
(1) Arthritis Care Res online. 2014 April 6. (2) J Rheumatol. 2017 Jul;44(7):1066-1070. (3) Nutrients. 2021 Feb 4;13(2):506. (4) JAMA. 2013;309:155-162. (5) Ann Rheum Dis. 2015 Jun;74(6):1024-9. (6) JAMA. 2013;310:1263-1273.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.
On March 31, Governor Kathy Hochul announced that nearly 70 million COVID-19 over-the-counter tests have been distributed by the State so far as part of ongoing efforts to protect New Yorkers during the pandemic.
“As we’ve seen throughout the pandemic, test kits are a critical tool in the fight to stop the spread of COVID-19 and prevent exposure to others,” Governor Hochul said. “We have already distributed nearly 70 million COVID-19 tests, and we will continue to focus our efforts on distributing at-home tests to New Yorkers and build up our stockpile so we can bolster our preparedness for the future, keep our communities safe, and safely move forward through this pandemic.”
As more New Yorkers utilize at-home tests over on-site testing, the State is scaling down its testing sites. The State has retained contracts to swiftly re-open testing sites through June if needed. Nearly 100,000 tests have been conducted at state testing sites since January 7. There are 1,910 registered locations to obtain a test in New York State, locations can be found here. All 15 of the State’s vaccine sites remain open and New Yorkers over the age of 50 are encouraged to get a second booster in accordance with the recently expanded CDC guidance.
State Health Commissioner Dr. Mary T. Bassett said, “The distribution of at-home COVID-19 tests is a critical tool helping to curb spread in our communities. I thank Governor Hochul and our partners at the Division of Homeland Security and Emergency Services for distributing millions of rapid test kits statewide, particularly to high risk communities. New research released by the Center for Disease Control and Prevention reminds us that we must continue to center equity across all of our pandemic response efforts. In getting tests to nursing homes, senior centers, food banks, and NYC Housing Authority tenants, and in keeping our state-run mass vaccination sites open to all, that’s exactly what New York State is doing.”
Division of Homeland Security and Emergency Services Commissioner Jackie Bray said, “COVID is still a very real threat and it’s critical we remain vigilant in our work to protect communities. Thanks to Governor Hochul’sleadership, New York has expanded our testing distribution operation to a scale few might have thought possible just a year ago, but we cannot rest on this accomplishment alone. As we move forward into the spring, we will continue to support our local partners however we can to ensure New Yorkers have the tools to stay safe and healthy.”
Since the beginning of the year, 68,890,256 million tests have been distributed throughout New York, including over 33 million tests to schools, 19.5 million tests to nursing homes and adult-care facilities, and more than 12.5 million tests to local officials, including counties, for public distribution in their respective communities. The distribution efforts follow the procurement of more than 90 million rapid tests in recent months.
Earlier this month, Governor Hochul announced that more than 20 million COVID-19 over-the-counter tests will be distributed across the state through the Spring to bolster New York State’s ongoing preparedness efforts.
The Spring plan includes distributions of over-the-counter test kits to nursing homes, adult care facilities, NYC Housing Authority tenants, food banks, senior centers, and schools, while also partnering with elected officials for distribution to the public, during the next few months to help identify new COVID-19 cases and keep New Yorkers safe.
Ahead of the Omicron surge in late 2021, Governor Hochul and her team identified the need to secure over-the-counter test kits to combat the Omicron surge, providing regular distributions to the general public, prioritizing schools and adult care facilities across the state.
Of the over 90 million tests procured, nearly 23 million tests have been stored to help prepare for any potential surges later this year.
March is national Brain Injury Awareness Month, and in recognition Suffolk County Legislator Kara Hahn (D-Setauket) honored Selden based not-for-profit “The Social Brain” for its work to support the needs of impacted individuals and families on March 8.
“The Social Brain” works to reduce the social isolation that is often associated with a brain injury diagnosis by holding monthly events that include sports programs, bowling, baseball games, art paint nights, nature walks and picnics for individuals and families. Additionally, the organization increases awareness of brain injuries through its community outreach efforts at local schools and neighborhood events.
According to the Brain Injury Association of America, more than 3.6 million people of all ages sustain brain injuries in the United States every year with over 5.6 million Americans living with a permanent brain injury-related disability.
In 2007, Suffolk County declared each second week of March as Traumatic Brain Injury Awareness Week.With a goal to further public recognition of brain injuries, Legislator Hahn this month introduced legislation to illuminate the County’s H. Lee Dennison Building in green each March beginning in 2023.
That’s the advice of area physical therapists and orthopedic surgeons as Major League Baseball returns with a shortened spring training.
Some of the less experienced players, particularly those who might feel they need to prove something each time they step on the field, are especially vulnerable to injuring themselves, suggested Dr. James Penna, orthopedic surgeon and chief of Sports Medicine at Stony Brook Medicine.
“You’ll see the experienced players won’t go through it [but] the injury rate among the [players that have been in the league] for five years and under will be higher,” Penna said.
The challenge for players, even at the professional level, is that their training strengthens their body and increases their speed, but it doesn’t help with the kind of urgency a game situation creates for athletes.
“They’re not doing stuff that’s high stakes,” Penna added. “That’s the real difference.”
Staying busy in leagues where no one is watching and then returning to the bright lights of Yankee Stadium or a nationally televised game can cause stress hormones like cortisol to increase.
“It takes three to six years [as a professional athlete] depending on the sport, where you start to get into a routine where it’s not all energy and angst,” Penna said. The athletes who do the same thing all the time won’t have any change in their bodies or their minds when they return to major league games.
Pitchers are among the most vulnerable baseball athletes, as they may try to stretch themselves out with too many pitches and too many innings quickly, said Joel Marimuthu, supervisor of rehabilitation services at Huntington Hospital.
Looking back at 2020, when spring training was also shortened amid the COVID-19 pandemic, the number of injuries increased, Marimuthu said.
“If the players are watching what happened in 2020, especially with all the increased elbow, shoulder, back, hamstring pulls, they’ll be mindful this season,” Marimuthu said.
Complete preparation for game situations includes a range of training and body conditioning and a gradual increase from working in a gym or on a field somewhere to playing in a game.
“You never want to go from 0 to 60 as an athlete,” said Marimuthu. “You want to come up to speed gradually.”
Training a range of muscles involved in different activities can improve strength and flexibility and reduce the risk of injuries, doctors said.
“We see the most benefit from athletes staying balanced,” Penna said. “If you work on a flexion activity, you have to work on an extension activity. As much as it’s become cliche, you have to cross train.”
Even if athletes don’t participate in different sports, they need to engage in activities such as yoga, pilates and lower body work to prevent injuries, Penna said.
Athletes at any level, who think they might have sustained an injury, run the risk of more significant damage if they play through discomfort that goes beyond the usual wear and tear from sports.
Physical therapists use the acronym PRICE as a guide: protect, rest and ice, Marimuthu said.
College sports injuries
The pandemic has created a similar situation for college athletes, who weren’t able to compete for varying lengths of time amid canceled and shortened seasons.
With fewer games and matches, numerous athletes got injured as they returned to
game action.
“We saw a very, very rapid uptick in injuries,” Penna said.
Athletes had higher injury rates in upper body, lower body and core muscles.
Sports hernias were also prevalent, as student athletes didn’t do enough dynamic exercises to strengthen their core and increase their flexibility.
For female athletes, the injuries to their lower extremities are “through the roof,” Penna said, including to the anterior cruciate ligament in the knee. “The ACL [injury] rates among girls is bad.”
Penna urges athletes not to wear cleats on turf. Even though a sneaker might slip, and athletes might not be able to run as fast, they won’t likely have the kind of tearing that comes from a shoe that’s gripping the ground while the rest of the leg moves in another direction.
Coaches and trainers should “go to great lengths to make sure their quads are balanced with their hamstrings and their core is well maintained,” Penna said.
Young athletes in general ignore their core, which means more than just sit ups. Penna suggested they do more dynamic motions, like lunges.
Penna said it’s natural amid stronger competition for athletes of any level to push themselves to levels that might cause injury.
With so many experts available to help with sports injuries, injured athletes of any age and ability, from weekend warriors to high school and college athletes, have numerous places they can go for advice and care after an injury.
Marimuthu and Penna both suggested that the first point of contact should be a primary care physician.
“I’ve always felt comfortable keeping strong primary care doctors around to keep us honest,” Penna said.
Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States, yet it is one of the most preventable types of cancer. For 2021, the National Cancer Institute reported nearly 150,000 new cases diagnosed with approximately 53,000 fatalities. Affecting men and women of all racial and ethnic groups, colorectal cancer is most often found in people age 50 and older.
One of the biggest challenges physicians face when discussing colorectal cancer is debunking myths surrounding identifying and treating the disease. Catholic Health Gastroenterologist Kanika Kaur, MD, addressed what she commonly hears from patients.
Myth: There is nothing I can do to lessen my risk of colon cancer.
Fact: There is a lot people can do to reduce their risk of colon cancer. A diet low in red meat and processed meat, high in fruits and vegetables is very important. Smoking is a well-known risk factor for colon cancer along with many other cancers. Also, regular exercise may reduce your risk of developing colorectal cancer. The single biggest modifiable risk factor for colorectal cancer is failure to be screened. Colorectal cancers develop from pre-cancerous polyps, which are growths on the lining of the colon and rectum. Screenings detect and allow doctors to remove polyps before they become cancerous.Colonoscopy with polyp removal reduces the risk of developed colon cancer by up to 90%
Myth: Colorectal cancer is fatal.
Fact: Colorectal cancer is highly treatable, especially when detected early. More than 90% of patients with a localized cancer that is confined to the colon or rectum are alive five years after diagnosis. Sadly, about only one-third of colorectal cancers are diagnosed at an early stage. A majority of cases are identified when the disease has spread beyond the wall of the colon or rectum and to other parts of the body. This decreases the chances of the cancer being cured.
Myth: I should only have a screening if I have symptoms.
Fact: This is false. The reality is that early colorectal cancer usually has no symptoms. This is why it is important to get screened. It is recommended all men and women age 45 and older should have a screening. Those with a personal or family history of colon cancer, a history of inflammatory bowel disease and those with symptoms such as rectal bleeding are considered at high risk and may need to be screened before the age of 45. Additionally, women with a personal or family history of ovarian, endometrial or breast cancer may also need to be screened at an earlier age.
Myth: Only those with a family history of colon cancer are at risk.
Fact: Nearly three-quarters of all new colorectal cancer cancers are with individuals with no known risk factors for the disease.
Myth: Colorectal cancer affects only older, white men.
Fact: Colorectal cancer impacts men and women. Additionally, people of color are more likely to be diagnosed with colorectal cancer in its advanced stages, suggesting that they may require colon cancer screening at a younger age.
Myth: A colonoscopy is a difficult procedure.
Fact: A colonoscopy is not painful. The most unpleasant part of the procedure is the preparation that is required the day before the exam. But this is important as an inadequate prep may lead to missed findings such as polyps or a need to repeat the procedure.
Myth: Finding a colon or rectal polyp means I have cancer and need surgery.
Fact: A polyp is a pre-cancerous lesion that, if not treated, can progress to cancer. If polyps are detected early and removed before they can progress, colon cancer can be prevented. Colonoscopy and sigmoidoscopy have been shown to prevent deaths from colon cancer – a fact that has been well demonstrated over time. Most polyps are treated by removing them during the colonoscopy. Even large polyps can be removed without surgery.
More information on Catholic Health’s comprehensive colorectal cancer and digestive health services may be found by visiting chsli.org. To find a Catholic Health physician near you, please call (866) MY-LI-DOC.
About Catholic Health
Catholic Health is an integrated system encompassing some of the region’s finest health and human services agencies. The health system has 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices.
Medications and lifestyle changescan reduce your risk
By David Dunaief, M.D.
With all of the attention on infectious disease prevention these past two years, many have lost sight of the risks of heart disease. Despite improvements in the numbers in recent years, heart disease still underpins one in four deaths in the U.S., making it the leading cause of death (1).
Heart disease is on the decline due to a number of factors, including better awareness in lay and medical communities, improved medicines, earlier treatment of risk factors and lifestyle modifications. We are headed in the right direction, but we can do better. Heart disease is something that is eminently preventable.
Reduce your baseline risks
Significant risk factors for heart disease include high cholesterol, high blood pressure and smoking. In addition, diabetes, excess weight and excessive alcohol intake increase your risks. Unfortunately, both obesity and diabetes are on the rise. For patients with type 2 diabetes, 70 percent die of cardiovascular causes (2).
Inactivity and the standard American diet, rich in saturated fat and calories, also contribute to heart disease risk (3). The underlying culprit is atherosclerosis, fatty streaks in the arteries.
Another potential risk factor is a resting heart rate greater than 80 beats per minute (bpm). In one study, healthy men and women had 18 and 10 percent increased risks of dying from a heart attack, respectively, for every increase of 10 bpm over 80 (4). A normal resting heart rate is usually between 60 and 100 bpm. Thus, you don’t have to have a racing heart rate, just one that is high-normal. All of these risk factors can be overcome.
Medication’s role in reducing risk
Cholesterol and blood pressure medications have been credited to some extent with reducing the risk of heart disease. Unfortunately, according to 2018 National Health and Nutrition Examination Survey (NHANES) data, only 43.7 percent of those with hypertension have it controlled (5). While the projected reasons are complex, a significant issue among those who are aware they have hypertension is a failure to consistently take prescribed medications, or medication nonadherence.
In terms of lipids, statins have played a key role in primary prevention. Statins are effective at not only lowering lipid levels, including total cholesterol and LDL — the “bad” cholesterol — but also inflammation levels that contribute to the risk of cardiovascular disease. The JUPITER trial showed a 55 percent combined reduction in heart disease, stroke and mortality from cardiovascular disease in healthy patients — those with a slightly elevated level of inflammation and normal cholesterol profile — with statins.
The downside of statins is their side effects. Statins have been shown to increase the risk of diabetes in intensive dosing, compared to moderate dosing (6).
Unfortunately, many on statins also suffer from myopathy (muscle pain). I have had a number of patients who have complained of muscle pain and cramps. Their goal is to reduce and ultimately discontinue their statins by following a lifestyle modification plan involving diet and exercise. Lifestyle modification is a powerful ally.
Do lifestyle changes really help?
The Baltimore Longitudinal Study of Aging, a prospective (forward-looking) study, investigated 501 healthy men and their risk of dying from cardiovascular disease. The authors concluded that those who consumed five servings or more of fruits and vegetables daily with <12 percent saturated fat had a 76 percent reduction in their risk of dying from heart disease compared to those who did not (7). The authors theorized that eating more fruits and vegetables helped to displace saturated fats from the diet. These results are impressive and, to achieve them, they only required a modest change in diet.
The Nurses’ Health Study shows that these results are also seen in women, with lifestyle modification reducing the risk of sudden cardiac death (SCD). Many times, this is the first manifestation of heart disease in women. The authors looked at four parameters of lifestyle modification, including a Mediterranean-type diet, exercise, smoking and body mass index. The decrease in SCD that was dose-dependent, meaning the more factors incorporated, the greater the risk reduction. SCD risk was reduced up to 92 percent when all four parameters were followed (8). Thus, it is possible to almost eliminate the risk of SCD for women with lifestyle modifications.
Monitoring your heart disease risk
To monitor your progress, cardiac biomarkers are telling, including inflammatory markers like C-reactive protein, blood pressure, cholesterol and body mass index.
In a cohort study of high-risk participants and those with heart disease, patients implemented extensive lifestyle modification: a plant-based, whole foods diet accompanied by exercise and stress management (9). The results showed an improvement in biomarkers, as well as in cognitive function and overall quality of life. Most exciting is that results occurred over a very short period to time — three months from the start of the trial. Many of my patients have experienced similar results.
Ideally, if patient needs to use medications to treat risk factors for heart disease, it should be for the short term. For some patients, it may be appropriate to use medication and lifestyle changes together; for others, lifestyle modifications may be sufficient, as long as patient takes an active role.
By focusing on developing heart-healthy habits, we can improve the likelihood that we will be around for a long time.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.