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Education, Medication, Diet, and Exercise

The list of diseases such as high blood pressure, diabetes, and stroke that can be managed, cured or prevented is endless. Certainly, cholesterol and heart disease are at the top of the list. Studies clearly demonstrate that managing cholesterol through education, medication, diet and exercise can significantly reduce the risk of heart disease.

Education –

Know your numbers. Learn the difference between unsaturated and saturated fats. Make yourself a student of healthy living through diet and exercise. Avoid fads and focus your effort on scientifically proven methods. Many experts feel that those with genetically high cholesterol should use exercise and diet to maintain health but will also need require the addition of a statin drug to manage cholesterol effectively.

Statin Drugs -

There are many methods to lower your LDL (bad cholesterol). However, no method has been proven more successful than statin drugs. Multiple landmark studies confirm that for those individuals needing statin drugs to control their cholesterol, the benefits far outweigh the risks.

By inhibiting an enzyme in the liver, statin drugs limit the liver’s ability to produce cholesterol thereby significantly lowering LDL (bad cholesterol) and triglycerides and modestly increasing HDL (good cholesterol). As a result, their unique benefits include preventing and reducing plaque in arteries, stabilizing existing plaque, reducing inflammation of the arterial wall, and improving overall vascular function. Statin Drugs Include: Lipitor (atorvastatin); Lescol (fluvastatin); Mevacor (lovastatin); Pravachol (pravastatin); Zocor (simvastatin); Crestor (rosuvastatin).

Clinical studies that have shown that statin drugs significantly reduce the risk of heart attack and death in patients with proven coronary artery disease (CAD) and can also reduce cardiac events in patients with high cholesterol levels who are at increased risk for heart disease. And although statins are best known for lowering cholesterol, they may also have several other benefits: they may prevent Alzheimer’s disease, and they may also have a positive impact on diabetes and blood pressure.

Exercise –

Second only to statin drugs, no other method of the prevention of CAD has proven more effective than exercise, specifically aerobic exercise. It is well documented that physically active people have a lower incidence of CAD than sedentary people. For the prevention of CAD, the following exercises are defined as aerobic: High Amount/High Intensity – a caloric equivalent of jogging 20 miles per week at 65 -80 percent intensity, Low Amount/High Intensity – a caloric equivalent of jogging 12 miles per week at 65 to 80 percent intensity, Low Amount/Moderate Intensity – a caloric equivalent of walking 12 miles per week at 40 to 55 percent intensity.

Exercise is a valuable prevention tool on many levels: it reduces weight, LDL, and blood pressure, and it increases HDL. Research has found that the amount of exercise matters more than the intensity. For example, those exercising 5 or more days per week benefited more than those exercising less often. However, it is important to remember that ALL exercise groups showed improvement.

Diet –

Following a Mediterranean diet is one way you can reduce CAD and cut your risks for other diseases. While no Mediterranean diet has more value than another, the following equation highlights the factors that make a Mediterranean diet so valuable. First, eat a variety of fruits, vegetables, whole grains, beans, nuts, and seeds, with olive oil as an important source of fat. Then, add moderate amounts of fish, poultry and fresh dairy. Finally, subtract red meat from your diet, or at least limit your consumption.

The Dietary Approaches to Stop Hypertension (DASH) diet is the American version of the Mediterranean diet and has been found to reduce blood pressure and LDL levels. It is rich in fruits and vegetables, moderate in low-fat dairy, and low in animal protein. It promotes the use of legumes and nuts as plant sources of protein.

Along with increasing your plant-based foods and decreasing your consumption of red meat, you may also want to replace some of the carbohydrates in your diet with proteins or monounsaturated fats. This switch can improve lipid levels.

Fiber, Nuts, Tea, and Alcohol –

Dietary soluble fibers such as pectin, wheat dextrin, and oat products will reduce LDL. Some suggest that a combination of soluble fiber with plant sterols may be beneficial. Walnuts, high in polyunsaturated fatty acids, have been shown to positively impact serum lipid levels. Almonds, pistachios and other nuts have shown similar results. Those consuming nuts more than four times per week showed the most significant improvement. Also, those with moderately high LDL who drank green tea once to twice per day while following a low-fat diet found more improvement in LDL reduction than they did with a placebo. Moderate alcohol consumption (1-2 drinks per day) has been shown to improve HDL levels. Red wine has the added antioxidant benefit even in its non-alcohol form. 

Weight Loss –

Fat cells secrete chemicals that negatively affect lipid metabolism. “Maintaining a body that is slim and trim with consistent exercise and a low-calorie diet limited in saturated fats is the key”

Supplements –

While the internet is littered with information on thousands of supplements claiming to lower cholesterol and provide other life enhancing outcomes, few are proven effective. Of these, only fish oil, taken in concentrated high doses (> 6g/day) has been proven to lower triglycerides and LDL.

Multivitamins, soy proteins, and other grain products, while not cholesterol reducing, are valuable to many. But when it comes to reducing cholesterol, garlic, policosanol, Vitamin E, and isoflavone supplements have failed the scrutiny of scientific research. Plant sterols such as BenecolR sisosterol and campesterol, found in Promise activTM, have been shown to slightly reduce serum cholesterol levels; however, no studies have demonstrated their ability to lower the incidence of CAD. In fact, the Nutrition Committee of the American Heart Association has suggested that the general population not use these products until further studies determine their safety and efficacy, due in part to potential side effects.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Many Health Benefits of Love and Valentine's!

This year, Valentine’s Day is Valentine’s Weekend! And, while you may wonder what that has to do with health and wellness, you might be surprised to learn that love can be good for your health! Studies show that it is in our DNA to seek out good relationships and that these solid relationships can lead to a happier, safer and healthier life. Conversely, infatuation and less committed, volatile relationships that are “on and off,” are very stressful and unhealthy. But those fortunate to participate in a stable and satisfying long-term relationship are the beneficiaries of many health benefits! Whether you have spouse, partner, or close friend, (love is love is love), feeling connected, respected, valued, and loved is critically important to your health and wellness! So celebrate Valentine's Day and enjoy all the love that surrounds you!

10 Ways Love and Valentine's are Good for You!

  1. Less Sick Visits to your Physician - The US Department of Human Services found that couples in a committed long-term relationship are less likely to require sick visits to their physician. And, when hospitalized, these “love birds,” have shorter hospital stays. One theory for this health benefit is that couples in good relationships watch after each other to ensure regular healthy visits for routine care and testing. Consequently, they are less likely to have unexpected serious illnesses.
  2. Less Depression & Substance Abuse - Experts feel that social isolation is associated with unhealthy behavior and depression. Happy, loving and committed couples are far less likely to suffer from depression. Furthermore, these couples are less likely to engage in risky and unhealthy behaviors such as excessive drinking and drug abuse.
  3. Lower Blood Pressure - Researchers have found a strong relationship between marital status and blood pressure. Happily married couples have the lowest, while unhappily married couples have the highest. Happy singles scored somewhere in between. It is also interesting to note that non-married committed couples and well-adjusted singles with strong support groups had lower blood pressure.
  4. Less Anxiety - Studies show that long-term committed couples have far less anxiety than new romance. MRI brain scans found both groups showed high activation in areas of the brain related to romance, but only new couples had activation of the area of the brain associated with anxiety.
  5. Pain Control - A CDC report on pain included a study of more than 127,000 adults and found that married people were less likely to complain of headaches and lower back pain. In fact, one study showed, when a happily married couple held hands, pain thresholds improved and, the happier the marriage, the greater the effect.
  6. Better Stress Management - Similar to the findings on pain, there is a strong link between happy and committed couples and stress management. The support and love from a strong and healthy relationship provides good coping methods to help overcome adversity…job loss, illness etc. 
  7. Boosted Immune System - Solid loving relationships can boost your immune system. In fact, researchers at Carnegie Mellon University found that people who exhibit positive emotions are less likely to get sick after exposure to cold or flu viruses.
  8. Quicker Healing Time - It may be that a wound from “Cupid’s Arrow” will heal faster when you are in a loving relationship. Researchers at Ohio State University Medical Center gave married couples superficial wounds and followed their healing time. The wounds healed nearly twice as fast in spouses who interacted warmly compared with those who behaved with hostility.
  9. Longevity - Strong research indicates that married people live longer. Researchers found that people who had never been married were 58% more likely to die than married people. Some reasons purported were mutual financial, emotional and physical support and assistance from children. One common denominator for a short life span is loneliness and those in a healthy relationship may live longer because they feel loved and connected.
  10. Happiness - A study in the Journal of Family Psychology showed that happiness depends more on the quality of family relationships than on the level of income.  So, according to the research, when it comes to a long, happy and healthy life…love is more important than money!

SOURCES: WebMD

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

There is plenty of summer remaining … so make time to get to the water! Research shows that spending time outdoors has many positive effects on your health. Moreover, new research has found that being near a body of water makes us calmer and healthier. You know that special feeling you get when you drive to the lake or the beach and jump out of the car and smell the fresh air and hear the sound of splashing in the lake or the waves of the ocean? Well, it is not just because you’re on vacation…the water makes your muscles relax and breath deeper. Your brainwaves slow down to simulate the gentle roll of the water…lake or ocean! These “blue environments,” not to be confused with “blue zones” are the subject of extensive research at the University of Exeter Medical School in the UK.

Time spent near water promotes physical activity, general fitness and well-being. In addition, noted for reducing the incidence of diabetes and other diseases associated with obesity. Additionally, time near the water slows down our heart rate, reduces stress hormones and improves mental health. In fact, the study also found that subconsciously, people consistently preferred pictures of natural environments (rivers, lakes, oceans) even when compared to attractive urban landscapes. In fact, urban landscapes with water (rivers, fountains etc) were far more popular than those without. Also, health disparities between coastal and inland communities are more noticeable for low-income individuals who do not have the means to venture to the coast. This may be one of the reasons that four out of the five “Blue Zones” discovered by Dan Buettner are islands.

WHY BEING IN, ON, OR AROUND THE WATER IS HEALTHY

In addition to the benefits of being by a body of water, just being outdoors promotes better health and wellness:

Sources: NIH, Global News, Plume, L, University of Exeter Medical School in the UK.

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

February is American Heart Month!

American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease.

Not So Young at Heart!

A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.

What does this mean?

The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.

What Can You Do?

The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.

The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.    

The Calculator - For Example:

Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.

The CDC “Heart Age Test” is simple:

Visit: www.framinghamheartstudy.org or www.heartfoundation.org

Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc

Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.

Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.

The Solution

To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).

In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.

What Individuals can do…

What Public Health Policy Can do…

BY THE WAY…I took the test:

Male: 65

Systolic Blood Pressure: 110

No high blood pressure or diabetes; non smoker

BMI: 22.5

HEART AGE: 62

SOURCES: WWW.CDC.GOV

EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog

EVERY SUNDAY in "The Sunday Times" - Read Dr. Paul J. Mackarey “Health & Exercise Forum!” in hard copy

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!

Heart Rate, or pulse, is the speed or number of times the heart beats (measured by the number of contractions of the heart) per minute. It can be detected in areas of the body where the artery is close to the skin: the palm side of the wrist, side of the neck, groin, back of the knee, or top of the foot. In healthy adults, a resting heart rate is between 60 and 100 beats per minute, however, in conditioned athletes, it is often well below 60. When the heart rate is not within normal parameters, it can be an indication of what is happening around you…fear, anxiety, fatigue, contentment, or a medical problem.

Determine Your Resting Heart Rate

The first step to determine the status of your heart rate (HR) is to measure your resting heart rate. A normal resting heart rate for a healthy adult is between 60 and 100 beats per minute. The best time to measure it is immediately after you wake up in the morning before you get out of bed (or when sitting and relaxing). Place your index and middle fingers on the side of your neck or on the palm side of your wrist. Then, count the number of beats you feel for 60 seconds. 

Interpreting Results

Whether you determine that your HR is too high or too low don’t panic. Take your HR repeatedly and document results so you can discuss it with your primary care physician. It is not unusual to find a wide range of numbers which varies individually. For example, it is not unusual for a conditioned athlete (marathon runner) to have a resting HR of mid to high forties or low fifties. More common in the general population, however, is a high resting HR and this can be an indication of a potential health problem. When your resting HR is high it indicates that your heart is working harder than it needs to…especially if you are at rest! Remember, your heart is a muscle and it doesn’t work very efficiently when it is deconditioned…it has to work harder than it should to pump blood through your body, even at rest!

Some reasons for a high resting heart rate:

Tips to Lower Your Resting Heart Rate

All is not lost! The good news is that you can lower your resting heart rate and improve heart health with a few lifestyle changes.

Exercise

Probably the best way to lower your resting HR is to avoid a sedentary lifestyle and get moving. Inactivity leads to a downward spiral of poor health …obesity and its associated problems of high blood pressure, and diabetes.   

Remember, you don’t have to run 26.2 miles to be fit and healthy. The American Heart Association recommends 150 minutes of moderate-intensity aerobic exercise per week. And, it can be broken down into 10-15-20 minute sessions once, twice or three times per day.

Stress Management

The negative impact of stress and anxiety on health and wellness is well document. While avoiding stress may not be possible, one can learn to manage it. Exercise is one effective way but there are others. Meditation, breathing exercises and yoga are a few. Visit a YouTube video on Progressive Muscle Relaxation (PMR).

Limit Caffeine and Avoid Nicotine

Caffeine and nicotine are stimulants and can raise your heart rate.

Maintain a healthy body weight

Losing weight will lower your HR. A healthy diet that maintains a body mass index (BMI) between 18 and 25 for adults is an essential component to a lower HR and overall good health. A BMI over 25 is considered overweight and over 30 obese. Use the BMI calculator from the CDC at: www.cdc.gov>adult_bmi

Hydration

Dehydration can lead to thicker blood. Thicker blood requires the heart to work harder to circulate blood throughout the body. Drinking plenty of water, (15.5 cups for men and 11.5 cups per day for women), will adequately hydrate the body.

Sleep

For many, getting 8 hours of sleep per night is easier said than done. But, adequate sleep contributes to overall good health and a lower heart rate.

Lowering your resting heart rate is an essential component to good health. The steps necessary to attain a lower heart rate such as exercise, eating healthy, maintaining a healthy BMI, hydrating, and getting adequate sleep will also contribute to overall physical and mental health and wellness. Discuss how you might begin your journey to a healthier lifestyle with your primary care physician or health care professional.

SOURCES: Cleveland Clinic; Johns Hopkins University, Centers for Disease Control

Read Dr. Mackarey’s Health & Exercise Forum – Every Monday

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.

For further inquires related to this topic email: drpmackarey@msn.com

For all of Dr. Mackarey's articles visit https://mackareyphysicaltherapy.com/forum/

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.

February is American Heart Month!

American Heart Month is not just for lovers. Long after the Valentine’s roses wilt, our hearts will require special attention for a long healthy life. It is the goal of The National Heart, Lung, and Blood Institute to motivate Americans to adopt healthy lifestyles to prevent heart disease. And, in 2021, a healthy heart may be more important than ever to reduce the risk of severe illness from COVID-19.

Not So Young at Heart!

A recent study by the Center for Disease Control (CDC) found that while many Americans believe that they are “young at heart”, it turns out that many have hearts older than their actual age. For example, the study found that the average American male heart is eight years older and the average American female heart is five years older than their chronological age.

What does this mean?

The CDC’s findings may offer some explanation for the fact that many Americans die from heart attacks, strokes, and heart failure when compared to other people around the globe. Furthermore, while more Americans use heart medications more than other people in the world, heart attack and stroke continue to be the leading cause of death in the US, killing more than 80,000 each year.

What Can You Do?

The CDC has developed a new test to determine “Heart Age,” which has been found to be a much more reliable indicator of a person’s risk for heart disease. The heart age test will determine if your heart is older, younger or average for your age, which can be much more important for longevity than chronological age.

The CDC is encouraging people to take matters into their own hands …be proactive. In addition to calculating your Body Mass Index ((BMI), the CDC is asking people to use an online calculator to determine their heart age. The calculator will give a person a more accurate percentage of risk for heart attack or stroke. Based on the outcome, one must see their family physician or cardiologist to discuss the results and implement a plan.    

The Calculator - For Example:

Heart Age is very easy to use: You just need to enter your age, sex, blood pressure, whether you are treated for high blood pressure, whether you smoke or have diabetes, and your body mass index (BMI), with a handy calculator if you don’t know it. The tool gives you your risk for heart disease in the next ten years, compared with normal.

The CDC “Heart Age Test” is simple:

Visit: www.framinghamheartstudy.org

Enter: sex, blood pressure, (list if controlled), diabetes (list if controlled), smoking history, and body mass index (BMI), a simple height/weight calculation found on-line at www.bmicalculator.cc

Example: A 53 year old women with an acceptable BMI, may actually find that she is at great risk for suffering a heart attack or stroke because she smokes cigarettes and has uncontrolled high blood pressure. The calculator includes all the significant factors proven by science to affect a person’s risk of heart attack or stroke. These include: blood pressure, weight, BMI, blood sugar, cholesterol, age, sex and smoking history.

Example: 50 year old male smoker has uncontrolled high blood pressure of 140/96, no history of diabetes, and a BMI of 30 has a predicted heart age of 72 years. A female with a similar profile would have a heart age of 74 years.

The Solution

To some, the solution may be obvious and for others it may be impossible. In the previous example of the 50 year old smoker, if he quit smoking for one year, he would halve reduced his heart age by 14 years (15 years for a woman). If he would reduce his blood pressure to 120, he would reduce his heart age by 6 years (10 years for a woman). And, if both risk factors were removed, he would reduce his heart age by 19 years (23 for a woman).

In the above examples, the 53 year old man does not have to take his 72 year old heart age as a death sentence.

What Individuals can do…

What Public Health Policy Can do…

Require health plans to cover, with limited co pays or deductibles, preventative services such as blood pressure screening nutritional counseling, prescription exercise and tobacco cessation products.

Promote health, wellness through diet and exercise by sponsoring health fairs and establishing bike lanes and walking trails in the community.

Read Dr. Mackarey’s Health & Exercise Forum – Every Monday

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician.

For further inquires related to this topic email: drpmackarey@msn.com

See all of Dr. Mackarey's content at: https://mackareyphysicaltherapy.com/forum/

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.