Are you ready to get answers to your most pressing heart health questions from a nationally known blood pressure expert and director of The Hypertension Institute?

Well, I’ve got great news! Dr. Mark Houston has agreed to answer your questions and I will be interviewing him later this month. I want to ask the questions you want answers to. Post your question as a comment to this post.

Here’s a little background information on Dr. Houston. He’s been practicing medicine since 1974 when he graduated from Vanderbilt Medical School. He went on to complete his medical internship and residency in California. He returned to Vanderbilt University Medical School and from 1978-1990 performed many roles including Medical Director and Associate Professor of Medicine.

Dr. Houston is triple board certified by the American Board of Internal Medicine, the American Society of Hypertension, and the American Board of Anti-Aging Medicine. In addition to his medical background he also obtained a masters degree in clinical human nutrition in 2003. In 2008, Dr. Houston was selected by Consumer Research Council as one the TOP PHYSICIANS in the United States. Just this past November and May, 2009, Dr. Houston was selected by USA Today as one of the most Influential Physicians in the U.S. in both hypertension and hyperlipidemia.

Dr. Houston is a consulting reviewer for over 20 major medical journal in the U.S., he’s completed over 70 clinical research studies in hypertension, hyperlipidemia, and cardiovascular disease, and Dr. Houston has published over 150 medical articles in peer-reviewed journals. He speaks nationally and internationally on hypertension and has written three best-selling books – The Handbook of Antihypertensive Therapy, Vascular Biology for the Clinician, and What Your Doctor Does Not Tell You About Hypertension: The Revolutionary Nutrition and Lifestyle Program to Help Fight High Blood Pressure.

The list of Dr. Houston’s accomplishments goes on and on. I’ve covered just some of the highlights of his career above. With all of his research commitments, speaking engagements, etcetera; he still works with patients one-on-one in Nashville, Tennessee, and teaches Vanderbilt medical students, interns, and residents.

This is a great opportunity for you to get your questions answered. When submitting your question, keep in mind Dr. Houston areas of specialty – hypertension (high blood pressure), lipid disorders (cholesterol/blood fats), prevention and treatment of cardiovascular diseases, nutrition, clinical age management and general internal medicine.

Make the most of Dr. Houston’s generous offer to make time in his busy schedule to answer your questions.

Submit your question by posting as a comment below.

All the best,
Lisa Nelson RD
Heart Healthy Tips

http://www.hearthealthmadeeasy.com

The U.S. Center for Disease Control has identified four lifestyle factors that can drastically reduce your risk of chronic disease, such as diabetes, heart disease, and cancer.

1. Do not smoke – ever.
2. Eat a diet high in fruits, vegetables, whole grains, and low in meat.
3. Exercise a minimum of 30 minutes everyday.
4. Keep your BMI less than 30.

These four factors were used to analyze a little over 23,000 Germans between the ages of 35 and 65. Only 9% met and maintained all 4 factors, but this 9% was 78% less likely to develop a chronic disease.

February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.

All the best,
Lisa Nelson RD
Heart Healthy Tips
http://www.hearthealthmadeeasy.com

Flavonoids are a type of antioxidant found in fruits, vegetables, and certain beverages. Flavonoids are a hot topic because of their reported antiviral, anti-allergy, antiplatelet (blood clotting), anti-inflammatory, anti-tumor (cancer), and antioxidants health benefits. Many of the beneficial effects of fruits, vegetables, tea, and red wine are linked to flavonoids versus known nutrients and vitamins.

Antioxidants protect cells against damage caused by free radicals, which lead to oxidative stress and cell damage. Oxidative stress is linked with cancer, aging, atherosclerosis, ischemic injury, inflammation, and neurodegenerative diseases. For example, the oxidation of LDL cholesterol plays a critical role in the development of heart disease.

Flavonoid Sources:

High Flavonoid Content (>50 mg/100 g of food)
Onion, kale, green beans, broccoli, endive, celery, cranberry, orange juice

Medium Flavonoid Content (1-5 mg/100 g of food)
Salad, tomato, bell pepper, strawberry, broad bean, apple, grape, red wine, tea, tomato juice

Low Flavonoid Content (<1 mg/100 g of food)
Cabbage, carrot, mushroom, pea, spinach, peach, white wine, coffee

If you struggle to eat a wide variety of fruits and vegetables everyday consider supplementing your diet with Juice Plus to boost your daily antioxidant intake.

All the best,
Lisa Nelson RD
Heart Healthy Tips

Lisa Nelson RD #9: Vitamin D Deficiency Symptoms – Is there a connection between vitamin D and heart disease? What level vitamin D should individuals maintain to prevent heart problems?

Dr. Shelby-Lane: It is a known and documented fact that too little Vitamin D puts the heart at risk. Yet many patients are not routinely tested, and if so, they do not take the proper steps to reach optimal Vitamin D levels between 50 to 100 ng/dL. Most lab tests give 30 as a low normal, yet this is not optimal. This can by done by diet, sun exposure (in most cases) or adequate supplementation. But most of all, people are not tested. Research suggests Vitamin D deficiency may be an unrecognized heart disease risk factor.

Researchers say a growing body of evidence suggests that vitamin D deficiency increases the risk of heart disease and is linked to other, well-known heart disease risk factors such as high blood pressure, obesity, and diabetes.

For example, several large studies have shown that people with low vitamin D levels were twice as likely to have a heart attack, stroke, or other heart-related event during follow-up, compared with those with higher vitamin D levels.

“Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated,” says researcher James H. O’Keefe, MD, director of preventive cardiology at the Mid America Heart Institute in Kansas City, Mo., in a news release. “Vitamin D is easy to assess and supplementation is simple, safe and inexpensive.”

Most of the body’s vitamin D requirements are met by the skin in response to sun exposure. Other less potent sources of vitamin D include foods such as salmon, sardines, cod liver oil, and vitamin D-fortified foods like milk and some cereals. Vitamin D can also be obtained through supplements.

Vitamin D deficiency is on the rise. Vitamin D deficiency symptoms are traditionally associated with bone and muscle weakness, but in recent years a number of studies have shown that low levels of the vitamin may predispose the body to high blood pressure, congestive heart failure, and chronic blood vessel inflammation (associated with hardening of the arteries). It also alters hormone levels to increase insulin resistance, which raises the risk of diabetes.

In a review article published in the Journal of the American College of Cardiology, researchers surveyed recent studies on the link between vitamin D deficiency and heart disease to come up with practical advice on screening and treatment.

They concluded that vitamin D deficiency is much more common than previously thought, affecting up to half of adults and apparently healthy children in the U.S.

Researchers say higher rates of vitamin D deficiency may be due in part to people spending more time indoors and efforts to minimize sun exposure through the use of sunscreens. Sunscreen with a sun protection factor (SPF) of 15 blocks approximately 99% of vitamin D synthesis by the skin.

“We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight,” says O’Keefe. “A little bit of sunshine is a good thing, but the use of sunscreen to guard against skin cancer is important if you plan to be outside for more than 15 to 30 minutes of intense sunlight exposure.”

Testing for Vitamin D Deficiency

Vitamin D levels can be measured with a blood test for a specific form of vitamin D called 25-hydroxy vitamin D (25(OH)D). Vitamin D deficiency is defined as a blood 25(OH)D level below 20 ng/dL. Normal levels are considered to be above 30 ng/dL.

Again, criteria for optimal levels is between 50 to 100 ng/dl.

All the best,
Lisa Nelson RD
Heart Healthy Tips

Whole grain nutrition sales have increased 17% in the last year according to the Packaged Facts market research firm. Whole grain nutrition is linked to numerous benefits, such as decreased heart disease risk, improved digestive health, and reduction in cancer. Retail sales hit $5 billion in 2008 and anticipated to reach $6 billion by 2013.

Fortunately, this appears to be a new trend that is not a short term “fad”!

Great sources of whole grain nutrition include:

100% whole wheat bread
Whole wheat pasta
Whole grain cereal
Barley
Oatmeal
Brown rice
Wild rice
Buckwheat
Millet
Popcorn
Quinoa
Amaranth

Receive a step by step plan to promote heart health and weight loss with a Mini Diet Makeover. As a special New Year’s bonus you’ll receive a complimentary copy of the Calorie Counter for Dummies. Learn more here – http://www.lisanelsonrd.com/minidietmakeover.html

You can learn more about how to use dietary fiber to reduce heart disease risk here.

Share how you have increased your whole grain intake below!

All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight
http://www.hearthealthmadeeasy.com

Let’s talk about snacks for a moment. I believe there is a general perception that snacking is bad and you need to cut out snacking if you want to lose weight and be heart healthy. Well, the opposite is actually true. Let me explain.

It is important to eat regularly, every 3-4 hours to maintain your metabolic rate, promote stable blood sugar levels, and prevent insulin spikes. By maintaining a high metabolism you boost the calories you burn throughout the day, which helps you lose weight. By maintaining stable blood sugar levels and preventing insulin spikes you will prevent drops in energy and halt a chain reaction that can lead to heart health complications (increased C-reactive protein, increased blood viscosity, increased clotting factor, increased free radical damage, etc.).

Now, this doesn’t mean just any food will work. You need to select heart healthy snacks. This means eating snacks that balance carbohydrates with protein and/or heart healthy fats. Fat and protein slow the breakdown of carbohydrates, preventing the rapid rise in blood sugar and the corresponding increased insulin release.

Here are healthy snacks that are high in carbohydrates:

Whole grain crackers
Dried Fruit
Pretzels
Fig bars
Fresh fruit

You can make these snacks heart healthy by combining with a protein. These protein sources that are easy to include with snacks:

Glass of skim milk
Yogurt
Cheese
Nuts
Peanut Butter

Here’s an example of how you can apply this to your daily snacks.

Mid-morning snack: Yogurt with granola
Mid-afternoon snack: Nuts mixed with dried fruit
Evening snack: Light frozen yogurt topped with strawberries

Receive a step by step plan to promote heart health and weight loss with a Mini Diet Makeover. As a special New Year’s bonus you’ll receive a complimentary copy of the Calorie Counter for Dummies. Learn more here – http://www.lisanelsonrd.com/minidietmakeover.html

All the best,
Lisa Nelson RD
a target=”_blank” href=”http://www.lisanelsonrd.com/howtolowercholesterol.html”>How to Lower Cholesterol in 8 Simple Steps

All right, this green tea article has been hanging over my head for at least a month now. I just couldn’t get motivated to wade through all the research to determine if yes, this is an effective way to lower cholesterol and prevent heart disease, or no, it’s just a lot of hype.

Well, I sat down and sorted it all out today and here’s what I found.

Health Claim

The proposed health claim for green tea is that drinking at least 5 fluid ounces as a source of catechins may reduce risk factors associated with cardiovascular disease.

What are catchins?

Green tea contains catechins, which are a type of flavenoid with antioxidant properties. Antioxidants slow the oxidation process. The oxidation of LDL molecules is what results in plaque formation. Therefore, increasing antioxidant intake should slow oxidation of LDL, resulting in less arterial plaque formation.

Also, when molecules are oxidized, free radicals are released that damage cells. These free radicals can increase inflammatory issues associated with cardiovascular disease.

How flavenoids work

The body recognizes flavenoids as foreign particles and works to eliminate them from the body. Flavenoids themselves do not act as an antioxidant and they are poorly absorbed by the body. However, the proposed benefit of extra flavenoids is that as the body eliminates the unwanted flavenoids, damaging free radicals are also eliminated.

Tea production

The various types of tea are produced differently. The leaves of oolong tea and black tea are allowed to oxidize (enzymes in the tea change catechins to larger molecules). Green tea is not oxidized, but produced by steaming fresh-cut leaves whereby enzymes are inactivated and little oxidation occurs. The least processed tea is white tea, which contains the highest levels of catechins. Green tea contains the second highest catechin level, approximately 125 mg catechins per serving (or ~25% dry weight of fresh tea leaves).

Here’s a little breakdown on tea oxidation:
Black tea – Highest oxidation; also, highest caffeine content and strongest flavor; 90% of all tea served in the West is black tea
Oolong tea – 10-70% oxidized
Green tea – Low oxidation
White tea – Minimal oxidation; Uncured, unfermented; Lower caffeine content that other teas

FDA Review

In 2005, the FDA did not approve the health claim for green tea, because the link between green tea and reduced cardiovascular disease risk was too weak and more conclusive evidence was needed.

Recent Research

This past June, 2008, a study was published that links green tea to reduced flow-mediated dilation of brachial arteries (major blood vessels in the upper arms). Flow-mediated dilation is related to coronary endothelial function and is an indicator for cardiovascular disease risk. Increased dilation is good. It means the heart has to do less work to move blood throughout circulation. (The endothelium is the inner layer of an artery, which blood flows against.)

This was a study of 14 healthy individuals that consumed 6 grams of green tea, followed by a measure of flow-mediated dilation. The results showed an increased flow-mediated dilation with tea (peak at 30 minutes post consumption). There was no change to antioxidant status after consumption. It’s proposed that the improved flow-mediated dilation is how green tea reduces cardiovascular disease risk.

The Hype

I came across multiple articles with headlines screaming “Green Tea Protects Against Heart Disease” since this study was published in June. I think there is significant research that still needs to be completed before it can be determined for sure how tea works to prevent heart disease. A study of 14 individuals is a small study.

Drinking 6 grams of green tea, would equal about three – 6 ounce cups of green tea each day. (Based on making 1 six ounce cup of tea with 1 teaspoon or 2.25 grams of green tea.) However, the study results are based on consuming 6 grams of tea in one setting followed by improved flow-mediated dilation at peak levels 30 minutes after consumption. How likely is it for you to drink three cups of tea quickly, back-to-back to reproduce the short-term benefit shown in this study?

To me, that is not a very effective way to reduce heart disease risk. But, I will say that if you like green tea – drink it. Many studies are showing that green tea is beneficial to heart disease. The what, how, and how much is yet to be determined. Who knows what future studies will find?!

To receive regular heart health and weight loss tips for dietitian Lisa Nelson, sign up for The Heart of Health and grab your copy of the special report “Stop Wasting Money – Take Control of Your Health” today!

All the best,
Lisa Nelson RD

A recent study published this past September compared the benefits of flax oil versus fish oil in raising blood levels of heart healthy omega 3’s. Adequate omega 3 intake is linked to lower blood pressure, lower triglycerides, increased HDL cholesterol, and reduced arterial inflammation.

Flax oil contains the omega 3 fatty acid ALA (alpha-linolenic acid), while fish oil contains EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). The benefits of ALA continue to be studied, but EPA and DHA have been positively linked to heart benefits.

The body can convert ALA to EPA and DHA, but it’s been well known that this conversion process is not efficient. According to a recent study published in Nutrition Reviews, 8-20% of ALA is converted into EPA. From this, only 0.5-9% is converted to DHA.

To test the benefits of ALA supplements (flax oil) in amounts commonly consumed, the study followed 62 firefighters. The participants were divided into 6 groups and monitored for 12 weeks. Here are the six groups:

1.2 grams of flax oil per day
2.4 grams of flax oil per day
3.4 grams of flax oil per day
0.6 grams of fish oil per day
1.2 grams of fish oil per day
Sunflower placebo

Results showed an increase of EPA and DHA in the blood for those taking both levels of fish oil supplements. The EPA levels in red blood cells almost doubled by the studies end.

Now, the flax oil supplements did not have the same result. Those receiving 1.2 grams of flax oil daily did not show a significant rise in EPA and DHA, only ALA. The 2.4 g and 3.6 g flax oil supplements increased ALA, EPA, and DHA levels. EPA was increased 30% with a 2.4 g supplement and 40% with 3.6 g of flax oil daily. However, there was no corresponding increase in DHA. This confirmed the original belief that conversion of ALA into DHA is minimal.

The results of this study support my recommendations related to omega 3 supplements. First, consume a diet rich in omega 3 fatty acids (i.e. fish, nuts, flaxseed). Second, select a fish oil supplement high in EPA and DHA. Choose a supplement with 850 mg of DHA and EPA per gram of fish oil. Third, if you do not tolerate fish oil, select a flax oil supplement providing at least 1 gram of omega 3 fatty acids daily.

Sign up for The Heart of Health ezine to receive regular heart health and weight loss tips from dietitian Lisa Nelson. Subscribers receive the free e-course “8 Simple Steps to Lower Cholesterol”.

All the best,
Lisa Nelson RD

I’m sure you’ve heard of the Mediterranean Diet and its’ link to heart health. The Mediterranean Diet emphasizes fruits, vegetables, whole grains, fish, and monounsaturated fats (olive oil).

Those that follow a Mediterranean Diet have a reduced risk of developing heart disease and dying from a heart attack. Even those that have survived a heart attack and lived to adopt the Mediterranean Diet significantly reduced their risk of a second heart attack and other complications.

In an interesting twist, while many westerns try to follow a Mediterranean diet to reduce heart disease, the native Mediterranean population has gradually adopted a more Western diet. The Mediterranean area has seen an income rise that’s resulted in extra dollars being spent on meat and saturated fat food sources, leading to the negative results those of us in the U.S. are all too familiar with. Over the past 4 decades the average calorie intake in the Mediterranean countries has increased ~30%. So, the once healthy Mediterranean people now face increasing weight epidemics – 75% of the population overweight or obese in Greece, with over half of the population in Italy, Spain, and Portugal following suit. These countries are now supporting the “Mediterranean Diet” as a part of their cultural heritage they can not let die.

Here’s a quick breakdown of the characteristics common to a Mediterranean Diet:

• Consume high intake of fruits and vegetables
• Select whole grains
• Consume healthy fats (canola and olive oil)
• Eat nuts in moderation
• Low red wine consumption
• Limit eggs to less than 4 times per week
• Consume little red meat
• Eat fish regularly

Let’s get into more specifics.

Fruits, vegetables, and whole grains
A high intake of fruits, vegetables, and whole grains reduces LDL (the “bad”) cholesterol that leads to a build-up of arterial plaque. Grains in the Mediterranean region are whole grain with very little unhealthy trans fats. Breads in the Mediterranean region are typically eaten without butter or margarine.

Healthy Fats
When following a Mediterranean diet you need to choose fats wisely. Include monounsaturated fat and polyunsaturated fats. Sources of these healthy fats include olive oil, canola oil, nuts, and fish. The Mediterranean diet approach does not include a high saturated fat intake or trans fatty acids, both of which contribute to heart disease.

Olive oil – provides monounsaturated fat, which helps reduce LDL cholesterol. To receive the highest level of antioxidant benefits, select “extra-virgin” and “virgin” olive oils, the least processed forms. When you see the term “light” on olive oil labels, it indicates a reduced olive flavor.

Nuts – high in fat and calories, but low in saturated fat and depending on the nut you select can be a good source of heart healthy omega 3 fatty acids (i.e. walnuts). Eat in moderation due to high calorie content and limit the heavily salted nuts or honey roasted.

Wine
Red wine can have a similar affect to aspirin in that it reduces blood clotting. Red wine also contains antioxidants. If you’ve been following my posts, you know that I am not a supporter of using alcohol to reduce heart disease risk. If you already drink wine, continuing to do so in moderation (less than 4 ounces of wine per day) may be beneficial. If you do not currently consume wine, I do not recommend you start. Too much wine will counteract your good intentions and lead to additional complications, such as increased blood pressure.

Omega 3’s and Fish
Increase your intake of heart healthy omega 3 fatty acids, which are linked to reduced triglycerides, reduced arterial inflammation, lower blood pressure, and high HDL (good) cholesterol. Include fish (I don’t mean battered and fried) as a regular part of your diet in place of the more typical red meats, use flaxseed in your diet, and consider an omega 3 supplement.
You’ll receive regular heart health and weight loss tips from dietitian Lisa Nelson when you subscribe to The Heart of Health ezine and start your journey to heart health with the free e-course “8 Simple Steps to Lower Cholesterol Naturally” today!

All the best,
Lisa Nelson RD

A study from the National Cancer Institute found individuals consuming the most red and processed meats at greater risk of death from cancer and heart disease versus those eating lower levels.

The ten year study began in 1995 and evaluated the dietary intake of over 500,000 men and women between the ages of 50 and 71. The study divided types of meat into three categories – red meat, white meat, and processed meat.

Red meat was defined as beef, pork, ham, bacon, hamburger, hot dogs, liver, pork sausage, and steak. As well as meats found in foods like pizza, stews, and lasagna.

White meat was classified as fish, chicken, and turkey.

Processed meat included white or red meats that were cured, dried, or smoked, such as bacon, chicken sausage, lunch meats, and cold cuts.

Individuals eating red meat at the highest levels consumed ~4.5 ounces per day based on a 2,000 calorie/day diet. This is equal to approximately 2 pounds of beef or pork each week. Compare this to the group with the lowest intake of red meat at 5 ounces per week or ~ 0.5 ounce per day.

Those with the highest intake of processed meat consumed approximately 1.5 ounces per day versus the lowest intake group at 0.11 ounces per day.

Men eating red meat at the higher levels each day had a 31% greater risk of dying and women 50% greater risk of dying due to heart disease. The study found that 11% of all deaths in men and 16% of all deaths in women could’ve been prevented by consuming the lower levels of red meat. Looking at just heart disease, death due to heart disease could have been reduced 11% in men and 21% in women if red meat intake was reduced from the highest level to the lowest.

A high intake of processed was linked to a 16% increased risk of dying for men and 25% increased risk for women.

This doesn’t mean you need to switch to a vegetarian diet. Individuals eating white meat had a slightly lower risk of death.

Possible reasons for the increased risk of death linked to eating red meat and processed meat maybe due to the carcinogens formed during cooking, iron in red meat causing oxidative cell damage, and/or saturated fat in red meat increased cancer risk and elevated cholesterol levels.

Here are some tips for making wise meat selections.

1. Select lean cuts of meat, such as your “loins” and “rounds”.
2. Choose cuts of meat with the least amount of marbling (visible fat).
3. Trim visible fat before cooking.
4. Marinate before grilling. May decrease formation of carcinogens if marinated in beer or wine prior to cooking.
5. Broil versus frying or roast large cuts and skim off the fat.
6. Drain oil and rinse ground beef in hot water to decrease fat.

All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps