Diet, Cognitive Ability May Play Role in Heart Disease

Seniors who eat plenty of fruits and vegetables and who have good cognitive function are much less likely to die from heart disease than those who have poorer cognitive function and eat fewer fruits and vegetables, a new study has found.

Cognitive function refers to the ability to think, remember, plan and organize information.

Researchers at the Drexel University School of Public Health in Philadelphia analyzed diet and cognitive data on 4,879 people (3,101 women and 1,778 men), age 70 and older, who took part in the U.S. Longitudinal Study of Aging. The participants were followed for an average of seven years.

The analysis revealed that:

• Those who ate three or more servings of vegetables daily had a 30 percent lower risk for dying from heart disease and a 15 percent lower risk for dying from any cause during the follow-up period than those who ate fewer than three servings of vegetables a day.
• There was a significant association between higher consumption of fruits and vegetables and decreased prevalence of cognitive impairment.
• People who scored high on cognitive functions tests were less likely to die from heart disease or any other cause during the follow-up than were those with low scores.

The study was to be presented Wednesday at the American Heart Association's annual meeting in Orlando, Fla.

New Heart Attack Treatment Guidelines Stress Coordination

There's a message for doctors, hospitals and communities in new guidelines for treatment of coronary disease and heart attacks: Get organized.

Every community should have an organized system of emergency care for heart attacks, including programs to identify patients before they get to hospitals and strategies for getting them to medical centers equipped to perform artery-opening procedures, say the guidelines issued by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.

"The focus on integrated systems for patients with STEMI is important," said Dr. Sidney C. Smith Jr., a professor of medicine at the University of North Carolina, a past president of the American Heart Association and co-chair of the group that wrote the guidelines. "It affects a large number of the population that have heart attacks and will improve their treatment for sure."

STEMI is an acronym derived from the pattern seen on an electrocardiogram in the most severe form of heart attacks. The goal is to get a heart attack victim as quickly as possible to a medical center for what is formally called percutaneous coronary intervention (PCI) -- insertion of a balloon-tipped catheter into a blocked heart artery to reopen the blood vessel, usually followed by implantation of a stent, a thin tube, to be sure it remains open.

"The general recommendation is to move a patient if at all possible directly to hospitals where they are able to do immediate angioplasty [PCI]," said Dr. Spencer B. King III, president of the St. Joseph's Heart and Vascular Institute in Atlanta, a past president of the American College of Cardiology and co-chair of the guidelines group. "If that is not possible, then there should be very rapid transport to hospitals that do angioplasty."

The guidelines include recommendations on changes in treatment of heart attacks and coronary disease based on new research findings. For example, stenting now is recommended in many cases where the left main coronary artery, which provides blood to the majority of the heart, is blocked.

"It was previously thought not advisable to do it, but to go directly to bypass surgery," King said. "But evidence continues to build that for some patients with left main blockage, stenting should be considered."

Several studies, notably one from Korea, found similar outcomes for stenting or surgery in treating left main artery blockage, King said.

Other technical issues covered by the guidelines include:

• Recommendations on use of a powerful new clot-dissolving drug, prasugrel (Effient), as an alternative to clopidogrel (Plavix), commonly prescribed after PCI. The greater ability of the new drug to dissolve clots does carry an added danger of excessive bleeding.
• Use of a wire threaded into the coronary artery to gauge whether build-up of plaque deposits are great enough to warrant PCI.
• Use of aspiration thrombectomy, in which the clot causing a heart attack is sucked out before a stent is implanted.
• Recommendations on use of blood thinners and clot-dissolvers before, during or after PCI.
• Recommendations on the types of X-ray dye used to view the heart arteries during PCI in patients with chronic kidney disease.

"But the big recommendation is that we need to improve the system of how patients get into one hospital when they are having a heart attack and then get into another hospital, if necessary," Smith said.

The guidelines will be published in the Dec. 1 issues of the Journal of the American College of Cardiology and Circulation, and the Nov. 18 issue of Catheterization and Cardiovascular Interventions.

Tips for Cold Weather

When the weather gets cold, elders especially may develop a reduction in their body temperature more easily, as a result of decreased ability in temperature control and decrease in subcutaneous fat. Excessive drop in body temperature can lead to hypothermia. Elders with chronic illnesses, such as chronic respiratory diseases or asthma, are also vulnerable to disease deterioration in cold weather.

Cold Weather Tips

1. Put on adequate clothing. Wear several layers of not too tight or too bulky clothing. Always wear a hat and gloves, since ears and fingertips as well as noses are extremely susceptible to frost nip and frost bite.
2. Consume hot and easily digestible food and beverages with higher calories, like hot milk, soup, noodles and rice. Remember, alcohol actually accelerates the loss of body heat because it dilates blood vessels, so avoid alcoholic beverages.
3. Keep the home environment warm but well ventilated. Do not overload electricity supply.
4. Remain indoors or in places with sunlight. Continue with usual daily activities, but do more exercise to generate heat, improve blood circulation, and maintain flexibility of joints.
5. Exercise care and concern for the elderly. If you happen to know of a single elder living alone or with chronic illnesses, give him/her a call or pay a visit.
6. Stay off the ice. Determining the strength of ice is extremely difficult. Ice must be at least six inches thick to maintain the weight of a person and it takes weeks of freezing to get to that thickness.

How to Talk to your Doctor

Today, patients take an active role in their health care. You and your doctor will work in partnership to achieve your best possible level of health. An important part of this relationship is good communication. Here are some questions you can ask your doctor to get your discussion started:

About Your Disease or Disorder

• What is my diagnosis?
• What caused my condition?
• Can my condition be treated?
• How will this condition affect my vision now and in the future?
• Should I watch for any particular symptoms and notify you if they occur?
• Should I make any lifestyle changes?

About Your Treatment

• What is the treatment for my condition?
• When will the treatment start, and how long will it last?
• What are the benefits of this treatment, and how successful is it?
• What are the risks and side effects associated with this treatment?
• Are there foods, drugs, or activities I should avoid while I'm on this treatment?
• If my treatment includes taking a medication, what should I do if I miss a dose?
• Are other treatments available?

About Your Tests

• What kinds of tests will I have?
• What do you expect to find out from these tests?
• When will I know the results?
• Do I have to do anything special to prepare for any of the tests?
• Do these tests have any side effects or risks?
• Will I need more tests later?

Understanding your doctor's responses is essential to good communication.

Here are a few more tips:

• If you don't understand your doctor's responses, ask questions until you do understand.
• Take notes, or get a friend or family member to take notes for you. Or, bring a tape-recorder to assist in your recollection of the discussion.
• Ask your doctor to write down his or her instructions to you.
• Ask your doctor for printed material about your condition.
• If you still have trouble understanding your doctor's answers, ask where you can go for more information.
• Other members of your health care team, such as nurses and pharmacists, can be good sources of information. Talk to them, too.

Water Gives a Healthy Day

Water: Meeting Your Daily Fluid Needs

Ever notice how lifeless a house plant looks when you forget to water it? Just a little water and it seems to perk back up. Water is just as essential for our bodies because it is in every cell, tissue, and organ in your body. That's why getting enough water every day is important for your health.

Healthy people meet their fluid needs by drinking when thirsty and drinking fluids with meals. But, if you're outside in hot weather for most of the day or doing vigorous physical activity, you'll need to make an effort to drink more fluids.

Where do we get the water that we need?

Most of your water needs are met through the water and beverages you drink.
You can get some fluid through the foods you eat. For example, broth soups and other foods that are 85% to 95% water such as celery, tomatoes, oranges, and melons.

What does water do in our body?

Water helps your body with the following:

• Keeps its temperature normal.
• Lubricates and cushions your joints.
• Protects your spinal cord and other sensitive tissues.
• Gets rid of wastes through urination, perspiration, and bowel movements.

Why do we need to drink enough water each day?

You need water to replace what your body loses through normal everyday functions. Of course, you lose water when you go to the bathroom or sweat, but you even lose small amounts of water when you exhale. You need to replace this lost water to prevent dehydration.

Your body also needs more water when you are—

• In hot climates.
• More physically active.
• Running a fever.
• Having diarrhea or vomiting.

To help you stay hydrated during prolonged physical activity or when it is hot outside, the Dietary Guidelines for Americans 2005 recommend these two steps:

1. Drink fluid while doing the activity.
2. Drink several glasses of water or other fluid after the physical activity is completed.¹

Also, when you are participating in vigorous physical activity, it's important to drink before you even feel thirsty. Thirst is a signal that your body is on the way to dehydration.

Some people may have fluid restrictions because of a health problem, such as kidney disease. If your healthcare provider has told you to restrict your fluid intake, be sure to follow that advice.

Tips for Increasing Your Fluid Intake by Drinking More Water

Under normal conditions, most people can drink enough fluids to meet their water needs. If you are outside in hot weather for most of the day or doing vigorous activity, you may need to increase your fluid intake.

If you think you're not getting enough water each day, the following tips may help:

• Carry a water bottle for easy access when you are at work or running errands.
• Freeze some freezer-safe water bottles. Take one with you for ice-cold water all day long.
• Choose water instead of sugar-sweetened beverages. This tip can also help with weight management. Substituting water for one 20-ounce sugar-sweetened soda will save you about 240 calories.
• Choose water instead of other beverages when eating out. Generally, you will save money and reduce calories.
• Give your water a little pizzazz by adding a wedge of lime or lemon. This may improve the taste, and you just might drink more water than you usually do.

Do sugar-sweetened beverages should be counted?

Although beverages that are sweetened with sugars do provide water, they usually have more calories than unsweetened beverages. To help with weight control, you should consume beverages and foods that don't have added sugars.

Examples of beverages with added sugars:

• Fruit drinks.
• Some sports drinks.
• Soft drinks and sodas (non-diet).

Super Food & Health Food, Sprouts, Nutrition by Natalie

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