diet, Everyday Living, Fitness, lifestyle, New Face of 60, SUPER AGERS, WELLNESS

CAN A NUMBER SAVE YOUR LIFE?

Excerpted from The Harvard Report

One thing I’ve learned is that today, more than ever, you MUST advocate for yourself when it comes to medical care. I’m super lucky in that I’m healthy and don’t really have anything big going on at this point. But, the more you know about the basics, the healthier you can stay!

You have so many important numbers to remember—your bank account PIN, your kids’ phone numbers, and your alarm system code, just to name a few. Numbers that may be less familiar are the ones you learn when you see your doctor for a routine physical and blood tests—your waist circumference, body mass index (BMI), blood pressure, cholesterol, triglycerides, and blood sugar. You need to know these six numbers because they provide important clues to your heart health.

Once you know your numbers, you can take steps to lessen your heart risks through some small, common-sense lifestyle changes. “The key is to focus on control of blood pressure, cholesterol, blood sugar, and weight, to exercise and eat right, and to avoid tobacco. That is good advice for everyone trying to reduce their risk of heart disease,” says Deepak Bhatt, professor of medicine at Harvard Medical School, and director of the Integrated Interventional Cardiovascular Program at Brigham and Women’s Hospital.

Even if you have a genetic propensity for heart disease that you’ve inherited from a parent, lifestyle changes to get your numbers under control can make you less likely to develop heart problems. Adopting lifestyle measures may also lower your odds of getting diabetes and reduce the excess weight that can lead to joint pain, allowing you to lead a more mobile, independent life.

1 Waist circumference

Why it matters: Carrying too much extra weight around your middle puts you at increased risk for heart disease and type 2 diabetes.

How to measure it: You can measure your waist circumference at home. Wrap the tape measure around your middle, about at the level of your belly button. It’s also helpful to calculate your waist-to-hip ratio—the size of your belly compared to your hips. To get this ratio, divide your waist circumference by your hip circumference.

What’s healthy:

  • 35 inches or less waist circumference
  • 0.8 or lower waist-to-hip circumference
    How to bring your numbers into normal range:
  • Pick up the pace. Walk, swim, bike, or dance for at least 60 minutes on most days of the week.
  • Alternate aerobics with at least two days a week of strength training.
  • Before you eat, consider whether you’re really hungry. Never eat while reading a book, working, or watching TV. You could consume more calories than you intended.
  • Avoid high-calorie, high-sugar packaged and processed foods.

2 Body mass index (BMI)

Why it matters: BMI is a measure of your weight in proportion to your height. It can indicate how much body fat you have. Being overweight or obese puts strain on your heart and increases your risk for heart disease, type 2 diabetes, sleep apnea, and other health conditions.

How often you need it tested: Your doctor should weigh you and calculate your BMI during your regular checkup. You can also weigh yourself and keep track of your BMI at home using an online calculator (health.harvard.edu/topic/BMI-Calculator). BMI should be one of several tools your doctor uses to gauge whether you’re overweight, because it can’t distinguish between fat and muscle, and it may not always be accurate if you’ve lost both muscle and bone mass.

What’s healthy: 18.5 to 24.9 kg/m2

How to bring your numbers into normal range:

  • Aim for a healthy weight loss of 1 to 2 pounds per week. To do that, trim 500 calories a day from your diet.
  • Leave a little food on your plate, especially when eating out in restaurants. Save about 25% of your meal to eat the next day.
  • Choose foods that are nutrient-dense and high in fiber, such as carrots, tomatoes, oranges, and oatmeal. They will make you feel fuller.
  • Instead of having a bowl of ice cream or piece of cake for dessert, reach for fruit. 0

Blood pressure

Why it matters: Having high blood pressure forces your heart to work harder. It increases your risks for heart disease and stroke, as well as for kidney disease and heart failure. You can have high blood pressure and never know it or feel it, so it’s important to get tested routinely.

How often you need it tested: Every two years if you have normal blood pressure, once a year if your blood pressure is high-normal (between 120/80 and 139/89). Ask your doctor how often you need to be tested if your blood pressure is high (140/90 or greater). You can also test your blood pressure more often at home, but first have your doctor show you how to get an accurate measurement with your own blood pressure monitor.

What’s healthy: Less than 120/80 mm Hg

How to bring your numbers into normal range:

  • Follow the DASH (Dietary Approaches to Stop Hypertension) diet, which is high in fruits, vegetables, and low-fat dairy and is low in saturated fat, total fat, and cholesterol. (For more information, see dashdiet.org.)
  • Limit salt to less than 2,300 milligrams (mg) per day (about a half-teaspoon).
  • Take a brisk walk around your neighborhood, office, or recreation center for at least 30 minutes a day.
  • Limit alcohol to one drink or less a day.
  • Eat foods that are high in potassium (such as bananas, spinach, and baked potato), which lessens the effects of sodium. Talk to your doctor before taking potassium supplements, because getting too much potassium from supplements can be harmful to older adults, especially those who have kidney problems.
  • Take a blood pressure–lowering drug, if your doctor says you need it.

Cholesterol

Why it matters: Having high LDL (bad) cholesterol and low HDL (good) cholesterol may contribute to the formation of fatty plaques in your arteries, which can lead to heart disease, heart attack, and stroke.

How often you need it tested: That really depends on your overall heart disease risk. Your doctor can give you guidance, or you can use the calculator at diseaseriskindex.harvard.edu/update/. Women with coronary artery disease or diabetes should be tested once a year. Ask your doctor how often is appropriate for you to be tested.

What’s healthy:

  • Total cholesterol—Less than 200 mg/dL
  • HDL cholesterol—Greater than 50 mg/dL
  • LDL cholesterol—Less than 130 mg/dL (less than 100 mg/dL for those at high risk for heart disease)

How to bring your numbers into normal range:

  • Cut out foods that are high in saturated fat (meat, butter, whole milk), and trans fat (cookies, pastries, French fries). Replace them with foods high in polyunsaturated and monounsaturated fats (canola oil, olive oil, fish).
  • Get no more than 200 mg of cholesterol per day in your diet by cutting back on high-cholesterol foods such as egg yolks, red meat, whole milk, cheese, and shrimp.
  • Eat more of foods that help lower cholesterol, such as oatmeal, nuts, vegetable oils, and fatty fish (salmon, mackerel, trout).
  • Take a cholesterol-lowering drug, such as a statin or fibrate, if your doctor prescribes it.
What is your heart risk score?Do you know how likely you are to have a heart attack or stroke in the next 10 years? Researchers have developed two important and easy-to-use tools for estimating your odds of having a heart attack, stroke, or other significant heart disease within the next decade.1 The Framingham Risk Score: The Framingham Risk Score is designed for people who don’t currently have heart disease. It calculates your risk of having a heart attack or dying from cardiovascular disease in the next 10 years based on youragegendertotal cholesterolHDL cholesterolsmoking statussystolic (top) blood pressure.To calculate your Framingham Risk Score, visit hp2010.nhlbihin.net/atpiii/calculator.asp.2 The Reynolds Risk Score: The Reynolds Risk Score is more specifically targeted to women. It incorporates two additional risk factorshigh-sensitivity C-reactive protein (hsCRP) score, a marker of inflammationwhether either of your parents had a heart attack before age 60, an indicator of your genetic risk.The Reynolds Risk Score calculates your risk of having a heart attack, dying of heart disease, or needing a heart procedure (such as bypass surgery or angioplasty) in the next 10 years. To calculate your Reynolds Risk Score, visit reynoldsriskscore.org.Regardless of which tool you use, discuss your results—and next steps—with your primary care physician or cardiologist.

Triglycerides

Why it matters: Triglycerides are a type of fat in the body. Having high triglycerides combined with high LDL cholesterol speeds up the buildup of plaque in the arteries.

How often you need it tested: Have your triglycerides tested when you have your cholesterol checked (see above).

What’s healthy: Less than 150 mg/dL

How to bring your numbers into normal range:

  • Because your body stores excess sugar as triglycerides, eliminate the extra sources of sugar in your diet—like sweetened cereals, sweet tea, and sodas.
  • Add a few extra servings daily of high-fiber foods such as fruits, vegetables, and whole grains.
  • Take a triglyceride-lowering drug such as a fibrate, niacin, omega-3 fatty acid, or statin if your doctor prescribes it.

Blood sugar

Why it matters: High blood sugar is an indicator that your body doesn’t make enough insulin or isn’t able to properly use insulin, a hormone that helps move glucose (sugar) from the blood into the cells. Having high blood sugar over time can damage the blood vessels, nerves, and organs such as the kidneys and eyes. Knowing that your blood sugar is high will let you take steps to lower it, and possibly delay or prevent type 2 diabetes.

How often you need it tested: Your doctor should check your fasting glucose level or hemoglobin A1C as part of a blood test done during a routine physical.

What’s healthy: A fasting blood glucose level of less than 100 mg/dL and an A1C of below 5.7%

How to bring your numbers into normal range:

  • Plan out each week’s meals in advance, choosing recipes made from vegetables, whole grains, and lean protein (such as skinless chicken breast, tofu, or fish).
  • Throw out the ice cream, cookies, and other processed/packaged foods that are high in refined carbohydrates. Replace them with lighter options, such as carrot sticks, whole-wheat pretzels, and hummus.
    • Make sure all the cereals and breads you buy say 100% whole grain on the package.
    • Write down everything you eat for two weeks. A food journal will let you see how many calories you’re consuming, so you can cut back if needed.
    • Also write down every time you exercise. Make sure your exercise plan includes both aerobics and strength training. Regular exercise brings down blood sugar levels while it burns calories.
Your heart risksPrint out this chart and take it with you to your doctor so you can figure out your heart risks and start working to lower them. Next to each test is the healthy range for that test. Write your test results in the space below each test.
1WAIST CIRCUMFERENCE
What’s healthy:
 < 35 inchesYour waist circumference:
2BODY MASS INDEX (BMI)
What’s healthy: 18.5 – 24.9 kg/m2Your body mass index:
3BLOOD PRESSURE
What’s healthy:
 <120/80 mm HgYour blood pressure:
4TOTAL CHOLESTEROL
What’s healthy:
 <200 mg/dLYour total cholesterol:
LDL (bad) CHOLESTEROL
What’s healthy: <130 mg/dL
(or <100 mg/dL if you’re at high risk for heart disease)Your LDL cholesterol:
HDL (GOOD) CHOLESTEROL
What’s healthy: >50 mg/dLYour HDL cholesterol:
5TRIGLYCERIDES
What’s healthy:
 <150 mg/dLYour triglycerides:
6FASTING BLOOD SUGAR
What’s healthy:
<100 mg/dL

I know this can look overwhelming….but, take it slow. Ask for a copy of your bloodwork and review it at home. I’ve learned that when my Internist’s PA or Nurse calls me and says “everything looks great…”, I need to ask for particular numbers and then request a call from my doctor to chat about how I’m feeling and what I need to work on to get my numbers within healthy range. You’ll find your doctor is very responsive to this request. It’s just that most patients DONT ask for additional information. So…..they don’t get it! Change the pattern. Take control of your health!

Live well. Move more.

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