The S.T.E.P.S. To A Healthier Heart
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Stepping Into Better Heart Health
This is Dr. Jennifer H. Mieres, FACC, FAHA, MASNC. she’s an award-winning (we counted 9 major awards) professor of cardiology, and a leading advocate for women’s heart health. This latter she’s done via >70 scientific publications, >100 research presentations at national and international conferences, 3 books so far, and 4 documentaries, including the Emmy-nominated “A Woman’s Heart”.
What does she want us to know?
A lot of her work is a top-down approach, working to revolutionize the field of cardiology in its application, to result in far fewer deaths annually. Which is fascinating, but unless you’re well-placed in that industry, not something too actionable as an individual (if you are well-placed in that industry, do look her up, of course).
For the rest of us…
Dr. Mieres’ S.T.E.P.S. to good heart health
She wants us to do the following things:
1) Stock your kitchen with heart health in mind
This is tied to the third item in the list of course, but it’s a critical step not to be overlooked. It’s all very well to know “eat more fiber; eat less red meat” and so forth, but if you go to your kitchen and what’s there is not conducive to heart health, you’re just going to do the best with what’s available.
Instead, actually buy foods that are high in fiber, and preferably, foods that you like. Not a fan of beans? Don’t buy them. Love pasta? Go wholegrain. Like leafy greens in principle, but they don’t go with what you cook? Look up some recipes, and then buy them.
Love a beef steak? Well we won’t lie to you, that is not good for your heart, but make it a rare option—so to speak—and enjoy it mindfully (see also: mindful eating) once in a blue moon for a special occasion, rather than “I don’t know what to cook tonight, so sizzle sizzle I guess”.
Meal planning goes a long way for this one! And if meal-planning sounds like an overwhelming project to take on, then consider trying one of the many healthy-eating meal kit services that will deliver ingredients (and their recipes) to your door—opting for a plants-forward plan, and the rest should fall into place.
2) Take control of your activity
Choose to move! Rather than focusing on what you can’t do (let’s say, those 5am runs, or your regularly-scheduled, irregularly attended, gym sessions), focus on what you can do, and do it.
See also: No-Exercise Exercise!
3) Eat for a healthier heart
This means following through on what you did on the first step, and keeping it that way. Buying fresh fruit and veg is great, but you also have to actually eat it. Do not let the perishables perish!
For you too, dear reader, are perishable (and would presumably like to avoid perishing).
This item in the list may seem flippant, but actually this is about habit-forming, and without it, the whole plan will grind to a halt a few days after your first heart-health-focused shopping trip.
See also: Where Nutrition Meets Habits!
4) Partner with your doctor, family, and friends
Good relationships, both professional and personal, count for a lot. Draw up a plan with your doctor; don’t just guess at when to get this or that checked—or what to do about it if the numbers aren’t to your liking.
Partnership with your doctor goes both ways, incidentally. Read up, have opinions, discuss them! Doing so will ultimately result in better care than just going in blind and coming out with a recommendation you don’t understand and just trust (but soon forget, because you didn’t understand).
And as for family and friends, this is partly about social factors—we tend to influence, and be influenced by, those around us. It can be tricky to be on a health kick if your partner wants take-out every night, so some manner of getting everyone on the same page is important, be it by compromise or, in an ideal world, gradually trending towards better health. But any such changes must come from a place of genuine understanding and volition, otherwise at best they won’t stick, and at worst they’ll actively create a pushback.
Same goes for exercise as for diet—exercising together is a good way to boost commitment, especially if it’s something fun (dance classes are a fine example that many couples enjoy, for example).
5) Sleep more, stress less, savor life
These things matter a lot! Many people focus on cutting down salt or saturated fat, and that can be good if otherwise consumed to excess, but for most people they’re not the most decisive factors:
Hypertension: Factors Far More Relevant Than Salt ← sleep features here!
Stress is also a huge one, and let’s put it this way: people more often have heart attacks during a moment of excessive emotional stress—not during a moment when they had a bit too much butter on their toast.
It’s not even just that acute stress is the trigger, it’s that chronic stress is a contributory factor that erodes the body’s ability to handle the acute stress.
Changing this may seem “easier said than done” because often the stressors are external (e.g. work pressure, financial worries, caring for a sick relative, relationship troubles, major life change, etc), but it is possible to find peace even in the chaos of life:
Want to know more from Dr. Mieres?
You might like this book of hers, which goes into each of the above items in much more depth than we have room to here:
Heart Smarter for Women: Six Weeks to a Healthier Heart – by Dr. Jennifer Mieres
Enjoy!
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4 ways to cut down on meat when dining out – and still make healthy choices
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Many of us are looking for ways to eat a healthier and more sustainable diet. And one way to do this is by reducing the amount of meat we eat.
That doesn’t mean you need to become a vegan or vegetarian. Our recent research shows even small changes to cut down on meat consumption could help improve health and wellbeing.
But not all plant-based options are created equal and some are ultra-processed. Navigating what’s available when eating out – including options like tofu and fake meats – can be a challenge.
So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat.
Mikhaylovskiy/Shutterstock Health benefits to cutting down
Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians still eat more meat than recommended.
Only a small percentage of Australians (10%) are vegetarian or vegan. But an increasing number opt for a flexitarian diet. Flexitarians eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish.
Our recent research looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising.
The study found health benefits when people halved the amount of meat and dairy they ate and replaced them with healthy plant-based foods, like tofu or legumes. On average, their dietary fibre intake – which helps with feeling fuller for longer and digestive health – went up. Saturated fats – which increase our blood cholesterol levels, a risk factor for heart disease – went down.
Including more fibre and less saturated fat helps reduce the risk of heart disease.
Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner.
Filling your plate with fibre-rich foods can help lower cholesterol. Wally Pruss/Shutterstock How it’s made matters
For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor heart health and some forms of cancer.
But the same can be true of many processed meat alternatives.
Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be high in salt and saturated fat.
Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options.
So if you’re cutting down on meat for health reasons, it’s important to think about what you’re replacing it with. The Australian Dietary Guidelines recommend eggs, legumes/beans, tofu, nuts and seeds.
Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt.
What about when dining out?
When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option.
Eating a range of colours is one way to ensure variety. Mikhail Nilov/Pexels Here are our four ways to make healthy choices when you eat out:
1. Fill half your plate with vegetables
When cutting down on meat, aim for half your plate to be vegetables. Try to also eat a variety of colours, such as leafy green spinach, red capsicum and pumpkin.
When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal.
2. Avoid the deep fryer
The Australian Dietary Guidelines recommend limiting deep fried foods to once a week or less. When dining out, choose plant-based options that are sautéed, grilled, baked, steamed, boiled or poached – instead of those that are crumbed or battered before deep frying.
This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option.
3. Pick wholegrains
Scan the menu for wholegrain options such as brown rice, wholemeal pizza or pasta, barley, quinoa or wholemeal burger buns. Not only are they good sources of protein, but they also provide more dietary fibre than refined grains, which help keep you fuller for longer.
4. If you do pick meat – choose less processed kinds
You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages.
If sharing dishes with other people, you could try adding unprocessed plant-based options into the mix. For example, a curry with lentils or chickpeas, or a vegetable-based pizza instead of one with ham or salami. If that’s not an option, try choose meat that’s a lean cut, such as chicken breast, or options which are grilled rather than fried.
Laura Marchese, PhD candidate at the Institute for Physical Activity and Nutrition, Deakin University and Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When Science Brings Hope
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There’s a lot of bad news out there at present, including in the field of healthcare. So as some measure of respite from that, here’s some good news from the world of health science, including some actionable things to do:
Run for your life! Or casually meander for your life; that’s fine too.
Those who enjoy the equivalent of an average of 160mins slow (3mph) walking per day also enjoy the greatest healthspan. Now, there may be an element of two-way causality here (moving more means we live longer, but also, sometimes people move less because of having crippling disabilities, which are themselves not great for healthspan, as well as having the knock-on effect of reducing movement, and so such conditions yield and anti-longevity double-whammy), but for any who are able to, increasing the amount of time per day spend moving, ultimately results (on average) in a lot of extra days in life that we’ll then get to spend moving.
Depending on how active or not you are already, every extra 1 hour walked could add two hours and 49 minutes to life expectancy:
Read in full: Americans over 40 could live extra 5 years if they were all as active as top 25% of population, modeling study suggests
Related: The Doctor Who Wants Us To Exercise Less & Move More
Re-teaching your brain to heal itself
Cancer is often difficult to treat, and brain tumors can be amongst the most difficult with which to contend. Not only is everything in there very delicate, but also it’s the hardest place in the body to get at—not just surgically, but even chemically, because of the blood-brain barrier. To make matters worse, brain tumors such as glioblastoma weaken the function of T-cells (whose job it is to eliminate the cancer) by prolonged exposure.
Research has found a way to restore the responsiveness of these T-cells to immune checkpoint inhibitors, allowing them to go about their cancer-killing activities unimpeded:
Read in full: New possibilities for treating intractable brain tumors unveiled
Related: 5 Ways To Beat Cancer (And Other Diseases)
Here’s to your good health!
GLP-1 receptor agonists, originally developed to fight diabetes and now enjoying popularity as weight loss adjuvants, work in large part by cutting down food cravings by interfering with the chemical messaging about such.
As a bonus, it seems that they also can reduce alcohol cravings, especially by targetting the brain’s reward center; this was based on a large review of studies looking at how GLP-1RA use affects alcohol use, alcohol-related health problems, hospital visits, and brain reactions to alcohol cues:
Read in full: Diabetes medication may be effective in helping people drink less alcohol, research finds
Related: How To Reduce Or Quit Alcohol
Take care!
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The Brain’s Way of Healing – by Dr. Norman Doidge
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First, what this book isn’t: any sort of wishy-washy “think yourself better” fluff, and nor is it a “tapping into your Universal Divine Essence” thing.
In contrast, Dr. Norman Doidge sticks with science, and the only “vibrational frequencies” involved are the sort that come from an MRI machine or similar.
The author makes bold claims of the potential for leveraging neuroplasticity to heal many chronic diseases. All of them are neurological in whole or in part, ranging from chronic pain to Parkinson’s.
How well are these claims backed up, you ask?
The book makes heavy use of case studies. In science, case studies rarely prove anything, so much as indicate a potential proof of principle. Clinical trials are what’s needed to become more certain, and for Dr. Doidge’s claims, these are so far sadly lacking, or as yet inconclusive.
Where the book’s strengths lie is in describing exactly what is done, and how, to effect each recovery. Specific exercises to do, and explanations of the mechanism of action. To that end, it makes them very repeatable for any would-be “citizen scientist” who wishes to try (in the cases that they don’t require special equipment).
Bottom line: this book would be more reassuring if its putative techniques had enjoyed more clinical studies… But in the meantime, it’s a fair collection of promising therapeutic approaches for a number of neurological disorders.
Click here to check out The Brain’s Way of Healing, and learn more!
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Optimism Seriously Increases Longevity!
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Always look on the bright side for life
❝I’m not a pessimist; I’m a realist!❞
~ every pessimist ever
To believe self-reports, the world is divided between optimists and realists. But how does your outlook measure up, really?
Below, we’ve included a link to a test, and like most free online tests, this is offered “as-is” with the usual caveats about not being a clinical diagnostic tool, this one actually has a fair amount of scientific weight behind it:
❝Empirical testing has indicated the validity of the Optimism Pessimism Instrument as published in the scientific journal Current Psychology: Research and Reviews.
The IDRlabs Optimism/Pessimism Test (IDR-OPT) was developed by IDRlabs. The IDR-OPT is based on the Optimism/Pessimism Instrument (OPI) developed by Dr. William Dember, Dr. Stephanie Martin, Dr. Mary Hummer, Dr. Steven Howe, and Dr. Richard Melton, at the University of Cincinnati.❞
Take This Short (1–2 mins) Test
How did you score? And what could you do to improve on that score?
We said before that we’d do a main feature on this sometime, and today’s the day! Fits with the theme of Easter too, as for those who observe, this is a time for a celebration of hope, new beginnings, and life stepping out of the shadows.
On which note, before we go any further, let’s look at a very big “why” of optimism…
There have been many studies done regards optimism and health, and they generally come to the same conclusion: optimism is simply good for the health.
Here’s an example. It’s a longitudinal study, and it followed 121,700 women (what a sample size!) for eight years. It controlled for all kinds of other lifestyle factors (especially smoking, drinking, diet, and exercise habits, as well as pre-existing medical conditions), so this wasn’t a case of “people who are healthy are more optimistic as a result. And, in the researchers’ own words…
❝We found strong and statistically significant associations of increasing levels of optimism with decreasing risks of mortality, including mortality due each major cause of death, such as cancer, heart disease, stroke, respiratory disease, and infection.
Importantly, findings were maintained after close control for potential confounding factors, including sociodemographic characteristics and depression❞
Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study
So that’s the why. Now for the how…
Positive thinking is not what you think it is
A lot of people think of “think positive thoughts” as a very wishy-washy platitude, but positive thinking isn’t about ignoring what’s wrong, or burying every negative emotion.
Rather, it is taking advantage of the basic CBT, DBT, and, for that matter, NLP principles:
- Our feelings are driven by our thoughts
- Our thoughts can be changed by how we frame things
This is a lot like the idea that “there’s not such thing as bad weather; only the wrong clothes”. Clearly written by someone who’s never been in a hurricane, but by and large, the principle stands true.
For example…
- Most problems can be reframed as opportunities
- Replace “I have to…” with “I get to…”
- Will the task be arduous? It’ll be all the better looking back on it.
- Did you fail abjectly? Be proud that you lived true to your values anyway.
A lot of this is about focusing on what you can control. If you live your life by your values (first figure out what they are, if you haven’t already), then that will become a reassuring thing that you can always count on, no matter what.
Practice positive self-talk (eliminate the negative)
We often learn, usually as children, to be self deprecatory so as to not appear immodest. While modesty certainly has its place, we don’t have to trash ourselves to do that!
There are various approaches to this, for example:
- Replacing a self-criticism (whether it was true or not) with a neutral or positive statement that you know is true. “I suck at xyz” is just putting yourself down, “Xyz is a challenge for me” asks the question, how will you rise to it?
- Replacing a self-criticism with irony. It doesn’t matter how dripping with sarcasm your inner voice is, the words will still be better. “Glamorous as ever!” after accidentally putting mascara in your eye. “So elegant and graceful!” after walking into furniture. And so on.
Practice radical acceptance
This evokes the “optimistic nihilism” approach to life. It’s perhaps not best in all scenarios, but if you’re consciously and rationally pretty sure something is going to be terrible (and/or know it’s completely outside of your control), acknowledging that possibility (or even, likelihood) cheerfully. Borrowing from the last tip, this can be done with as much irony as you find necessary. For example:
Facing a surgery the recovery from which you know categorically will be very painful: with a big smile “Yep, I am going to be in a lot of pain, so that’s going to be fun!” (fun fact: psychological misery will not make the physical pain any less painful, so you might as well see the funny side) ← see link for additional benefits laughter can add to health-related quality of life)
Plan for the future with love
You know the whole “planting trees in whose shade you’ll never sit”, thing, but: actually for yourself too. Plan (and act!) now, out of love and compassion for your future self.
Simple example: preparing (or semi-preparing, if appropriate) breakfast for yourself the night before, when you know in the morning you’ll be tired, hungry, and/or pressed for time. You’ll wake up, remember that you did that, and…
Tip: at moments like that, take a moment to think “Thanks, past me”. (Or call yourself by your name, whatever works for you. For example I, your writer here, might say to myself “Thanks, past Nastja!”)
This helps to build a habit of gratitude for your past self and love for your future self.
This goes for little things like the above, but it also goes for things whereby there’s much longer-term delayed gratification, such as:
- Healthy lifestyle changes (usually these see slow, cumulative progress)
- Good financial strategies (usually these see slow, cumulative progress)
- Long educational courses (usually these see slow, cumulative progress)
Basically: pay it forward to your future self, and thank yourself later!
Some quick ideas of systems and apps that go hard on the “long slow cumulative progress” approach that you can look back on with pride:
- Noom—nutritional program with a psychology-based approach to help you attain and maintain your goals, long term
- You Need A Budget—we’ve recommended it before and we’ll recommend it again. This is so good. If you click through, you can see a short explanation of what makes it so different to other budgeting apps.
- Duolingo—the famously persistence-motivational language learning app
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Caramelized Caraway Cabbage
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Cabbage is an underrated vegetable for its many nutrients and its culinary potential—here’s a great way to make it a delectable starter or respectable side.
You will need
- 1 medium white cabbage, sliced into 1″ thick slabs
- 1 tbsp extra-virgin olive oil
- 1 tbsp caraway seeds
- 1 tsp black pepper
- ½ tsp turmeric
- ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400℉ / 200℃.
2) Combine the non-cabbage ingredients in a small bowl, whisking to mix thoroughly—with a tiny whisk if you have one, but a fork will work if necessary.
3) Arrange the cabbage slices on a lined baking tray and brush the seasoning-and-oil mixture over both sides of each slice.
4) Roast for 20–25 minutes until the cabbage is tender and beginning to caramelize.
5) Serve warm.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Curcumin (Turmeric) is worth its weight in gold
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Avocado Oil vs Olive Oil – Which is Healthier?
Take care!
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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead
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Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.
So what is knee osteoarthritis and what are the best ways to manage it?
Pexels/Kindelmedia More than 2 million Australians have osteoarthritis
Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.
Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.
Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.
Is it caused by ‘wear and tear’?
Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.
Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.
Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.
This has led to a global call for a change in the way we think and communicate about osteoarthritis.
What’s the best way to manage osteoarthritis?
Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.
Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.
Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.
Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.
Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.
Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.
Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.
Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.
Opioids are not recommended. The risk of harm outweighs any potential benefits.
What about surgery?
People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.
Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.
However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.
Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.
Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.
The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.
I have knee osteoarthritis. What should I do?
The care standard links to free evidence-based resources to support people with osteoarthritis. These include:
- education, such as a decision aid and four-week online course
- self-directed online exercise and yoga programs
- weight management support
- pain management strategies, such as MyJointPain and painTRAINER.
If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.
Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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