Dr. Know-How7 Questions To Ask Your Doctor at Your Next Visit

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7A HEARTY GUIDE:What Not To Eat

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2013 FEBRUARY HEART HEALTH MONTH

Heart Health

A special publication of the Ocala StarBanner

By Darci Swisher |CTW Features

Just about everyone who has had a blood pressure reading has been confused by the two numbers the doctor tells them. After all, why two?

The American Heart Association explains that blood pressure is most commonly expressed as a pair of numbers written as a ratio.The first number your doctor says is the top number, and the higher of

the two, and is referred to as “systolic.” It measures the “pressure in the arteries when the heart beats (when the heart muscle contracts),” according the AHA website.

The second number is the bottom number, and the lower of the two, and is referred to as “diastolic.” It measures the “pressure in the arteries between heart beats (when the heart muscles is resting between beats and refilling blood).”

For adults older than 20, the AHA defines normal blood pressure as less than 120 systolic and less than 80 diastolic. A high blood pressure diagnosis is typically given for people who have a series of high blood pressure readings at or above 140 systolic and 90 diastolic.

More information can be found on the AHA website, www.heart.org. •

UnderUnderstanding blood pressure readings is as easy as knowing what a simple fraction says about your health

Pressure 80 120

To Pinot or Not to Pinot?Do red wine’s health benefits add up?

Most people have no doubt heard encouraging words about red wine and

better health; how that glass of Cabernet Sauvignon with dinner may reduce the risk of heart disease.But before reaching for the corkscrew, exercise caution.“If you’re over 50, and if you don’t drink alcohol, don’t start,” says Christine Gerbstadt, registered dietitian and spokesperson for the American Dietetic Association.Despite red wine’s healthy aura, Gerbstadt and other nutrition professionals are wary of promoting it. They question whether it’s actually beneficial, whether consuming alcohol may lead to other issues and whether people wouldn’t be better off with heart-healthy alternatives.“There’s no indication that it [red wine] does anything for heart disease,” says Roger B. McDonald, Ph.D., professor, Department of Nutrition, University of California, Davis.No scientific comparison trials have been done to determine the specific effect of wine on heart disease risk, according to a statement from the American Heart Association. (http://www.americanheart.org).“There are compounds in wine shown in vitro [test tubes] to work. Once they get in the body they haven’t been shown to work,” McDonald says.If wine doesn’t improve a person’s health, can it have downsides?Yes, says Dr. Gerbstadt.Wine is caloric. A 5-ounce serving of red wine contains about 125 calories. If a person drinks a glass a day, she could be

gaining 12 pounds a year if those calories aren’t subtracted elsewhere, Gerbstadt says.And if people eliminate other foods to accommodate wine calories, they may be missing out on nutritional food choices.“Wine is luxury calories. The amount of calories in a serving [of wine] don’t add significant vitamins or minerals to the diet,” Gerbstadt says.The alcohol may disrupt sleep and interfere with medications. But for those drinking wine for sake of better health, there are inexpensive and low-risk steps one can take to reduce the likelihood of developing coronary heart disease.Staying active and sticking with a low-calorie diet are your best options, according to McDonald. Red wine is touted for its heart protective benefits because it’s rich in antioxidants and phytonutrients (plant substances) that may increase a person’s “good cholesterol.”Some of the same antioxidants are found in red grape juice and red grapes, which don’t have alcohol’s downside, Gerbstadt says.“Eat red grapes with the skins; the skin has the benefits. Slice red grapes into a salad,” she says.Instead of the glass of wine with dinner, enjoy a grape juice cocktail.Dr. Gerbstadt suggests mixing a small amount of grape juice to reduce the drink’s calories.“Take an ounce of grape juice, add chipped ice and fill the glass with club soda. You get all the phytonutrients with far fewer calories; it’s very refreshing,” she says.(One ounce of grape juice is 2 tablespoons; about 19 calories.) •

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Sixmembersof theoriginalMunroeHeart team—25yearsandcounting.(Left to right) Robert Feldman,MD;MarkRandolph,RN; BonnieRickel, RN;Carol Floyd, RN;KathyReeves, RNandMikeSistrunk, RN.

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Itbeganwithan idea.Apromise.Twenty-five yearsago, on February 15, 1988, three physicians and 18teammembers atMunroe Regional founded the firstcomprehensive cardiovascular program inMarionCounty—MunroeHeart.Their mission was simple:to create the safest andmost successful heart programin Central Florida and beyond.

Reflective of the growing and changing needs of thecommunity,MunroeHeart instantly meant that patientsand families wouldn’t have to travel to a distant city forhigh-quality heart care. And over the next 25 years,MunroeHeart grew, expanded and evolved into oneof the leading heart programs not only in Florida, butin the nation—with quality and outcomes that rivalthe best in the country.

And over those first 25 years,MunroeHeart has setnew standards in heart care, leading the way in new,innovative surgical techniques and advanced patient care.In fact, many of today’s state-of-the-art techniques andprotocols for heart care have been defined and developedwith the participation ofMunroeHeart along the way.

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Yes, in our first 25 years, we have made great strides.More than 100,000 cardiac procedures. FourCardiothoracic Surgeons, five InterventionalCardiologists, four dedicated Cardiac Anesthesiologists,a Cardiac Electrophysiologist, a network of communitycardiologists andmore than 300 Cardiac CareTeammembers. All focused on that same single mission: tocreate one of the safest andmost successful heartprograms in the United States.

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UnderPressure

If the above phrase strikes fear into your heart, chances are you’re at risk for heart disease. Here’s how to pick heart-smart foods by cutting out (or down on!) saturated fats, trans fats, added sugar, sodium, refined white flour and cholesterol

You EatYOU ARE WHAT

By Jeff SchnauferCTW Features

Like many of us, Linda Van Horn recently found herself scanning the labels at the supermarket, this time looking for multi-grain

crackers that were low in sodium and fat. Unlike many of us, Dr. Van Horn is a professor of preventive medicine at Northwestern University and a spokesperson for the American Heart Association. Yet it still took her five minutes to find the right crackers.“It takes a little time to find the best nutrition - the best bang for your bite,” Van Horn says.From sodium to saturated fat, added sugar to cholesterol, millions of us stalk the supermarket aisles each day seeking out clues to decipher the heart-healthy foods we put on our plates at home. Even with recent advances in food labeling, it can be tricky. So we asked Van Horn and a couple other nutrition experts for a little help. Saturated Fat and Trans Fat - “Food labels can be a huge help in finding heart healthy picks,” says Karen Ansel, Syosset, N.Y., a spokesperson for the Academy of Nutrition and Dietetics. “The first thing people should be looking at is the saturated fat content. Heart health experts recommend eating no more

than 7 percent of your total calories from saturated fat. While we used to think high cholesterol foods raised cholesterol levels in people, we now know that saturated fat is the main culprit in high cholesterol.” Saturated fat is found mainly in red meat, dark meat poultry with skin, full fat cheese and yogurt, whole and 2 percent milk and butter.Next, take a look at trans fats. “There are fewer of these than ever in foods, but in some cases they are still out there,” Ansel says. “Unfortunately, when it comes to heart health there is no safe level of trans fats. Because of a labeling loophole, food labels can still say zero trans fats when they contain less than a half-gram, so you really need to do some sleuth work and scan the ingredient list for the words ‘partially hydrogenated.’ Those words are a tip-off that there are small amounts of trans fats, which can really add up. “ Added Sugar“It’s best if you eat less than more,” says Janet de Jesus, a nutritionist at the National Heart, Lung and Blood Institute in Bethesda, Md. “There is not a daily value on the label for sugar. Generally, I tell people to compare labels. If one cereal has 12 grams and one has 5 grams, it’s probably

better to choose the one with less sugar in it.” Sodium“Sodium is at the moment probably one of the most important pieces of data to look at on the food label because the amount of sodium in the product varies all over the place,” Van Horn says. “There is a huge interest in reducing the American consumption of sodium. High intake of sodium contributes to high blood pressure that can lead to cardiovascular disease.”Processed foods, whether they be in a box or a can, is where much of our sodium comes from, Van Horn says. Yet the single biggest sodium containing food is bread. “It really does make sense to look at the labels,” Van Horn says. “Look for breads that are high in multigrain flour.”Frozen foods can be really tricky, de Jesus says. “A lot of people get prepared meals or frozen lasagna or stir-fry. They can be really high in sodium. I was looking at a

brand of stir-fry the other day and it looked really good on the cover, but had about 1,000 milligrams of sodium. That’s just for a single serving.”Soups, too, can be tricky, de Jesus says. “They can be alarmingly high in sodium. Some even in saturated fat.”“The goal for heart healthy eating is less than 1,500 milligrams (of sodium) a day, so a person would want to make sure that all entrees contain less than 400 milligrams and any snack foods contain less than about 150 milligrams,” Ansel says. “The real key for sodium is limiting packaged foods as much as possible since they usually contain large amounts of added sodium for freshness and flavor. By sticking with fresh foods and no sodium added foods like whole grain pasta, brown rice, couscous and quinoa, you’ll be much less likely to rack up the sodium.”

CholesterolDietary cholesterol is only found in animal products, Van Horn says. “You see it in

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What To Ask Your ServerJanet de Jesus recently was in her favorite restaurant and thought about buying some of the canned tomato soup they served to customers. Her husband had enjoyed it before, so why not take it home and heat it up?

Then she read the label.

“I nearly fell on the floor,” de Jesus recalls. “Its’ saturated fat was so high. That shows you that with restaurant food you don’t know what you are getting.” That doesn’t mean you’re helpless, de Jesus says.

“You can ask what fat it’s prepared with,” de Jesus says. “Ask if it’s cooked in butter or if it’s fried, or if it’s steamed or it’s cooked in oil. I would avoid the fried and go for more of the steamed or poached or baked.”

Ask what kind of sauce comes on it, as well. Cream sauces and cream soups are high in fat and calories, de Jesus says. “Try to get more clear soups,” she says. You can also ask about the

portion size.

“You often don’t know until it comes out,” de Jesus says. “You’re really surprised, but then you eat it all anyway.”

If the portions are too large, ask for a box to take half home before you start eating. Put the portion you want to save into the box immediately.

When it’s time for dessert, “I would definitely look for fruit based desserts, so you’re getting something out of it,” de Jesus says. “Things like cheesecake will be high in calories and high in fat. If you can, share with a friend. Try for a sorbet or a little fruit with a topping on it.”

•

© CTW Features

eggs, which are not labeled, usually,” The American Heart Association continues to recommend less than 300 milligrams of cholesterol per day. “We are awaiting new guidelines,” Van Horn says. “The impact of dietary cholesterol is known to behave in a lot of ways like saturated fat, but it is not as powerful as saturated fat.”White Flour“It’s not so much that it’s bad for you, it’s just that it’s not necessarily good for you,” Van Horn says. “White flour offers no dietary fiber and almost no nutrients. Shifting to multigrain is a better option.”Finally, remember that you are eating more than one meal per day and often more than one item per meal.“It gets tricky, because you don’t eat just one food at a time, you generally eat a mixed meal,” de Jesus says. To make your supermarket experience a little easier, consider visiting a web site while you shop.

“A good starting point is www.choosemyplate.gov,” Ansel says. “Often people struggling with nutrition issues will need even more tailored information. For those I’d recommend meeting with a registered dietitian. Readers can find a dietitian in their area at www.eatright.org.” •

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LowerCholesterol

Bright Ideas to7With myriad foods and pills promising to do the trick, what are the most important and effective ways to keep cholesterol under control?

By Bev Bennett CtW Features

Y ou can’t turn back the clock. The older you get the greater your risk of cardiovascular disease.But

the good news? Saving the planet and your wallet are not mutually exclusive when it comes to making your home more sustainable.You can’t reset your gene pool to erase your family’s health history either.However, you can take steps to reduce your cholesterol, which is one of several indicators of heart attack risk. What’s more, some of the most effective strategies are also those you’ll find enjoyable – or at least manageable. Knowledge, friendships and great food are a few of the keys to help you improve your cholesterol. Here are seven quitter-proof ways to do it.

1. Know Your LDL Cholesterol NumbersFor years you’ve heard your total cholesterol is an indicator of heart health. Keep that number under 200 mg/dL (milligrams per deciliter of blood), or whatever your physician recommends for your individual profile, and you’re fine. Now the emphasis is on LDL (bad) cholesterol, which is associated with heart disease and stroke, according to Marc Gillinov, heart surgeon, Cleveland Clinic, Cleveland, Ohio.LDL is the major carrier of cholesterol in the blood; high levels can lead to plaque build-up in your arteries.Your LDL should be below 130 mg/dL if you’re healthy without heart disease risk factors.“If your LDL cholesterol is high, set a reasonable goal with diet,” Dr. Gillinov says.

2. Eat For PleasureChanging your eating habits should be one of your first steps to lower your cholesterol.But if you think that means no, as in no fun, think again.“A cholesterol lowering diet can taste really good,” says Dr. Gillinov, co-author of “Heart 411” (Three Rivers Press, 2012).Become a culinary explorer and enjoy new textures and flavors from a wide range of vegetables, fruits, nuts, seeds, legumes and whole grains.In fact, “the more plant based your diet becomes the more you’re forced to vary your diet. You’re less bored, more satisfied,” says Julia Zumpano, registered dietitian, Cleveland Clinic.Eliminate one meat meal a week.“It could be as simple as a pasta dish without meat, or bean soup. It could

be a salad with beans instead of meat,” says Zumpano, who works with the women’s cardiovascular center.Include at least two servings a week of fish. Make fish such as salmon, sardines or mackerel that are high in omega-3 fatty acids part of the menu.Omega-3 fatty acids don’t specifically benefit your cholesterol, but do help improve triglyceride and blood pressure numbers, which reduce your cardiovascular risk, Zumpano says.If you want to add one cholesterol-specific item to your diet, make it a food that’s high in dietary fiber. Dr. Gillinov recommends oatmeal, which contains soluble fiber to lower cholesterol “a little bit.”

3. Eat Fats, But SelectivelyRemember when reducing your

cholesterol meant switching to fat-free foods?Now healthy fats, such as olive oil, nuts and avocado, eaten in moderation, get a nod from heart experts, while saturated fat and trans fat are still to be avoided.Following a diet high in saturated fat, from marbled meats, ice cream and butter can increase your total cholesterol and your LDL cholesterol levels. Trans fat, also called trans fatty acids, is no improvement. Consuming trans fats also increases your LDL cholesterol and at the same time may reduce your HDL (good) cholesterol.You’ll find small amounts of trans fat in fatty meats and dairy products, but the greater source is artificial trans fat from foods made with partially hydrogenated vegetable oil. Manufacturers are

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reducing their use of trans fat, but you can also look at packaged food’s Nutrition Facts panel and choose products with zero trans fat. If you’re a cheese lover you may have more of an adjustment to make.The ingredient is on most experts’ lists of foods to reduce. “Cheese has a lot of fat and a lot of salt,” says Dr. Malissa Wood, Massachusetts General Hospital Heart Center, Boston. Zumpano recommends you limit cheese to three meals a week if you have high cholesterol, and opt for reduced-fat varieties.

4. Hang Out With Health-Minded FriendsYour social network can influence your eating and lifestyle habits, according to research.So choose your friends for your good health.“If you have friends who go on a bike ride on Saturday, rather than going to a bar, this will benefit you,” says Dr. Wood, author, with Dimity McDowell, of “Smart at Heart” (Ten Speed Press, 2011).And if you don’t have great health habits, your friends can gently remind you to do better.

“Surrounding yourself with people who will support what you’re doing provides accountability,” Dr. Wood says.

5. Butts OutOf course you don’t smoke, but if you’re around smokers encourage them to stop for everyone’s heart health. When people cease smoking their LDL cholesterol goes down and their HDL cholesterol goes up, according to Dr. Wood.

Researchers recently discovered the link between cigarettes and cholesterol. Cigarette smoke contains a toxic compound that slows the production of HDL cholesterol, according to the University of Florida College of Medicine-Jacksonville.

6. Design an Achievable DietAlthough losing weight is one of the more challenging steps you can take, it’s well worth doing, even if there’s no way you’re getting to your ideal size.“There’s definitely a link between weight loss and cholesterol,” Zumpano says.Lose weight and your cholesterol profile should improve, and if you’re overweight or obese you should see improvement by losing 10 percent of your body weight, according to the dietitian.Of course, if you’re following a pleasurable plant-based diet and enjoying physical activities with friends, dropping pounds doesn’t seem like a sacrifice.

7. Take Medications If IndicatedUnfortunately, it’s hard to reduce your LDL

cholesterol by more than 10 to 15 percent by dietary changes alone, according to Dr. Gillinov.For many people that’s good enough. But if you need to see greater improvement, you’ll want to consider cholesterol-lowering statin drugs. Statins, however, could put you at risk for side effects, so talk to your physician about taking this step.Also understand that medications aren’t an alternative to losing weight, eating less saturated fat or quitting smoking.You’ll want a combination of lifestyle changes and medications if you’re at moderate to high-risk for cardiovascular disease, according to Shirya Rashid, Ph.D., assistant professor, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.Her research suggests that if you’re overweight your body produces hormones that could create resistance to statins. “You’ll counter the effectiveness of the drug if you don’t lose weight and get more exercise,” Rashid says. •

By Jessica RoyeR ocken cTW FeaTuRes

It’s no secret that heart disease is a bit of a problem in the U.S. It causes one in every four deaths, according to the Centers for Disease Control and

Prevention’s Division for Heart Disease and Stroke Prevention.

That’s about 600,000 people each year.

Complicating this problem is the fact that many of the risk factors for heart disease don’t have recognizable symptoms. People with high blood pressure or elevated cholesterol likely feel just fine. Many smokers quite enjoy their habit, thank you very much. Or what about gender and ethnicity, which also play a role in determining one’s risk for heart disease. Sudden cardiac death kills about 150,000 people each year, reports Dr. Gerald Fletcher, a cardiologist with the Mayo Clinic, Rochester, Minn., and spokesperson for the American Heart Association (AHA). “They felt great, so they didn’t do anything about their risks or family history.”

So if your risk factors aren’t making you feel bad (until they make you feel really bad by causing a cardiac event), the best solution is to be proactive:

Risky Business

Understanding the top risk factors for heart disease – and taking action to address the ones that apply to you – is the best way to prevent a problem, and perhaps even reverse troubles that have already begun.

We’ll start with the “easy” ones, although it’s never easy to change lifestyles and habits. But making changes to these situations will immediately begin reducing your risk:

Risk Factor #1: High Blood PressureNinety million Americans have

hypertension, notes Dr. Khalid Sheikh, a board-certified cardiologist and lipidologist and author of “Don’t Let Your Heart Attack”(Telemachus Press, 2012). This increases the risk of stroke and heart attack, and “unless you have it checked, you may not know,” he says.

The AHA estimates that only half of those with high blood pressure have it controlled properly, and Fletcher believes people may be misinformed about what’s acceptable. “Some think 140/90 is pretty good, but it needs to be 110/70,” he says. “Anything above 120/80 involves cardiovascular risk.”

Some high blood pressure can be controlled through regular physical activity and losing weight, as well as

Man? Smoker? Overweight? African American? Move to the front of the line for heart disease. Understanding all of the factors that could put you at risk is vital to prevention

reducing salt intake, but in other cases, medication may be needed as well. So begin by having your blood pressure checked, recommends Dr. Nakela Cook, a medical officer in cardiovascular science with the National Heart, Lung, and Blood Institute (NHLBI). “Know your number and understand if you need treatment,” she says. “Then make sure your treatment gets it down.”

Risk Factor #2: High CholesterolThis is another risk factor that

requires medical diagnosis, Cook explains. Cholesterol helps create the plaque that clogs arteries, Sheikh says. And Fletcher believes this is perhaps the most direct risk factor for heart disease.

It’s specifically high LDL cholesterol that correlates to heart attacks and most strokes, Fletcher says. For a time it was believed high “good cholesterol,” or HDL, had a protective effect on the heart, “but it’s not as protective as we thought,” he says. “Thirty percent of people with high HDL still have heart disease.”

Eating a proper diet can help lower cholesterol, Fletcher reports, and for those who need medication, statins handle cholesterol quite effectively (when taken as directed), and they’re becoming less expensive.

Risk Factor #3: Overweight/Obesity“We are the fattest country in the

world,” Fletcher says. And our waistlines are a particular problem. “Abdominal obesity is worse than [high] total body weight,” he explains. Scientists are not sure why, but weight gained around the waist is particularly associated with cardiovascular disease. “It’s a toxic kind of fat,” Fletcher says, adding that abdominal girth should be less than 40 inches in men and 35 inches in women.

Related to rising rates of obesity and poor dietary choices are rising rates of high blood sugar and type 2 diabetes, which is bad for the cardiovascular system (not to mention the metabolic symptoms of the disease itself), these experts note.

Interventions to lessen these risks include eating a healthy diet – reduce saturated and trans fats and add more

fruits, vegetables, and whole grains, suggests Cook – and adding physical activity, 30 minutes of moderate-intensity movement a day. “If you sit for six hours at your job and don’t get out and exercise, that’s the same as smoking a pack and a quarter a day,” Sheikh says.

Risk Factor #4: SmokingThis is “the one I know everyone has

a choice about,” Cook says. “And in addition to heart disease, smoking increases the risk of so many other diseases. If you can quit, it’s so important to do so.”

Scientific data makes it abundantly clear that smoking promotes arthrosclerosis (the culprit behind most heart disease), Sheikh says. “For every cigarette you smoke, you’re taking 11 minutes off your life.”

And then there are the things in life that can’t be controlled – the risk factors embedded in your genes:

Risk Factor #5: Gender“We know men have a higher risk [for

heart disease] at a younger age,” Cook says. Risk for heart disease begins to increase in men after age 45 and in women after age 55, she reports.

America’s Heart Disease Burden

• About 600,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths.

• Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were in men.

• Coronary heart disease is the most common type of heart disease, killing more than 385,000 people annually.

• Every year about 935,000 Americans have a heart attack. Of these, 610,000 are a first heart attack. 325,000 happen in people who have already had a heart attack.

Risk Factor #6: RaceStatistics indicate that certain races

and ethnicities are “disproportionally affected” by heart disease, Cook says. A recent University of Alabama at Birmingham study revealed that despite medical advances, African Americans still have twice the risk of fatal heart disease as Caucasians.

African Americans have higher rates of high blood pressure, Cook adds. Overweight and obesity are more prevalent among African Americans and Latinos than other ethnic groups. These factors, along with variations in diet and education and differences in the way minorities are evaluated and treated by healthcare professionals, all contribute to elevated risk, these experts report. “This is an area of intense research and care focus,” Cook says. “We’re trying to identify people early enough to be able to help them.”

Risk Factor #7: Family HistoryPremature heart disease among immediate members of your family

(your mother, father, siblings, and

children) can signal cardiovascular troubles ahead for you, explains Cook. Be sure to let your doctor know if a male relative has had heart disease before age 55 and a female relative before age 65.

After reviewing your risk factors, “put all the pieces of the puzzle together” with the help of your doctor, Cook says. Doctors are also learning more about the way inflammatory diseases, such as rheumatoid arthritis and even gingivitis, can contribute to cardiovascular problems, Sheikh says. So your entire medical history may be relevant.

In a detailed consultation, your healthcare provider can create a personalized risk profile and a tailored approach to taking action. This “often will be a combination of diet changes, exercise changes, quitting smoking, and a focus on whether additional testing and medications are necessary,” Cook says.

“It’s just something you have to do for yourself,” Fletcher says. “It’s a long, tough process to stay healthy sometimes.” But it’s certainly worth it.•

© CTW Features

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Nurse ‘Warriors’ get their dueNurses take center stage in a new coffee-ta-ble book by photographer Carolyn Jones, who aims to shed new light on the profession. “The American Nurse” includes portraits, inter-views and biographies of 75 men and women from across the country.Alongside black-and-white photographs, Jones captures the personal stories of nurses in New York, rural eastern Kentucky, Wyo-ming, Wisconsin, Baltimore, Louisiana, San Francisco, Chicago, San Diego, Nebraska and the District of Columbia. Through their stories, the book explores such issues as end-of-life and neonatal care, cutting-edge medical treatments and the special needs of war veterans, coal miners and Native Ameri-cans.

“Nurses do fight to care for us, in spite of ourselves, in spite of the obstacles in their way. And they fix us, and when they can no longer fix us, they make sure that we are comfortable and that our time leaving this earth is as rich as it is entering,” Jones said. — The Washington Post

Workout DVDs to offset excess

For many people, the holiday season began with Halloween and will end with a multi-pound weight gain by the new year. If you’re looking for a way to offset some of those calories, a slew of new exercise DVDs is here to help.“Dance Off the Inches: Latin Cardio Party” includes three routines based on samba, raggaeton and cumbia dance forms.The 10 Minute Solution series has two new releases: “Tighten & Tone Pilates” and “Cardio Hip Hop.” Each includes five 10-minute workouts that can be done individually or combined to create custom workouts.The Element series also has two new DVDs on the market: “Accelerated Pilates with a Resistance Band,” a 30-minute sculpting routine that comes with a free resistance band, and “Yoga for Energy & Relaxation,” which comes with two yoga programs that will at least help take your mind off Snickers bars.

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core-strengthening exercises to help you walk tall.

Lyme diseaseAsk about retreatment, then pull up your socks (to avoid reinfection).

Carried by sesame-seed-size black-legged ticks, this bacterial infection attacks joints causing arthritis-like damage and discomfort. On the rise in parts of the U.S. and Canada, Lyme disease usually clears up with antibiotics — but not always.TrieD-AND-True fix: One course of antibiotic drugs. NeW upgrADe: A second course of antibiotics may be worth trying to knock out lingering infection and symptoms. Ask your doctor if it’s a

Try these relief upgrades for joint paind R S . O Z A N d R O I Z E N

DR. MEHMET OZ

DR. MICHAEL ROIZEN

DOCS on Page 3D

Gastrocnemius

Upper body muscles work continuously to maintain balance and lift arms

Abdominals

Exercises large leg muscles

Puts steady burden on lungs, heart to supply oxygen to muscles

Gluteus maximus

Treadmills and their benefits

Source: American Medical Association, Wellness Guide to Lifelong Fitness

These are some reasons why a treadmill can give a more demanding workout than most other cardiovascular exercisers:

Calories burned per hour when used at intense level

TreadmillStair stepper

Cross-countryski machine

Rowing machine Stationary bike

700627

606

595498

Graphic: Paul Trap

Hamstrings Quadriceps

Soleus

Personal Trainer

© 2012 MCT

ChAlleNge on Page 7D

challengehealthy-holiday

The

Eight holiday strategies to get you in the best shape of your By Alice BurronCasper (Wyo.) Star-Tribune

It’s no wonder most people gain one to five pounds during the holidays. The holidays span two full months (three if you count Halloween), which is plenty of time to over-indulge in seasonal goodies and slack off exercising.But picture this: You are in the habit of eating wholesome, healthy foods as well as active every day. As a result, you look and feel amazing throughout the holidays. Your attitude is spot-on because you know you’re giving yourself a head-start to the New Year.

That’s right, you can — and should — use the holidays as an opportunity to get in the best shape of your life.Don’t let the occasional setback hinder your effort and weaken your commitment to stay healthy this holiday season. By taking the time to plan ahead and strategize, you will develop a realistic and successful way to stay at a healthy weight all year long.Pick any or all of the strategies below to ensure success:

STArT yOur NeW yeAr’S reSOluTiON eArly Make your first 2013 resolution, something such as: “To start the new year off with a solid exercise and eating routine that promotes my healthy weight.” Then start planning it now, and pick a start date before the holidays begin. For guaran-

teed results, include a plan to keep portion sizes small, eat healthful foods full of nutrients, eat regularly and have an exercise plan that includes both aerobic exercise and strength training.ChAlleNge yOurSelf TO mAiNTAiN, DON’T gAiNIf you love a good challenge, this strategy is for you. (And, if you’re able, find someone to do this with you). Weigh in sometime the week before Thanksgiving and again after New Year’s. If you stay within 3 percent of your body weight, you’ve completed the challenge successfully. Treat yourself to something significantly special, such as a shopping trip, a new household item or — better yet — a new piece of exercise equipment or a gym membership.

piCk A pOST-hOliDAy gOAlIf you want to drop a pant size or fit into beach clothes for a beach-bound vacation, set a post-holiday goal, such as running a race in the spring. Set your goal before the holidays begin, and work toward that goal during the holidays. Daily goal reminders, such as a sticky note placed on your bathroom mirror or a smartphone calendar reminder, can help keep you on track.

giVe yOurSelf A gifTDon’t forget to give yourself a gift this holiday season. You deserve a more muscular and toned body this Christmas. This self-given gift of fitness

isTockphoTo.com

www.ocala.com TUESDAY, NOvEmbEr 6, 2012 | OCALA STAR-BANNER | 1D

life, a section in the Ocala StarBanner full of the interesting lifestyle topics and local features each day of the week.

CLASSIFIED INSIDE

ComiCS 4d ◆ TeleviSion 5d ◆ CRoSSWoRd 6d ◆ ABBY 6d

MOvIES‘The Well-Digger’s Daughter’ is filled with grand passion, life-and-death struggle, 3D

TELEvISIONTweets mock

Diane Sawyer as ‘tipsy’ and

‘hammered’ on election night, 2D

Adam lambert to host ‘Vh1 Divas’ show

“VH1 Divas” will be getting some testosterone this year: Adam Lambert is joining in.

Lambert will host and perform at the Dec. 16 event. Miley Cyrus, Demi Lovato, Kelly Row-land, Jordin Sparks and Ciara also will hit the stage at the special honoring dance music and its current and classic divas.

Tributes to Whitney Houston and Donna Summer also are planned.

Lambert said in a statement Thursday the show will be “the most fabulous concert of the year.”

“VH1 Divas” will benefit VH1’s Save the Music Foundation. The venue for the event hasn’t been announced. The show will air live at 9 p.m. EST.

man pleads no contest in ‘Bling ring’ case

A man who was accused of burglarizing Paris Hilton’s home as part of the “Bling Ring” case has pleaded no contest to receiving jewelry stolen from the heiress.

Roy Lopez Jr. entered the no contest plea Thursday in Los Angeles and was sentenced to three years of supervised probation.

His attorney, David Diamond, says the plea allows Lopez to get his life back on track while supporting their contention that Lopez was never involved in burglarizing Hilton’s home.

A prosecutor says Hilton has opted not to seek restitution.

The 32-year-old Lopez was charged with others in a series of break-ins at the homes of stars such as Hilton, Lindsay Lohan and Orlando Bloom.

Several other defendants, including the alleged ringleaders, have taken plea deals.

Diaz, firth in london for ‘gambit’ world premiere

In the trailer for their new movie “Gambit,” Britain’s Colin Firth and American co-star Cameron Diaz are shown in various states of undress. But the two say fans shouldn’t get the wrong idea — “Gambit” is a caper film, not a love story.

Speaking at the comedy’s world premiere in London on Wednesday night, Diaz said flesh was only flashed for laughs in the film.

Firth agreed. Referring to a scene where he appears without trousers, he said audiences will get “treated” to 20 minutes of his knees, but that’s all.

The associaTed press

Adam lambert will host and perform at the “vH1 divas” event on dec. 16 in new York.

Today’s party in the Swamp and parade in the streets starts a weekend worth chomping on to with danceable rock in the plaza, stellar blues at High Dive — and a special salute to veterans at the Phillips Center.

1 uf homecomingThe Gators go chomp-

ing down University avenue in the parade, starting at noon today at Gale Lem-erand drive; and they go Growling — with Josh Turner, Tracy morgan and a cast of hundreds, at 8 tonight in Ben hill Griffin stadium.

2 The final ‘free friday’

also at 8 tonight, the finale in this year’s series of concerts at Bo diddley com-munity plaza features The shambles, whose playlist fea-tures everything from steely dan and ray charles to The rolling stones and cream.

4 Veterans Day Concert

The Gainesville community Band’s musical salute to those who served features a program designed to put both a lump in your throat and a smile on your face, starting at 3 p.m sunday at the phillips center.

3 Siberian Virtuosi

With 12 violinists and a pianist, this state ensemble of the republic of sakha (ya-kutia) wows audiences with works like mozart’s rondo for Violin and piano, and performs at 7:30 p.m. sunday at University auditorium.

5 Jimmy Thackery

The venerable blues guitarist performs at high dive on sunday in a show that’s sponsored by the north central florida Blues society and starts at 7 p.m. with the pete karnes Blues Band.

MusT LisTweeklyBILL DEAN’s top 5

By Rob Ryan Staff writer

After the simultaneously dreary and overly fre-netic slog that was “Quantum of Solace,” fans of James Bond were understandably worried about his next outing. But the fans needn’t have wor-ried; as it turns out, James Bond is still in very capable hands, and “Skyfall” is one of his best adventures in decades.

With its sure-handed direction, more than capable cast, airtight yet nuanced script and some of the most exciting action sequences this side of “The Avengers,” it’s an absolute blast from start to finish that will make longtime fans

cheer and show neophytes what gives 007 his enduring appeal.The movie opens with one of the most

sensational action sequences in Bond’s long history. Bond (Daniel Craig) is chasing

an enemy agent through Istanbul in an attempt to recover a hard drive containing a list of all of

MI6’s undercover agents in terror organi-zations throughout the world. As the chase progresses, Bond careens through the city and across the rooftops on foot and then by car, motorcycle and train.

The sequence is a virtuoso effort on the part of director Sam Mendes and his crew (one of several throughout

BOND is backLatest film ‘Skyfall’ is one of the famed character’s best adventures in decades

‘Skyfall’Rated: pG-13Starring: daniel craig, Judi dench, Javier Bardem, ralph fiennes, naomie harris and Bérénice Lim marlohe★★★★★

F I L M R E V I E W

SkyfAll on Page 2D

insidea look at ■

Javier Bardem’s character in “skyfall,” See page 3D

The girls who ■

left Bond shaken and stirred, See page 2D

daniel Craig as James Bond in “Skyfall.”

sony picTUres

To be ThankfulBeing thankful is often a realization that strikes

people when times get tough. for others, the act of appreciating what life brings is routine. We are writing a story about what it means to be thankful. What are you thankful for this year? send us your thoughts in an email to castrol@gvillesun.com and include your name, daytime phone number and where you are from. We thank you for it.

lifemovies&music

www.gainesville.com FrIDAY, NOvEmbEr 7, 2012 | THE GAINESVILLE SUN | 1D

CLASSIFIED INSIDE

The associaTed press

A slice of maple pumpkin pie with cinnamon-maple whipped cream.

Great turkeys need equally great sides

The associaTed press

Peach cranberry sauce is simple to make: Just combine the ingredients in a saucepan and cook until the sauce thickens.

The Associated Press

A classic Thanksgiving dinner is only complete with the classic finish — an aromatic pumpkin pie rich with cinna-mon, ginger and nutmeg, and topped

with pillowy soft mounds of whipped cream. To sweeten both the pie and the cream, we turned to maple syrup, which complements the other ingredients with a rich, but still subtle, sweetness.

mAple pumpkiN pie WiTh CiNNAmON-mAple WhippeD CreAm Start to finish: 1 hour 15 minutes Servings: 8

fOr The pie 9-inch prepared deep-dish pie crust in a pan 15-ounce can pumpkin puree 1 cup grade B maple syrup 1 cup heavy cream 4 eggs 1 teaspoon cinnamon 1 teaspoon dried ground ginger ½ teaspoon nutmeg Pinch of salt

fOr The WhippeD CreAm 1 cup heavy cream 1 teaspoon cinnamon ¼ cup sugar Heat the oven to 350º F. Place the pie crust on

a baking sheet. To make the pie filling, in a medium bowl,

whisk together the pumpkin puree, maple syrup, heavy cream, eggs, cinnamon, ginger, nutmeg and salt. Pour into the prepared pie crust. Bake for 50 to 60 minutes, or until the center is just barely set. Set on a rack to cool completely.

When ready to serve, make the whipped cream. In a medium bowl, whisk together the heavy cream, cinnamon and maple sugar until the cream forms soft peaks. Serve alongside the pie.

Nutrition information per serving: 530 calories; 310 calories from fat (58 percent of total calories); 35 g fat (16 g saturated; 0.5 g trans fats); 170 mg cholesterol; 50 g carbohy-drate; 3 g fiber; 28 g sugar; 6 g protein; 220 mg sodium.

Pumpkin pie a classic finish to holiday meal

The Associated Press

The turkey may be the centerpiece, but a classic Thanksgiving dinner sim-ply isn’t complete without

a bevy of traditional sides. To accompany our bird, we went with a cranberry sauce cooked with peaches for a delicate tex-ture and fruitiness to balance the tart berries. For the mashed potatoes, we kept it basic — sour cream, butter and chives.

And because you can never

have enough carbs at Thanks-giving, we added a second variety of potatoes — herb-crusted sweet potatoes.

peACh CrANBerry SAuCe

Start to finish: 15 minutes Servings: 6 12-ounce bag fresh cranber-

ries 10-ounce bag frozen peaches,

chopped

Zest and juice of 2 oranges ¾ cup sugar Pinch of salt In a medium saucepan over

medium heat, combine all ingredients. Cook, stirring occasionally, until the cranber-ries pop and the mixture has reduced to a thick sauce, about 10 minutes. Allow to cool.

Nutrition information per serv-ing: 130 calories; 0 calories from fat (0 percent of total calories); 0 g fat (0 g saturated; 0 g trans fats); 0 mg cholesterol; 33 g carbohydrate; 3 g fiber; 30 g sugar; 1 g protein; 25 mg sodium.

Cranberry sauce, sweet potatoes and mashed potatoes are part of a classic Thanksgiving meal.

The Associated Press

Children don’t care if you’ve slaved hours over the Thanksgiving turkey.

And they certainly don’t appreciate the nuanced layers of flavor you once

extracted from the bird with the help of expert brining and seasoning and rotating and roasting and trussing and fussing.

You know, back before you had kids.

Back when you had time to worry about such things.

Balancing a gaggle of little ones with the demands of getting Thanksgiving dinner on the table doesn’t mean sacrific-ing good taste.

It just means you need simple recipes that effortlessly deliver stunning results.

Which is why we created this plain Jane turkey and gravy recipe that tastes anything but ordinary.

Turkey with brown sugar-cider brineThe Associated Press

if you are going to go to the (admittedly little) trouble of brining your Thanksgiving turkey, be

sure to set the bar higher than simply adding mois-ture.

Granted, this is the primary goal of a brine.

Soaking the bird in a salty solution prior to roasting does help plump the meat and keep it moist during cooking.

But this also is a great opportunity to add plenty of added flavor to your holiday turkey.

To make the most of that opportunity, we decided to brine our turkey in apple cider, brown sugar, sage and black pepper.

The flavor ends up being at once subtly sweet, but also boldly savory.

And that is a combination that makes the meat a perfect partner for all of the classic Thanksgiving sides that you’ll be serving this year.

Plain Jane turkey is easy to cook, and it packs a lot of flavor. Serve it with plain Jane gravy (shown below).

phoTos from The associaTed press

A simple recipe that brings out a stunning flavor

A table fullTURKEYof

plAiN JANe on Page 6D

BriNe on Page 6D

SiDeS on Page 6D

lifefood&wine

HOLIDAY SIDE DISHA simple vegetable recipe that will impress without hours of prep, 6D

ThanksBeing thank-

ful is often a realization that strikes people when times get tough. for others, the act of appreciating what life brings is routine. We are writing a story about what it means to be thankful. What are you thankful for this year? send us your thoughts in an email to castrol@gvillesun.com and include your name, daytime phone number and where you are from. We thank you for it.

IN SEASONChefs’ tricks for cooking perfect Brussels sprouts — a great holiday side dish, 6D

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The Washington Post

There is something almost paradoxical about an exhibition devoted to por-traits of poets. One imag-

ines poets, of all the creative types, to be the most inward, cartographers of the disembod-ied landscape, and not given to advertise their material pres-ence in the world.

But the National Portrait Gallery’s engaging exhibition “Poetic Likeness: Modern Amer-ican Poets” presents the great American poets of the past century in the flesh, recalling an era when poets had an audience, rose on occasion to the status of celebrity and were considered essential props at major public affairs. The pleasure of the show is its critical edge, its focus on serious poetry during a specific period of time — from the emergence in the 19th century of Walt Whitman’s form-shatter-ing genius to the culture-shat-tering crisis of Vietnam.

Curated by David Ward, “Poetic Likeness” feels idiosyn-cratic yet canonical, a subjective but deeply considered attempt to define a pantheon of worthy poets, without regard for the trivialities of fame or reputation.

The focus on Whitman and Ezra Pound as the progenitors of a 20th-century tradition means that many famous poets are not included. Henry Wadsworth Longfellow was too backward looking, too much interested in singing “the little songs of the masses” (to borrow Whitman’s assessment), to be part of the show. And more recent celebrity poets such as Maya Angelou, who recited at Bill Clinton’s 1993 inauguration, aren’t included either, falling outside Ward’s self-imposed cutoff in the 1970s,.

“I couldn’t do a survey of all American poetry,” Ward says — it would be too large to manage. The exhibition also draws almost entirely on the National Portrait Gallery’s own collec-tion, making it impossible to take an encyclopedic approach. Ward readily acknowledges the many lacunas.

And even inclusion in the exhibition doesn’t mean endorsement. Ward’s wall texts are deliciously indulgent, filled with subjective responses and critical assessments.

“Sandburg’s writing and his public persona suffer from an excess of ingenuous sincerity,” Ward writes of Carl Sandburg, a

Portrait exhibit of poets from the 19th century to the 1970s on display.

The WashinGTon posT

“Robert Frost,” a portrait by Clara Sipprell, is included in the exhibition “Poetic likeness: modern American Poets,” at the national Portrait Gallery.

By Amanda WilliamsonCorrespondent

William Faulkner called it the best novel ever written. Ernest

Hemingway believed that anyone who wanted to be a writer

had to read it.

More than a century since Leo Tolstoy penned the lives of

Anna Karenina and her fellow Russian aristocrats, “Anna

Karenina” still begs to be told.

The novel, published as a series from 1873 to 1877, has been

adapted for the screen 12 times since its publication. The most

recent adaptation, directed by British director Joe Wright, hits

American theaters on Friday.

In the 130-minute film, Keira Knightley plays the beautiful

S T O r Y

IN TrAvELWill iconic Jersey Shore ever be the same after Hurricane Sandy?, 5F

IN BOOkSHedrick Smith observes that we are to blame for U.S. financial woes, 3F

exhiBiT on Page 2F

ANNA on Page 2F

American poets in the flesh Keira Knightley plays the beautiful Russian

aristocrat in the 13th film adaptation of Leo Tolstoy’s masterful novel ‘Anna Karenina’

ThanksBeing

thankful is often a realiza-tion that strikes people when times get tough. for others, the act of appreciating what life brings is routine. We are writing a story about what it means to be thankful. What are you thankful for this year? send us your thoughts in an email to go@starbanner.com and include your name, daytime phone num-ber and where you are from. We thank you for it.

Jude law stars as Alexei Karenin, Anna’s husband.

domhnall Gleeson and Alicia vikander star as Konstantin levin and Kitty.in the film,

Anna Karenina (Keira Knightley) abandons her unhappy marriage to Karenin (Jude law), and begins a destructive love affair with Count vronsky (Aaron Taylor-Johnson) that eventually ends in her suicide.

phoTos By WorkinG TiTLe fiLms

lifearts&leisure

www.gainesville.com WEDNESDAY, NOvEmbEr 7, 2012 | THE GAINESVILLE SUN | 1D

MONDAY: Plugged In• News on the Latest in Personal Technology• Tech Talk by Rob Witzel (A User-Friendly

Column on Technology & Gadgets)• Plan Your Week: Entertainment Highlights

for the Week

TUESDAY: Health & Fitness• Health, Fitness, Nutrition & Lifestyle

Changes• Dear Pharmacist by Suzy Cohen• Dr. Jock by Marilyn Preston, Column on

Fitness• You Docs Column and You Docs Q & A• Personal Trainer, a How-to on Exercise

WEDNESDAY: Food & Wine• Stories on Cooking, Food & Wine Trends,

and Preparing Healthy Dishes at Home• Everyday Cheapskate, Tips to Save Money• Local Events for Foodies

THURSDAY: Rotating Topic• Local Features & Wire Stories

FRIDAY: Movies & Music• Movie Reviews & Movie Times• The Top 5 List of the Weekend’s Events by

Bill Dean and Dave Schlenker

SATURDAY: Religion/Faith & Homes• Homes• Local Features

SUNDAY: Arts & Leisure• Travel & Books• Local Features

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Caregiver’s

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Holiday Gift

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Directory

DECEMBER

A special supplement to

November 2012

A guide for those who

provide care and support

to elderly family

and loved ones.

Caregiver’sResourceGuide

By DaRci sWisheRcTW FeaTuRes

Valerie Booher was at the doctor’s office for an unrelated issue when her physician noticed that her

blood pressure was high.To be cautious, her doctor had her

come back twice in subsequent weeks for rechecks – and found it elevated both times. Given that Booher’s parents both have high blood pressure, and that

she was carrying an extra 100 pounds, her doctor decided to take action.

“She said it wasn’t crazy high, but she wanted to put me on medication so there was no damage to my heart over time,” says Booher, 38, of Westmont, Ill. Although she was no stranger to exercise, it wasn’t a routine part of her life, so she talked to her doctor about proceeding with physical activity following her diagnosis.

“I was nervous,” Booher says. “I

thought I would have a heart attack or something. I asked my doctor about it and she said I was fine to exercise.”

When left untreated, high blood pressure, or hypertension, is a disease that can have serious, and even deadly consequences, since it raises a person’s risk of heart attack, stroke and heart and kidney failure. The American Heart Association estimates that more than 74 million U.S. adults have high blood pressure.

Exercise is beneficial for cardiovascular disease in general, as other cardiovascular issues can accompany hypertension, says Dr. Ernesto L. Schiffrin, physician-in-chief of Sir Mortimer B. Davis-Jewish General Hospital, in Montreal and president of the International Society of Hypertension.

“In the long term, the fact that people do perform exercise regularly will be associated with a progression of reduction of blood pressure,” he says.

In addition, he says most people also experience weight loss, which is crucial as studies show that obesity, and even being overweight, is closely related to high blood pressure.

Dr. Shiffrin recommends his patients with extremely high blood pressure not engage in physical activity until it’s controlled, either by medication or a lifestyle modification, or a combination. A stress test can be given “to make sure exercise won’t trigger a cardiovascular event,” he says.

For those able to exercise, he advises they engage in a kinetic-type of exercise, like walking or jogging, in moderation – achieving about 60 percent of their maximum heart rate. If a patient is used to being sedentary, he points out that it’s important to go slowly, building from a half an hour of activity four to five days a week to an hour most days.

“We’re not trying to create Olympic athletes,” Dr. Shiffrin says. “We’re trying to make people feel good, lower their cardiovascular risk, lose weight and improve their feeling of well being.”

Plus, he adds, exercise can precipitate a cardiovascular event if done too vigorously. Anyone who experiences

High blood pressure is one of the deadliest risk factors when it comes to heart disease, and it can be risky to exercise when you have it. Here, doctors offer the most effective, safest tips to start exercising, what exercises to do, how often, and warning signs of when to stop

ExerciseGET DOWN WITH shortness of breath, develops chest

pain or feels faint should cease exercising and consult their doctor immediately, Dr. Shiffrin says.

Exercising with a qualified personal trainer is typically the safest route for anyone beginning a new exercise routine, but finding a professional who has previously worked with a client with hypertension is key, says Noby Takaki, a master personal trainer at East Bank Club in Chicago.

While a trainer should be cautious because of the diagnosis, she has found that many exercises can be modified to fit an appropriate routine.

“Trainers should know how to progress a client without causing adverse effects,” Takaki says. “Just because someone has hypertension does not mean that the client can’t be pushed. It just means that you need to be aware of how hard you’re pushing your client, and to know their limits.”

For her clients with hypertension, she recommends they ask their doctors about the timing of taking their medications with their workout schedule, as well as what types of exercises to definitely include – and avoid.

Four years after her high blood pressure diagnosis, Booher saw another doctor for a routine checkup. Although she hadn’t taken her medication yet for the day, her blood pressure was at a healthy level. A couple of weeks later, after decreasing her medications and tracking her blood pressure at home, her regular doctor told her she could stay off her medicine.

“It was a huge victory for me,” she says.

Booher isn’t sure whether to credit her exercise routine of strength training, walking, jogging and spinning, the fact that she’s dropped 30 pounds, or reduced sodium in her diet – or all three.

“Because of my family history, it might come back,” she says. “I am confident if I continue exercising and hopefully lose about 80 more pounds, it’ll be gone for good.”

© CTW Features

,T’S UPWHA DOC?

EDDICE COMPANION, PA-CCardiology

Board Certified - 14 years Cardiology experience

DENISE RAYCHOK, A.R.N.P.Cardiology

Board Certified: Acute Care Nurse PractitionerUniversity of South Florida

1800 SE 17 St., Suite 700 • Ocala, FL(352) 789-6008 • urbancardiology.com

HEART HEALTH MONTH

Schedule your annual check-upwith Urban Cardiology today!

THANKYOU, DR. URBANDear Dr. Urban and office staff,“Thanks for your prayer and savingmy life in 2012. You aremy Heart’sGuardian Angel. Thanks for watchingover me and for beingmy heart, legs,arms, hands and feet. That meant a lottome and gives me strength knowingyou support and care for me.”Love to everyone in your office,Karon Johnson

Heart disease and stroke are the firstand fourth leading causes of deathin the U.S. So what can peopledo to aviod these heart problems?

See a doctor before symptoms and issues arise.Here are some insightful questions to ask yourdoctor to learn the best ways to prevent heartproblems before they happen.1. Do I Need To Change My Diet?“You should eat healthy, more fruit andveggies, and whole grains in your diet. Youshould have foods that don’t bump your bloodsugar too high.” “Stay away from the transand unsaturated fats. Make sure you haveomega-3 fatty acids that you get from fish andsome plant sources.”2. What type of exercise do yourecommend?Dr. Urban suggests walking or swimmingsince they are easier on the joints.3. Why is blood pressure important?Hypertension is a risk factor for cardiovasculardisease. Good control is the key to reducingyour risk.

4. What Should My Cholesterol Level Be?Some people are genetically predisposed tohigh cholesterol. “You can watch your dietand still have a cholesterol at 300,” Dr. Urbansays. He explains that there is good and badcholesterol, high-density lipoprotein andlow-density lipoprotein. The ratio of goodcholesterol (HDL) and the bad cholesterol(LDL) is more important than the number.The more HDL you have and the less LDLyou have, the better.5. Do I need to loseWeight?Weight is a risk factor you can controlwith a good diet and exercise. “By keepingyour weight down you decrease the risk ofcardiovascular disease.”6. If I’m A Smoker, Do I Really Need ToStop?“The fact is yes,” Dr. Urban says. Mostsmokers are worried about lung cancerwhen in fact they are just as susceptible tocardiovascular disease if not more so.

Karon JohnsonWhat’s the number one way to prevent heart issues?

See your doctor.Get to the heart of the matter by asking these all-important questions

PAUL L. URBAN, M.D.Interventional Cardiology

and Clinical Cardiology

We know Ocala by heart