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Know the signs of heart disease, change your lifestyle - and stay alive

Detroit Free Press (MI)


Feb. 09--It wasn't a heart attack that changed Lenora Williams' life. It was jaw discomfort.

Five years ago, the Farmington Hills woman casually mentioned to her doctor that she noticed an uncomfortable feeling up through her jaw especially when she walked strenuously or climbed stairs. Williams wasn't concerned, but her doctor was.

She sent Williams to a cardiologist who, after some tests, discovered that one of her arteries was 75% blocked. After undergoing surgery to reopen the artery, Williams embarked on a journey to improve her heart health through diet and exercise with the help of the Cardiac Rehabilitation Program at Botsford Hospital in Farmington Hills.

"Before (the diagnosis) I pretty much ate whatever I wanted without paying too much attention to diet even though my cholesterol was borderline," Williams said. "And I should have because both my parents had heart disease. In retrospect, I should have been paying more attention."

Now, she skips the sweets and eats more whole grains, fruits and vegetables. She eats more fish and lean meats like chicken and pork tenderloin -- baked and not fried.

"I cut out red meat. Maybe once a year I'll allow myself red meat," Williams said. "I substitute ground turkey for beef and it actually taste pretty darn good. ...

"I have had to really make some changes in this journey."

Different symptoms

Williams had heart disease but didn't know it. And she's not alone.

Heart disease is still the nation's No. 1 killer of women (and men). In fact, among women, 1 in every 3 deaths is caused by heart disease. And, in Michigan, 11,522 women died of heart disease in 2011, according to the state Department of Community Health's latest statistics. There are plenty of steps women can take to protect their hearts, especially through the foods they eat. But, first, they need to know the symptoms of heart disease, which are different than those in men.

"With men, they have the typical elephant-sitting-on-their-chest-type feeling," says Cindy Grines, vice president of academic and clinical affairs at DMC Cardiovascular Institute in Detroit. "Women may not have chest pain at all."

That was true for Williams, who was lucky her doctor knew the signs.

"I did have some symptoms, but not the traditional symptoms," she says. "I wasn't aware the symptoms can be different for women."

In addition to shortness of breath, women with heart problems tend to feel weak and dizzy and experience pain in unusual locations, like the elbow or back, Grines says.

"It's actually typical for a woman to have atypical symptoms," she said. "And a lot of physicians don't realize that, and they miss the fact that the woman is probably having a heart problem."

Raising awareness is the key reason Americans mark National Heart Health Month each February. The designation by the American Heart Association that is now in its 50th year puts cardiovascular diseases -- which include stroke, coronary heart disease, arrhythmia and heart attack -- in the spotlight.

The efforts appear to be working. The American Heart Association says that since it launched its Go Red for Women campaign a decade ago, more than 627,000 women have been saved from heart disease and 330 fewer women are dying of it every day.

A health scare

For Natasha Cottingham, 32, it was her fiance's health scare that prompted her to adopt a heart-healthy diet.

Cottingham's fiance, Michael Bailey, 33, of Oak Park had a heart attack caused by a blockage in his left main coronary artery -- a condition so deadly it is dubbed the widow maker.

"They took me to the hospitaland told me I had a blocked artery and within 25 minutes a stent was put in," Bailey said, recalling the events that took place last December after he fell ill in class at Specs Howard School of Broadcasting in Southfield. Feeling chest pain, he left class and notified security officers, who then called an ambulance. "My life was hanging in the balance within 45 minutes."

Now, the couple say, they are more focused on eating for heart health. They cook with healthier oils and rarely eat fried foods. While they ate fruits and vegetables before Bailey's heart attack, they definitely eat more of them now.

"We eat more whole grains, and we bought a blender to make smoothies for breakfast," Bailey says.

In addition to what they eat, Cottingham says, they watch how much they eat.

"I am probably more health-conscious and eat smaller portions," she says. "So far both of us have lost a little bit of weight."

One of the keys to heart-healthy eating, dietitians say, is learning to read food labels closely.

"The labels provide tremendous information about the quality of the foods, and the variety is enormous," says Gail Posner, a registered dietitian and owner of Healthy Ways Nutrition Counseling in West Bloomfield.

She tells clients to pay close attention to serving size when studying labels. If you're looking at a box of crackers, "ask yourself would you stop at the five-cracker recommended serving size?" If the answer is no, she says, double the amount of calories, fat and sodium numbers.

Both Williams and Cottingham said that their first grocery shopping trip following Bailey's heart attack was overwhelming and took awhile.

"It was probably the longest day of my life," Cottingham said. "I read the label on everything I bought."

Changing a diet

Adopting a healthy diet and maintaining a healthy weight are key to fighting heart disease, experts say.

Choose foods that are high in nutrients -- vitamins, minerals and fiber -- and low in calories. Opt for whole grains, fish, lean proteins and fat-free and low-fat dairy products.

Kay Bell of Birmingham adopted a heart-healthy diet after undergoing surgery to correct a heart arrhythmia. The 66-year-old Birmingham resident signed up for St. Joseph Mercy Oakland hospital's Metabolic Nutrition and Weight Management Program. In six months, she lost 50 pounds and lowered her risk for type 2 diabetes, which can lead to heart disease.

"With that (weight loss), all my cardiac indicators improved," Bell says.

She says she has learned to be more conscientious of what she eats. Now, Bell says, she eats five times a day and eats more whole fruits and vegetables, has a protein with each meal and keeps in mind portion sizes and and the way she prepares foods.

"I've learned how much 2 teaspoons of salad dressing is," Bell says. "Now I buy an oil blend and put it in a shaker-top bottle, so I can shake it into the pan instead of pouring 2 tablespoons in."

A heart-healthy lifestyle starts with awareness, Bell and others say.

"The fact that I didn't know I ... was metabolically at risk for heart disease was the scary part."

Almost Fried Rice

Makes: 6 ( 1/2 cup) servings / Preparation time: 20 minutes

Total time: 45 minutes

2 tablespoons trans fat-free margarine, divided

1/2 cup diced onion

1 clove garlic, peeled, minced

1 teaspoon gingerroot, minced

1/2 cup diced celery

1 cup thinly sliced baby bok choy

1/2 cup grated carrot

1 egg

2 egg whites

2 cups cooked pearled barley

1 1/2 tablespoons reduced-sodium soy sauce

1 tablespoon hoisin sauce

1 teaspoon brown sugar

1/2 teaspoon ground mustard

1/8 teaspoon ground ginger

1/8 teaspoon garlic powder

1/8 teaspoon black pepper

3 green onions, thinly sliced

In a large nonstick skillet over medium heat, melt 1 tablespoon plus 2 teaspoons margarine and saute onion, garlic and gingerroot until fragrant, about 3 minutes. Add celery and saute 2 to 3 minutes. Add bok choy and carrots, and continue to saute an additional 3 to 5 minutes.

Remove vegetable mixture from skillet and set aside. In the same skillet, add remaining 1 teaspoon of margarine. Whisk together the egg and egg whites, add to skillet, and cook and stir over medium heat until completely set. Add vegetable mixture back to skillet, along with cooked barley. In a small bowl, whisk together soy sauce, hoisin sauce, brown sugar, ground mustard, ground ginger, garlic powder and black pepper. Add sauce to the skillet and combine until heated through. Stir in sliced green onions and serve.

Created by Darlene Zimmerman, MS, RD, and tested by Susan Selasky for the Free Press Test Kitchen.

131 calories (21% from fat), 3 grams fat (1 gram sat. fat, 0 grams trans fat), 21 grams carbohydrates, 3 grams protein, 238 mg sodium, 30 mg cholesterol, 33 mg calcium, 3 grams fiber. Food exchanges: 1 starch, 1 vegetable, 1/2 fat.

Skillet Sweet Potatoes with Brown Sugar and Bourbon

Makes: 8 ( 1/2 -cup) servings / Preparation time: 15 minutes

Total time: 45 minutes

5 cups sliced ( 1/4 -inch-thick), peeled, sweet potatoes (about

22 ounces)

2 tablespoons trans fat-free margarine

1/3 cup fresh-squeezed orange juice

3 tablespoons brown sugar

2 tablespoons bourbon (optional)

1 tablespoon honey

1 teaspoon orange zest

1/8 teaspoon salt

Fill a steamer-friendly saucepan with a 1/2 -inch of water. Place steamer basket on top of the saucepan (water should not touch bottom of the basket). Working in batches if necessary, place half the sliced sweet potatoes in the steamer basket. Cover tightly and heat to boiling; reduce heat to low and steam 10 to 15 minutes, or until potatoes are crisp-tender. Remove potato slices from steamer basket and repeat process with remaining sweet potatoes.

In a large, nonstick skillet, heat margarine, orange juice, brown sugar, bourbon, honey and orange zest over medium heat until sugar dissolves. Add cooked sweet potatoes and continue cooking until potato slices are coated and glaze thickens; about 5 to 8 minutes. Season with salt and serve.

Created by Darlene Zimmerman, MS, RD, and tested by Susan Selasky for the Free Press Test Kitchen.

123 calories (15% from fat), 2 grams fat (0 grams sat. fat, 0 grams trans fat), 24 grams carbohydrates, 0 grams protein, 102 mg sodium, 0 mg cholesterol, 29 mg calcium, 2 grams fiber. Food exchanges: 1 starch, 1/2 fruit, 1/2 fat.

Honey Dijon Salmon Fillets with Dilled Panko Crust

Serves: 4 / Preparation time: 15 minutes

Total time: 40 minutes

Vegetable oil cooking spray

4 (5-ounce) salmon fillets

3 tablespoons honey

2 tablespoons Dijon mustard

2 teaspoons balsamic vinegar

1/3 cup panko crumbs

1 tablespoon minced fresh dill

1 teaspoon olive oil

1/8 teaspoon salt

Preheat oven to 400 degrees.

Coat a baking sheet with cooking spray. Arrange salmon fillets on baking sheet.

In a small bowl, stir together honey, mustard and vinegar. Coat each fillet with honey mustard sauce; set aside.

In a separate bowl, combine panko crumbs, dill and olive oil; toss to coat. Add salt and mix. Sprinkle tops of fillets with crumb mixture. Bake salmon 12 to 15 minutes in preheated oven, or until fish flakes easily with a fork.

Created by Darlene Zimmerman, MS, RD, and tested by Susan Selasky for the Free Press Test Kitchen.

298 calories (30% from fat), 10 grams fat (2 grams sat. fat, 0 grams trans fat), 20 grams carbohydrates, 30 grams protein, 315 mg sodium, 81 mg cholesterol, 19 mg calcium, 0 grams fiber. Food exchanges: 4 lean meat, 1 starch.

Source: Darlene Zimmerman, registered dietitian, Henry Ford Hospital's Heart & Vascular Institute


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