Whole Grains for Your Heart? Use the 5 to 1 Fiber Rule

Grain and cereal food selection in heart shaped porcelain bowls over lokta paper background. Green freekeh wheat in large dish with ears.

Ever since your doctor told you to start eating more fiber-rich foods, such as whole grains, vegetables, fruits, and legumes (beans, split peas, chick peas, and lentils), you switched to eating whole wheat bread. You congratulated yourself on trading in (reluctantly) your soft white “wonder” for a 21-grain brick, but your new kind of loaf may not be as healthy and whole as you might think.

Why You Need More Dietary Fiber

There is accumulating evidence that eating more dietary fiber reduces your risk for:

• Type 2 diabetes
• Cardiovascular disease
• Certain cancers
• Weight gain
• Obesity
• Diverticular disease
• Functional constipation

According to a study published in the American Journal of Medicine, as your fiber intake goes up, your risk of metabolic syndrome goes down resulting in less inflammation and a drop in obesity risk. It was concluded that greater dietary fiber intake is associated with a lower risk of both cardiovascular disease and coronary artery disease. (See ‘”Inflammation / Foods that Heal and Harm“)

It’s no surprise that another study concluded that for every additional 7 grams of fiber consumed, heart disease risk decreased by 9%. Seven grams of fiber really doesn’t equate to that much food. You can get 7 grams through a serving of whole grains plus beans or lentils (e.g., rice and beans), or a few servings of fruits and vegetables.

How Dietary Fiber Benefits Your Heart

The cardiovascular benefits of dietary fiber include:

  • Helps get rid of excess bile (reduces LDL “bad” cholesterol)
  • Reduces cholesterol production
  • Feeds our “good” bacteria
  • Changes our gut hormones
  • Promotes eating low-calorie-density foods
  • Increases satiety
  • Delays gastric emptying

These effects collectively help control your cholesterol, body weight, blood sugar, and blood pressure which all reduce your risk for cardiovascular disease.

Also, per a study published in the European Journal of Clinical Nutrition, dietary fiber has been shown to reduce inflammation, specifically, C-reactive protein, a sensitive inflammatory marker that can predict chronic disease.

Eat More Whole Plant Foods

Consuming more dietary fiber means eating lots of whole plant foods, such as:

Whole Wheat Oatmeal Pancakes
Whole Wheat Oatmeal Pancakes

Soluble fiber acts like a “cholesterol sponge”. Sources include:

  • Oats
  • Nuts
  • Seeds (especially flaxseeds)
  • Legumes
  • Most fruits

Sources of insoluble fiber, a.k.a. “Nature’s Broom”, help prevent constipation and include:

  • Whole wheat
  • Wheat bran
  • Brown rice
  • Other whole grains
  • Most vegetables

When shopping for “packaged” grain products, such as bread, crackers and ready-to-eat cereals, the first word in the ingredients list should be “whole”. However, the remaining ingredients might look like a bunch of chemicals, so how do you choose?

The “Five to One Fiber Rule”   

A more reliable strategy to identify a healthy whole grain food product is to   Continue reading “Whole Grains for Your Heart? Use the 5 to 1 Fiber Rule”

Be Aware If You Passed Your Treadmill Stress Test

Having his heart's functions checked

When I first started working in cardiac rehabilitation as a new college grad, one of my Phase 3 cardiac rehab patients had a heart attack when he was only 35 years old. If that wasn’t unsettling enough, he had his heart attack the DAY AFTER he “passed” his treadmill test. Back then, I couldn’t understand how that could possibly happen, but I now know better.

How Sensitive Is Your Treadmill Test?

Here’s what you need to know. Currently, the exercise ECG is the most cost-effective first-line screening tool, but its accuracy relies on the ‘sensitivity’ of the test. Sensitivity refers to the percentage of cases in which exercise testing accurately identifies the presence of coronary artery disease (CAD). Unfortunately, the exercise ECG it is not 100% sensitive to detecting coronary artery disease. 

Per the American College of Sports Medicine, the current sensitivity for detecting CAD using the exercise stress test is only about 70%.  In other words, if you test 100 cardiac rehab patients with documented coronary artery disease, only 70 patients would show evidence of CAD per the stress ECG test. If you’re one of the 30 remaining patients, where does that leave you?

False Negatives

Well, don’t start your celebratory dance (or meal) just yet. It just means that you may fall in either of the following groups:

  1. You have a negative stress test. That is, you actually “passed” and show no signs of coronary artery disease.
  2. You have a false-negative finding. This means you’ve been given a negative stress test result (normal) where no CAD ‘appears’ to be present, but you actually have CAD.

The bottom line… a negative exercise ECG test is no guarantee that you do NOT have coronary artery disease (CAD) even if your cardiologist tells you, “Everything looks great! See you in a year.” So sorry to burst your bubble, but that’s the reality. Cardiac events that occur after a negative stress test happen all too often, but it’s not so perplexing to me anymore.

Causes of False-Negatives (Lower Sensitivity)

Stress test results are only as valuable as your performance, the technician’s monitoring, and the test interpretation. Here are some factors that may increase your chances of a false-negative finding:    Continue reading “Be Aware If You Passed Your Treadmill Stress Test”

The #1 Biggest Mistake That Affects Blood Pressure Readings

Blood pressure_dollarphotoclub_15479127_600x400Have you ever had your blood pressure taken and were surprised to discover that it was higher or lower than you expected? Did you know that simple variations can cause your blood pressure reading to deviate between 5 and 50 points? Beware… the most common error when measuring blood pressure is improper blood pressure cuff size.

Whether you take your own blood pressure at home or rely on a clinician to do so, using the wrong size cuff happens frequently. Since your blood pressure reading predicts your risk of stroke, heart disease and renal failure and assesses your need for hypertensive medications, you want to be sure the reading isn’t artificially low or elevated.

Why Cuff Size Matters

An essential part of measuring a blood pressure involves compressing the artery, so that no blood flows through it. The “cuff” is the part that wraps around your arm and the bladder inside inflates to apply the compression. It is CRITICAL that the cuff is the right size.

When the Cuff is Too Small

BP Cuff_AdultWhen the cuff size is too small, your blood pressure will be artificially HIGH — and can deviate by as much as 50 mmHg. This happens because the undersized cuff may not be able to completely close off the artery. It has to inflate a lot and you’ll get a higher reading. The result: a false diagnosis and over-treatment. It’s not uncommon that some obese people are incorrectly diagnosed with high blood pressure when it is actually normal.

When the Cuff is Too Large

Large BP CuffWhen the cuff size is too big, your blood pressure will be artificially LOW — but may not deviate as much as from the error of using a cuff that’s too small. It will read low because the bladder in the cuff will overlap (covering more than 100% of your arm), so the cuff ends up inflating on itself. In other words, it will cut off the supply of blood too easily and you’ll get a lower reading. Taking your blood pressure with a cuff that’s too large is dangerous because you and your doctor may think your blood pressure is normal and not as high as it actually is.

NOTE: When you’re exercising, your blood pressure is expected to rise, but the wrong size cuff could produce a reading that’s low or too high which could be problematic and symptomatic of cardiovascular disease.

Why This Mistake Occurs So Frequently

Using the wrong size cuff is mainly due to a laxity in protocol and/or by the clinician or a lack of emphasis on proper blood pressure cuff sizing in medical training. As a result, neglecting cuff size becomes the standard practice in the everyday work environment, i.e., in doctors’ offices and in both outpatient and inpatient hospital facilities.

Measuring for Cuff Size

Measuring tape

Use a flexible measuring tape (not metal) and measure the circumference of your arm at about the midpoint between your shoulder and elbow. (Allow your arm to relax and hang down at the side of your body.) If you don’t have a measuring tape, you can also use a piece of string or ribbon. Your cuff size will be determined by your arm size.

Apple c heart symbol_40x54Fit Tip: After measuring your arm, MEMORIZE ITS SIZE! Whenever you get your blood pressure taken, ask the clinician the cuff’s range (it’s printed on the cuff).  Blood pressure cuffs do not come in uniform sizes, so you have to know your arm size. You may be an Adult Small in one cuff, but that could vary depending on the manufacturer.

Up Next! … “10 Factors That Can Affect Blood Pressure Readings(i.e., arm position, posture, and your bladder)

Fit Minute | ‘Bendopnea’ – Do NOT Ignore this Symptom

Do you get short of breath when you bend forward, such as to tie your shoelaces or put on a sock? If so, this is a symptom recently coined as “bendopnea” (pronounced bend-op-nee-ah).

A study of 102 heart failure patients showed bendopnea was present in 29 out of 102 subjects (28%). The average time it took for these symptoms to appear was eight seconds. Some patients thought their bendopnea was due to being out of shape or overweight, but were more likely to have other symptoms of advanced disease.

Heart failure, often referred to as congestive heart failure or (CHF), is a serious condition, but people often mistakenly think that it means that the heart has stopped beating. Heart failure occurs when your heart cannot pump enough blood and oxygen to maintain blood flow to other organs in your body. The reoxygenated blood from your lungs starts building up inside your lungs when your heart can’t keep up with ejecting it to other organs in need. The first signs and symptoms that you’ll notice are:

  • Shortness of breath (worse with exertion and/or while lying down)
  • Excessive fatigue
  • Swelling in the lower extremities (legs, ankles, feet)

Chest pain, including angina, is not typically a complaint with CHF. According to the Centers for Disease Control and Prevention, about 5.1 million people in the United States have heart failure. Heart Failure Fact Sheet

Try this test:  Sit down and bend forward at the waist. Are you short of breath within 30 seconds? If you have bendopnea, you have:

  • Too much fluid in your body
  • Elevated pressure in your heart and your pulmonary veins and capillaries
  • Increased pressure when leaning forward (bending)

Risk Factors for Heart Failure

  • Coronary artery disease (the most common type of heart disease)
  • History of a heart attack
  • High blood pressure
  • Atrial fibrillation
  • Diabetes
  • Smoking
  • Not enough physical activity
  • Overweight/obesity
  • Valvular heart disease
  • Excess alcohol intake

Apple c heart symbol_40x54Fit Tip: If you have bendopnea, be sure to tell your physician. It can be difficult to assess when you are retaining fluid. This assessment is a simple and noninvasive tool to diagnose excessive fluid retention and compromised blood flow.

Source:
Study by the Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. Characterization of a novel symptom of advanced heart failure: bendopnea. Journal of the American College of Cardiology. 2014.