Tips for guaranteed weight loss

Tips for guaranteed weight loss

With fad diets and fitness routines round every corner, it is quite difficult to keep a tab on which weight loss tips really do work and which don't. Should you join that bhangra aerobics class, adopt that no-carb diet, or eat dinner at 6pm? Never mind all that loophole-ridden weight loss jargon, step over to the healthy side. Here are 10 tips for guaranteed weight loss that will set your weight straight, and help you adopt some really healthy, weight-friendly habits for life.  

Weight loss tip 1: Decide how much weight you need to lose - Most people start their weight loss journey by claiming to be xyz kilos overweight. This isn't a healthy way to project or aim for weight loss. Calculate your desired weight against your height by using reliable methods like the BMI, and set a healthy weight loss target. This is often half the battle won.
Weight loss tip 2: Time management - This is quite often overlooked. Decide which part of your day will be dedicated to exercise, when in the week you will stock up on groceries, and when you will do the cooking - all within your current work and home life routine. If you don't do this now, your days will be rushed and unplanned, and you won't be able to sustain your weight loss efforts.
Weight loss tip 3: Stock your kitchen - Keep your house well-stocked with fruits, vegetables, healthy meats, grains, cereals, spices, and flavourers. Follow our tricks to healthy cooking, cooking vegetables for the week, and low-fat cooking posts to understand how best you can stock your kitchen with healthy and delicious ingredients. All of this will go into helping the next step - cooking healthy meals at home.
Weight loss tip 4: Eat healthy homecooked meals - Whether it's you who's cooking, a family member, or house help, ensure that every one practises healthy cooking methods, and ingredients. Ask any person who's lost weight the healthy way, and you will always hear about how healthy homecooked meals were a big reason behind it. Use less oil, low salt, fresh produce, and you'll start seeing results in no time.
Weight loss tip 5 : Start a cardio + weights workout - A healthy weight loss programme is incomplete without a good exercise routine, and weight training mixed with cardio is the best way to lose weight. Of course, variations and forms exist, but any workout that stresses on muscle tone and increased heart rate will always help you lose weight and keep it off. You can either start a home workout today, or rely on gyms for fitness training.
Weight loss tip 6: Alter your snacking habits - At Health Me Up, we have several healthy snacking ideas for you. Set those French fries aside, skip that aerated drink, and ban those unhealthy deep fried samosas. Explore the healthy snack world and you will find several appetisers, party snacks, movie snacks and meal accompaniments that'll satisfy every craving of yours.
Weight loss tip 7: Have at least one active hobby - It isn't sufficient to rely on just 30 to 60 minutes of physical activity per day. Moving from bed to office chair, and back to bed, isn't a healthy way to live. Buy a motion sensor gaming console that lets you enjoy social games with friends and family, plan weekend trips, clean your house once a week, dance, play sports, the list is endless. Get out of the coffee shop and dining table rut, and you'll have fun along with the healthy weight loss.
Weight loss tip 8: Find a solution to combat stress - As we pointed out in our post about stress and weight loss, stress is always detrimental to healthy weight loss in the long run. Find ways to combat stress and you'll soon realise that your diet and exercise aren't sabotaged anymore, and that you truly do see results. Look at yoga, meditation, deep breathing exercises, or simple hobbies like reading to fight stress.
Weight loss tip 9: Drink plenty of water - You've known that your body relies heavily on water for all important bodily functions, and yet you skimp on drinking adequate quantities of water every day. Well, it's time to stop that. Check out some exciting ways to make water interesting and you'll be packing it away in no time. Do not forget to carry a water bottle to your workout, and take a few sips after every 2-3 minutes of exercise.
Weight loss tip 10: Plan healthy vacations - Why go all the way with healthy weight loss, when one tiny vacation will just come along and topple it all? Healthy vacations aren't impossible. Take a look at how you can eat smart on a holiday, and then at bodyweight workouts that you can carry with you wherever you go, to understand how to holiday right. Above all, remember that these are lifelong habits that'll help you stay fit forever and not short term weight loss quickfixes.

 

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HOW TO AVOID OBESITY

HOW TO AVOID OBESITY

In today's world it's more difficult than ever to keep your weight under control, as evidenced by the fact that over 2/3 of all American adults are now overweight or obeseⁱ, as are one in three children.
Part of the blame rests with the processed food corporations that spend billions of dollars marketing unhealthy foodsⁱⁱ as "healthy choices."
So what do "naturally thin" people know that the rest don't?
David Zinczenco, editor in chief of Men's Health magazine, and Matt Goulding address this question in a recent article featured on Yahoo Healthⁱⁱⁱ, stating that most thin people tend to live by a series of "laws" that keep them from gaining excess weight.
These seven rules are simple enough that most can follow them:

1. Avoid "Dieting": By dieting, you're setting yourself up to gain more weight than ever.
2. Avoid "Fat-Free": Fat doesn't make you fat; you need fat in your diet to help you process certain nutrients.
3. Sit Down to Eat: Eating more slowly and savoring your meal boosts levels of two hormones that make you feel fuller.
4. Plan Your Meals and Snacks: Planning your responses to hunger helps you shed pounds faster.
5. Eat Protein: Those who eat moderately high levels of protein (including organic animal protein) are twice as likely to lose weight and keep it off as those who don't eat much protein.
6. Move Around: "Fit people stay fit by having fun."
7. Watch Less TV: Nearly 30 percent of people who watch more than four hours of TV a day have a BMI of 30 or higher.

(To read more about these rules, please see the original article.) I do believe Americans in particular have traded convenience for health, and that is partly visible in the list above.
Staying lean includes skipping conveniences like fast food and driving everywhere you need to go... It's important to understand that poor dietary and lifestyle choices are at the very root of skyrocketing obesity- and disease rates. But, while the seven "laws of thin people" compiled by Zinczenco and Goulding are good ones, from my experience these rules are still coming up a short. So, below I will review several more that I believe are CRUCIAL factors for successful long-term weight management and optimal health.

Rule #1: Severely Limit Fructose in Your Diet

It is important to understand that your diet is THREE times more important for controlling your weight than your exercise. It's very easy to sabotage any benefit you'd receive from exercise by consuming fructose-laden foods and beverages, including sports drinks, sodas, and fruit juices. If you consume any processed foods or sweetened beverages at all, reading the labels is a necessity. You may be shocked to realize just how much sugar is in the products you consume on a regular basis.
Why is limiting fructose so important for weight management and optimal health?
The reasons are numerous, but if I could make you memorize just one thing that can truly help you improve your health, it would be that eating fat does not make you fat; eating excessive fructose does! If you were to view soda with the same disdain most people give to a chunk of lard, you'd be on the right track... Ironically though, the lard would actually be more healthful for you than the soda!
Fructose simultaneously prevents weight loss and promotes fat storage, by:

• Diminishing your satiety (feelings of fullness) as it does not stimulate a rise in leptin, one of the most powerful hunger and fat storage regulators in your body. And, of course, when you're feeling hungry you tend to eat more. Leptin resistance, just like insulin resistance, is also one of the most significant factors underlying a vast array of diseases. For example, it plays a significant if not primary role in the development of heart disease, obesity, diabetes, osteoporosis, autoimmune diseases, reproductive disorders, and perhaps the rate of aging itself.
  
• Not suppressing ghrelin (also known as "the hunger hormone"). Glucose, on the other hand, does suppress ghrelin, making you feel satiated
• Slowly, if consumed chronically, causing insulin resistance, which hampers weight loss efforts
• Converting directly to fat more readily than any other sugar. It is also known to raise triglycerides significantly
• Robbing your body of micronutrients while assimilating itself for use (in the case of foods containing high fructose corn syrup. Whole fruits on the other hand does not have this particular problem as the fruit contains all these extra nutrients along with the fructose)

With all these simultaneous factors coming into play every time you consume fructose, it's easy to see why a high-fructose diet can propel you into a vicious cycle of over-eating while also being malnourished.
My recommendation is to keep your total fructose intake below 25 grams of fructose per day, if you're in good health. Most people will also benefit from limiting your fructose from fruit to 15 grams a day, and, if you need to lose weight, you likely will need to limit your total fructose consumption to 15 grams a day total, including that from fruit.

Rule # 2: Reduce Your Grain Carb Consumption

Excess weight	Depression	Bloating	High blood pressure
Fatigue and frequent sleepiness	Brain fogginess	Low blood sugar	High triglycerides

If you experience any of the following symptoms, chances are very good that the excess carbohydrates in your diet are, in part or whole, to blame: the primary reason for cutting out as many grain carbs as possible is because grains convert into sugar in your body, spiking your insulin levels. Eventually, your body becomes insulin resistant, and that's when the majority of the problems really set in. Obesity is just the beginning. Insulin resistance is in fact one of the hallmarks of nearly every chronic disease known to man, from diabetes, to heart disease, to cancer.
If you want to be optimally healthy and normalize your weight, reducing your carb consumption is essential. This includes:

• Breads and baked goods (ALL grains, including organic ones)
• Rice
• Pasta
• Potatoes

We all need a certain amount of carbohydrates, of course, but, through our addiction to grains, corn, sweets and other starchy and sugary foods, we are consuming far too many. Your body's storage capacity for carbohydrates is quite limited, so here's what happens to all the excess: they are converted, via insulin, into fat and stored in the adipose (fatty) tissue.

Rule # 3: Increase Your Healthy Fat Consumption

Carbs (sugars) provide your body with energy, but it's fast burning and doesn't satisfy very long. Once you decrease carbs in the form of sugar/fructose and grains, you need to replace them with increased amounts of vegetable carbs and healthy saturated fats. Fats will not only make you feel satiated longer than carbs, but will also provide you with high quality fuel your body needs. And, while eating grains and sugars will raise your insulin levels and promote insulin resistance, eating fat does not. However, the quality of the fats is very important. Loading up on margarine and vegetable oils is asking for trouble as these types of trans fats have been linked to:

Cancer: They interfere with enzymes your body uses to fight cancer	Decreased immune function: They reduce your immune response	Obesity
Diabetes: They interfere with the insulin receptors in your cell membranes	Problems with reproduction: They interfere with enzymes needed to produce sex hormones	Heart disease: Trans fats can cause major clogging of your arteries

At the other end of the spectrum you have saturated fats, which are:

Preferred fuel for your heart	Useful antiviral agents (caprylic acid)	Useful for lowering cholesterol levels (palmitic and stearic acids)
Carriers for important fat-soluble vitamins A, D, E and K, and required for the conversion of carotene to vitamin A, for mineral absorption, and for a host of other biological processes	Effective as an anticaries, antiplaque and anti fungal agents (lauric acid)	Modulators of genetic regulation and prevent cancer (butyric acid)

Sources of healthy fats that you'll want to add to your diet include:

Olives and Olive oil (for cold dishes)	Coconuts, and coconut oil (for all types of cooking and baking)	Butter made from raw grass-fed organic milk
Raw Nuts, such as, almonds or pecans	Organic pastured egg yolks	Avocados
Grass fed meats	Palm oil	Unheated organic nut oils

Another healthful fat you want to be mindful of is animal-based omega-3. Deficiency in this essential fat can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3's and the best sources of this fat, please review this previous article.

Rule # 4: Avoid All "Diet" Foods, Especially Diet Sodas

Soda, in my opinion, is one of the primary health threats. A single can of Coke contains about 10 teaspoons of sugar. However, the alternative may be even worse. Diet sodas, which typically contain either aspartame or sucralose (Splenda), or a combination of both, can wreak havoc on your health in just as many ways as fructose, but since they are manmade chemicals, the toxic ramifications and side effects can be magnified.
Billions of dollars worth of advertising tells you that diet soda gives you all the pleasure of a sweet beverage or snack without any of the worries associated with excess calories. Too bad it really is too good to be true.
In fact, artificial sweeteners have actually been positively linked to weight gain—not weight loss! More recent research has demonstrated that your brain can tell the difference between real and artificial sugar, and not only are artificial sugars less satisfying to your brain at a cellular level, they also increase your craving for the real thing. So artificially sweetened foods and snacks, and diet soda in particular, must be avoided if you don't want to fuel sugar cravings.

Rule # 5: Be Sure to Eat PLENTY of Organic Vegetables

One of the best ways to improve your health is to make sure you're eating plenty of fresh, minimally processed high quality vegetables, ideally locally-grown and organic, with a majority of them consumed raw. One simple way to boost your vegetable intake is to juice them. I highly recommend it to anyone working to restore or improve their health. You can review my comprehensive approach to how to juice on my vegetable juicing page.
And for every vegetable you pack onto your plate or into your glass, you'll have less room for all those other simple carbohydrates that can expand your waistline.

Rule # 6: Optimize Your Exercise Program

A healthy diet and exercise go hand in hand when it comes to creating and maintaining optimal health. If you are struggling with your weight, exercise is clearly one of the key factors that can synergize the effects of healthy food choices. But did you know that by making some minor changes in the types of exercises you engage in, you can speed up and dramatically improve the results?
It's true.
The key to boosting weight loss and getting the most out of your exercise routine is to make sure to incorporate high-intensity, short-burst-type exercises, such as my Peak Fitness Program, two to three times per week. Several studies have confirmed that exercising in shorter bursts with rest periods in between burns more fat than exercising continuously for an entire session.
This has been shown to hold true even when the session is not done at an extremely high intensity.
This may be because these types of exercises are the closest to how the human body was designed to move—like that of a hunter-gatherer. A recent study highlights the benefits of this type of daily movement. The researchers noted that the ideal "exercise prescription" would include the following aspects of normal hunger-gatherer living:

A variety of exercises performed regularly (weight training, cardio, stretching, etc.)	Alternate difficult days with easier days	Exercise outdoors, which helps maintain vitamin D levels and improve mood
Interval training sessions performed once or twice a week	Weight training at least twice a week	Walk and run on softer, uneven terrain, such as grass and dirt, possibly barefoot or using "simpler shoes that do not drastically restrict foot motion or alter natural foot strike dynamics"
Exercise with a friend to receive social stimulation as well	Ample time for rest after physical exertion	Recreational activities, including dancing and sex

I completely agree that variety is yet another key to getting the most benefits from your exercise. A sound, well-rounded regimen would include:

• High intensity interval exercises
• Conventional aerobics
• Strength training
• Core exercises like Pilates
• Stretching like Yoga or active isolated stretching

If you're like most Americans, you probably have between a few and several unnecessary pounds you'd prefer not to be carrying around every day. I'm here to tell you that not only is it possible to take off the extra weight with a little thoughtful planning, it is also possible to keep the weight off simply by following a few sensible guidelines above and my nutrition plan.

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HOW TO PREVENT DIABETES

HOW TO PREVENT DIABETES

Sitting May Prompt Diabetes

Among women‚ being seated for long periods of time every day raises the risks of developing type–2 diabetes.

An emerging factor for chronic disease‚ sedentary behavior – marked by an obvious lack of routine physical activity‚ may prompt the onset of type–2 diabetes among women. Thomas Yates‚ from the University of Leicester (United Kingdom)‚ and colleagues assessed 585 men and women‚ ages 40 and over‚ for the amount of time they spend sitting during the course of the week. Additionally‚ the team collected blood samples to identify markers linked to diabetes and metabolic dysfunction. The researchers found that women who spent the longest time sitting have higher levels of insulin‚ as well as elevated levels of leptin (a chemical released by fatty tissue in the abdomen)‚ and higher amounts of inflammatory markers including C–reactive protein and interleukin–6. These correlations were not found in the male study subjects. Urging that women need to engage in 30 minutes of moderate to vigorous intensity exercise a day‚ the study authors conclude that: “Total self-reported weekday sitting time was associated with biomarkers linked to chronic low–grade inflammation and poor metabolic health in women … independent of physical activity.”

1. Get movingPhysical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes, but you’ll get the best benefits if you do various types of exercise, according to the American Diabetes Association (ADA).

The ADA recommends a half-hour of mild aerobic activity (like dancing or tennis) five times per week, based on results from a landmark, 16-year study by the Harvard School of Public Health, which found that even brisk daily walking reduces risk of type 2 diabetes by 30%.

Why resistance training? Because muscle is a good absorber of blood sugar (which gets it out of the bloodstream).

Do a full-body workout – engaging chest, back, butt and legs – for 30 minutes twice a week, according to Melina Jampolis, M.D., a member of the CNN Health team.

If that doesn’t fit your schedule, exercise for 10 minutes each day, varying your routine.

“You need to challenge yourself and change things up to keep getting a benefit from it,” she says.

You don’t have to hit the gym, adds Howard Shapiro, M.D., author of Eat and Beat Diabetes with Picture-Perfect Weight Loss (Harlequin). 
1. Get movingPhysical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes, but you’ll get the best benefits if you do various types of exercise, according to the American Diabetes Association (ADA).

The ADA recommends a half-hour of mild aerobic activity (like dancing or tennis) five times per week, based on results from a landmark, 16-year study by the Harvard School of Public Health, which found that even brisk daily walking reduces risk of type 2 diabetes by 30%.

Why resistance training? Because muscle is a good absorber of blood sugar (which gets it out of the bloodstream).

Do a full-body workout – engaging chest, back, butt and legs – for 30 minutes twice a week, according to Melina Jampolis, M.D., a member of the CNN Health team.

If that doesn’t fit your schedule, exercise for 10 minutes each day, varying your routine.

“You need to challenge yourself and change things up to keep getting a benefit from it,” she says.

You don’t have to hit the gym, adds Howard Shapiro, M.D., author of Eat and Beat Diabetes with Picture-Perfect Weight Loss (Harlequin).
3. Pour a spoonful of vinegarTwo tablespoons of apple cider vinegar a day lowers the blood sugar surge you get eating from eating carbs, thereby lowering your blood sugar, according to a series of studies by Carol Johnston, Ph.D., professor and director of the Nutrition Program at Arizona State University.

And no, you don’t need to take it straight. Johnston recommends making a vinaigrette with 2 parts vinegar to 1 part olive oil (avoid bottled dressings, which have the opposite ratio) and starting your dinner with vinaigrette-dressed salad or steamed vegetables.

4. Spice it upIn an often-quoted 2003 study, Pakistani researchers along with Richard Anderson, a scientist with the U.S. Department of Agriculture, found even 1 gram of cinnamon daily reduces blood sugar.

Subsequent U.S. studies haven’t confirmed the benefits of the spice or cinnamon supplements, but diabetes experts still recommend adding it to your diet.

“It can’t hurt, sprinkled on toast or whatever,” Johnston says.

5. Drink more coffeeHold on to your mugs: An 18-year, 125,000-participant study (84,276 were women) by the Harvard School of Public Health showed that women who drank six or more cups of coffee per day reduced the risk of type 2 diabetes by nearly 30% – although that much coffee can pose other health risks. 

 

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strategies to prevent unintentional injuries among children

strategies to prevent unintentional injuries among children

This is one of three pieces of NICE guidance published in November 2010 on how to prevent unintentional injuries among under-15s. A second publication covers unintentional injuries on the road and a third covers the provision of home safety equipment and home risk assessments.
This guidance is for commissioners and providers of health services, local authority children’s services, local authorities and their strategic partnerships, local highway authorities, local safeguarding children boards, police, fire and rescue services, policy makers, professional bodies, providers of play and leisure facilities, and schools.
It is also for other public, private, voluntary and community organisations and services which have a direct or indirect role in preventing unintentional injuries among under-15s.
The recommendations cover:

• Planning and coordinating local activities.
• Workforce training and capacity building through national standards and curricula.
• Injury surveillance to monitor the incidence of unintentional injuries among under-15s and plan preventive initiatives.
• Fitting permanent safety equipment and carrying out home safety assessments
• Outdoor play and leisure, including policies to ensure public play spaces are safe, and education and advice on water and firework safety.
• Road safety, including strategies to help reduce vehicle speed in areas near where children and young people are present and managing road safety partnerships.

Please note: this guidance includes some of the information from NICE’s draft guidance on Preventing unintentional injuries among children and young people aged under 15 - information, advice and education for outdoor play and leisure.  Following the consultation on that draft guidance, NICE will not be publishing final guidance – see Preventing unintentional injuries among under 15s - outdoor play and leisure for further details, the draft guidance and supporting documents.

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Natural Ways to Stop Feeling Depressed

Natural Ways to Stop Feeling Depressed

• Life is a drag.
• What’s the point of anything?
• I’ll never be happy.

Do any of these gloomy thoughts sound familiar? It’s likely they do. The occasional case of the blues is perfectly normal, but that doesn’t make dealing with it any easier. If you allow them to, negative thoughts can fester and lead to serious depression. That’s why it’s important to take action early to bust yourself out of a slump.
While these suggestions won’t eliminate your problems, they can help you break a negative thought pattern and stop feeling depressed. If you think you might have a serious mental health problem, don’t hesitate to see a medical professional.
1. Understand the emotional cycle – Life is an emotional roller coaster. Some days you feel like nothing can stop you. Other days you feel utterly hopeless. Most of the time you’re somewhere in between. Understanding the pattern of positive and negative emotions will help you put your feelings in perspective. Next time you feel down, just remember that it’s a natural emotion that will inevitably pass. Knowing that a feeling of depression is only temporary makes it less dreadful.
2. Spend time with positive people – Nothing affects the way you think and feel more than the people you interact with. Thoughts (both positive and negative) are contagious. If you are surrounded by negative people, it’s only natural that you’ll start to think and feel the same way. To improve your outlook on life, spend time with positive people. Search them out and try to understand the way they see the world. Chances are their happiness will rub off.
3. Reflect on past success – In the wake of a colossal failure, it’s easy to forget everything you’ve ever done right. Take a few minutes to remember your past accomplishments and build yourself up. What made you successful before? What are your strengths? Frequently, this exercise will build self confidence, help you figure out what went wrong, and generate ideas for success in the future.
4. Focus on gratitude – It’s human nature to measure ourselves against those ahead of us on the social ladder. Studies have shown that people care more about being richer than their friends than actually making more money. When you consider everything good in your life and compare it to the problems of less fortunate people, the issue that’s making you depressed won’t seem as serious.
5. Change of scenery – One of the best ways to change the way you feel is to change your environment. When you get in a slump, you start to associate your problems with everything around you. It can get to the point where your environment is a constant reminder of your problems. This can be a dangerous cycle. The solution is to change things. Change doesn’t have to be radical. Cleaning up, adding more lights, or including pleasant decorations can completely change the mood of a room.
6. Break your routine - Going through the same routine, day after day, can be monotonous and depressing. It often leads to getting caught in a rut. To get out of it you need to temporarily change your routine. If you can, take a day off from work. Do something you don’t normally have time for or something you’ve never tried. In the long run, taking a day off every now and then to get out of slump will make you happier and more productive.
7. Interact with animals and nature – It’s funny when you consider how humans put so much importance on their own tiny problems. Animals don’t think this way. A little bird doesn’t mope around because it isn’t an eagle or because another bird beat it to a tasty seed. Animals live in the present moment and they show love unconditionally. Observing and interacting with them will help you get over your problems.
8. Get moving – As Johnny Cash famously suggested, “Get a rhythm, when you get the blues.” Moving to a beat makes everyone feel better. The same is true for movement in general. Hitting the gym or going for a walk will help you shed the lethargy that comes with feeling depressed. The more enthusiastic your moments, the better you will start to feel.
9. Think about the big picture – As Carl Sagan made evident with the Pale Blue Dot, we’re insignificant creatures living in a vast universe on a tiny planet. In the long run, everything we do will probably be forgotten. Some might find this depressing, but it shouldn’t be. It means that all our problems are illusory. In a million years no one will remember what you did or didn’t do. What matters is the present moment and enjoying every second of life that we’re blessed with.
10. Do something to help yourself – Above all, the best way to stop feeling depressed is to take action. What is your biggest problem? How can you alleviate it? Once you decide to stop moping and start moving forward you won’t have time to feel depressed. Action will occupy your mind and give you something to look forward to. Once you get some results, you’ll build momentum and positive thinking will keep getting easier.

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HOW TO STOP OSTEOPOROSIS

HOW TO STOP OSTEOPOROSIS

Tips on what you can do to prevent osteoporosis.
Osteoporosis can be a devastating disease, but the good news is that it’s preventable. Here are some steps you can take to decrease your risk:
Your Diet

• Drink your milk. Low-fat and skim milk, nonfat yogurt, and reduced-fat cheeses (except cottage cheese) are healthy sources of the calcium you need to build strong bones. Fortified milk products also have the vitamin D needed for proper calcium absorption.
• Go fish. Canned sardines and salmon, eaten with their bones, are also rich in calcium. Mackerel and other oily fish are rich in vitamin D.
• Eat greens with gusto. Leafy green vegetables have lots of calcium, plus the potassium and vitamin K you need to block calcium loss from bones. Fill up on broccoli, bok choy, kale, Swiss chard, and turnip greens. Bananas also supply a potassium boost.
• Serve yourself soy. Soy contains not only calcium but also plant estrogens, and it seems to help maintain bone density. Substitute soy flour for regular flour in recipes from pancakes to cupcakes. Nibble on roasted soybean “nuts” instead of peanuts. Reach for soy cereal and soy cheeses. Make malts and smoothies with soy milk.
• Don’t overdo protein. High protein intake can raise your excretion of calcium. Limit yourself to the RDA of 50 grams daily for women, 63 grams for men. Many Americans eat twice that much.
• Limit caffeine. Limit your caffeine intake to the equivalent of three cups of coffee a day, since caffeine causes the body to excrete calcium more readily.
• Eat your onions. In male rats, those fed one gram of dry onion daily experienced a 20% reduction in the bone breakdown process that can lead to osteoporosis — slightly more than with the drug calcitonin.

Your Exercise Plan

• Get with the program. A regular program of weight-bearing exercise helps stop further bone loss and may be one of the few ways to build bone as you age. By improving your posture, balance, and flexibility, it also reduces your risk of falls that can break fragile bones. Exercise for at least 30 minutes three times a week. Try walking, running, weight lifting, stair climbing, tennis, or volleyball. Swimming won’t do; your bones and muscles must work against gravity for a bone-building effect.

Medical Options

• Test your bones. Bone-density tests are the only way to predict your fracture risk and definitively nail down a diagnosis of osteoporosis. All women over 65 should be scanned, as well as younger postmenopausal women with one or more osteoporosis risk factors. Some doctors recommend that women have a baseline scan at menopause. When repeated at intervals of a year or more, the scans can determine your rate of bone loss and help monitor prevention and treatment efforts. Most experts recommend a dual energy X-ray absorptiometry (DEXA) test.
• Get measured. Ask your doctor to measure your height on an annual basis. A loss of one or two inches is an early sign of undiagnosed vertebral fractures and osteoporosis.
• Seek treatment. Confer with your doctor about conditions that can threaten bone density and what countermeasures you may need. Conditions include hyperparathyroidism, hyperthyroidism, hypogonadism, certain intestinal and kidney disorders, and certain cancers.

Supplements

• Choose calcium. Both women and men need 1,000 mg of elemental calcium a day during midlife. The need rises to 1,500 to 2,000 mg daily after menopause in women and after age 65 in men. Most people don’t get enough in their diets, so supplements are recommended. Because the body can absorb only a limited amount of calcium at once, take supplements in two or three doses during the day, preferably with meals. Make sure the supplement contains vitamin D, which facilitates the absorption of calcium.

Lifestyle Factors

• Quit smoking. Among 80-year-olds, smokers have up to 10% lower bone-mineral density, which translates into twice the risk of spinal fractures and a 50% increase in risk of hip fracture. One in eight hip fractures in women is linked to long-term cigarette use. What’s more, fractures heal slower in smokers, and are more apt to heal improperly.
• Avoid excessive alcohol. Too much alcohol prevents your body from absorbing calcium properly. Limit yourself to one drink a day for women and two drinks a day for men.
• Don’t let depression linger. Depression causes your body to produce cortisol, a stress-related hormone that saps minerals from bones. One study showed that women with clinical depression had lower bone densities in their hips and spines. So see a doctor or therapist for treatment.

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Reproductive Health Act

Reproductive Health Act

 Help us stop the radically pro-abortion and ironically, anti-choice "Reproductive Health Act" (RHA)

 S.2524 (Klein)/S.2844 (Stewart-Cousins)/A.6112 (Glick)

 

The 2012 legislative session began on January 4th, with Governor Cuomo’s State of the State Address.  The Governor outlined his agenda in a plan called Building a New New York.  In this comprehensive plan for our state, Cuomo said that he “…will fight for passage of the Reproductive Health Act.  This Act protects the fundamental right of reproductive freedom and a woman’s right to make private health care decisions."  As we have observed over this past year, Governor Cuomo is a formidable opponent who has managed to bring the legislature in line with his agenda.

The Reproductive Health Act seeks to have abortion declared a ‘fundamental right’ in New York State, prohibiting even basic and widely supported protections, such as parental consent and limits on government funding of abortion. The law would allow any "health care practitioner" to perform an abortion, jeopardize any agency that does not refer for abortion and seriously threaten conscience protections for hospitals and medical professionals.

 

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Ways of Preventing Swine Flu

Don’t know whether or not to get the H1N1 vaccination? You might want to read some of these precautions before you sign up for the shot. If you’re opting for other ways to dodge the flu, here are 14 tips to boost your immunity and stay healthy this flu season.
1. Optimize your vitamin D level. Adequate levels of vitamin D are essential for our immune systems to function optimally. Unfortunately there are no significant dietary sources of vitamin D, most of our intake comes from exposure to sunlight. If you live far from the equator, you simply don’t get enough sun through Fall and Winter to make all the vitamin D you need. So unless you supplement during this period, your innate immunity will be compromised. vitamin D plays such a crucial role in so many aspects of your body’s functioning, that supplementing with it makes sense whether you decide to get the flu shot or not.
We know that influenza always gets worse during the winter months. Now there is good evidence to suggest that this is because as sunlight hours lessen during the winter, the people living in the northern hemisphere become vitamin D deficient and are susceptible to influenza infections of all kinds.
The current recommendations from the Food and Nutrition Board of the U.S. Institute of Medicine: from 200 to 600 IU/day depending on one’s age, are way too low.
These values were originally chosen because they were found to prevent osteomalacia (bone softening) and rickets. It is now recognized that vitamin D has many additional physiological functions, for which these levels are totally inadequate. A number of scientists are therefore calling for the Food and Nutrition Board in the U.S. and its counterparts abroad to reassess their current recommendations. Get your 25 hydroxy vitamin D level checked by your Doctor (if that is not an option, you can self test your level with ZRT labs)
Although the current normal range is between 20 and 50ng/ml, this is much too low for optimal health. You want your level to be between 50 and 70ng/ml.
This is the most important step you can take to prevent the flu! It may require a number of months taking 5,000 to 10,000 IU of vitamin D3 daily (especially during winter) under a doctor’s supervision, to optimize your blood level. Monitor your 25 hydroxy vitamin D status every three months until you are in the optimal range, then cut back to a maintenance dose of at least 2,000 IU a day.
2. Get adequate sleep. This is an indispensable requirement for a strong immune system.
3. Get adequate exercise. This keeps you robust.
4. Take actions to lower your stress levels.
Do breathing exercises, meditate, practice yoga, spend time doing something that makes you happy. Feeling spent, overwhelmed and or mentally run down has a causal relationship to your physical health.
5. Wash your hands frequently but not excessively. It decreases your likelihood of spreading a virus to your nose, mouth or other people. Be sure you don’t use antibacterial soap because of the risk of creating resistant bacteria. Rather use a simple chemical-free soap.
6. Avoid sugar and processed foods as they decrease your immune function dramatically.
7. Eat phytonutrient rich meals (lots of colorful salads and dark greens).
8. Eat lots of garlic, it works as a broad spectrum antibiotic.
9. Take a probiotic daily (look for one with 10-20 billion organisms). A strong immune system relies heavily on having a strong foundation in the gut.
10. Keep a supply of antiviral herbal supplements on hand. As opposed to antiviral drugs, antiviral herbs do not cause resistant strains because they are multifaceted and contain literally thousands of different medicinal compounds. Thus they are able to attack viruses with a full spectrum of synergistic substances. Andrographis, Olive leaf extract, Grapefruit seed extract and Elderberry extract all have antiviral properties. Use one or a combination of some of them as a prophylactic measure, for example, whenever you travel (airports) or enter a potentially compromised environment such as a large office, auditorium, stadium, theater etc.
And if you really want to go all out, here are 4 more tips:
11. Take 1-2 grams of fish oils daily– it’s beneficial for immune function.
12. Take 2 grams of vitamin C daily, yes it does help.
13. Stock your home pharmacy with an immune building formula. Look for one that contains Cordyceps and Astragulus — take it throughout the flu season.
14. Keep homeopathic Oscillococcinum on hand. Take it at the earliest sign of a cold or flu as early intervention is essential.
If you are exposed to someone with the flu directly, you can take one dose twice a day for two days. You can also take one vial once a week throughout the winter, and two or three times a week during flu season, as a preventative measure.

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HOW TO PROTECT HEART DISEASE

HOW TO PROTECT HEART DISEASE

5 medication-free strategies to help prevent heart disease

You can prevent heart disease by following a heart-healthy lifestyle. Here are five strategies to help you protect your heart. 

Heart disease may be a leading cause of death, but that doesn't mean you have to accept it as your fate. Although you lack the power to change some risk factors — such as family history, sex or age — there are some key heart disease prevention steps you can take.
You can avoid heart problems in the future by adopting a healthy lifestyle today. Here are five heart disease prevention tips to get you started.

1. Don't smoke or use tobacco

Smoking or using tobacco is one of the most significant risk factors for developing heart disease. Chemicals in tobacco can damage your heart and blood vessels, leading to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.
In addition, the nicotine in cigarette smoke makes your heart work harder by narrowing your blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — smoking only while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.
Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. This risk increases with age, especially in women older than 35.
The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

2. Exercise for 30 minutes on most days of the week

Getting some regular, daily exercise can reduce your risk of fatal heart disease. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.
Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may be a factor in heart disease.
Try getting at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't give up. You can even break up your workout time into 10-minute sessions.
And remember that activities such as gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3. Eat a heart-healthy diet

Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt. The diet is rich in fruits, vegetables, whole grains and low-fat dairy products, which can help protect your heart. Beans, other low-fat sources of protein and certain types of fish also can reduce your risk of heart disease.
Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels.
Major sources of saturated fat include:

• Red meat
• Dairy products
• Coconut and palm oils

Sources of trans fat include:

• Deep-fried fast foods
• Bakery products
• Packaged snack foods
• Margarines
• Crackers

Look at the label for the term "partially hydrogenated" to avoid trans fat.
Heart-healthy eating isn't all about cutting back, though. Most people need to add more fruits and vegetables to their diet — with a goal of five to 10 servings a day. Eating that many fruits and vegetables can not only help prevent heart disease, but also may help prevent cancer.
Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish, such as salmon and mackerel, are a good natural source of omega-3s. Omega-3s are present in smaller amounts in flaxseed oil, walnut oil, soybean oil and canola oil, and they can also be found in supplements.
Following a heart-healthy diet also means drinking alcohol only in moderation — no more than two drinks a day for men, and one a day for women. At that moderate level, alcohol can have a protective effect on your heart. More than that becomes a health hazard.

4. Maintain a healthy weight

As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.
One way to see if your weight is healthy is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat. BMI numbers 25 and higher are associated with higher blood fats, higher blood pressure, and an increased risk of heart disease and stroke.
The BMI is a good, but imperfect guide. Muscle weighs more than fat, for instance, and women and men who are very muscular and physically fit can have high BMIs without added health risks. Because of that, waist circumference also is a useful tool to measure how much abdominal fat you have:

• Men are considered overweight if their waist measurement is greater than 40 inches (101.6 centimeters, or cm)
• Women are overweight if their waist measurement is greater than 35 inches (88.9 cm)

Even a small weight loss can be beneficial. Reducing your weight by just 10 percent can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes.

5. Get regular health screenings

High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

• Blood pressure. Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more-frequent checks if your numbers aren't ideal or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury.
• Cholesterol levels. Adults should have their cholesterol measured at least once every five years starting at age 20. You may need more frequent testing if your numbers aren't optimal or if you have other risk factors for heart disease. Some children may need their blood cholesterol tested if they have a strong family history of heart disease.
• Diabetes screening. Since diabetes is a risk factor for developing heart disease, you may want to consider being screened for diabetes. Talk to your doctor about when you should have a fasting blood sugar test to check for diabetes. Depending on your risk factors, such as being overweight or a family history of diabetes, your doctor may recommend first testing you for diabetes sometime between ages 30 and 45, and then retesting every three to five years.

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Natural Solutions for Kidney Stones

Natural Solutions for Kidney Stones

Kidney stones are the result of calcified deposits in the kidneys. There are different types of stones, and they come in different sizes. Some may pass easily, and others are quite painful to pass and may even require surgery. According to the National Institutes of Health, they may be caused by excess uric acid, or a buildup of calcium that was not utilized for muscles or bones. There are natural remedies that people with kidney stones may want to consider.

Nutrition

The most noninvasive approach to resolving kidney stones is through nutrition. Making a few dietary changes can often address the cause of the kidney stones. Uric acid stones often occur when there is too much meat in the diet. Cutting back on meats and other acid-producing foods such as sweets, junk food, soda and alcohol can help reduce the amount of uric acid in the bloodstream. Eat a diet rich in whole grains, fresh fruits and vegetables, lean proteins and healthy oils and fats. Drinking plenty of water each day to flush the kidneys is also very important. The rule of thumb is half your weight in ounces of water each day. Therefore, a 180 pound individual should drink at least 90 ounces of water. Keep in mind, certain substances such as coffee and alcohol are dehydrating, so extra water should be consumed with these drinks. In addition, avoid calcium supplements while treating kidney stones.

Herbs

Herbs such as hydrangea, crampbark and lemon may help ease the discomfort of kidney stones, but gravelroot is an herb that actually helps to dissolve them. It has long been used by herbalists for this very purpose, hence its name. According to the University of Maryland Medical Center's guide to complementary medicine, goldenrod is another herb that has received recognition for its effectiveness in treating kidney stones because of its diuretic and anti-inflammatory effects. Lastly, cornsilk is a mild diuretic that may be used to help pass the stones. Many of these herbs can be found in natural health food stores as herbal teas or in capsule form.

Homeopathic Remedies

The least aggressive approach to natural health care may very well be homeopathy. Homeopathic remedies are taken from organic substances that are toxic in their natural state. However, they are diluted to such minute proportions, that very little of the substance remains. Homeopathy is based on the principle that "like cures like," and that the body has the innate ability to cure itself. This may sound similar to the idea behind vaccines, except with homeopathic remedies, there are few, if any, side effects. Homeopathic medicines for kidney stones include Berberis vulgaris, sarsaparilla, hydrangea and benzoic acid. A homeopathic evaluation includes a complex assessment to determine the correct remedy. Consult with a homeopathic physician for individual recommendations and dosing.

Precautions

Alternative therapies should be used in conjunction with, not in place of, conventional medical care. Always consult your physician or health care practitioner before using herbal supplements because some herbs may interfere with certain medications.

Kidney stones are the result of calcified deposits in the kidneys. There are different types of stones, and they come in different sizes. Some may pass easily, and others are quite painful to pass and may even require surgery. According to the National Institutes of Health, they may be caused by excess uric acid, or a buildup of calcium that was not utilized for muscles or bones. There are natural remedies that people with kidney stones may want to consider.

Nutrition

The most noninvasive approach to resolving kidney stones is through nutrition. Making a few dietary changes can often address the cause of the kidney stones. Uric acid stones often occur when there is too much meat in the diet. Cutting back on meats and other acid-producing foods such as sweets, junk food, soda and alcohol can help reduce the amount of uric acid in the bloodstream. Eat a diet rich in whole grains, fresh fruits and vegetables, lean proteins and healthy oils and fats. Drinking plenty of water each day to flush the kidneys is also very important. The rule of thumb is half your weight in ounces of water each day. Therefore, a 180 pound individual should drink at least 90 ounces of water. Keep in mind, certain substances such as coffee and alcohol are dehydrating, so extra water should be consumed with these drinks. In addition, avoid calcium supplements while treating kidney stones.

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Herbs

Herbs such as hydrangea, crampbark and lemon may help ease the discomfort of kidney stones, but gravelroot is an herb that actually helps to dissolve them. It has long been used by herbalists for this very purpose, hence its name. According to the University of Maryland Medical Center's guide to complementary medicine, goldenrod is another herb that has received recognition for its effectiveness in treating kidney stones because of its diuretic and anti-inflammatory effects. Lastly, cornsilk is a mild diuretic that may be used to help pass the stones. Many of these herbs can be found in natural health food stores as herbal teas or in capsule form.

Homeopathic Remedies

The least aggressive approach to natural health care may very well be homeopathy. Homeopathic remedies are taken from organic substances that are toxic in their natural state. However, they are diluted to such minute proportions, that very little of the substance remains. Homeopathy is based on the principle that "like cures like," and that the body has the innate ability to cure itself. This may sound similar to the idea behind vaccines, except with homeopathic remedies, there are few, if any, side effects. Homeopathic medicines for kidney stones include Berberis vulgaris, sarsaparilla, hydrangea and benzoic acid. A homeopathic evaluation includes a complex assessment to determine the correct remedy. Consult with a homeopathic physician for individual recommendations and dosing.

Precautions

Alternative therapies should be used in conjunction with, not in place of, conventional medical care. Always consult your physician or health care practitioner before using herbal supplements because some herbs may interfere with certain medications.

References

• National Institutes of Health; Kidney Stones
• Herbs for Health and Healing; Kidney Stones
• Dr. Vikas Sharma, Homeopathic Specialist

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THINGS YOU CAN DO TO PROTECT CANCER

If you are a smoker, make the effort to quit. If you are not a smoker, don't start. Avoid exposure to other people's smoke. Know the seven warning signs of cancer and see your physician if you observe one of them. Don't overeat, drink too much alcohol or eat too many fatty foods. Instead, eat more whole grains, cereal, bread, pasta, fresh fruit and fresh or steamed vegetables – especially broccoli, cauliflower, cabbage and Brussels sprouts. Keep your intake of lean meat, skinless poultry or fish to no more than 6 ounces per day.    Exercise. A 30-minute walk each day is one of the simplest ways to incorporate exercise into your daily routine. Know your family's medical history and pay attention to a possibly inherited disposition toward certain cancers. Avoid getting a tan. If your skin will be exposed to the sun for more than 15 minutes, use a sunscreen with a sun protection factor (SPF) of 15 or higher. If you are a woman over 20, examine your breasts for lumps or changes at least once a month. If you are a woman over 40, follow your physician's advice for mammograms. If you are a man or woman over 40, follow your physician's recommendations for digital rectal exams. Follow your employer's policies for limiting exposure to harmful chemicals in the workplace. Always wear protective equipment when indicated, know what to do if there is a spill or accidental exposure, and report any hazardous conditions to your supervisor or safety committee representative.

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FACT ON HIV/AIDS

FACT ON HIV/AIDS

HIV (human immunodeficiency virus) infects cells of the immune system

Infection results in the progressive deterioration of the immune system, breaking down the body's ability to fend off some infections and other diseases. AIDS (Acquired immune deficiency syndrome) refers to the most advanced stages of HIV infection, defined by the occurrence of any of more than 20 opportunistic infections or related cancers.

HIV can be transmitted in several ways

HIV can be transmitted through:

• unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person;
• transfusions of contaminated blood;
• the sharing of contaminated needles, syringes or other sharp instruments;
• the transmission between a mother and her baby during pregnancy, childbirth and breastfeeding. 

34 million people live with HIV worldwide

The vast majority are in low- and middle-income countries. An estimated 2.5 million people were newly infected with the virus in 2011.

HIV is the world’s leading infectious killer

About 25 million people have died to date. An estimated 1.7 million people died of HIV/AIDS in 2011.

Combination antiretroviral therapy (ART) prevents the HIV virus from multiplying in the body

If the reproduction of the HIV virus stops, then the body's immune cells are able to live longer and provide the body with protection from infections. If the HIV positive partner in a couple is on ART, the likelihood of sexual transmission to the HIV-negative partner decreases dramatically.

Over 8 million HIV-positive people had access to ART in low- and middle-income countries at the end of 2011

Overall, the coverage of ART in low- and middle-income countries continued to increase and was 54% of the close to 15 million people eligible for treatment.

An estimated 3.34 million children are living with HIV

According to 2011 figures most of the children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Over 900 children become newly infected with HIV each day.

Mother-to-child-transmission of HIV is almost entirely avoidable

Access to preventive interventions remains limited in most low- and middle-income countries. But progress has been made. In 2011, 57% of pregnant women living with HIV received the most effective drug regimens (as recommended by WHO) to prevent mother-to-child transmission of the virus.

HIV is the strongest risk factor for developing active TB disease

In 2011, approximately 430 000 deaths from tuberculosis occurred among people living with HIV. That is one quarter of the estimated 1.7 million deaths from HIV in that year. The majority of people living with both HIV and TB reside in sub-Saharan Africa (about 79% of cases worldwide).

There are several ways to prevent HIV transmission

Key ways to prevent HIV transmission:

• practice safe sexual behaviors such as using condoms;
• get tested and treated for sexually transmitted infections, including HIV;
• avoid injecting drugs, or if you do, always use new and disposable needles and syringes;
• ensure that any blood or blood products that you might need are tested for HIV.

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DETAILS:CORONARY HEART DISEASE

coronary heart disease

 

Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease.

Causes, incidence, and risk factors

Coronary heart disease (CHD) is the leading cause of death in the United States for men and women.
Coronary heart disease is caused by the buildup of plaque in the arteries to your heart. This may also be called hardening of the arteries.

• Fatty material and other substances form a plaque build-up on the walls of your coronary arteries. The coronary arteries bring blood and oxygen to your heart.
• This buildup causes the arteries to get narrow.
• As a result, blood flow to the heart can slow down or stop.

A risk factor for heart disease is something that increases your chance of getting it. You cannot change some risk factors for heart disease, but others you can change. See: Heart disease - risk factors

Symptoms

Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. This is especially true in the early stages of heart disease.
Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person.

• It may feel heavy or like someone is squeezing your heart. You may feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.
• The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
• Other symptoms include shortness of breath and fatigue with activity (exertion).

Women, elderly people, and people with diabetes are more likely to have symptoms other than chest pain, such as:

• Fatigue
• Shortness of breath
• General weakness
  

  Signs and tests

  Your doctor or nurse will examine you. Your doctor will often order more than one test before making a diagnosis.
  Tests may include:
  

  • Coronary angiography -- an invasive test that evaluates the heart arteries under x-ray
  • Echocardiogram stress test
  • Electrocardiogram (ECG)
  • Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD
  • Exercise stress test
  • Heart CT scan
  • Nuclear stress test 

  Treatment

  You may be asked to take one or more medicines to treat blood pressure, diabetes, or high cholesterol levels. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.
  Goals for treating these conditions in people who have coronary artery disease:
  

  • Blood pressure less than or equal to 140/90 (even lower for patients with diabetes, kidney disease, or heart failure)
  • HbA1c levels if you have diabetes at a level recommended by your doctor
  • LDL cholesterol level less than or equal to 100 mg/dL (even lower for some patients)

  Treatment depends on your symptoms and how severe the disease is. Your doctor may give you one or more medicines to treat heart disease, blood pressure, diabetes, or high cholesterol. Follow your doctor's directions closely to help prevent coronary artery disease from getting worse.
  Never stop taking your medicines without talking to your doctor first. Stopping heart medicines suddenly can make your angina worse or cause a heart attack.
  Your doctor may refer you to a cardiac rehabilitation program to help improve your heart's fitness.
  Procedures and surgeries used to treat CHD include:
  

  • Angioplasty and stent placement, called percutaneous coronary interventions (PCIs)
  • Coronary artery bypass surgery
  • Minimally invasive heart surgery  

  Expectations (prognosis)

  Everyone recovers differently. Some people can maintain a healthy life by changing their diet, stopping smoking, and taking medications exactly as the doctor prescribes. Others may need medical procedures such as angioplasty or surgery.
  Although everyone is different, early detection of CHD generally results in a better outcome.

  Calling your health care provider

  If you have any risk factors for CHD, contact your doctor to discuss prevention and possible treatment.
  Immediately contact your health care provider, call the local emergency number (such as 911), or go to the emergency room if you have:
  

  • Angina or chest pain
  • Shortness of breath
  • Symptoms of a heart attack

  References

  1. Gaziano JM, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P,eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 49.
  2. Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Forceon Practice Guidelines. Circulation. 2010;122(25)e584-e636.
  3. Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 70.
  4. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women--2011 Update:a guideline from the American Heart Association. Circulation.2011;123(11);1243-1262.

 

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SOLVING HIGH BLOOD SUGARS

Solving High Blood Sugars 

Any type of illness can raise your blood sugar because of the stress hormones that are produced.  Therefore, your blood sugar level may be high even when you are not able to eat.  Blood sugar levels may also become hard to control.  If blood sugar levels get high enough, it can lead to a life-threatening condition called diabetic ketoacidosis (DKA).

Diabetic Ketoacidosis or DKA

DKA is caused by not having enough insulin in the body.  When you do not have enough insulin, the body burns fat for energy.  This breakdown of fat produces ketones (an acid).  DKA can occur when high levels of ketones build up in the blood.  When you are sick, it can develop within a few hours or overnight.  If not treated, it can lead to coma and death.

Insulin Pump

Insulin used in a pump often wears off in 3 - 4 hours.  If a problem occurs with your infusion set or your pump, DKA can develop within hours.  You must be aware of the causes and warning signs of DKA.  You will need to check your blood sugars every 2 to 3 hours when you are sick. You should have urine ketone testing strips available at all times.  You may also need to inject insulin with a syringe to treat high blood sugars until your blood sugars are controlled.

Causes of High Blood Sugars with Insulin Pump Users

• Any illness, infection, surgery.
• Infection at infusion site.
• Infusion set has pulled out or disconnected.
• Physical or emotional stress.
• Insulin exposed to extremes in temperature.
• Some medicines may increase blood sugar levels.
• Old or expired insulin.  Once opened, insulin is good for 28 days.
• Infusion set has been in longer than 3 days.

Warning Signs and Symptoms

Symptoms of high blood sugars are early warning signs of DKA.  Be careful!  Signs and symptoms of DKA are often the same as the flu.  If you live alone, you should tell a family member or close friend that you are ill and have them call to check on you several times each day.

Symptoms of High Blood Sugars

• Increased thirst (your body needs extra fluids).
• Increased urination (your body’s way of getting rid of extra sugar).
• Fatigue (your body’s cells are not getting enough sugar or energy because you lack insulin).
• Weight loss (your body is burning fat for energy).
• Dehydration (due to increased urination, vomiting, diarrhea, fever).

Symptoms of DKA

• Nausea or vomiting.
• Abdominal pain.
• Rapid, labored breathing.
• Fruity odor to the breath.
• Severe dehydration.

Steps to Take for High Blood Sugars

• If your blood sugars are over 250 mg/dL, 2 times in a row, and are not coming down with extra insulin, read the Troubleshooting Questions on the next page.  These questions may help you figure out the cause of your high blood sugars.
• Check your urine for ketones every time you urinate.
• If ketones are negative, you can bolus insulin using the pump once.  Keep testing your blood sugar and ketones every 2 hours.  If your blood sugars do not improve after a bolus from the pump, you will need to inject all insulin using a syringe.
• If ketones are positive, use a syringe to take rapid-acting insulin (Humalog^®/NovoLog^®/Apidra^®).  This insulin can be taken every 2 hours until the blood sugar is back to your target range and ketones are negative.
• Change your reservoir and infusion set.
• Drink fluids. (see Nutrition Guidelines below)
• Call the UWHC Diabetes Clinic for help.  The clinic number is 608.263.7741.  If after hours, weekends or holidays, call 608.262.0486 and ask for the diabetes team on-call.  The team is available 24 hours a day.

Troubleshooting Questions

Ask yourself the questions below if your blood sugars are over 250 mg/dL.  This may help you to find the cause of high blood sugars and prevent DKA.

Health

• Are you getting a cold or virus?
• Is your stress level higher than usual?
• Are you ovulating or premenstrual?
• Have you gained or lost weight suddenly?

Blood Sugar Control

• Are you having frequent low blood sugars?
• Have you checked your blood sugars during the night?  You may be having lows and not waking up.
• Are you having swings of low and high blood sugars?
• What are you using to treat low blood sugars?

Insulin

• Are you estimating too much or too little insulin to cover high blood sugars?
• Are you estimating too much or too little insulin to cover your carbohydrates?
• Does your correction scale need to be adjusted?
• Has your insulin been exposed to extremes in temperature?  If in doubt, use a new vial. Insulin does not work when exposed to extreme temperatures.

Activity

• Have you changed your level of activity?
• Are you having low blood sugars during or after activity?
• Are you using a temporary basal or decreasing your bolus when you are active?
• Does your insulin need to be adjusted with exercise?

Food

• Are your meals balanced?  Are you eating enough carbohydrates?
• Does the food contain hidden sources of sugar or fat?
• Do you have gastroparesis?  This affects how your stomach empties.  If you think you do, contact your diabetes nurse to discuss how to adjust your bolus settings.

Medications

• Have you started a new medication which causes high blood sugars?  This might include prednisone, cortisone shots, and others.

Infusion Set

• Are you having problems with your pump?  Most problems are related to infusion sets and not the pump.  Call the pump company’s 24 hour help-line.  If the pump is failing or you are getting pump alarms, call them.
• Do you feel lumps when removing the infusion set?
• Is the infusion set painful to touch?
• Is there bleeding around or in the infusion set?
• Are there bubbles in the tubing or the cartridge/reservoir?  Cold insulin can cause bubbles.
• Do you use the same sites or areas all the time?  Do you change your infusion set every 2 to 3 days?  The tissue needs time to heal before choosing that site again.  If you have had diabetes a long time and use the same area for your injections, the tissue may not be healthy.  This will affect insulin absorption.

Nutrition Guidelines to Prevent Dehydration

• Drink water and other liquids.
• Take small amounts of fluid every 10 minutes (8 ounces per hour is best). 
• With vomiting and diarrhea, your body loses electrolytes like potassium and sodium. Replace these losses with bouillon, soups, sports drinks, juices, and other options listed below.
  • Non-diet soda
  • Jell-O
  • Pudding
  • Juices
  • Popsicles
  • Sports drinks
  • Cooked cereals
  • Soups or bouillon
  • Crackers or toast
  • Sherbet or ice cream

Hint: White sodas that are warm and flat are better tolerated than cold, carbonated sodas.

• If you cannot eat your normal meals, replace carbohydrates with foods that have sugar. These foods must have sugar (regardless of your blood sugar level) to prevent the breakdown of your fat into ketones.  You will need to take insulin to cover the sugar in the liquids and high blood sugar.

When To Call Your Diabetes Team (Phone Number: ________________________ )

• If your urine is positive to ketones. 
• If you have symptoms of DKA.
• You are unable to control your blood sugar.
• If in doubt, go to the nearest Emergency Room.  Do not delay treatment.  Ketoacidosis needs to be treated right away.  This can be life-threatening if not treated quickly.  Discuss with your health care team when to use the Emergency Room.

Information You May Be Asked by Diabetes Team

• How long you have been sick. 
• Current symptoms (especially those related to DKA). 
• Blood sugar levels. 
• Urine ketone levels. 
• What you have been able to eat and drink. 
• Your temperature (whether or not you have a fever). 
• Amount of insulin taken.
• Last time you took insulin.

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

 

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