Sunday, April 11

Those Two Dreaded Words

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Diet and exercise are still your best weapons against heart disease

How to sneak more exercise into your day

Although most of us wish it weren’t true and wish there were a magic pill to keep our hearts healthy, diet and exercise remain the undeniable keys to a healthy heart. We know that, but … we’re too busy for one more thing, can’t afford a gym membership, are too tired after work, want to spend what little time we have with our children.

So is the 10,000-step craze a gimmick or smart idea?

Activity monitors tracking your daily steps has become almost a mantra, and that is just fine with Dan Muñoz, M.D, M.P.A, assistant professor of medicine in the Division of Cardiology and medical director for quality at the Vanderbilt Heart and Vascular Institute in Nashville.

“Activity is almost a medication,” he says. “It is a really important thing for a number of reasons.”

And while Muñoz says there is no magic number of steps to take each day, 10,000 works.

“We all live busy lives, and it is hard to find the time to exercise,” the cardiologist says. “But getting those steps in each day will have an impact long-term. Walking is a great exercise. The more active you stay, the better for your heart. Ideally, we all need 30 minutes of exercise that gets your heart rate up four to five days a week.”

Muñoz acknowledges that it is a tougher goal for those with desk jobs than more physically active jobs but insists it is possible for everyone.

“When you go to the supermarket, park farther from the entrance,” he recommends. “When you have the choice of an elevator or steps, take the steps. Small changes can make big differences.”

Tennesseans can also take advantage of the abundance of greenways and green spaces in larger cities, according to the cardiologist. The state also includes the Great Smoky Mountains National Park in East Tennessee. You get a great view in addition to all levels of hikes.

To find additional places to walk or hike, go to to flip through Tennessee’s official vacation guide, which includes sections such as “Experiences” where you can find hiking paths and waterfalls to walk to as well as a wealth of other outdoor activities.

“The key is to avoid just being sedentary,” says Sonya Angelone, a registered dietitian nutritionist. “If you have a sedentary job, get up every half hour. Do something. Go outside and walk around the building. Go up and down a flight of steps. Engage your muscles.”

Important note: The only caveat is to make sure you have no limitations or injuries. If you do, check with your physician before trying any of these ideas.

How to sneak better nutrition into your diet

One aspect of the formula for heart health is to pursue a healthy lifestyle. Muñoz says that means eating a heart-healthy diet.

“A heart-healthy diet is anchored in fruits, vegetables and whole grains,” he says. “And although you don’t need to cut it out completely, limit red meat in favor of white meats such as chicken and fish. Preparation is also important. Baked or broiled fish or chicken is healthier than anything deep fried.”

Confusion abounds about nutrition. Sometimes it is hard to keep up with the latest science, sometimes the science changes and sometimes we just can’t remember what the science says.

One study shows eggs are packed with protein; they are good for you. Another study shows egg yolks have cholesterol; eggs are not good for you.

Butter is better than margarine, or is it that margarine is better than butter?

What is the difference between monounsaturated, saturated, partially hydrogenated and trans fats?

Angelone holds a masters of science degree and spends her days counseling people in the San Francisco area about nutrition. Before she reveals the answers to some of the biggest nutritional conundrums, Angelone says there is one important point to remember about nutrition: There is no one-size-fits all. Each of us is different and can process food differently. Age and activity level make a difference. Medical conditions can also alter nutritional recommendations.

Now, drumroll please, here are Angelone’s answers to two of the most common and perplexing questions about nutrition:


Although the newest dietary guidelines remove the limit of eggs and dietary cholesterol, they still recommend avoiding excess. Eggs are a nutritious food, but whether they are good or bad depends on the person. Genes help determine how someone metabolizes nutrients, including cholesterol. Some people absorb excess dietary cholesterol and should limit eggs (one of the richest sources in our diets). But, most people can consume eggs regularly. They just need to be sure the eggs aren’t cooked in excess oil and don’t come with bacon, hash browns, white toast and butter!

Good health starts with what we put in our bodies.

Also, the recommendations are different for a healthy person wanting to eat a healthy diet versus someone with heart disease who is trying to reverse the disease. For the latter, I limit dietary cholesterol, including eggs. The American Heart Association is a good site for great information.

On Balance: Neutral

Suggestion: Ask your physician to run a cholesterol balance test. This will tell you whether your high cholesterol is because your liver makes too much cholesterol or because you absorb too much cholesterol.

Butter or margarine?

I do not like margarine — ever. It has trans fats. That simply means that something has been artificially added to make the margarine harden into a stick or tub. The producer transformed liquid oil into a solid fat by adding hydrogen atoms — thus the term hydrogenated. This process changes the fat into an unhealthy fat.

Now there has been so much pressure from the government that producers are going back to using transformed fats. While they are not using palm oil, which is not healthy, coconut oil is not healthy either. The liver uses saturated fats to make cholesterol.

Some people believe that coconut oil is not bad because of a study. There were two groups, one that substituted sugar for fat and another group that substituted coconut oil for fat. It wasn’t that the coconut oil was better. It was that the sugar is so bad.

On Balance: Butter is always the best choice.

Suggestion: Try nut butter instead.


About Author

Debra Gibson Isaacs has been a writer and photographer for more than 30 years. Based in Lexington, Kentucky, she is an avid adventurer with a passion for animals, particularly black bears, dogs and alligators.

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