Heart Attack: Know the Symptoms

Each year over 1 million people in the U.S. suffer a heart attack and about half of them die. Many people do not recognize the symptoms of a heart attack and that can lead to permanent heart damage and even death. It’s important to recognize the symptoms of a heart attack and to call 911 immediately if you or someone around you is exhibiting any of the symptoms.

Here are some symptoms of a heart attack:

- Chest discomfort - pressure, squeezing, or pain
- Shortness of breath
- Discomfort in the upper body - arms, shoulder, neck, back
- Nausea, vomiting, dizziness, lightheadedness, sweating

Women can have different symptoms. The most common pre-heart attack symptoms in women are:

- Unusual fatigue
- Shortness of breath
- Pain in the shoulder blade or upper back

The most common acute symptoms are:

- Chest pain
- Midback, neck, or jaw pain
- Nausea or vomiting
- Shortness of breath
- Palpitations
- Indigestion

For a great diagram of heart damaged an a blocked artery, check out What is a Heart Attack? from the National Heart, Lung, and Blood Institute.

For more information on heart attacks, check out these links:

About Heart Attacks (American Heart Association)

Heart Attack (Mayo Foundation for Medical Education and Research)

Heart Attack Treatments (American Heart Association)

How Is a Heart Attack Treated? (National Heart, Lung, and Blood Institute)

Caffeine in Your Diet

For most people, consuming moderate amounts of caffeine (200 to 300 milligrams) is not a problem. However, consuming too much caffeine can cause anxiety, restlessness, sleeping problems, headaches and other problems.

Some people are more sensitive to caffeine than others. Caffeine can also interact with certain medications so it is important to know how much caffeine you are consuming.

If you think you may be consuming too much caffeine, here are some suggestions:

Keep track of your caffeine consumption: Read nutrition labels to see if caffeine is listed.

Cut back on the amount you consume: If you drink coffee or tea, take one less drink per day or cut back on the amount you have in each cup. You don’t want to cut back too much all at once because that can cause withdrawal symptoms.

Use the decaffeinated versions of drinks: If you drink tea, try switching to herbal or decaffeinated tea; switch to decaffeinated coffee; if you drink soda, look for the caffeine-free version.

Watch medications: Many pain relievers contain caffeine so read the label and make sure you select one with no caffeine.

Amount of caffeine in certain beverages:

Here is a list of some common beverages with the caffeine levels (in milligrams) in each one (in coffee and tea, the caffeine amount will depend on how long it is brewed):

Generic brewed coffee, 8 oz (240 mL) 95-200
Generic brewed, decaffeinated, 8 oz (240 mL) 2-12
Starbucks Espresso, 1 oz (30 mL) 58-75
Starbucks Vanilla Latte, 16 oz (480 mL) 150
Black tea, 8 oz (240 mL) 40-120
Black tea, decaffeinated, 8 oz (240 mL) 2-10

Soft Drinks (12 oz. serving)
7Up, regular or diet 0
Coca-Cola Zero 35
Diet Coke and Diet Coke With Lime 47
Dr Pepper, regular or diet 42-44
Mountain Dew, regular or diet 54
Pepsi, regular or diet 36-38
Sprite, regular or diet 0

Medications:
Anacin, Maximum Strength, 2 tablets 64
Excedrin, Extra Strength, 2 tablets 130
NoDoz, Maximum Strength, 1 tablet 200

For a more complete list, visit Caffeine Content of Food and Drugs from the Center for Science in the Public Interest.

More caffeine links:
Caffeine and Migraine (American Headache Society, Committee on Headache Education)

Caffeine: How Much Is Too Much? (Mayo Foundation for Medical Education and

Caffeine and Cardiovascular Disease (American Heart Association)

Making Healthier Food Choices When Eating Out

Just about everyone loves to eat out every once in a while. Some people eat out a lot. Whether you do it occasionally or regularly, you need to make healthy food choices when eating out. I found some great web sites with all kinds of helpful information to help you decide where and what to eat.

I found an interactive fast food menu from the Cooperative Extension System that provides nutritional information on certain items from McDonald’s, Burger King, Subway, Domino’s Chick-Fil-A, and Taco Bell. Check it out at Interactive Fast Food Menu

Here are some other great web sites:

Making Better Choices at Fast Food Restaurants (PDF117 KB) Alliance for a Healthier Generation; American Heart Association; Clinton Foundation

Healthy Dining Finder CDC. Healthy Dining.Helps you find healthier menu selections and corresponding nutrition information at restaurants ranging from fast food to fine dining. You enter your zip code and you get a list of restaurants with some sample food items.

Eating Out American Heart Association. Get clues from the menu to help you make healthy choices when dining out.

Portion Distortion! (NIH. National Heart, Lung, and Blood Institute) This is a fun interactive site that has a quiz where they show you pictures of what portions used to look like and what they are today and you have to guess how many calories are in today's portions as well as how long it will take you to exercise off those calories. What used to be large sizes are now regular sizes and portions seem to be getting bigger and bigger. This quiz should open your eyes so you can see how many calories you are consuming with those "super-sized" portions.

Crib Injuries Land Thousands of Toddlers in ER Each Year

In a report just published in the journal Pediatrics, researchers found that each year in the United States, nearly 10,000 children under the age of 2 arrive in emergency rooms with injuries suffered while in cribs, playpens and bassinets. Most of the injuries are caused when children fall out of the crib. That is why it is important to make sure that your crib is properly set up.

For the complete story, you can read it at http://www.nlm.nih.gov/medlineplus/news/fullstory_108946.html (this link is only good for 60 days).

Both Consumer Reports and the Consumer Product Safety Commission (CSPC) have excellent crib safety tips. Check out these links:

Crib Safety Tips (CSPC)

Crib Safety Tips (Consumer Reports)

If you are shopping for a crib, check out Choosing a Crib from the American Academy of Pediatrics

Diet High in Fiber Might Lengthen Your Life

A study was released in the Feb. 14 online edition of the Archives of Internal Medicine that found that eating lots of whole grains reduced risk of dying from any cause. There are many health benefits to eating fiber, including reducing the risk of heart disease and some cancers. To read the whole news story, visit http://www.nlm.nih.gov/medlineplus/news/fullstory_108805.html (this link is only active for 60 days from today).

Here are some foods that are high in fiber:

Beans, artichokes, sweet potatoes, berries, prunes, spinach
Bran muffins, Oatmeal, Bran or multiple-grain cereals, (cooked or dry), Brown rice, Popcorn, 100% whole-wheat bread

You should add fiber to your diet slowly. Increasing dietary fiber too quickly can lead to gas, bloating and cramps.

The U.S. Department of Agriculture (USDA) 2010 Dietary Guidelines for Americans recommends increasing the amount of whole grains in your diet. The guidelines are a great resource to help you find foods that are good for you and they will help you figure out how much of each type of food you need in your diet.

Here are some tips from the guidelines:

- Reduce intake of solid fats (major sources of saturated and trans fatty acids).
- Replace solid fats with oils (major sources of polyunsaturated and monounsaturated fatty acids) when possible.
- Reduce intake of added sugars.
- Reduce intake of refined grains and replace some refined grains with whole grains.
- Reduce intake of sodium (major component of salt).
- If consumed, limit alcohol intake to moderate levels.
- Increase intake of vegetables and fruits.
- Increase intake of whole grains.
- Increase intake of milk and milk products and replace whole milk and full-fat milk products with fat-free or low-fat choices to reduce solid fat intake. Increase seafood intake by replacing some meat or poultry with seafood

Here are some other great links to check out:

Dietary Fiber: Essential for a Healthy Diet (Mayo Foundation for Medical Education and Research)

Fiber: Start Roughing It! (Harvard School of Public Health)

Why Is It Important to Eat Grains, Especially Whole Grains? (U.S. Dept. of Agriculture)

Child Nutrition

From time to time I post information on child nutrition since I think it's really important to get kids off to a strong start with healthy eating patterns. There is such an epidemic of obesity in this country that I feel it's important to share useful information for parents so they can make sure their kids are eating healthy foods.

I found a great chart in the Dietary Guidelines for Americans that lists the calorie requirements by age group. This will help parents figure out exactly how many calories their child needs.

Ages 2 to 3: Girls and boys
Calories: 1,000 to 1,400, depending on growth and activity level

Ages 4 to 8: Girls
Calories : 1,200 to 1,800, depending on growth and activity level

Ages 4 to 8: Boys
Calories: 1,400 to 2,000, depending on growth and activity level

Ages 9 to 13: Girls
Calories: 1,600 to 2,200, depending on growth and activity level

Ages 9 to 13: Boys
Calories: 1,800 to 2,600, depending on growth and activity level

Ages 14 to 18: Girls
Calories: 1,800 to 2,400, depending on growth and activity level

Ages 14 to 18: Boys
Calories: 2,200 to 3,200, depending on growth and activity level

To find out the exact calorie breakdown for each activity level, check out the full text for Dietary Guidelines for Americans

For kids over the age of two, 50-60% of their diet should come from carbohydrates (from the healthy sources of carbs.)

Examples of Healthy Sources of Carbohydrates:

whole-grain cereals
brown rice
whole-grain breads
fruits
vegetables
low-fat dairy

Limit caffeine intake. Kids who consume one or more 12-ounce (355-milliliter) sweetened soft drink per day are 60% more likely to be obese. Soda has a lot of caffeine and a lot of empty calories with no nutritional value.

In both kids and adults, too much caffeine can cause:

jitteriness and nervousness
upset stomach
headaches
difficulty concentrating
difficulty sleeping
increased heart rate
increased blood pressure

To help your kids get a healthy respect for food at an early age, it's important that they become involved in preparing healthy foods. Rachael Ray's Yum-O organization's web site has a great recipe finder where you can search for recipes using a number of criteria such as food type, age group, and much more. She offers some great recipes that kids can make with the help of a grownup. Check out the recipe finder at http://www.yum-o.org/recipe_search.php.

Heart Health: Watch Your Cholesterol

Since February is National Heart Month, I will be posting heart-related posts occasionally throughout the month. Today’s topic is cholesterol since that is one of the most important things that we need to watch in our diets in order to prevent heart disease.

There are two types of cholesterol: LDL, which is the bad kind of cholesterol, and HDL, which is the good kind. (To help you remember the difference, think of the first letters of each: L=lousy and H=healthy.) Cholesterol comes from two different sources: your body and the food that you eat. Your liver and other cells in your body make up about 75 percent of the cholesterol and foods make up the other 25 percent. (American Heart Association).

According to the National Cholesterol Education Program guidelines: “In all adults aged 20 years or older, a fasting lipoprotein profile (total cholesterol, LDL cholesterol, high density lipoprotein (HDL) cholesterol, and triglyceride) should be obtained once every 5 years.

Here are the classifications of HDL, LDL, and total cholesterol:

LDL Cholesterol
<100>190 Very high

Total Cholesterol
<200>240 High

HDL Cholesterol
<40>60 High

(The last value in each category should be "greater than or equal to"--I could not get that symbol formatted--sorry about that.)

The above figures are from Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)

Here are some tips from the U.S. Food and Drug Administration for lowering your cholesterol:

- Cut back on foods with lots of fat such as fatty meats, fried foods, whole milk, fatty cheeses, butter, margarine, oils, lard, and creams.
- Cut back on food with lots of cholesterol, such as egg yolks and whole eggs.
- Eat more fruits and vegetables.
- Cut back on fatty snacks and desserts, such as candy, cookies, doughnuts, muffins, pastries and pies.
- Exercise at least 30 minutes most days.
- If you are overweight, try to lose weight. Try to lose weight by cutting back on the amount that you eat. Even a small amount of weight loss can help lower your bad cholesterol, and you will also help your health in other ways.
- Ask your doctor if you need to take medicine to help lower your cholesterol. Triglycerides are another form of fat in your blood. They can also raise your risk for heart disease. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment.
Cholesterol (U.S. Food and Drug Administration)

Some other nutrition tips for lowering cholesterol:

- Choose leaner cuts of beef and pork
- Eat fish at least twice a week
- Use low-fat cheeses and other dairy products
- Eat more fiber and whole grains (whole grain pasta is a lot tastier than regular)

For more tips on lowering cholesterol through nutrition, visit the American Heart Association’s web page Cooking for Lower Cholesterol

Other great web sites:

Cholesterol: Top 5 Foods to Lower Your Numbers (Mayo Foundation for Medical Education and Research)

Heart-Healthy Home Cooking: African American Style (National Heart, Lung, and Blood Institute) – PDF

Tips for Eating Out (American Heart Association)

February is National Heart Month

February is National Heart Month and throughout the month I will be posting information on various aspects of cardiovascular health. To start things off, I thought I'd share a few great web sites where you can find detailed information on cardiovascular health.

Heart Disease (Centers for Disease Control and Prevention)

High Blood Pressure: Things You Can Do to Help Lower Yours (American Academy of Family Physicians)

High Blood Pressure (NIH, National Heart, Lung, and Blood Institute)

About Cholesterol (American Heart Association)

High Blood Cholesterol (NIH, National Heart, Lung, and Blood Institute)

Have fun in the snow, but be safe--Winter Safety Tips

The American Academy of Orthopaedic Surgeons (AAOS) just issued a press release that has some great winter safety tips. With all the snowy and icy weather that is affecting a huge chunk of the country, I thought I'd share some safety tips with you. These tips come straight from the press release. A link to the full release is at the bottom of the list, as well as links to some other great winter safety information.

SLEDDING SAFETY TIPS:

- Don't sled near or on public streets. Sled only in designated and approved areas where there are no obstacles in the sledding path.
- Sit in a forward-facing position and steer using your feet or the rope steering handles.
- Children should wear a helmet while sledding and should always be supervised by parents or other adults.
- Carry a cell phone in case there is an emergency.

WINTER SAFETY TIPS FROM THE AAOS:

- Check snow and ice conditions before heading out to take part in outdoor activities. Pay attention to news warnings about storms and severe drops in temperature.
- Don't drink or smoke before going outside in the cold. Alcohol, nicotine and caffeine increase the risk of cold injury to the skin.
- If you get wet, get inside as quickly as possible and remove your wet clothes.
- Don't forget about frostbite, and check yourself every half-hour for signs. Go inside if your toes, fingers, ears or other parts of your body become numb.

SHOVELING/SNOWBLOWING SAFETY TIPS:

- Clear snow early and often. Begin when a light covering of snow is on the ground to avoid trying to clear packed, heavy snow.
- Use a shovel that is comfortable for your height and strength. Do not use a shovel that is too heavy or too long for you. Consider buying a shovel that is specially designed to prevent too much stooping. Space your hands on the tool grip to increase your leverage.
- Push the snow instead of lifting it, as much as you can. If you must lift, take small amounts of snow, and lift it with your legs: Squat with your legs apart, knees bent and back straight. Lift by straightening your legs, without bending at the waist. Then walk to where you want to dump the snow; holding a shovelful of snow with your arms outstretched puts too much weight on your spine.
- Do not throw the snow over your shoulder or to the side. This requires a twisting motion that stresses your back.
- Never stick your hands or feet in the snow blower! If snow becomes impacted, stop the engine and wait at least five seconds. Use a solid object to clear wet snow or debris from the chute.
- Beware of the recoil of the motor and blades after the machine has been turned off.

Above information taken from: American Academy of Orthopaedic Surgeons Press Release, February 1, 2011

For more information from the AAOS:

Sledding Safety

Winter Sports Safety

Prevent Snow Shoveling and Snow Blowing Injuries