Penn Heart and Vascular

Penn Heart and Vascular Update

Friday, February 5, 2016

How To Reduce Heart Disease Risk Factors During Menopause

Menopause means saying goodbye to birth control, tampons, and some other “friends” women get close with during their fertile years. But it can also mean saying hello to something else: a higher risk of heart disease.

Like men, a woman’s risk for heart disease increases with age. But that risk increases even more for women when they start menopause.

Menopause Doesn’t Cause Heart Disease, But Here’s Why It Raises Your Risk

Menopause is when a woman’s menstrual period stops as she gets older. This happens because her ovaries stop producing the hormones estrogen and progesterone.

This decline in estrogen is thought to be a major factor in why women have a greater risk of developing heart disease once they are post-menopausal.

Heart disease is the leading killer of women in the United States, and it has killed more women than men each year since 1984.

It’s not that menopause causes heart disease, says Nazanin Moghbeli, MD, MPH, clinical assistant professor of medicine and associate director of women’s cardiovascular program at Penn Medicine.

Menopause causes “several things to change in a woman’s physiology, and some of those changes can lead to heart disease,” Dr. Moghbeli explains.

“The lipid profile of women actually starts to change, so that cholesterol starts to go up. And higher cholesterol can put you at higher risk for heart disease,” she says. “That happens pretty immediately after menopause.”

At the same time, blood pressure also begins to rise.

“The blood pressure is not directly related to menopause. It’s kind of related to the aging process,” Dr. Moghbeli says. “But those two factors—the blood pressure and the cholesterol rising—can increase the risk of heart disease.”

How Do You Reduce Your Heart Disease Risk During Menopause?

There are steps you can take to go through the changes of menopause without developing a heart condition. They include:

Eating Healthy

Yes, anyone can benefit from eating healthy. But that’s especially true for women in menopause because they’re at a higher risk for developing heart disease.

The American Heart Association recommends eating a healthy diet that includes lots of fruits and vegetables, whole grains, low-fat dairy products, and skinless poultry and fish. A healthy diet is also low on sodium, saturated fat and sugar-sweetened beverages.

Staying Active

“Aerobic exercise is really a key part as well,” Dr. Moghbeli stresses. She recommends that women get around 45 to 50 minutes of aerobic exercise most days of the week. Aerobic exercise can lower your cholesterol and blood pressure.

“That can be fast walking. It can be bicycling,” Dr. Moghbeli says. “It can be anything that really gets your heart rate up.”

Knowing Your Numbers

One of the most effective ways to prevent heart disease is to know important numbers for your heart—like your blood pressure and cholesterol—to see if you have risk factors that need to be addressed. For instance, Dr. Moghbeli says high cholesterol can be both diet-controlled and medication-controlled, depending on the severity.

So, getting regular checkups can help you monitor the health of your heart as you go through menopause.

Reducing Stress

You should also be mindful of your stress levels. “Stress can really impact your cardiovascular well-being,” Dr. Moghbeli notes.

“Sometimes, women are running their households, taking care of their parents, working, taking care of kids—and the stress level can really be quite high,” she explains. This can worsen things like high blood pressure and overall cardiovascular stress.

Finding ways to relieve any stress you might feel—whether that be doing yoga or reading—can improve your overall cardiovascular health, Dr. Moghbeli says.

Avoiding Horomone Replacement Therapy

Hormone replacement therapy (HRT) can relieve some of the symptoms that occur with menopause, such as hot flashes and vaginal dryness. The medications give a woman’s body adequate levels of estrogen and other hormones.

But studies about hormone replacement therapy have found that it can also increase a woman’s chances of having a stroke or heart attack.

“We don’t recommend that women take it for prevention of heart disease,” Dr. Moghbeli explains. It might, however, still be reasonable to use it as a short-term method to treat menopause symptoms.

Kicking the Smoking Habit

Smoking increases your risk of heart disease whether you’re menopausal or not, but the stakes are much higher for women in general.

“Smoking at any time in your life raises that risk much higher,” Dr. Moghbeli says. And considering that menopause already increases your risk as well, you’re better off quitting smoking or never starting.

The bottom line: Menopause might be a natural stage in a woman’s life, but heart disease doesn’t have to be.

Learn more about how you can minimize your risk for heart disease during menopause.

Schedule an appointment with a physician at the Women's Cardiology Center at Penn.

Wednesday, February 3, 2016

A Guide to Grains

It’s safe to say grains have been a part of the human diet for...well a long time. Think about it. Oats, rice, wheat, corn - food made from these are all grain products. And we’ve all heard how whole grains are important in maintaining a healthy weight and heart.

But for many people grains can be confusing and intimidating. What exactly is a grain and which are the healthiest to eat? What’s the difference between whole grains and refined grains? And how do you even cook them?

Grains 101

Grains are made of up three edible parts: the bran, the germ and the endosperm. The bran and germ contain the most fiber, antioxidants, fatty acids, minerals and vitamins.

When grains contain 100% of its bran, germ and endosperm they are called whole grains. Whole wheat, oats, rye corn, brown rice, quinoa are just a few examples of whole grains and are an important source of fiber and other nutrients. The American Heart Association recommends that half of all grains that you eat are whole grains. Typically, this results in three to five servings each day for ages nine and up.

Refined grains are grains that have been milled, or ground into, which means the bran and germ have been removed and thus lose important nutrients. Examples include white rice and all-purpose flour (common in baking), white bread and pasta. Though many refined grains are enriched with vitamins and iron after being processed, fiber is not reintroduced.

Benefits of eating whole grains

Studies have shown eating whole grains can lower the risk of stroke, type 2 diabetes and heart disease.

Grains contain a variety of essential nutrients, including:

  • Fiber - a staple of a healthy diet, fiber makes you feel full and assist in maintaining a healthy weight. It may also help lower blood pressure and cholesterol.
  • B vitamins, riboflavin, niacin, folate - maintains a healthy metabolism and supports healthy skin, hair and muscles.
  • Iron - helps your body carry and store oxygen.
  • Magnesium - a mineral that assists in hundreds of bodily processes.
  • Selenium - regulates the thyroid and supports a healthy immune system.

Overcoming food store anxiety

You’ve reached aisle 10 in the grocery store, but 50 options are staring back at you and not all grains are created equal. Here’s the key: look at the first ingredient on the nutrition label. If you see “whole” or “whole grains” you know you’ve hit the jackpot.

Ingredients to keep an eye out for:

  • brown rice
  • buckwheat
  • bulgur
  • millet
  • oatmeal
  • popcorn
  • quinoa
  • rolled oats

  • whole-grain barley
  • whole-grain corn
  • whole-grain sorghum
  • whole-grain triticale
  • whole oats
  • whole rye
  • whole wheat
  • wild rice

Interested in learning how to cook with all your whole grains? Check out a helpful cheat sheet from Whole Foods.

Tuesday, February 2, 2016

Meal Planning For Better Heart Health

When it comes to improving heart health, we all know that eating a well balanced, nutritious diet is at the top of the list. Easily said, but not always easily done. Planning out meals for the week is a great way to make sure you stay on top of this goal.

Think Ahead!

Create a list of healthy ingredients and aim to go shopping once a week. Then, take time on Sundays to make healthy meals and snacks to last the whole week through. Guaranteed, you’ll be more likely to choose a healthy option if it’s already made and ready to go.

What better month to give this a try than Heart Month? We’ve created a month’s worth of tips and recipes for you to try.

So, print out this blank calendar and start planning.

Be sure to let us know your favorites!

Week #1: Focus on Breakfast

Week #2: Focus on Lunch

Week #3: Focus on the Afternoon Snack

Week #4: Focus on Dinner

Heart Healthy Breakfast Tips and Recipes

Focus on the most important meal of the day…Breakfast!

Let’s be honest, the idea of being able to sit down and enjoy a nice breakfast is a real treat, but it is also not always practical with a busy schedule. Breakfast can be easily left out during the hustle and bustle of the morning.

With a little planning, having some healthy and nutritious meals ready and waiting might make it easier to give your body the energy it needs to start the day. Make sure that you include ingredients that have protein and fiber to help fill you up and satisfy you until your next snack or meal.

Recent research has shown that skipping breakfast may be associated with higher levels of heart disease in certain populations. Bottom line, make an effort to eat breakfast. It is a piece of advice that stands the test of time!

Here are some tips and recipes for you to try that will make it easier:

Idea #1: Muffins or scones

Make a batch to last the whole week long. You can even freeze the extras. Try to find recipes that include whole grains which contain the fiber needed to stabilize your blood sugar and fill you up.

Recipe to try: Multi-grain Scones

Idea #2: Smoothies

Start the day off with a filling smoothie chock full of fresh fruit, yogurt and maybe even a sneaky vegetable or two! ;) Add some spinach for a (mostly) flavorless boost of nutrients!

Recipe to try: Big Green Monster Smoothie

Idea #3: Oatmeal

Fill up with heart-healthy grains! You can make oatmeal overnight in the crockpot so there is literally no prep first thing in the morning. Portion it out in mason jars, put it in the refrigerator and you’re set for the week. You can “spice” up each serving by piling on the fresh fruit or even some cinnamon. YUM!

Recipe to try: Easy Overnight Oatmeal

Idea #4: Eggs

Eggs are back on the “nice list” after decades worth of concern. Filled with protein and “good for you fats”, eggs are a great way to start the day and keep your stomach satisfied until lunch. Try a veggie-filled crustless quiche, freezing the extra portions later.

Recipe to try: Crustless Smoked Turkey and Spinach Quiche

Idea #5: Vegetable hash

If you’re going for a nice sit-down breakfast or even just want a great side for your eggs, replace the starch filled potato hash with the vegetable that’s making a big time comeback this year - cauliflower!

Recipe to try: This recipe comes from one of our Facebook fans!

Vegetable Hash

Use vegetables leftover from last night's dinner (cooked al dente) - cauliflower, onions, shallots, garlic. In a non-stick pan with minimal cooking spray or olive oil, saute until just carmelized or browned. Enjoy as a side with eggs instead of the traditional hashbrowns!

Packable Heart Healthy Lunches

Imagine it’s midday. So far you have been eating great. But you are busy and rushing, maybe you have an appointment to get to, maybe a meeting or maybe you just don’t feel like making anything. So you cave and get take out or throw in that TV dinner because how can you beat two minutes and 30 seconds to a hot meal? Don’t do it!

We’ve got some great ideas for you that will allow you to enjoy a quick and healthy lunch, even on the go.

Packing your lunch doesn’t have to mean settling for a PBJ (although there’s nothing wrong with that!).

Idea #1: Salads

The greens and vegetables in this classic lunch are no doubt incredibly healthy. But when it comes to the salad dressing, store bought dressings can be filled with sugar and sodium. So...make your own! It is quick and easy. You can even keep some in the refrigerator at work and when you do end up ordering out, stick to a salad that you can put your own dressing on. Add the dressing to one of these Mason Jar Salads and you are good to go.

Recipe to try: Simplest Vinegar and Oil Quick Salad Dressing

Idea #2: Rotisserie chicken

When you have a little more time during the weekend, cook up a simple slow cooker rotisserie style chicken. Take the skin off (we know, the best part, but not the healthiest) and use the meat for quick lunches throughout the week - salads, soups, sandwiches, the list goes on! You can even use the bones to make your own chicken broth.

Recipe to try:Caprese Wraps with Chicken

Idea #3: Soups to last all week

This is a great meal to prepare ahead on a weekend, portion out and enjoy all week long! If you need help making your favorite soup recipes heart-healthy we’ve got some great tips for you.

Recipe to try: White Bean Soup

Idea #4: Whole grains

When a hot meal isn’t an option, it is great to have a filling cold meal on the plan. The AHA recommends 3-5 servings of whole grains a day. Get your grains in with a heartier lunch - build a quinoa bowl!

Recipe to try: Tangy Quinoa Salad

Idea #5: Spiralize some veggies

“Zoodles” are all the rage right now. Grab a zucchini from the store and make some “Zoodles”. They can be eaten cooked or raw and are a great alternative to a heavy pasta!

Recipe to try: Zucchini Noodles with Pesto

Heart Healthy Dinners Made Easy

Life can be hectic and it isn’t always easy to make a healthy, nutritious dinners after work or during the evening rush. Planning ahead can make this much easier. Having all of the ingredients you need on hand and even some prep work done ahead of time can make eating healthy dinners during the week feasible!

By making your meals at home, you are already ahead of the game. One of the top sources of added sodium is in processed foods and eating out. Being able to add additional vegetables and decrease ingredients that might not be nutritious choices is a great benefit.

Below are some great tips for quick and delicious meals that take away the stress during the week!

Idea #1: Crock pots for the win

Take the stress out of preparing dinner by preparing it before heading out in the morning. A healthy homemade meal will be a nice surprise when you return in the evening.

Recipe to try: BBQ Pulled Pork Sliders with Homemade Potato Chips

Idea #2: Seafood

High in heart healthy omega 3’s, the American Heart Association recommends eating seafood twice a week. Plan ahead and work fish into your meal plan!

Recipe to try: Citrus Honey-Glazed Salmon with Whole Grain Rice and Snap Peas

Idea #3: Winter squash

Winter squash can be used in many of your meals to up the nutrient factor as this vegetable tends to be high in potassium, fiber and protein. Use it as a substitute to meat or to make other meals more hearty!

Recipe to try: Butternut Squash and Macaroni Casserole

Idea #4: Greens

Add greens to your favorite comfort dishes. Like Meatloaf! The taste is hardly noticed but the health benefits can be huge. **If you have concerns about eating greens and taking anticoagulants, read this.

Recipe to try: Turkey Meatloaf

Idea #5: Hearty beans

Pick one night a week and enjoy a meatless meal. Add beans to add fiber and protein without the added saturated fats that meat can contain.

Recipe to try: Three Bean Vegetarian Chili

Snacks that Keep It Healthy

We’ve all felt the dreaded afternoon slump - the moment in the day after lunch when your body starts to drag. Often the first inclination is to grab a snack. But, the go-to pick-me-up isn’t always the most heart healthy option.

Snacking can be a healthy part of our diets - if the snacks we choose are nutritious and eaten in moderation.

So...plan ahead. WIth a little prep, you can have a week’s worth of healthy snacks on hand. And if you start to feel sluggish and unfocused in the afternoon, take a five minute break, grab one of those snacks you have and head out for some fresh air!

Idea #1: No-bake cookies

Make a batch of healthy cookies ahead of time for when that craving for something sweet hits. Sometimes called energy bites, these can be filled with whole grains and protein. A great option for a mid-afternoon snack!

Recipe to try: No-Bake Chocolate Oat Cookies

Idea #2: Nuts

Eaten in moderation, nuts have proven themselves over the years in the heart health department. Nuts can help lower LDL (“bad” cholesterol) and are filled with fiber and protein that can fill you up and give you the energy you need to get through the rest of your day! Make up a batch of trail mix or nuts on their own and portion them out to eat all week long.

Recipe to try: Trail Mix

Idea #3: Vegetables

Pre-cut carrots, celery, broccoli and peppers on a Sunday and store in the fridge for an easy to grab snack. Pair it with a healthy dip!

Recipe to try: Hummus

Idea #4: Avocados

Avocados are all the rage these days. These nutrient dense foods contain over 20 essential nutrients including fiber and heart-healthy fats. Consider them a great food to fill you up in the afternoon.

Recipe to try: Italian Guacamole

Idea #5: Nachos

If you’re looking for something a little more filling or even something to share, change up some of the classic appetizers to make them a bit more heart-healthy.

Recipe to try: Sweet Potato Nachos