Monthly Archives: July 2012

Healthy Vacations

Vacations can be challenging to maintain a healthy lifestyle.

 To maintain a healthy lifestyle it takes a little extra planning. My family just returned from travelling across the country from Michigan to Idaho. This involved a lot of driving 12 hours a day. It was tempting to stop for fast food, or eat out, but we chose to adhere to our healthy lifestyle.

Breaking up travel with exercise is helpful.

Next time you make travel plans be sure to include exercise to break up the doldrums of long car rides.  We found paths to walk, mountains to hike, swimming and white water rafting  to keep our activity levels up and not just sit all day. Yellowstone National park was amazing, but it shocked me how many people had to sit to watch Old Faithful, or could not walk the board walks to the most amazing sites such as Grand Prismatic Springs. We chose to hike 2000 feet up and hiked Avalanche Trail one day. That is not a trail for those unfit, as brings you from from 8580 ft to 10580ft in elevation. Good cardiovascular health is important.    

Eating healthy while on vacation takes some planning. 

While on vacation our plan was to maintain a healthy eating plan and save money. We decided there isn’t anything wrong with Peanut butter and Jelly on whole wheat bread. It is a good protein source for big adventures, carbs for quick energy and low in saturated fat.  Bags of cut vegetables are easy to buy at grocery stores instead of fast food stops. Fruit is plentiful, bags of apples travel well, grapes washed and ready to eat can make the time pass. We made a game to see who could  peel grapes the fastest. Snacks include granola bars, pita bread and hummus, cherries. Instead of soda water bottles were easily refilled en route, and the occasional bottled milk provided satiation and calcium. Not to say we didn’t eat out but it sure made the night with pizza feel like a treat and extra special. Often in working in cardiac rehabilitation I would have long haul truckers who had heart attacks and felt challenged to eat healthy. Truck stops are often just a few yards away from a town which always holds a grocery. Hit the fresh food aisle instead of the truck stops while traveling.

Fast Food Challenges

Meal times can be tough when family obligations allow you limited time for preparation. 

Some people are always thinking ahead and can plan by preparing early, either a crock pot meal, or cook something ahead of time and just warm it up. But any family can tell you there are days that you just don’t have the time so you succumb to the ever inviting, immediate gratification of fast food. We all know we should not eat it, but it happens. The more often we eat it, the easier it gets to go back again and again. By doing this often you are mentoring your children to accept this as normal behaviour and also teaching there taste buds to crave the unhealthy food choices.

My family prided themselves on avoiding fast food. I am ever grateful to a seventh grade home economics teacher who thoroughly investigated with her class the fast food industry. They watched movies like Food Inc, Supersize Me, etc. After this the two children decided to be vegetarians. This lasted a couple of months, then they gradually added meat back into the diet, but limited the number of days per week of eating it. They kept to the no fast food for quite some time, my daughter avoided it for a few years. When we had an exchange student from Japan living with us, who spoke very little English, I asked her on her final few days what else she wanted to do in the US.  She stuttered and stumbled trying to tell me something that I couldn’t comprehend. Then as if a lightbulb went off, her eyes brightened, she ran to get paper, and began sorting through the crayons. Finally she finds a yellow crayon and draws….you guessed it ….the golden arches.  She proceeded to show me with her hands a BIG Mac. I think she was greatly disappointed with the Big Mac, as it really isn’t so big as she had envisioned. We then proceeded to take her to Burger King. My daughter who spent 3 years avoiding fast food was mortified. She and I can now say though since that experience we have not eaten fast food since.

How do you not eat fast food?

 Our sports teams now stop at grocery stores instead of fast food restaurants. Kids can then select their own food choices. I hope the coaches mentor them to choose healthy choices instead of junk food or processed foods like Lunchables.

 I once worked as an athletic trainer to a class A division one football team. The coach was morbidly obese, tipping the scales near 450 lbs. He had numerous operations for stomach stapling (back in the day that what it was called) and yet continued to put the weight right back on. Well when we travelled his rule was to go no more than two hours without stopping for food. I wonder now how many of his former football players are obese. He would have done better to mentor the kids with a stop for an apple, or a water break, which could have easily been taken with the team. 

Grab and Go Food Choices

Think about the time it takes to stop for fast food, could you run into a grocery and get foods like:

  •  bag of grapes, apples, oranges
  • box of graham crackers and jar of peanut butter
  • string cheese
  • jerky
  • bottled water
  • pretzels
  • cut up veggies and dip
  • bean dip and torillas
It would be less expensive, healthier and you would be showing the kids by example how to avoid the feeling that fast food is the only way to go. 



How to get your family to eat healthy

Raising a family can be particularly trying when it comes to meals. From early on children start to exert their independence and it often start with food. The “NO” when it comes to getting them to eat something. I know of many parents who simply gave up and fed their children nothing but chicken nuggets and hot dogs because “that is all they will eat”. As parents we must role model healthy eating, make it fun and Be a parent!!!


 Young children should be started early with healthy eating, choose fruits instead of ice cream. If highly refined sugary foods are introduced early of course your child will choose the sweets over the healthy fruit choices. Hold off as long as possible with sweets.

Make eating fun

A favorite story of mine is when my son was about three I would read to him every night and a favorite story was about the Incredible Hulk. So when I introduced split pea soup I told him it was Hulk soup and if he ate it he would be as big and strong as Hulk. He promptly wolfed down the soup and expected to see changes immediately. I told him it would take several days for it to work and the more he ate the better the effects. He bought it! It took over a year before he caught on, but to this day loves Hulk soup.

Veggies – make them fun! 

Allow them to be finger foods, build towers with carrot sticks, be ravenous dinosaurs eating the tops off all the trees (broccoli), count how many leaves to get to the middle of a brussel sprout, see who can pull the longest string out of celery.

Expect to hear “No thanks, they aren’t my favorite.” Be ready to reply “Of course they aren’t your favorite, we don’t all get to eat our favorite foods every day.” Just because they reject it one day keep offering it, insist on at least one bite to see if you still don’t like it. Yes mine still don’t like summer squash or cooked sweet potatoes – I think they ate these all their early formative years. Role model eating these foods anyway, don’t eliminate them from your diet.

Soda is the exception

Too many kids go straight to the fridge and look for soda or juice. Encourage water! Water with every meal, water when thirsty, water with snacks. Get them used to drinking water. Keep a pitcher in the fridge, use ice cubes, have water bottles ready to just pull from the fridge and go. Stock up on your favorite ones so we can reduce the plastics from store bought water. Add a twist of lemon or a small amount of juice for the treat. If you already have a soda addict. Have them measure out the amount of sugar that is in the drink, it is a good visual experiment, then continue to measure out the most they have had in one day, then add it in the approximate sugar from the rest of their daily intake – ice cream, cookies etc.  Let them decide if it is healthy or not.

Don’t be a short order cook.

Cook a healthy meal for everyone, have healthy snacks out instead of letting the children rummage through the refrigerator or kitchen. My children always come home to a bowl of fruit on the table, and maybe some whole grain cracker or hummus and vegetables. If the kids are demanding and complaining about the food choices have them help plan and prepare. Nothing better than getting them to cook as prepares them for the future, teaches how food is produced, like how much butter really goes into cookies. What fruit combinations work in smoothies, how to hide kale in a recipe, these are good challenges for teens.

What is the purpose of a stress test?

A stress test is  used to identify the hemodynamic response of the heart to a large load of physical stress and compare it to the resting response. The heart rate must increase to provide oxygenated blood flow to exercising muscles. The blood pressure should increase related to the increased work as well. The heart rhythm is monitored through and ECG. The healthcare providers are looking to see if there are changes in the ECG with activity.

There are multiple leads used for the ECG, as the healthcare provider is observing the heart at each different angle, not as a flat surface. If the ECG shows changes in what is called the ST segment, the contraction portion of the ventricle or bottom chamber of the heart this can be a clue that there may be poor blood flow in this region. There are very characteristic patterns in the ECG regions which can clue the healthcare provider in as to what region of the heart is showing poor blood flow. They would diagnose this as ischemia.

There are many different ways of imaging the heart in addition to the ECG. Often the stress test is combined with an echo cardiogram, in which ultrasound is used to visualize the movement of the heart walls. When the blood supply is limited to the wall of the heart there will be evidence of poor contraction of the heart muscle or sometimes it become  aneurysmal instead of  squeezing itself inwards it bulges out.  The other common imaging is a nuclear scan in which radioactive isotopes are injected into the the body. The heart is then scanned  at rest and post intensive exercise. The isotopes tag on to the heart muscle. If there is a reduction noted in the scan it is usually a result of ischemia. If there are locations where there is no uptake both at rest and with physical stress than this is an are that is most likely scarred permanently due to a previous heart attack.

The walking on the treadmill is very physical. Some patients cannot tolerate this level of exertion due to other issues, knee, hip or foot issues, neuropathy, poor gait, fear, uncontrolled blood pressure etc. In this case the healthcare provider can chemically stimulate the heart to speed up and put enough strain on the heart to simulate the response it would give with physical exertion.

If you have had a heart condition in the past such as a heart attack, coronary artery bypass surgery, stents or progressive angina  you can expect your healthcare provider to stress test your heart every one to two years. It is felt it is better to be proactive and catch ischemic issues before they cause a heart attack. As a heart attack scars the heart muscle. Scar tissue in the heart is not flexible and thus reduces the pumping ability of  heart. As the pumping ability decreased the heart cannot keep up with the demand for blood flow to sustain necessary work loads. This is not only a physical problem causing shortness of breath, weakness and fatigue, but it also means not getting enough blood flow to major organs. Particularly of note are the kidneys. Approximately 25% of the blood pumped out with each beat goes directly to the kidneys. For many patients a severe heart problem can also lead to kidney damage. Again it is better to be proactive and address poor blood flow before damage can be done.

If you are concerned or fearful of having a stress test let your healthcare provider know. There are different stress test protocols that can be used. One thing I was always concerned about in cardiac rehabilitation was patients practicing for their stress test. There is a reason the stress test is done under physician supervision. By bringing the heart to such strenuous workloads vulnerable plaques or unstable plaques can cause problems. Therefore I always advise do not give yourself your own stress test! Plan your daily exercise as just that daily exercise not a stress test.

As any test it is not a perfect test. There are some people who can pass a stress test with no problem yet may have heart problems that just can’t be detected by this test. The important thing to remember is being persistent in working with your healthcare provider to discuss your symptoms and what provokes them as well as what relieves them. Keep a diary of symptoms and share that on each office visit.