For a healthy heart eat a rainbow every day!

Fiber, vitamins, minerals, electrolytes, high nutrients, low-calorie, no artificial flavors or colors, natural sugars are part of a heart healthy diet and all easily available in a diet rich in colorful vegetables. If it is hard to get your servings of vegetables per day consider smoothies, chopping into small pieces adding small amounts to every meal you make. Ask yourself are you getting 4 1/2 cups a day of vegetables? Most will say no. Try new vegetables, search the internet for recipes.

Nutrition recommendation for heart patients

Load up on nutritionally dense low caloric foods. Don’t let the day go by without eating vegetables. Challenge yourself with legumes and  beans which provides essential fiber in the diet. Drink water regularly. Avoid fast food and eating out as much as possible. Use fresh herbs and spices, yet avoid salt.

Mediterranean Diet PyramidHow Fiber Works Infographic

Grief triggered from news

Most of us in the US tonight are feeling an overwhelming sensation of grief following the news of the school shooting in Connecticut.

I could not help but to feel grief upon hearing the horrible news today coming out of Connecticut. My heart aches for these families. The raw pain they must be feeling, the heaviness in their hearts, the overwhelming anger towards those who did the crimes, the loss,  and the timing of the holidays makes it even worse. I feel compelled to reminded my readers how grief and heart disease are connected. The hospitals need to be prepared. With grief comes increased heart pain. Emotional distress is a trigger for angina as well as heart attacks.

How will you grieve?

Is it possible to grieve and not have heart ache?  Should I use nitro if my heart aches?

Some suggestions if you are overwhelmed by grief I tell myself include:

  • Count your Blessings
  • Hug those you can
  • Express your love others
  • Light a candle
  • Meditate
  • Pray
  • Write about your emotion
  • Don’t allow your emotions over the situation compromise your health
  • Tune out…turn the news off…take a walk…..breathe the fresh air, enjoy the lights, listen to music


Emotional distress is a common trigger of angina.

With loss many experience increased heart symptoms of chest pressure, chest discomfort, pain, heaviness, fatigue and energy loss.

 Heartache the emotional pain recognition site in the brain is located near the region that senses and interprets sensations. When we suffer emotionally, the brain responds by releasing neurochemicals we experience in our body as an intense aching in our upper abdomen and lower chest. Grief-related stress can increase blood pressure and heart rate, raise levels of the stress hormone cortisol, constrict blood vessels, and disrupt cholesterol-filled plaques that line arteries. Any one of these changes raises the risk of heart attack.

Grief also makes blood “stickier” and therefore more likely to clot. Acute stress tends to increase levels of the hormones known as catecholamines which causes platelets to stick together. If a plaque bursts, the resulting clot is more likely to cut off blood to the heart.

American Heart Association’s Circulation reports scientists have found evidence that grief might actually break your heart. Studies show that people grieving the death of a close loved one could have a heart attack risk that is higher than normal.

The calculated the risk of a heart attack as 21 times higher in the first day after the loss of a loved one.  Risk declines steadily with each day after a loved one’s passing, but it remains eight times higher one week after the death and four times higher one month afterward, according to the American Heart Association journal Circulation

The link between grief and bereavement was strongest among people who had preexisting risk factors for heart disease and heart attacks, such as high blood pressure or unhealthy cholesterol levels. People mourning the loss of a loved one might further increase their heart-attack risk by sleeping poorly, eating less,  and skipping their medications. Other factors may include binge eating of comfort foods, increased alcohol or tobacco in an effort to comfort oneself from the intense loss.


Broken Heart Syndrome; 

Takotsubo Cardiomyopathy is a type of heart failure caused by grief or stress where the left ventricle balloons out taking on an unusual shape like a Japanese fishing pot. The symptoms are the same as a heart attack but an electrocardiogram does not always show the problem. You experience chest pain, shortness of breath, arm pain, and sweating as in a classic heart attack but its different. Postmenopausal women who are grieving are the main patients who experience this type of heart failure. It is caused when experiencing grief, stress, emotional trauma, or physical stress. The best test to confirm this heart problem is a contrast echocardiogram or an angiograph which takes pictures of your heart. The recovery for this type of heart failure usually takes less time than a classic heart attack.



So that nitro bit….yep if you are feeling chest pain, sitting and  relaxing  controlling your emotional health by avoiding anger response or  intensive grief, …… and your doctor has  prescribed nitro  for you this would be an indication to  use it. Of course if it doesn’t get better and  your symptoms are worsening call 911.  Hospitals are you prepared?

Do you eat vegetable and legumes?

While working in cardiac rehabilitation I regularly reviewed patients diets. One very consistent issue was lack of eating enough dietary fiber. Many do not get adequate intake of vegetables, legumes and seeds. It wasn’t uncommon for a significant other to shake their head and report their loved one never eats vegetables, or if they do it is only one or two types, such as corn, and carrots. When discussing intakes of legumes, you would see many look at you with that what is she talking about face.

Beans, dried beans, chick peas, soy beans, lentils, kidney beans.

All of these foods are chocked full of fiber and protein, and are loaded with nutrition including potassium, iron, magnesium, B vitamins. So how does one incorporate eating more legumes in their diet? Start slowly, to avoid gas issues, unless your house is full of teenagers who think it is hilarious to see who can produce the loudest and stinkiest farts.

Add chickpeas, black beans or kidney beans to salads. Mix lentils into your rice dishes. Throw a handful into soups. When making foods  such as sloppy joes, or tacos make with half the amount of meat and add in  a cup or two of pinto, black, white or navy beans.   Hummus is a great way to incorporate legumes. Use as a dip for vegetables, put on a Wasa or Rye crisp cracker.  Use beans as a base for casseroles. Soups are a great way to add beans and legumes.  If your beans are coming out of a can, rinse them first, this will reduce the sodium in them by almost half. Dried beans are very inexpensive, therefore try to get into a habit of one to two times per week soaking and cooking up a batch. A favorite snack may be roasted chickpeas. I like to season them up with olive  oil, cumin and chili peppers, but also use a Tuscon blend seasoning, or garlic and onion powder/salt.Lentils sprout very easily. Try putting a in a jar, cover with water, rinse with new water daily and in three days you will have lentil sprouts to add to your salads.  A side dish this week was roasted chickpeas, brussel sprouts and cauliflower. Roast each, but not until mushy, keep the crunch, then toss in a bowl with seasoning of choice and fresh parsley. Even the kids will eat this dish. How Fiber Works Infographic

Nuts, seeds, and legumes 3-4 servings per week for 1600 calorie diet 4-5 servings per week for 2000 calorie diet
  • 1/3 cup or 1 and 1/2 oz nuts
  • 2 Tbsp peanut butter
  • 2 Tbsp or 1/2 oz seeds
  • 1/2 cup dry beans or peas






There is very good evidence that eating legumes lowers the risk for heart disease.

Research by a group looking at almost 10,000 men published in November 2001 showed that even one serving of lentils or chick peas a week lowers the risk of heart disease. And the best part is that the more you eat, the lower the risk. Eating legumes 4 times or more per week reduces the risk of heart disease by as much as 22%.

The risk of developing diabetes or heart disease is lower when legumes are regularly eaten instead of protein foods that are high in fat, such as meats and cheeses and other whole-milk dairy produces, and refined carbohydrates that are low in fiber, such as baked goods made with sugar and white flour.

Some people avoid beans due to the intestinal gas or bloating they may produce. But if you gradually increase the amount of beans you eat over several weeks, you can overcome that concern. Soak beans for 8 to 12 hours, replacing the water every few hours, and this also helps. Slow cook them, to help reduce the gas-forming compounds. Adding a little baking soda will also help, or you can buy enzyme products at the drug store that break down the gas-forming parts of the bean. Note: Since legumes have high amounts of fiber, it is very important to drink plenty of fluids, especially water, to avoid constipation as you increase them in your diet.



Oh yeah I mentioned vegetable earlier didn’t I?

Well as I tell my kids I don’t care if they aren’t your favorite food, they are a very important part of a healthy diet.  Learn to like them. Branch out, try different vegetables. Fresh is best, followed by frozen, and lastly canned. We joined a CSA this year. This is a community sustained agriculture program where you own a share of the farm. You get a box full of vegetable every week. So when meal planning we start with what fresh vegetables are on hand? What needs to be used first and plan the meals around the vegetables. Now how many heart patients do this? Initially not many, but after suffering a heart problem many are open to trying it. Get on the web and look up recipes that include veggies you have on hand or are willing to use. Break out of the old cooking methods, try roasting, grilling, satisfying, steaming, fresh.  Again they might not be your favorite part of the meal, but such an important part. About half your plate should be veggies. When you are in need of a snack, make sure it includes vegetables.  Neufchatel cheese – mixed with your favorite spices, or veggies such as dried tomatoes and dried peppers, chives and garlic,  together with fresh-cut veggies are a good snack to always have on hand. Take one day to prepare a boat load of fresh veggies every week so they are on hand, and an easy go to snack item.


Eat a variety of colors and types
3-4 servings per day for 1600 calorie diet 4-5 servings per day for 2000 calorie diet
  • 1 cup raw leafy vegetables (about the size of a small fist)
  • 1/2 cup cut-up raw or cooked vegetables
  • 1/2 cup vegetable juice

The Flu and Heart Disease

Things Heart Patients Should Know about the Flu

Many people don’t get flu vaccinations or  don’t really worry about getting the flu. However flu season poses special problems for heart patients.  The flu viruses might act as triggers for heart attacks in cardiovascular patients. It also triggers high blood sugars in the diabetics as a result of the stress of illness which then increases heart stress. It often takes longer to recovery from in heart patients and can be more serious with more complications. Here is what the American Heart Association reports on how the flu affects the heart.

The flu can leave most people sick for a few days, but it can be a much more serious ordeal if you have heart disease or have had a stroke.

In fact, the flu can cause complications, including bacterial pneumonia, or the worsening of chronic heart problems.

“It’s more stress on your heart. It has to work harder to pump blood through your lungs,” said Donna Arnett, Ph .D ., chair and professor of epidemiology at the School of Public Heath at the University of Alabama at Birmingham and the president of the American Heart Association.

Because of potential complications, which can sometimes lead to death when a patient is already sick, it becomes even more important to avoid the flu if you have heart disease and as you get older, Dr. Arnett said.



Scientists from TIMU Study Group and Network for Innovation in Clinical Research analyzed published clinical trials involving a total of 3,227 patients, half of whom had been diagnosed with heart disease. Participants, whose average age was 60, were randomly assigned to either receive flu vaccine or a placebo shot, then their health was tracked for 12 months.

A number of studies have shown a link between heart attacks and a prior respiratory infection. A 2010 study of about 78,000 patients age 40 or older found that those who had gotten a flu shot in the previous year were 20 percent less likely to suffer a first heart attack, even when such cardiovascular risks as smoking, high cholesterol, hypertension and diabetes were taken in account.

Scarier still, researchers report that up to 91,000 Americans a year die from heart attacks and strokes triggered by flu. This grim statistic prompted the American Heart Association and American College of Cardiology to issue guidelines recommending vaccination for patients with cardiovascular disease (CVD). The CDC advises flu shots for everyone over six months of age, but cautions that certain people should check with a medical provider before being immunized.

Sadly, fewer than half of Americans with high-risk conditions like heart disease get the shot, leaving themselves dangerously unprotected against both flu complications and cardiovascular events. In fact, the CDC actually uses heart attack rates to track seasonal flu outbreaks, says Dr. Bale. “They look for areas with a sudden surge in heart attacks and send a team to investigate, because the cause is almost always a spike in flu cases.”

Those who got the flu shot were 50 percent less likely to suffer major cardiac events (such as heart attacks or strokes) and 40 percent less likely to die of cardiac causes. Similar trends were found in patients with and without previous heart disease.

To picture how flu could ignite a heart attack or stroke in someone with CVD, think of cholesterol plaque as kindling, says Dr. Bale. “Inflammation, which has recently been shown to actually cause heart attacks, is what lights the match, causing plaque to explosively rupture through the arterial wall.”

When a plaque rupture tears the blood vessel lining, the body tries to heal the injury by forming a blood clot. If the clot obstructs a coronary artery, it can trigger a heart attack, while a clot that travels to the brain could ignite an ischemic stroke. It’s a myth that plaque buildup alone sparks heart attacks, since numerous studies have shown that what chokes off flow to the heart is a clot.

“Inflammation is a key player in destabilizing plaque, explaining why some people with relatively little build up in their arteries have heart attacks or stroke, while others with substantial plaque deposits never suffer these events,” says Dr. Bale, who advises all of his patients to get flu shots to guard against inflammation, the body’s response to viral and bacterial infections.

Another surprising benefit of getting a flu shot is reduced risk for pulmonary embolism (a blood clot in the lungs) and deep vein thrombosis (a clot in the legs). A 2008 study found that the threat of developing these problems dropped by 26 percent overall in participants who had been vaccinated in the previous year, with a 48 percent risk reduction in patients younger than 52.


Doctors have long known that flu viruses can worsen existing medical conditions and that heart patients are especially vulnerable during flu outbreaks. Flu viruses cause inflammation in the body, usually in the lungs. But they can also cause swelling in the heart itself or in the coronary arteries, which could lead to dangerous clots breaking off and causing a heart attack.

Seek medical care if you or the person you are caring for

  • has chest pain or difficulty breathing
  • has purple or blue discoloration of the lips
  • suddenly becomes dizzy
  • has severe or persistent diarrhea or vomiting and is unable to keep liquids down
  • is confused or isn’t responsive.

Returning to Exercise After Being Sick

If you have been exercising regularly and get sick it is important you return back to activity gradually. My experience working in Cardiac Rehabilitation when a patient had problems frequently they were trying to return to strenuous exercise too soon following illness. The risk of a serious cardiovascular event (heart attack or stroke) is doubled in the week following a serious respiratory infection, such as flu or acute bronchitis. This is according to a report in the European Heart Journal.

If you are coming down with an illness such as the flu, it is best not to exercise. Your body needs to use its energy to overcome the illness.  Exercising strenuously is like burning the candle at both ends.  The body doesn’t have the energy to fight illness, so the illness takes longer to overcome. There is also evidence you can drive a virus deeper into the system making it much harder to overcome.

 Never exercise if feverish.

A fever indicates your body is fighting an infection.  Exercise can cause your body temperature to rise dangerously high and lead to  heat stroke. This can also  lead to dangerous dehydration and even heart failure.

Good advice is when returning to exercise, work out one day at a low intensity for every two days you were ill.

I tell patients to cut their intensity to 50% of what they normally do, and start back with a short duration say no more than 20 minutes. Use the two-hour rule. You should feel fully recovered two hours after exercise. If you are exhausted for the remainder of the day it is too much on your body. It should take at least two full weeks to build back up following a nasty cold or flu bug.  Drink plenty of water during this time to help thin any mucus secretions from the lungs, this helps your body to expel these. If you had to take antibiotics be aware that some antibiotics   –  Cipro and Levaquin –  are known to increase the likelihood of muscle rupture, therefore go slow and  gently stretch.

There is no such thing as “sweating out” toxins, germs or viruses. Put all your energy towards resting and getting well.

Nausea Vomiting / Diarrhea

 These can cause dehydration and electrolyte imbalances. Wait to exercise until the symptoms have stopped completely  or 24 to 48 hours and you are re hydrated. One way to know if properly re hydrated is looking at the color of your urine. If the urine is bright yellow you are not hydrated. The color should be a very pale yellow. Also look at the skin on the back of your hand and give it a pinch. Does the skin stay up for several seconds, or does it quickly go back down. It should quickly go back down.  Electrolyte depletion can be very serious in heart patients, especially those on diuretics.  If in doubt or concerned ask your physician to draw electrolytes.  A weak 50%water to 50% electrolyte drink such as Power aid, or Gator Aid might be advisable.  Of course eating a banana which is easier on the belly than something like orange juice, also helps.

Most importantly listen to your body, go slow, give yourself the time to heal. Stop exercise if you notice your heart racing, shortness of breath, chest discomfort, weakness.