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What do heart experts eat for dinner?

They follow their own advice to enjoy lots of vegetables, legumes, lean protein, and a fruit-based dessert.


Image: Mizina/Thinkstock

Following a healthy diet is a proven and powerful way to lower your risk of heart disease. But do you ever wonder if doc-tors actually practice what they preach, especially with regard to their eating habits? While we obviously can't speak for all of them, four Harvard physicians with diverse ethnic backgrounds agreed to share examples of their favorite heart-healthy dinner menus.

Dr. Enrique Caballero, assistant professor of medicine

A native of Mexico, Dr. Caballero directs the Latino Diabetes Initiative at the Joslin Diabetes Center; his research interests include cardiovascular disease prevention.

Weighing in on the value of the body mass index

Your BMI estimates your body fat better than the number on a scale. But a tape measure is an equally important tool.


As your BMI rises above 25, so does your risk for developing high blood pressure, diabetes, and cardiovascular disease.
Image: designer491/iStock

The body mass index (BMI), a measurement derived from the relationship between your weight and your height (see box), is a common way to estimate body fat. It's a simple, fast, and essentially free tool that enables doctors to help identify people who might be at risk for health problems—including cardiovascular disease—that are linked to excess body fat.

Lend a hand, help your heart?

People who do volunteer work may reap benefits beyond the satisfaction of helping others.


Doing volunteer work may give you a greater sense of purpose in life—a positive emotion that’s been linked to a lower risk of heart disease.
Image: monkeybusinessimages/Thinkstock

If you volunteer on a regular basis, perhaps you've experienced the emotional rewards of donating your time. What you might not realize, however, is that volunteering may offer some added advantages for your heart.

The new generation of wearable medical alert systems

Cheap, mid-priced, and Cadillac. Which one is for you?

Option one

This basic option usually includes a button you wear on a pendant or wristband, and a base unit (similar to a speaker-phone) that you plug into your house phone jack. If you get into trouble, you simply press your button, which signals the base unit to call the alert system operators. An operator then talks to you through the speaker in the base unit and sends paramedics if you need help. Most gadgets are waterproof and have built-in batteries that don't need recharging; most batteries last for years and will be replaced free of charge if they run out.

Typical price: $25–$30/month

Considerations: Just like a wireless house phone, these buttons can signal the base unit only within a limited range, such as 400 feet. But the buttons don't provide two-way communication with operators; only the base unit does that. So what happens if you're upstairs when you call for help, but the unit is downstairs? How will you hear the operator? Answer: you'll need another speaker, called a voice extender (that costs extra). And what if you're unable to press the button after a fall? Or what if you fall when you're away from home? You'll need upgrades to address those issues, such as fall detection or cellular technology, typically available in options two and three, below.

Option two

Option three

This premium option usually upgrades the button to a top-of-the-line device that looks like a mini cellphone, and actually uses cellular technology to contact emergency help. The improved communication allows you to use the alert system wherever you go, whether it's the grocery store or the great outdoors. Unlike the other options, this device has a built-in speaker, so you can talk to an operator through the button. It also features global positioning system technology (GPS), which gives alert system operators the ability to send help to your exact location.

Typical price: $40–$50/month

Considerations: This button is thicker and larger than the type worn only at home, so you probably won't be able to wear it comfortably on your wrist—you'll have to put it in your pocket or wear it around your neck. Also, it must be charged every few days, just like a cellphone. If you're not faithful about that, the button won't work.

Additional services

The fine print

It's not enough to find the latest and greatest alert system. You'll want to make sure that the company you choose has low activation fees, no long-term contracts, no cancellation fees, discounts for add-ons to your service, free replacement for equipment that's not working, and most important: operators who are available 24 hours a day at a UL-listed call center, which means the center meets requirements for backup systems in the event of failures, and is certified by safety testing company UL.

There are many alert system companies that meet all of those standards. Your choice may be swayed by recommendations from a friend, your doctor, or a local hospital. Just do your homework, and then give the system a try. You may soon wonder how you ever got along without it.

Could you use an alert system?

An alert system is worth strong consideration if you live alone. But anyone at risk of falling could benefit from using one.

The story of a Georgia couple's tragedy in January 2016 underscores the need: An 86-year-old man fell out of his motorized wheelchair outside their home, and shouted for his 74-year-old wife. She fell while trying to reach him, and both wound up on the ground overnight, with no way to call for help. The wife died in freezing temperatures; her husband was dressed warmly and survived.

Think about how an alert system could help in your own living situation. What if, for example, you fell while a family member was in another part of the house, unable to hear you? What if you fell while your family member was out doing errands? What if you fell and were simply unable to shout for help? If you have an alert system, you'll save precious time and get treatment sooner. "I think these devices are a good thing, especially for people who don't have someone calling every day to be sure they are okay. Unfortunately, sometimes the very people who need them the most are the people who won't wear them," says geriatrician Dr. Suzanne Salamon, a Harvard Medical School assistant professor.

A quick guide to medical alert system option levels

Make sure the company you choose has low activation fees, no long-term contracts, no cancellation fees, free equipment replacement, and operators available 24/7.

Option one

Option two

Option three

  • A two-piece system that comes with a home base unit and a small, lightweight device worn on your wrist or around your neck.

  • System has a limited range; the button itself doesn't have two-way communication.

  • Price: $25-$30/month

  • Like option one, a two-piece system that comes with a home base unit and a small wearable device.

  • Upgrades option one to include fall detection, which is handy if you are unable to push your button.

  • Price: $30-$40/month

  • A larger device that looks like a mini cell phone, worn around your neck or kept in your pocket.

  • Uses cellular technology to contact emergency help from any location, even if you're away from home.

  • Price: $40-$50/month

 

Smart chocolate choices for a healthy heart

The advice to eat chocolate should be taken with a grain of salt.


Image: Leszek Kobusinski/Thinkstock

Like bees swarming a melting candy bar, the media buzz around the purported health benefits of chocolate has been hard to ignore. The possibility that such a sumptuous treat might actually be good for your heart is very sweet news, indeed.

But there's a lot more to this story that we need to understand before going hog wild in the candy aisle, says Dr. Howard Sesso, associate professor in the division of preventive medicine at Harvard-affiliated Brigham and Women's Hospital. "Simply recommending that people eat dark chocolate as a way of improving health is very misleading, since chocolate products tend to have a significant amount of fat, sugar, and calories." Instead, he and colleague Dr. JoAnn Manson are embarking on the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), a four-year trial involving 18,000 participants that is designed to tease out the intricacies of chocolate's health-promoting nutrients (www.cosmostrial.org).

Ask the Doctor: Which exercise is best for brains?


 Image: Thinkstock

Q. I heard regular aerobic exercise is better for the brain than strength exercises (resistance training). Is that true?

A. The study you probably heard about involved rats, not humans. The rats were made to engage each day in sustained aerobic exercise, high-intensity interval training, or resistance training, or they were allowed to just be sedentary. At the end of the study, the researchers examined the rats' brains. The rats doing regular aerobic exercise had more brain cells than the sedentary rats. However, the rats made to perform high-intensity interval training or the ones doing resistance training did not have more brain cells than the sedentary rats.

Foot problems? Try these tips to find comfortable shoes

Look for roomy toe boxes, soft inner soles, and sturdy heel counters to give you a better fit and help you stay on the go.


Image: Thinkstock

Bunions, hammertoes, corns, and calluses all make shoe buying a chore. But the wrong shoes can impair your mobility and independence. "Pain from any of those conditions can alter your gait," says Dr. James Ioli, assistant professor of orthopedic surgery at Harvard Medical School.

Corns and calluses

Bunions and hammertoes

A bunion develops at the base of your big toe when two bones no longer connect properly, causing the base to jut out-ward. Some people are genetically vulnerable to getting bunions. However, bunions are more likely to develop in people (often women) wearing shoes that crowd the toes.

Hammertoes are deformed, bent toes that may result from poorly fitting shoes, a ligament problem, or a bunion that pushes one toe over another.

If bunions and hammertoes don't bother you, there's no need to treat them. "I have many patients who are runners with hammertoes and bunions who successfully compete without any trouble. It's all a matter of individual mechanical issues," says Dr. Ioli. If the deformities bother you, surgery to realign the bones is possible, but that is a last resort.

Shoe hunt

Other options

Even a roomy toe box may cause a little friction when you walk. That's when using moleskin pads on your toes or feet can help. These soft pads have an adhesive backing that you attach to an affected foot or toe area, or to the inside of your shoe. It protects against friction. You can find moleskin pads in drugstores. Toe separators can help relieve pain from corns be-tween the toes.

Some shoes are designed specifically to relieve pressure on bunions. You can find them in specialty shoe stores. But prepare to pay more for these kinds of shoes. They typically run $100 to $200 per pair. Are they worth it? "If they relieve pressure points and decrease pain on the bunion or hammertoes or any deformity, that's good," says Dr. Ioli, "but you can find comfortable shoes for less if you do a little detective work."

Figure 1: Finding a comfortable fit for ailing feet

When shopping for comfy shoes, look for these important features.

 

Couch potato in midlife, smaller brain later?


Image: Yuri Arcurs/Thinkstock

News Briefs

Here's something to jolt you off the couch and get you exercising: a study published Feb. 10, 2016, in Neurology links poor fitness levels in middle age to brain shrinkage 20 years later. Researchers, including some from Harvard Medical School, looked at the cardiovascular fitness of about 1,100 people, average age of 40, who were free of dementia and heart disease. The participants had taken treadmill tests to determine their cardiovascular fitness levels based on how much oxygen their bodies used during exercise. About 20 years later, participants took another treadmill test and underwent neuropsychological testing and MRI brain scans. The scans showed that people who were unfit in middle age had smaller brains in older age, compared with people who were fit in middle age. This doesn't prove that inactivity in midlife causes brain shrinkage. But previous studies have shown that regular, moderate-intensity exercise may be associated with slower brain aging.

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