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Since the start of the year, you may have noticed an uptick of fad diets. Maybe it’s your mom trying a pescatarian regime, or your neighbor raving about his new Mediterranean diet. With so many diet trends buzzing around, it can be hard to separate what works from what doesn’t. This is especially true when it comes to heart healthy eating.
The American Heart Association released a study comparing diets and their heart healthy potential and organized the results in four tiers. With the help of Kelly Elliot, RD at Intermountain Health’s Denver Midtown Clinic - Weight Loss Center, we turned the study’s results into easy-to-digest bites.
“It is important to always be mindful of your diet to reduce risk factors for heart disease,” said Kelly. “Creating a lifestyle that works for you as an individual that you can follow is what matters, because it’s what you will stick to!”
Whether you’re a seasoned diet tryer, or just dipping your toes in heart-healthy waters, there’s important information for everyone.
Starting from the bottom of the barrel, we meet paleolithic and ketogenic diets. These diets, often hailed for their weight loss potential, may miss the mark when it comes to nourishing our hearts.
The paleolithic diet, while rooted in our ancestral past, falls short in meeting heart-healthy guidelines. With its emphasis on meat and fat, and limited intake of fruits, grains, and legumes, it takes a detour off the heart health highway.
Similarly, ketogenic diets focus on slashing carbs and loading up on fats. By cutting out essential food groups like fruits and grains, we risk missing key nutrients.
“These diets don't limit saturated fats, which can raise your LDL, which is the ‘bad’ cholesterol,” said Kelly. “One way to modify these diets is to reduce saturated fat by consuming nuts and seeds instead of animal proteins, but this has to be balanced with caloric intake.”
Kelly also added that because these diets are low in carbohydrates, they could be beneficial for people with diabetes. However, because diabetics are at a higher heart disease risk, their saturated fats should be limited.
Tier 3 diets include very low-fat and low-carb options, and present mixed heart health benefits.
“Both of these diets can potentially help with weight loss without omitting food groups and can help lower risk factors for heart disease,” said Kelly.
Very low-fat diets, while aiming to reduce overall fat intake, may inadvertently miss the mark on essential fatty acids. Likewise, low-carb diets, with their focus on slashing carbohydrates, could lead to a decrease in fiber-rich foods, which play a vital role in heart health.
“The drawback is that with low fat diets, they can lead to deficiencies in protein and essential fatty acids and B12, that the body requires for good health,” said Kelly. “On the other hand, a low carb diet can overemphasize animal-based protein and restrict fiber and increase saturated fat intake.”
Vegan and low-fat diets are the heart of Tier 2. These dietary paths offer a bounty of heart-healthy benefits – with some caveats.
The vegan diet, with its plant-based focus on fruits, vegetables, whole grains, and legumes, embraces the power of plants for heart wellness. However, tread carefully to ensure you’re meeting your nutritional needs, particularly for vitamin B12.
“No animal protein is consumed in vegan diets, so they are very low in saturated fat intake, but the restrictive diet can lead to B12 deficiency,” said Kelly. “It is recommended to include a B12 supplement and choose plant-based milk alternatives.”
Meanwhile, the low-fat diet promises reduced cholesterol and a lighter load on our hearts. By emphasizing lean proteins, whole grains, and fruits and vegetables, it is a good heart healthy diet. But it’s important to avoid overconsumption of less healthy carbohydrates, such as added sugars.
“People with high cholesterol or high LDL cholesterol can benefit from replacing foods high in saturated fats with foods that have unsaturated fats,” said Kelly.
Started from the bottom, and now we’re here with Tier 1’s DASH-Style, Mediterranean, pescatarian, and ovo/lacto-vegetarian diets. It’s the pinnacle of heart-healthy eating, where the nutrients shine.
We’ll start with the Dietary Approaches to Stop Hypertension, or DASH, diet. By the name alone, you might infer this diet’s ultra heart healthy nature. It emphasizes 8-10 servings of fruits and vegetables per day, whole grains, plant protein, and low-fat dairy, while limiting sodium.
According to Kelly, the DASH diet’s sodium limitations help cut out highly processed foods, which can help control weight and high blood pressure. “This diet provides adequate variety with adequate protein, moderate healthy fats and moderate healthy carbs intake, while minimizing sodium intake,” she said.
Moving onto the Mediterranean diet, with its emphasis on olive oil, fish, fruits, vegetables, and whole grains. These heart healthy foods make this a great choice for reducing heart disease risk. However, the Mediterranean diet also includes moderate alcohol consumption, which means two or less drinks for men a day, and one or less drinks for women per day.
Kelly cautioned against misinterpreting what moderate alcohol consumption is. “This does not mean, to have no alcohol for 3-5 days and then have all 3-5 drinks at one time,” she said. “These drinks should not include added sugar such as margarita mix, juices, and sugary sodas.”
A pescatarian diet is similar to a vegetarian diet, with the addition of fish, and sometimes includes dairy and eggs. Lacto-ovo vegetarians eat eggs and dairy, but not beef, poultry, fish, or pork. These diets may be lower in saturated fats, especially if whole milk products are not consumed. The biggest challenge with these diets boils down to protein.
Kelly explained it simply as there being complete and incomplete proteins. While animal proteins contain all essential amino acids, plant-based proteins are incomplete, and must be combined for full nutritional benefits.
“The way to do this is to combine a nut or seed or bean with a grain,” said Kelly. “For example, red beans and brown rice, or nut butter on whole grain bread, will allow you to consume all of the essential amino acids.”
While these diets might seem daunting, remember you’re not alone. A registered dietitian, like Kelly, can be an excellent starting source.
“Dietitians are full of ideas and strategies to help each individual overcome barriers to create effective behavior changes,” said Kelly. “It’s important to remember that baby steps and small changes lead to big impacts on your health over time!
Whether you're sticking to tried-and-true favorites like the DASH plan or exploring new diet horizons, the key is finding what works best for your heart. Remember, it's not about perfection – it's about progress. So go ahead, savor those veggies, indulge in some heart-smart protein, and above all, listen to what your body needs.
What We Dont Know We Dont Know in Health Care: September 24, 2024 -Oral Care, Monitored Meals, and Aspiration PneumoniaProper oral care is crucial for maintaining optimal health. Keeping the mouth clean not only helps maintain the protective properties of saliva but also reduces bacteria in the mouth which can be a source of infection in aspiration pneumonia. In addition, monitoring meals and assisting with feeding for those at high risk for aspiration is also a necessity. The process of swallowing involves dozens of muscles that start in the mouth and include the pharynx, larynx, and esophagus. These muscles can become weakened with age and from various, often age-related diseases. The aging population is especially at risk for aspiration pneumonia due to comorbidities, frailty, and conditions that can impair swallowing. As a result, aspiration pneumonia is one of the leading causes of death from infection in individuals over the age of 65. One study shows that 1 in 10 deaths from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene (Sjogren et al., 2008). Unfortunately, proper oral care and monitoring of meals is often overlooked in the health care setting. Perhaps the greatest reason for this is the challenge that almost every health facility faces today: adequate staffing. When I started working in acute care as an RN over 20 years ago, nursing assistants (these are the staff generally responsible for proving oral care in an acute care setting) were typically responsible for 5-7 patients. Nurses had 3-5 patients (this was on a step down cardiac unit). Between the nurse and the assistant, we were able to provide oral care at every meal and offer one-on-one assistance to any patient that was at risk for aspiration. This is no longer the case. RNs oftentimes look after upwards of 8 patients, and there is generally either no nursing assistant on the floor or only 1 for a patient load that can exceed 20. Consequently, proper oral care is neglected. I have often seen patients that are aspirating during meals, but do not have adequate staffing on hand to provide them with the supervision and monitoring that they need. This presents a hazardous catch-22: the aging individual needs to eat to maintain nutritional needs yet he/she needs assistance with eating to prevent aspirating pneumonia. How can this be remedied? If the family is present, they can provide oral care and meal monitoring. If meal monitoring is required for an at-risk individual, its recommended to touch base with the health care team to inquire as to what the specific aspiration precautions are (every individual may have a different need and/or recommendation). A care companion can also be hired to provide the needed care. I hired a companion for my father when he was in a skilled nursing facility. He was not getting his teeth brushed or flossed regularly, and I was seeing a decline in his dentition. Having this extra support provided him with much needed assistance and the care companion had the added benefit of encouraging him to eat more at every meal, something that was a bonus as he was not meeting his nutrient needs. Touching base with staff to request that oral care and meal monitoring be done can also be helpful. Having an advocate to ensure necessary care is getting done can also be very effective in the health care setting. What is proper oral care and effective meal monitoring? Proper oral care includes brushing the teeth for at least 1 minute after every meal. It also includes using a soft bristle brush, fluoride toothpaste, flossing daily. A final component of oral care that is often not discussed is denture care. Dentures should be cleaned at least once per day and removed at bedtime. Removing them prior to sleeping can greatly reduce the risk of pneumonia (Iinuma et al. 2014). Effective meal monitoring includes adequate supervision during mealtime for those at risk of aspiration. Such supervision includes ensuring the individual is properly positioned for a meal (head of bed as high as can be tolerated and supine position), takes small bites, eats slowly, swallows a couple times in between each bite, and intermittently takes a sip of liquid to clear the mouth of food particles. The use of straws is generally not recommended for an individual at risk for aspiration as it propels the food to the back of the throat and hence can increase risk. I recall when I was working as a Registered Nurse (RN) in acute care that I was constantly removing straws from the bedside of at risk individuals and often reminding them to eat slowly and swallow at least twice between each bite to ensure food clearance. Individuals at risk for aspiration often require a modified texture diet as it can further prevent the aspiration of food and liquids. This is a brief summary of the attention to detail needed in addressing oral hygiene and meal monitoring amongst the aging population. Both measures can play a significant role in reducing aspiration pneumonia. If you would like more information on understanding proper oral care or any other questions that you may have regarding aging life care, please feel free to reach out to me. Sources:1. Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. 2008. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: effect estimates and methodological quality of randomized controlled trials. J Am Geriatr Soc. 56:21242130. 2. Iinuma T, Arai Y, Abe Y, Takayama M, Fukumoto M, Fukui Y, et al. 2014. Denture wearing during sleep doubles the risk of pneumonia in the very elderly. J Dent Res. doi: 10.1177/0022034514552493 3. F Muller, 2015. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541086/#
By the time you read this, the reported deaths from COVID-19 and its variants in the U.S. will be close to 900,000. As staggering as that statistic is, its 400,000 short of the number of Americans killed by Heart Disease in the same time period. Heart disease is the leading cause of death for men and women of most racial and ethnic groups.Lets not allow the topic to overwhelm the fact theres a miracle inside your chest. Weighing about as much as a grapefruit, the heart is a powerful pump that drives five to six quarts of blood to every microscopic part of your body every second. And if it fails for even a second, the body is very unforgiving. Even though its the one piece of machinery driven by the brain, we tend to treat the heart like a kitchen appliance that we take for granted. Rarely serviced, rarely cleaned, and overworked until it burns out. Although heart bypass and transplant have become routine since the pioneering operations in the 1960s, its not like replacing the coffee maker you neglected too long. One Thing at a TimeThe better way to treat your heart with the respect it deserves is to start with changing just small habits. That way, youll avoid the relapse from trying to change everything at once and falling back to unhealthy heart habits inside of a month. The most obvious: if youre a smoker or heavy drinker, work on that first. Imagine a small team of remodelers arriving at your heart to do a makeover. The first thing theyre going to say is, Well, we cant do anything with the plumbing until we clear the smoke. Look for Help During Heart MonthQuitting smoking and reducing alcohol is never easy, but this is probably as good a time as any during the year to start a cessation program with help. February is American Heart Month, so youre likely to be reminded frequently of heart health and offered tips on modifying your routine to help your heart and prolong a happy life. If you only look to one place, trust the American Heart Association www.heart.org. Prediabetes and Heart DiseaseWhats your blood sugar level? If you dont know, you should find out from your doctor if youre not already monitoring it yourself. You could be pre-diabetic without knowing it or showing any symptoms. Theres a good chance you could avoid becoming diabetic and reverse your pre-diabetic blood sugar to normal with relatively little change to your diet and a slight increase inyour activity. Diabetes has long been linked to heart disease, but recent studies suggest that reversing prediabetes is also linked to fewer heart attacks and strokes. [Reversing Prediabetes linked to fewer heart attacks, strokes, heart.org, Jan. 26, 2021.]While youre at it, get your cholesterol tested and routinely monitor your blood pressure.If youre worried you might be at risk for heart disease, ask your doctor to perform a simple cholesterol test to let you know if youre at risk and should adjust your diet. Home blood pressure monitors are not expensive, theyre digital, and theyre easy to use. Blood pressure stations are common in supermarkets now, and you can also check your weight and pulse. Womens Heart HealthWhy the emphasis on womens heart health? The American Heart Association tells us that cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year about one woman every minute. They devote an entire website to womens heart health: Go Red for Women (www.goredforwomen.org). Here are just a few of the common misconceptions about womens heart health:Myth: Heart disease is for men, and cancer is the real threat for womenFact: Heart disease is a killer that strikes more women than men and is more deadly than all cancer forms combined. While one in 31 American women dies from breast cancer each year, heart disease is the cause of one out of every three deaths.Myth: Heart disease is for old peopleFact: Heart disease affects women of all ages. For younger women, the combination of birth control pills and smoking boosts heart disease risks by 20 percent. Heart defects are more common than you might think: 1.3 million Americans alive today have some form of congenital heart defect and at least nine of every 1,000 infants born each year have a heart defect. Even if you live a completely healthy lifestyle, being born with an underlying heart condition can be a risk factor.Myth: I run marathons no way I could be at risk.Fact: Factors like cholesterol, eating habits, and smoking can counterbalance your other healthy habits. You can be thin and have high cholesterol. The American Heart Association says to start getting your cholesterol checked at age 20. Earlier, if your family has a history of heart disease. Age and Heart HealthMany things, like wine and most people, grow better with age. The heart, however, takes more tending than a glass of fine wine. Avoid things that weaken your heart beyond the normal aging process. These are the usual suspects: smoking and tobacco use, lack of exercise, diet, alcohol, overeating, and stress. Some preexisting conditions you cant control: irregular heartbeat, congenital (inherited) heart defects, sleep apnea (although this may be a product of obesity or alcohol consumption).Viruses and MyocarditisMyocarditis is an inflammation of the heart muscle mostly caused by a virus, including COVID-19, and can lead to left-sided heart failure. The left ventricle of the heart is the part that pumps oxygen-rich blood back to the body. This valve tends to stiffen with age. Thats one of the many reasons why age combined with a preexisting condition puts you at greater risk of death from COVID-19. Even survivors of the novel coronavirus infection can sustain permanent heart damage. All people must protect themselves and others from COVID-19 by observing precautions, not just because of its immediate lethality but also because of its impact on the heart, known and unknown. How to Start with Your HeartThe factors involved in heart health and the onset of heart disease are many, varied, and complicated. But the common preventions (listed here, from the Mayo Clinic) are simple. You probably already know them by heart, so to speak:Not smokingControlling certain conditions, such as high blood pressure and diabetesStaying physically activeEating healthy foodsMaintaining a healthy weightReducing and managing stress Those may seem like six significant challenges, especially if you take on all six. But you should notice something else about them. Almost every one of them can affect the other five. So, if you pick one, youll find it easier to take on the next one. People who quit smoking usually discover that they have more energy within the first week, and exercise becomes easier. A little exercise and switching out one unhealthy food will help with weight, stress, blood pressure, and diabetes. Easy does it, especially if youre 65 and older. Youve spent a whole life learning one way. You can take your time. Learn to enjoy your healthier heart. But start today.First, Get a Checkup!Most of the questions this article has raised in your mind (Whats my blood sugar level? Whats my blood pressure? I used to smoke am I at risk?) can all be answered in a single doctors visit with simple lab work done a few days before. Schedule it now, before you start a program of exercise and diet. And schedule a regular exam per your doctors recommendation. Relieving the stress of not knowing will be a good start on your way to a healthier heart.
As our population ages, managing healthcare for seniors becomes increasingly critical. One significant concern is hospital readmissions, which can be costly and detrimental to a seniors health and well-being. In-home care has emerged as a promising solution to reduce hospital readmissions, providing seniors with the support they need to recover and maintain their health at home. This blog explores how in-home care impacts hospital readmissions for seniors, offering insights into its benefits and the role it plays in enhancing overall health outcomes. Understanding Hospital Readmissions What Are Hospital Readmissions? Hospital readmissions occur when a patient is discharged from the hospital but has to return for the same or related medical condition within a specific period, usually 30 days. Readmissions can be a sign of inadequate care, complications, or a lack of proper follow-up. For seniors, who often have complex health needs, the risk of readmission is higher, making it a significant concern for healthcare providers and families. Causes of Hospital Readmissions in Seniors Several factors contribute to hospital readmissions among seniors, including: Chronic Conditions: Conditions such as heart disease, diabetes, and respiratory issues can lead to frequent hospital visits if not managed properly. Medication Management: Incorrect use or misunderstanding of medications can result in complications and readmissions. Inadequate Follow-Up Care: Lack of proper follow-up after discharge can lead to complications or deterioration of health. Limited Support Systems: Seniors who live alone or have limited support may struggle with post-discharge care and recovery. The Role of In-Home Care in Reducing Hospital Readmissions Personalized Care PlansIn-home care provides a tailored approach to managing a seniors health. Care plans are developed based on the individuals specific needs and medical conditions, which can help prevent complications and reduce the likelihood of readmission. This personalized approach includes: Medication Management: Ensuring that medications are taken as prescribed and monitoring for potential side effects. Chronic Disease Management: Providing support for managing chronic conditions through regular monitoring and adjustments to care plans. Continuous Monitoring and SupportOne of the key benefits of in-home care is continuous monitoring and support. Caregivers can observe changes in the seniors condition and respond quickly to any issues that arise. This ongoing support includes: Health Monitoring: Regularly checking vital signs and tracking health indicators to catch potential problems early. Emergency Response: Being available to handle emergencies and provide immediate assistance if needed. Post-Discharge CareAfter a hospital discharge, in-home caregivers play a crucial role in ensuring a smooth transition and recovery process. Post-discharge care services include: Follow-Up Appointments: Assisting with scheduling and transportation to follow-up medical appointments. Wound Care and Physical Therapy: Providing necessary care for wounds or facilitating physical therapy exercises as prescribed by the doctor. Education and TrainingIn-home caregivers educate seniors and their families about managing health conditions, medication use, and lifestyle changes. This education helps in: Understanding Health Conditions: Ensuring that seniors and their families are well-informed about the seniors health conditions and treatment plans. Self-Care Techniques: Teaching techniques for managing symptoms and preventing complications. Companionship and Emotional SupportEmotional well-being is an important aspect of recovery. In-home care provides companionship and emotional support, which can positively impact a seniors overall health. This support includes: Reducing Loneliness: Offering social interaction and companionship to alleviate feelings of isolation. Encouraging Compliance: Motivating seniors to follow care plans and engage in healthy behaviors. Conclusion In-home care plays a vital role in reducing hospital readmissions for seniors by providing personalized, continuous, and compassionate support. By addressing specific health needs, managing medications, offering post-discharge care, and providing emotional support, in-home caregivers help seniors maintain their health and prevent complications. Investing in in-home care not only improves health outcomes but also enhances the quality of life for seniors, making it a valuable component of comprehensive healthcare management. For more information on in-home care services and how they can benefit your loved one, contact us at 412-810-6595. We are committed to providing exceptional care and support to help seniors thrive in their own homes.
Intermountain Health Good Samaritan Hospital senior E.R. is Colorado's first E.R. facility constructed with seniors needs in mind. By implementing a philosophy of care for the geriatric patient and implementing a variety of screenings designed for the senior population, physicians hope that their senior E.R. will help lower readmission rates and reduce the risk of harmful drug interactions. In order to give excellent emergency care to seniors in our community including specialized screening and care, physicians and nurses have taken workshops in sensory appreciation and ageism to learn how to better communicate with older adults and their caregivers. The Senior ER provides a less chaotic and stressful environment for senior patients while optimizing their discharge to the most appropriate and safe environment.
Intermountain Health Good Samaritan Hospital is a community-based, acute-care hospital in Lafayette, Colorado. Intermountain Health is a nonprofit faith-based health system with hospitals in two states. At Intermountain Health Good Samaritan Hospital, we are happy to tell you about us: our compassionate caregivers, our clinical excellence, our award-winning care and even our beautiful campus. But its really all about you. Our patients and families are the center of every thought, communication and action that takes place in this healing space.