“What We Don’t Know We Don’t Know” in Health Care: Oral Care, Monitored Meals, and Aspiration Pneumonia

Since the start of the year, you may have noticed an uptick of fad diets. Maybe its 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 doesnt. 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 Healths Denver Midtown Clinic - Weight Loss Center, we turned the studys 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 its what you will stick to!Whether youre a seasoned diet tryer, or just dipping your toes in heart-healthy waters, theres important information for everyone.Tier 4: Paleo Diets and VLDC/Ketogenic DietsStarting 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: Very Low-Fat Diets and Low-Carbohydrate DietsTier 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.Tier 2: Vegan Diets and Low-Fat DietsVegan 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 youre 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 its 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.Tier 1: DASH-Style, Mediterranean, Pescatarian, and Ovo/Lacto-Vegetarian DietsStarted from the bottom, and now were here with Tier 1s DASH-Style, Mediterranean, pescatarian, and ovo/lacto-vegetarian diets. Its the pinnacle of heart-healthy eating, where the nutrients shine.Well start with the Dietary Approaches to Stop Hypertension, or DASH, diet. By the name alone, you might infer this diets 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 diets 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 youre 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. Its 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. 

Youve heard it before, but since its American Heart Month, well say it again. Heart disease is the leading killer of U.S. adults. The number one cause of death is a frightening number, so heres a new number: 10. Knowing these 10 heart health risk factors, and how to manage them, can save your life.To understand your personalized heart health risk better, check out our online quiz. Or read along and learn the key to a healthy heart from our Intermountain Health caregivers.Maintaining a healthy heart is the cornerstone of overall well-being, as the heart serves as the engine of our body, said Carlos Albrecht, MD, an Intermountain Health cardiologist at St. James Healthcare.1. Family history/geneticsUnderstanding your family's medical history is vital for anticipating health risks. Genetics play a significant role in heart-related issues. After speaking to your primary care provider about your family history, minimize any risks with lifestyle changes.2. SmokingSmoking (including second-hand smoke) deteriorates the cardiovascular system, increasing the likelihood of heart-related issues. This includes traditional cigarettes, e-cigarettes, and vaping nicotine. Your primary care provider can help create a quitting plan.Viet Le, PA-C at Intermountain Medical Center, warned against smokings consequences. Cardiovascular disease and smoking do not mix, he said. It is the highest risk for death and highest risk for cardiovascular events.3. High blood pressureConsider high blood pressure a silent threat with serious consequences. While it often coincides with other risk factors, hypertension is the biggest indicator of heart disease. If your blood pressure is consistently higher than 130/80, consult your primary care doctor.4. Unhealthy dietA diet high in processed and unhealthy foods has direct implications for heart health. Opting for a diet rich in fruits, vegetables, and whole grains supports cardiovascular well-being. Need heart healthy dish ideas? Check out this Intermountain dietitian cookbook.According to Dr. Albrecht, a balanced diet plays a pivotal role in persevering cardiovascular health and reducing the risk of heart disease. "Just as a well-maintained engine ensures the smooth functioning of a vehicle, a healthy heart is crucial for optimal physical performance and longevity, he said.5. High cholesterolCholesterol is a waxy substance produced by the liver, but its also in foods like meat, poultry, and dairy products. Too much cholesterol can block your bloods circulation, so keeping your cholesterol levels low mitigates heart-related complications. Your primary care provider can order a blood test to obtain your cholesterol level, and help you address the results.6. DiabetesDiabetes introduces a layer of complexity to heart health. Unfortunately, diabetes and heart disease risk often coincide. According to the CDC, those with diabetes are twice as likely to have heart disease or a stroke than those without diabetes. Make a plan with your primary care provider to address your diabetes and minimize heart risk with lifestyle changes.7. Physical inactivityInactive lifestyles contribute to a range of heart-related issues, such as obesity and high blood pressure. Incorporating routine exercise is a great way to minimize these heart-related issues, and keep you feeling healthy.Make sure that youre being active, Le said. The American Heart Association says 150 minutes a week of moderate aerobic activity. That sounds like a lot, but you break it down, its 30 minutes, five days a week. And you can even break it down into 10-minute segments.8. ObesityExcess weight puts strain on the heart, impacting its efficiency and longevity. Everyones ideal body weight varies by person, so talk to your primary care provider about your Body Mass Index (BMI). A BMI calculator evaluates if you have an ideal BMI between 18.6 and 24.9.9. Not enough sleepAdequate sleep is a non-negotiable aspect of overall health, including heart health. According to the American Heart Association, adults need 7-9 hours of sleep each night, and children require eight to 16 hours, depending on their age.Enough sleep improves your bodys brain function, immune system, mood and energy, and reduces your risk of chronic disease.10. Too much stressHopefully reading these risk factors hasnt caused stress. Stress can contribute to high blood pressure, among other factors. Managing stress levels helps maintain overall cardiovascular well-being. Your primary care provider can introduce stress-reduction strategies, such as exercise, meditation, and breathing techniques.Maintaining the de-stressors in your life is important. It takes intention. It takes planning, said Le. Give yourself the gift of the present by knowing you can effect change.In the realm of heart health, knowledge is power. Harness this power by understanding your unique risks, regularly visiting your doctor, and taking on heart healthy lifestyle changes. Each choice you make contributes to your cardiovascular well-being.Prioritizing heart health is not just a choice, said Dr. Albrecht. It is a commitment to a vibrant and fulfilling life. 

Note: this is not medical advice and should not replace a discussion with your own treating physician. This document was created after compiling helpful over the counter and home remedies from patients and colleagues.Winter is a beautiful time of the year, but it also brings along various illnesses. With the constant change in temperature and dry air, it's easy to catch a cold or flu. However, being sick doesn't have to be miserable. Here are some tips to help you through your winter sickness.First off, make sure you are getting enough rest. Your body needs time to fight off the illness, so getting plenty of sleep is essential. Drinking lots of fluids is also crucial to staying hydrated. Warm liquids such as tea or soup can help soothe your throat and loosen congestion. Second, take over-the-counter medication to relieve your symptoms. Decongestants can help relieve nasal congestion, and pain relievers such as acetaminophen or ibuprofen can help reduce fever and body aches. However, be sure to read the instructions carefully and consult with a doctor if you have any doubts.Lastly, try to avoid spreading your illness to others. Cover your mouth and nose when you cough or sneeze, and wash your hands frequently with soap and water. Stay home if you're feeling unwell to prevent spreading the illness to others, and mask up if you need to leave the house. Reminder that we are fortunate enough to have vaccinations against flu, COVID and RSV which cause significant respiratory illness.In conclusion, being sick during the winter can be tough, but with plenty of rest, hydration, and medication, you can make it through. Ive gathered up some of the most common remedies used by myself, my patients, and my followers on social media and shared them below. Remember to take care of yourself and stay warm during the chilly winter weather.  Straight Off the ShelfNote: if you take other medications, its important to talk with your physician or pharmacist about how these over the counter meds may interact with your prescribed meds       Cough o   Vicks Vapo Rub on the chest and bottoms of feet o   Coricidin (good for those with cough and high blood pressure) o   Delsym Cough Medicine: dextromethorphan containing cough meds help with cough suppression, for dry coughs o   Mucinex: guaifenesin containing meds help to loosen up mucus in your though to help you cough it up, for wet coughs o   Sudafed: pseudoephedrine is a decongestant and can make you pretty wired/awake. caution if you have high blood pressure o   Dimetapp for kiddos 6 and older       Congestion/sore throat o   Afrin nasal spray: temporary congestion relief o   Flonase nasal spray: great for post nasal drip that causes sore throat o   Saline nasal rinses       General cold/flu symptoms o   Dayquil/Nyquil: remember, these contain acetaminophen aka Tylenol. so dont mix with additional tylenol unless instructed by your physician Know your meds! acetaminophen is also known as Tylenol; ibuprofen is also known as Motrin and is the same class of medications as naproxen aka Aleve  Home/Herbal RemediesNote: if you take other medications, its important to talk with your physician or pharmacist about how these remedies may interact with your prescribed meds      Nin Jiom Pei Pa Koa-Chinese herbal throat and cough syrup       Green tea       Ginger tea       Boom boom inhaler stick       Lemon, honey, and chamomile tea       Sleep      Epsom salts baths       Oscillococcinum       Black elderberry syrup       Raw garlic with honey       Mullein tincture       Electrolyte rich drinks like liquid IV, LMNT, pedialyte-- monitor sugar content       Fermented foods       Reishi       Ashwaghanda       Foods high in vitamin C (citrus!)  Soothing Tea RecipeIn a saucepan, bring the following to a boil, then remove from heat and enjoy: tips and enjoy:       8 oz water       1 tbsp apple cider vinegar      1 tbsp honey       1 cinnamon stick       1 clove of peeled and smashed garlic       small piece of peeled ginger             Tips & Tricks From a PCP:      after a viral infection, cough can last 4-6 weeks in some cases. if you have fever with the cough or its getting worse, talk with your doctor as it could indicate a bacterial infection       never underestimate the power of sleep and resting your body       a fever is technically a temperature over 100.4 degrees F       the symptoms of COVID, flu, and RSV overlap significantly. getting tested for these infections may be helpful in determining if you need further intervention       your gut health is key to your immune system. you may not be able to fully prevent getting sick, but a healthy mind and body will help you with resilience and recovery. focusing on fiber, mindfulness, sleep and regular exercise can help your gut stay strong!       most viral infections last about 5-7 days. but if you are experiencing shortness of breath, chest pain, high fevers, difficulty swallowing, dizziness, or wheezing, contact your physician immediately