Timi Gustafson, R.D.

This is Part 4 of a series of articles dedicated to heart health by Timi Gustafson RD.

There are many myths and false assumptions about sex after a heart attack or stroke. In truth, most survivors can safely resume a normal sex life after a reasonable period of recovery. While it is not advisable to have intercourse right after surgery, there is no reason to remain abstinent for weeks and months, unless there are other complications involved.

Understandably, patients and their partners can be hesitant to engage in sexual activity in the wake of a serious illness, fearing that the physical requirements of lovemaking may be too strenuous or cause more damage. An open conversation with a trusted physician or therapist can be helpful to separate facts from fiction.

Besides being apprehensive of another catastrophic event, heart patients may avoid sex or lose interest because they are too preoccupied with their situation to enjoy sexual pleasures. Some are saddened and depressed. Others develop a negative image of their own body. They may feel “incomplete” and unable to live a full life. Negative emotional responses like these are to be expected and should be considered as normal – for some time.

Most cardiologists encourage their patients to have sex as soon as they feel up to it. Sexual activity promotes physical fitness, not unlike other forms of exercising. In addition, sex (especially good sex) makes people happy and relaxes them, and happy people tend to heal faster.

There are, of course, a few extra precautions heart disease patients should take before returning to a normal sex life. Continued medical monitoring and frequent cardiac fitness tests are strongly recommended, even after apparent recovery.

Wanting to have sex again can also be a strong incentive for heart patients (and anyone else for that matter) to adopt a healthier lifestyle – including weight loss, heart-healthy eating, exercising, etc.

Heart disease and erectile dysfunction (ED)

For men, heart disease can be a cause for erectile dysfunction (ED), but ED can also be an indicator for cardiovascular problems. The reason is that the (much smaller) arteries that go into the penis can clog up – and when they do, there is a good chance that the arteries that go into the heart are similarly affected. That is why men who experience ED due to clogged arteries often suffer from high blood pressure as well. Smoking, in particular, contributes to both heart disease and to ED.

Certain medications are known to interfere with the ability of men to have sex after heart disease. For example, “beta-blockers,” which are prescribed to treat irregular heartbeat and to lower blood pressure, can cause erection problems. Heart patients who wish to use drugs against ED, like Viagra® and Cialis®, should definitely consult first with their physician to avoid sabotaging the efficacy of their heart medications. Men who take nitrates for angina (tightness in the chest) should exercise great caution, because a sudden decrease of blood pressure has been observed to occur when nitrates are combined with certain ED drugs.

Recovery may take time and patience

Any brush with a serious and sometimes life threatening illness leaves its mark. Overcoming fears of relapse and regaining one’s confidence are essential for the healing process to take hold. A great deal of patience with oneself and others is part of that.

If lack of interest in sex persists to the point where a couple’s relationship gets affected, some outside help in form of professional counseling may be in order. There are a number of ways heart patients and their partners can prepare together for the revitalization of their sex life. It is important for both not to put any unnecessary pressure on themselves and each other, for instance by setting arbitrary goals or by creating unreasonable expectations. Instead of worrying about performance, the primary focus should be on intimacy and reconnection. Even the terrifying experience of a serious health crisis can bring us closer together with loved ones and make us value each other more consciously.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

This is Part 3 of a series of articles dedicated to heart health by Timi Gustafson RD.

A better way to eat

Many heart disease patients are confused and uncertain about their dietary requirements. In truth, heart healthy eating does not have to be complicated. In fact, meal plans for heart patients can be easy and quick to make, and they don’t have to be bland and boring. In most cases, a few simple adjustments in your pantry and smart cooking techniques can make all the difference.

For detailed guidelines to heart healthy eating, go to Eating Lighter – Eating Smarter, a program that offers easy to follow meal plans for heart patients and everyone interested in a heart healthy diet.

Recipes for everyday heart healthy eating

Choosing quality ingredients and applying the right cooking techniques are a must for health-conscious meal preparation. Start by reducing or eliminating “empty” calories and unnecessary fat content from your meals. The trick is to accomplish this without taking away from the tastes and textures you love. If your diet bores you and leaves your taste buds out in the cold, you will not stick to it, no matter how beneficial it may be to your health.

It is a good idea not to depart right away from the eating habits you are accustomed to. Instead of introducing unfamiliar food items, try to modify the ones you always eat. Start with your favorites. If you never liked seafood all that much, don’t force yourself to eat fish, because it’s better for you. If you are more the “meat-and-potato” type, don’t give up eating what you like best. Instead, you can pick leaner meat cuts and learn lighter cooking methods. If necessary, cut back on your portion sizes. Make healthy ingredients, like vegetables and salads, your largest servings.

There are plenty of options you can explore to make your favorite meals more healthful and keep them tasty as well. For detailed guidelines to healthy meal modifications, go to Modified Recipes.

Eating out

Even the most radical “health nut” must be able to go out and have some fun. Dining out should be a pleasurable experience, unspoiled by guilt and regret. True, in most restaurants you have not much control over the chef’s cooking style – although you may ask for certain modifications, like lighter salad dressing or the omission of some ingredients. For this reason, you may want to patronize places where your wishes are readily accommodated.

It is also helpful to learn a little bit about the “restaurant lingo” commonly used in menus. Even the most detailed meal descriptions make no sense if you don’t know what they refer to.

Before you go to the restaurant of your choice, have a plan ready – a “dining out strategy,” if you will. Being prepared can help you maintain your willpower, and you won’t so easily give in to temptations. Part of that strategy is not to arrive too hungry.

For more tips to eating out, go to Dining Without Reservations.

Diet plans designed for heart health

The word “diet” is mostly associated with weight loss. While weight control is an important part of most dietary programs, there are also plans with primary focus on heart health. Two of these got a great deal of attention in recent times: One is called “Dietary Approaches to Stop Hypertension,” better known by its acronym “DASH” diet; the other is named the “Mediterranean Diet.”

The “DASH” diet

“Dietary Approaches to Stop Hypertension,” or DASH diet, is the brainchild of the National Institute of Health (NIH), a United States government health organization. The DASH diet is based on the NIH’s guidelines for the dietary treatment of hypertension and heart disease.

The DASH diet compiles meal plans that are dominated by fresh produce and other plant-based food products. The benefits of dietary fiber, potassium, calcium and magnesium are also emphasized. Animal protein is included in this diet but should be limited to reduce cholesterol. Non-fat or low-fat dairy products are recommended if consumed in moderation. Warnings are given about excessive intake of fat, sodium (salt) and sugar.

The Mediterranean diet

Despite of its name, this diet does not represent all (or even most) of the culinary cultures that developed over hundreds of years around the Mediterranean Sea. The most commonly known and practiced version in America was introduced by a Harvard professor in the mid-1990s. Its dietary principles are based on food patterns traditionally found in Greece and the southern parts of Italy.

The Mediterranean diet places great importance on fresh, natural ingredients and lean cooking methods. Vegetarian dishes dominate. Animal protein comes from fish and (to a lesser extent) poultry. Lean meats, i.e. lamb, are included but reserved for special occasions. Dairy products, especially cheese, are common staples. Olive oil is the principal source of fat and is used for cooking, salad dressing and as a dip.

Even wine is considered an important component of the Mediterranean diet. While the health effects of wine have been debated for years, there are strong indications that moderate consumption of red wine can be helpful in promoting heart health.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

Who would have guessed that nutrition labels could serve as a political football. We are talking about the fine print on the backside of the bags, boxes and cans our food comes in.

Now that the Food and Drug Administration (F.D.A.) is trying to introduce a new national food labeling program, politicians and interest groups from all sides jump on the bandwagon, offering their advice how to go about the project.

So far, government officials from twelve states have petitioned the F.D.A. to demand “complete and unbiased nutritional information from food manufacturers, whether good or bad.” This, they say, will empower consumers to make better-informed choices about the foods they purchase. Somebody shout “Amen!”

For quite some time now, food manufacturers and restaurant operators have been pressured on both federal and state level to be more open about the nutritional quality of their products. Yet, we are still far away from any meaningful consensus.

For example, a legislative effort to introduce tougher restrictions on food advertising to children has quickly become stalled in Congress, which makes further progress uncertain. In the meantime, a group of food manufacturers and advertising agencies have tried to come up with their own labeling program, which they proclaim will help fighting childhood obesity. They named it “The Children’s Food and Beverage Advertising Initiative.” Based on certain nutritional criteria, they then began to advertise a number of products as “healthy choices” for children. An official seal of approval was to be awarded for foods and beverages that met the “new” requirements. Surprisingly (or not), the items that made the cut and were certified as “healthy choices,” included sugary cereals, frozen dinners and notoriously fatty fast food items. Even defenders of the campaign admit that the industry could have been more discriminating in its selection.

On the other hand, when Congress asked a number of government agencies, including the Food and Drug Administration (F.D.A.), the Agriculture Department (U.S.D.A.) and the Centers for Disease Control and Prevention (C.D.C.), to draw up a set of guidelines for food advertisement to children, their recommendations were quickly dismissed by food manufacturers as “unrealistic.” The Association of National Advertisers said that compliance with those guidelines would “virtually end all food advertising as it’s currently carried out to kids under 18 years of age.” In other words, no deal.

Although I support the new attention nutrition labels are getting from all this back and forth, I seriously doubt that improved label designs will lead to better eating habits on a large scale. In a recent study, published in the Journal of the American Dietetic Association, researchers learned that only slightly more than half of American consumers check nutrition labels regularly, and only 44% say that nutritional data and ingredients have any influence on their purchasing decisions.

Statistics like these may be disappointing, but they are to be expected. Nutrition labels in their current form are not user-friendly. In many cases, they are outright misleading. For instance, most of the relevant data, like calories, fat, cholesterol, sodium, sugar, etc., are measured according to portion sizes – which are often determined arbitrarily.

What we need are radically different ways in which nutritional facts are disclosed and communicated to the public. Most importantly, the product information consumers are given must be more intelligible, truthful and relevant.

If both government agencies and food manufacturers are really interested in combating obesity and improving public health, especially on behalf of children, they will have to do better than simply print new labels. But hey, perhaps it’s a start.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

Obesity remains on the rise everywhere in America, and especially in the southern parts of the country. Two thirds of our population is now overweight to some degree and one third is considered obese.

According to a recently released report by the Centers of Disease Control and Prevention (CDC), based on a continued state-by-state survey, titled “Behavioral Risk Factor Surveillance System,“ obesity rates have nearly doubled since these studies were initially conducted some 16 years ago.

Obesity is measured by the body mass index (BMI). A person with a BMI of 30 or higher is diagnosed as obese. Someone who is a 5’8” tall and weighs 200 pounds, for example, has a BMI of 30.4. The definition can vary for athletes, pregnant women and also for children, depending on their age and gender.

Although obesity rates are up in every part of the population, there are observable racial differences, with more African Americans, Native Americans and Hispanics being affected than Caucasians. Age also seems to matter. Americans tend to become heavier after the age of 50.

More significant, however, are geographical differences. The states with the highest percentage of obese residents, 30% and over, are almost all in the south. Researchers say that culture and lifestyle may play a role, but also education, income and availability of food resources. Some point to the so-called “grocery gap,” that is the lack of availability and affordability of nutritious foods, like fresh produce, in low-income urban neighborhoods and poor rural areas.

Another massive obstacle is health education, or rather the lack thereof. Large parts of the population are simply ignorant or confused about the basic facts of healthful nutrition. Let’s face it; we have a persistent health illiteracy in this country.

If we are to expect people to improve their eating- and lifestyle habits, we must come up with better, more user-friendly ways to educate them. Many health books are too academic. Diet programs are expensive and promise more than they deliver. Nutrition and ingredients labels are difficult to decipher (perhaps on purpose) and don’t help to make better choices.

It is also futile to call for more physical exercise when neighborhoods are unsafe and parks are closed because of budget cuts. Schools are regularly forced to eliminate physical education (PE) from their curriculum, and poor communities can’t afford public pools and sport facilities.

Government-sponsored initiatives and national campaigns – like Michelle Obama’s “Let’s Move” program to reduce childhood obesity – could be a good start. But they are insufficiently funded and rarely reach those who need them the most.

What we really need is a mandatory national health literacy program in all public schools, to be taught across all grade levels. The “Edible School Yard” project of Alice Waters in Oakland, California could serve as an initial model. The kids who participate in this program not only learn how to grow foods and vegetables – even in the midst of an urban environment – and how to prepare wholesome meals from scratch, they also discover and appreciate the benefits of healthy living from early on, which will hopefully serve them well for the rest of their lives.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

This is Part 2 of a series of articles dedicated to heart health by Timi Gustafson RD.

Not all people are equally at risk of developing heart disease. Some are naturally less vulnerable through their genetic make-up. Many more stay healthy by practicing a health-conscious lifestyle. A close connection between lifestyle and heart health is supported by the fact that people who are less likely to suffer from heart disease have similar profiles:

Maintaining a healthy weight range

Staying within a healthy weight range is crucially important. High amounts of body fat force the heart to work harder. Triglycerides and LDL (a.k.a. “bad cholesterol”) become elevated and HDL (the “good cholesterol”) decreases. Blood pressure rises and Type 2 diabetes is likely to develop. If you have problems maintaining a healthy weight range, this is where you should start improving your health. (For more information about weight loss and weight management, go to “Succeeding at Weight Loss.”)

Maintaining HDL cholesterol levels over 40 mg/dl

HDL, the “good cholesterol,” helps cleaning blood vessels from plaque that accumulates there over time. Your lab tests should show HDL level over 40 mg/ dl to ensure the health of your blood vessels.

Keeping blood pressure low

High blood pressure is often called “the silent killer,” because it can lead to sometimes fatal heart attack and stroke without showing any prior symptoms. People who are overweight or obese should have their blood pressure closely monitored, even if they don’t experience any particular symptoms. A “normal” reading of blood pressure is 120/80 mm Hg or less (millimeters of mercury).

Maintaining normal homocysteine levels

Homocysteine is an amino acid found in the blood. If elevated, it is an indicator for increased risk of heart disease. Certain vitamins can help the body eliminate homocysteine, like folate, vitamin B6 and vitamin B12.

Not smoking

Besides poor eating habits and long periods of stress, smoking is one of the leading causes of heart disease. Smoking has the potential to lower HDL (“good cholesterol”), raise LDL (“bad cholesterol”) and elevate blood pressure. You have heard this many times before, but it can’t be emphasized enough: If you don’t smoke, don’t start! If you do smoke, do everything you can to quit as soon a possible!

Drinking alcohol – if at all, only in moderation

Consuming alcohol in moderation may have certain health benefits. “Moderate” drinking means two drinks for men and one for women per day. One drink equals 12 fl. oz. of beer, 5 fl. oz. of wine or 1.5 fl. oz. of distilled liquor. If a little is good, more is not better. In fact, “binge drinking” (having multiple drinks) can be dangerous. Besides the usual effects of drunkenness, excessive drinking may cause liver damage and contribute to obesity, high blood pressure, triglyceride elevation as well as the risk of heart failure and stroke.

Eating a diet low in saturated fats

Reducing saturated fats in one’s food is an important component of a heart-healthy diet. This means consuming less fat from meat and dairy products as well as from tropical oils, like palm oil and coconut oil. Better choices are fish, lean meats and poultry and nonfat or low-fat dairy products. All of these are rich sources of protein with lower fat content.

Eating a diet low in cholesterol

Dietary cholesterol is only found in animal products. A diet rich in red meat, liver, egg yolk and certain seafood, like lobster, shrimp, squid and caviar, can increase cholesterol levels in the blood. Over time, cholesterol can accumulate and cause narrowing of blood vessels, which can lead to atherosclerosis, also referred to as “hardening of the arteries.”

Limiting dietary sodium (salt)

Sodium is a major cause of high blood pressure, mainly because it is present in most processed and packaged foods. Moreover, eating large amounts of salt can interfere with the effectiveness of blood pressure lowering medications. Even healthy adults should limit their sodium intake to 1,500 to 2,300 milligrams (mg) a day or less (one level teaspoon of table salt equals 2,300 mg sodium.)

Eating a diet rich in fruits, vegetables and whole grains

A diet rich in fresh produce and whole grains, but low in fat, sugar and salt, is generally considered to be “heart healthy.” Fruits, vegetables, whole grain breads and brown rice contain antioxidants and phytochemicals, both of which are excellent promoters of heart health. They also provide soluble and insoluble fiber, which helps with the removal of toxins.

Eating a diet rich in soluble fiber

Fiber is the non-digestible part of plant foods. There are two types of fiber − soluble and insoluble – and they function very differently. Soluble fiber helps to lower LDL (“bad cholesterol”) and blood sugar levels. Soluble fiber is found in oats, dried beans and peas, barley, rice, and all fruits and vegetables.

Eating seafood and fish oil

Fish, especially the deep-sea fatty kind, like salmon and tuna, is a source of omega-3 fatty acids, which is an important component for lowering triglycerides and LDL (“bad”) cholesterol. Regular intake of fish oil also reduces the risk of blood clots forming and inflammation. If your diet does not include seafood in sufficient amounts, it is advisable to take a daily dose of fish oil in form of supplements.

Managing stress

Not all stress experiences are bad. Sometimes, stress can be invigorating, even addictive, depending on the situation. But often, stress is anxiety provoking. When people are continuously exposed to high levels of negative stress without relief, high blood pressure can develop as a result, which eventually can turn into a chronic condition. Smoking, drinking or mindless eating to cope with stress only add to the health risks.

The best way to manage stress efficiently is through physical exercise. Stress is a natural response to threats, which is also known as the “fight-or-flight-syndrome.” It is meant to help us survive in dangerous situations, either by defending ourselves or by way of escape. To facilitate either one, the body releases a powerful hormone called adrenaline. Short term, this is a great asset. But long term and without relief, this state of heightened alertness can become a serious health hazard. Rigorous physical exercise simulates best the natural fight-or-flight response and therefore diminishes the negative effects.

Being pro-active − Post-menopausal women

Pre-menopausal women have a lower risk of developing heart disease, because of the natural estrogen hormone their ovaries produce. By contrast, post-menopausal women and women who have had their ovaries surgically removed, no longer have the protection of estrogen and may encounter the same risk factors as men.

Making daily exercise a priority

Equally as important for good heart health as all dietary guidelines is a regular exercise regimen. We all have heard this time and again: A sedentary lifestyle is not healthy. Our bodies need to move. Yet, despite of better knowledge, most people do not get enough exercise on a regular basis. Exercising raises HDL (“good cholesterol”) and lowers mildly elevated blood pressure. It also improves circulation, strengthens the heart, helps with weight control and reduces stress.

Many people blame “lack of time” for not exercising enough. To all those I would say, you must get your priorities straight. Regular exercise makes you physically fit and gives you more energy. On the other hand, neglecting your body’s need for activity will eventually lead to serious health problems.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

This is Part 1 of a series of articles dedicated to heart health by Timi Gustafson RD.

Taking care of their heart’s health is not on most people’s mind – at least not until they run into problems. But when disaster strikes − like a heart attack at middle age − and there is a serious brush with loss of health and perhaps life itself, we realize the importance of keeping our heart healthy. By then it may be too late. It doesn’t have to come this far.

In a way, our bodies are designed to keep us in the dark about our true vulnerabilities. Especially when we are young, we tend to believe we are practically invincible and able to endure all sorts of abuse. We think we can get away with overeating, binge drinking, smoking, drug use, high level stress and sleep deprivation. For a while, that may hold up, but not forever. Over time, our bodies’ natural resilience diminishes and the consequences of our actions begin to show.

Of course, it is a “fact of life” that health problems come with age and growing older inevitably leads to physical decline and deterioration. But when we look at the most common diseases people suffer from today, they often turn out to be lifestyle-related – which means, they would be perfectly preventable.

Take heart disease. According to the Centers for Disease Control and Prevention (CDC), heart disease remains year after year the number one cause of deaths in America. Over 26 million Americans, roughly 12 % of the population, have been diagnosed with the disease in 2007 (the latest available data). The vast majority of all cases are lifestyle-related. The leading factors contributing to heart disease are poor eating habits, weight problems, lack of physical exercise, stress, anxiety and sleep deprivation. All of these derive from our behavior, not our nature. The good news is that we can make changes and turn this dismal situation around, if we choose to.

It is never too early to begin a heart-healthy lifestyle

Heart disease is not an illness that occurs suddenly. Heart disease develops over time and mostly by our own doing. In every stage of life, from early childhood on, steps should be taken to protect the heart. They include maintaining a healthy weight range, a wholesome, balanced diet, regular physical exercise, stress reduction, sufficient sleep as well as avoidance of drug and alcohol abuse.

There are also specific concerns and recommendations for different age groups to be considered.

Infants and Toddlers

The health needs of infants and toddlers are quite different from other age groups. They undergo phases of rapid growth and use up large amounts of calories, protein, fat and other nutrients. The optimal growth of the brain, nervous system, musculature, bones and other body organs depends on sound nutrition. Brain development, in particular, depends on fat. During the first two years of life, the brain grows faster than any other organ. Limiting fat in an infant’s diet can compromise the healthy development of the brain and the nervous system.

Fat is also a good source of concentrated calorie supply, which is needed for fast body growth. Because the amount of food a little stomach can handle is limited, fat is an important booster. But not all fats are equally beneficial. Preferable are “heart healthy” plant-based fats from olive-, canola- and avocado oil.

The nutritional quality of all foods infants and toddlers receive matters greatly. Young children are more vulnerable to pollutants, toxins and chemicals than adults. So-called “empty calories” from nutritionally poor foods should be avoided as much as possible.

Despite the risk of childhood obesity, calorie restriction is not warranted this early in life. This is not the time for dieting and fasting. Parents should not withhold food out of fear to bring up a “fat baby.” Feeding struggles between adults and babies can cause future problems with eating disorders in later years. This also holds true for the flip side. Pushing babies consistently to eating beyond their natural appetite can set the stage for a lifetime of overeating.

Generally speaking, the nutritional guidelines for infants and toddlers should be focused on growth and development support only. What happens nutritionally at this time in their lives forms the foundation for all that is to come in the way of their human potential.

Parents should be aware they are making an important investment in the health of their children by giving them the nutrition their young bodies require for a healthy start.

Children should be introduced to a vast variety of foods from early on to build their palate and develop their preferences. Wholesome foods, like fresh organic fruits and vegetables, should dominate their diet as soon as possible.

There are many ways to direct children towards healthy eating habits, which will hopefully serve them well for the rest of their lives. Bribery and punishment are not among them. Teaching by good example is a better approach. Young children learn mostly by imitation. If parents and older siblings adhere to healthy eating habits, the younger ones will adopt these more easily.

Children

The American Heart Association (AHA) recommends that children between the age of three and ten should be exposed to a diet that promotes heart health and reduces the risk of chronic diseases in the future. Eating- and lifestyle habits formed during childhood are expected to be more persistent than those developed during adulthood.

Between the ages of three and ten, children should be given reduced fat products to minimize animal fat intake. Sources of lean protein, like fish, skinless chicken breast and meats trimmed of fat, are preferable to their fatty counterparts, like burgers, hot dogs and processed lunch meats. Foods with high amounts of sugar or salt as well as fried items should be served as little as possible. The American Academy of Pediatrics (AAP) recommends an upper limit of saturated fat intake of 10% of total calories and 300 mg cholesterol for children per day.

By contrast, a rich supply of varied fruits, vegetables, legumes and whole grains should be included in most meals.

Childhood obesity has become a serious health risk factor today, and it is only getting worse. Unhealthy diets combined with sedentary lifestyles continue to foster this trend. Better food choices at home and in schools are necessary to turn the tide. Regular exercise must be a part of every child’s day. Physical education (PE) must be brought back and made mandatory for all grade levels. Families should spend more time on sports and outdoor activities than watching TV and playing video games. Parents are not helpless and children don’t have to be victims, if we choose to make the necessary changes.

Teenagers

Teenagers and young adolescents experience many profound changes in their lives, including dramatic growth spurts. Their nutritional needs alter accordingly. In fact, right before puberty, teenagers have the highest nutritional demand since infancy. The bodies of older teenagers and adolescents face the same risk factors for disease as young adults.

Social and lifestyle influences are most significant at this time. Parents find their influence fading as their kids start making their own choices. Teenagers tend to skip family dinners and rather go out with their peers. Frequently, home cooked meals are replaced with fast food and snacks. If fast food restaurants become the primary food source at this age, there is a great risk for nutritional imbalances and deficiencies that can jeopardize healthy growth and development.

This is the time where a lot of risky behavior comes into play. Experimentation with tobacco, drugs and alcohol is not uncommon, which can cause serious lasting health damages.

Obesity is on the rise at alarming rates in this age group as well. Today’s teenagers and adolescents are facing weight problems in numbers we have never seen before. Diabetes and heart disease are widespread and seem to occur earlier with every generation.

More and more young adults are also diagnosed with atherosclerosis, which is plaque building up inside their arteries. The arterial blockage can begin during childhood and progress throughout adolescence. High levels of blood cholesterol are associated with this disease. Children who have high cholesterol early in life are likely to suffer from cholesterol-related health problems as adults.

Genetic pre-conditions also may facture in. If there is a family history of heart disease, diabetes or high blood pressure, teenagers should be regularly monitored for those diseases.

Young Adults

For young adults life can be very stressful. This is the time to lay the foundation for their careers, start a family and so on. Taking care of health issues is often not a priority. Unfortunately, many problems quietly develop and progress during these years and remain unnoticed and untreated for too long.

Especially young adults should pay close attention to their weight, diet, physical fitness, stress level and sleep. Neglecting any of these will eventually come to haunt them.

Women in particular are at risk of gaining weight and developing heart disease. Those who try balancing careers and family life often push themselves too hard – at the expense of their health. Healthy eating, exercise, stress management and sleep hygiene should be placed on the top of their priority list.

Men also fall off the proverbial wagon quite easily. At young adulthood, males are inclined to overestimate their limitations. Many are unaware of their health needs or lack the basic knowledge how to meet those. They may feel invincible now, but the bill eventually will come due. It would be better to be pro-active, while there is time.

Generally, men tend to develop heart disease sooner than women, even when they manage to stay within a healthy weight range. The risk of heart disease increases with weight gain for both sexes. The typical male weight gain pattern is more troublesome, however, because men usually store fat around the belly and the waist, which is where most of the vital organs are located. For this reason, men are more vulnerable to a number of diseases in connection with weight gain, such as atherosclerosis, elevated cholesterol, diabetes, insulin resistance and hypertension. By contrast, females store their fat more likely around the hips and are less prone to suffer similar consequences − until they get older.

Mid-Life Years

Around age 40, most adults begin to contemplate more often their own mortality. This can be a turning point, also known as the proverbial “midlife-crisis.” During this time, priorities are re-examined and commitments can change in sometimes unforeseeable ways. Boredom, loss, regrets and search for new meaning may come to the forefront.

It is also a time when good health can no longer be taken for granted. Hypertension, diabetes or climbing blood cholesterol may be noted during a routine annual physical. Some adults encounter for the first time serious health problems, which can impact the rest of their lives.

Regular physical exams and blood cholesterol screening can help identify problems early, so effective treatments can be initiated while there is time. Preventive medical attention can help reduce the likelihood of irreversible heart damage.

At this age, it is especially important to maintain a health-promoting diet as well as regular physical activity. Monitoring calorie and fat intake is a must. So is cutting back on sugar and salt. Alcohol consumption should be kept at moderate levels and smoking should be completely out of the question. There is still plenty of fun left for the middle-age crowd – they just may have to look elsewhere.

Senior Adult Years

As we get older, lifestyle changes occur naturally. However, it is important for both physical and mental health to continue a full and active life, even in retirement. Healthy aging means foremost maintaining good health for as long as possible − by eating properly and by staying fit. That includes reducing calorie intake to adjust to changes in the metabolism.

Sports and physical activities should be pursued in an age-appropriate manner. Those who have never run a Marathon before should not consider it as a retirement hobby. Accepting one’s own limitations is part of the wisdom gained with old age. Efforts to stay healthy should not so much focus on age defiance, but rather on health preservation. There is a difference.

A major concern in the senior years is the heart. Fatal and near-fatal heart attacks are more likely to occur at age 65 and older. The risk factors of heart disease are similar to those of younger people, but the damage can be more severe due to the overall aging process.

For older people who live alone, it can be difficult to maintain a heart healthy diet. Many seniors don’t know how to cook, don’t have the space for a functioning kitchen, or don’t have easy access to quality food outlets. This can be a serious problem. Nutritional deficiencies make the aging process only worse. Relatives, neighbors and friends should keep an eye on older people to keep them from becoming undernourished.

Elder Adult Years

According to the U.S. Census Bureau, in 2004, 12 percent (36.3 million) of all Americans were over 65. By the mid-century, people 65 and older will comprise an impressive 21 percent (86.7 million) of the American population. The number of people living over eighty, ninety and even a hundred years is growing dramatically year after year.

Not only physical health, but also mental and emotional health are to be considered when people live that long.

The goal now is to maintain good health in terms of mobility and independence. Staying active and involved in the life of family and community are important. Living in isolation is not healthy at any age, but it is especially devastating for the aging.

The nutritional needs of elder adults can be more difficult to meet. The digestive system has slowed down and nutrient absorption is reduced. Protein, calcium, iron, B-vitamins and a number of trace minerals may need to be increased in the diet to counterbalance the lower absorption. Nutritional supplements, like a daily multivitamin and calcium, will cover many of the gaps and avoid nutritional deficiencies. Extra protein intake with slightly larger portions of fish, lean meats, skinless poultry, beans and legumes can also help.

Care givers must be aware of the different nutritional requirements of elderly people. There is no point in serving up heavy meals or fatty and sugary foods – just because you mean well and want to give grandma or grandpa a special treat. Small and slow is the right approach and it honors the body’s natural path.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

The American Association for Cancer Research (AACR) has recently reported (in their journal Cancer Epidemiology, Biomarkers & Prevention) that taking fish oil supplements may help reduce the risk of a certain type of breast cancer. The study the report is based on involved over 35,000 women between the age of 50 and 76 over a period of two years, plus six years of follow-up. The initial results showed that participants who took regularly fish oil supplements had a 32% reduced risk for developing ductal breast cancer, the most common type, which forms in the milk ducts. (By contrast, the occurrence of lobular breast cancer in the milk glands was apparently not affected.)

The researchers who conducted the study remained cautious about their findings. Exactly how fish oil can diminish the risk of breast cancer is not altogether clear, but there is significant evidence that fish oil has certain anti-inflammatory effects. Until now, scientists only believed that fish oil can help reduce cardiovascular risks. The potential benefits with regards to cancer are a new consideration and deserve more attention.

Inflammation is a probable contributor to many forms of cancer. Omega-3 fatty acids found in fish, especially in deep sea species like swordfish, salmon and tuna, are known for their inflammation suppressing properties. Because of the high concentration of omega-3 fatty acids, the benefits from fish oil supplements may be even greater than from eating seafood. This is the main reason why a link between fish oil and a lower risk of cancer makes sense.

There are caveats, of course. Fish do not produce omega-3 fatty acids themselves – they get it through their food. Microalgae in the water are the actual makers of the fatty acids. The larger a fish species grows, the longer it lives and the higher it ranks on the food chain, the more omega-3 fatty acids it ingests and accumulates from microalgae and prey – but also higher levels of toxins, including mercury, a common pollutant in fish. Since fish oil is derived from fatty fish tissue, a higher exposure to these toxins through fish oil supplements is not out of the question. In any case, regular users of these products should look for reputable brands that are tested for safety.

Those less inclined to make fish oil a staple of their diet can still obtain most of the same benefits from a variety of other foods:

Fish, of course is your other best source of omega-3. The wild-caught varieties are generally preferable to the farmed versions, not just because of concerns over pollution, but also for the higher fat content in deep sea- and cold water fish.

Cruciferous vegetables, like broccoli, cauliflower, Brussels sprouts and kale are loaded with antioxidants, which are known inflammation suppressants. Lettuce, spinach, tomatoes and other fresh salad ingredients contain multiple vitamins and nutrients that can help dampen inflammation. So can dark-colored fruits, like cherries and blueberries.

Garlic contains natural anti-inflammatory compounds, and so do certain spices, such as turmeric and curry. Olive oil is a good source of oleic acid, which has inflammation reducing effects. If you use olive oil for salad dressings or dips, opt for a superior quality that is less processed than regular cooking oils.

The best protection against inflammation, of course, is a healthy and balanced diet. Not all, but a significant amount of inflammation is caused by unhealthy eating habits and poor cooking techniques. Only through constant research and better knowledge and understanding how our bodies work can we hope to make the right choices in defense of our health and well-being.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

The full environmental impact of the oil spill in the Gulf of Mexico won’t be known for a long time, but there is great fear that all sea life in the region will be severely affected, both by the oil and the chemicals used to disperse it. The systemic pollution of our lakes, rivers and oceans, of course, has long been of concern, and this recent disaster only adds to the stress the fish and wildlife population is already exposed to. Not surprisingly, we ourselves are bound to ingest the poisonous substances we keep releasing into the environment through our food and especially our seafood.

One of the most common pollutants found in seafood is mercury. In one survey conducted in New York City, seafood dishes from twenty restaurants and sushi bars were tested for mercury content. The results were outright alarming. More than a quarter of the tested items exceeded not only the limits recommended by the Food and Drug Administration (F.D.A.), they qualified as hazardous enough to be removed from the market by legal action. Since a federal testing program for mercury does not exist, the contamination of seafood sold in the United States remains generally unknown. But there is no reason to assume that the findings of this investigation are limited to New York.

What is mercury?

Mercury is a metal found in soil and rock, but it is also released into the air and the water, mostly through industrial pollution and waste. When mercury gets in contact with water, it forms a toxin called methylmercury, which then is absorbed over time by tiny organisms.

How does mercury get into fish?

All fish species eat these organisms, whether they live in freshwater or in the ocean. Unfortunately, mercury cannot easily be eliminated through the digestive system. Instead, it accumulates and gradually poisons the animals. Larger carnivore fish species ingest the toxins of their prey as well. Consequently, the largest and longest living fish on top of the food chain have the highest concentration of pollutants, including mercury.

What makes mercury dangerous?

There is scientific evidence that elevated levels of mercury adversely affect the nerve cells in the brain and spinal cord. High doses may also cause damage to the digestive system and the kidneys. Children are at higher risk than adults. Because mercury passes through the placenta, it can be especially harmful to fetuses. For that matter, women who are pregnant or plan to get pregnant should exercise extra caution and reduce their seafood consumption if necessary.

Not all fish has the same level of toxins

The larger a fish grows and the longer it lives, the more it is exposed to toxins. Shark, tilefish, king mackerel, swordfish and sturgeon fit in this category and should be avoided or eaten only rarely and in small portions. More recently, the bluefin tuna has also been added to the list of seafood too contaminated for frequent consumption. Moreover, wild bluefin tuna is facing worldwide extinction and may not be available for much longer if demand remains high.

Tuna cuts used in sushi generally contain higher levels of mercury than other fish species. The consumption of raw tuna should be limited to one or two pieces per week or less. Better sushi choices with regards to mercury contamination are salmon, squid, octopus, and eel. It is considered safe to eat up to 12 ounces (two servings) of cooked fish per week, such as salmon, cod, shellfish, pollock, haddock, tilapia, sole, snapper and catfish.

What to look for in fish

It is advisable to buy fish only from reputable sources. Freshness and proper storage are most important. Avoid fish that looks slimy, dried out or has blood spots and other blemishes. Reassuring indicators are clear eyes and bright red gills. Fish is highly perishable and must be kept refrigerated, even during defrosting. “Wild caught” is still preferable to farmed fish, although, it may only be a question of time until most available seafood will be farmed. Thankfully, organic fish farming methods are on the rise.

Despite of all the bad news about environmental pollution affecting our food supplies, it must be said that the health benefits of eating seafood still outweigh the downsides. Seafood is a great provider of lean protein. Specific health benefits come from fish oil, which is rich in omega-3 fatty acids. There is general agreement among the experts that including fish in one’s diet can significantly lower the risk of heart disease and stroke. In other words, seafood is an important component of a healthy diet and deserves our protection as a vital resource.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

The use of antibiotics has been common in the meat industry for a long time, not only to treat sick farm animals or to protect them from diseases, but also to foster their growth. It seems that small doses of antibiotics administered daily makes the animals gain weight faster. According to a recent report in the New York Times (6/29/2010), 70 percent of the antibiotics used in agriculture are simply for the promotion of animal growth, not to fight illnesses.

While it is not altogether clear why exactly antibiotics, like tetracycline, have this growth-enhancing effect, there is speculation that the drugs kill the natural flora in the animals’ intestines and, therefore, allow for more efficient absorption of their feed. For an industry that measures profits in miniscule amounts, any weight gain is a welcome bonus.

Recently, although not for the first time, the Food and Drug Administration (F.D.A.) has raised concerns about the use of antibiotics for growth purposes, saying that the practice may lead to health risks for humans. To be sure, the treatment of livestock with antibiotics per se is not being questioned by the agency. However, some scientists have become increasingly worried about the treatment of farm animals with the same drugs that are also applied to fight diseases in humans.

If certain antibiotics are routinely administered to animals over long periods of time, the bacteria living in those animals will eventually become resistant to these drugs. In turn, the drugs themselves may no longer be effective to treat humans with illnesses or infections caused by these bacteria.

A case in point is the controversy over an antibiotic named Baytril. This drug is widely used by poultry farmers to protect their chickens and turkeys against E-coli infections. Baytril is a sister drug of Cipro, which was developed for the treatment of humans. Both belong to the same class of antibiotics, known as fluoroquinolone, and are among the most effective drugs of this kind we have currently available. For years, the F.D.A., medical experts and consumer advocates have all warned that Baytril should not be used for agricultural purposes, because it potentially compromises the efficiency of Cipro and other antibiotics needed to treat humans.

The meat industry continues to promote the facilitation of antibiotics as an absolutely vital tool for the protection of both livestock and consumers against the threat of numerous diseases. Although there is a growing awareness among animal feed producers that spreading antibacterial resistance is a serious problem, defenders of antibiotic drug use in agriculture point out that people are already overexposed to antibiotics through medical treatment. Indeed, the World Health Organization (WHO) has repeatedly warned against the excessive prescription of antibiotic drugs for minor illnesses and infections.

The bottom line is that as consumers and as patients we are at risk of being overdosed with antibiotics by ways of food intake and medical treatment. As more bacteria become resistant to the most commonly available drugs, we find ourselves more and more vulnerable to diseases we have no means left to fight.

Already the effects are quite alarming. More than 100,000 patients die annually from infections they acquired in hospitals – caused by bacteria that have become resistant to the available antibiotics. And these people succumbed while they were under medical supervision. The total number of victims is completely unknown.

It is clear that the meat industry is not going to eliminate or reduce even the non-therapeutic use of antibiotics any time soon. According to a report released by the United States Department of Agriculture (USDA), discontinuing these drugs for growth purposes would inevitably lead to “decrease in feed efficiency, raise food costs, reduce production and raise prices for consumers.” An outright ban on antibiotics beyond disease control would cause tens of millions of dollars in annual losses for the industry, the USDA report concludes. In a word – it’s not going to happen.

The F.D.A.’s renewed demands for changing these policies will probably (again) not be successful. Of course, that is not all the agency’s fault. There is simply not enough political will to stand up to so much industrial might. However, as consumers, we can make our voices heard through our pocket books. Producers and purveyors of meat products are already beginning to take notice and are searching for ways to reduce drug use for the sole purpose of growth enhancement. Unfortunately, the only alternative we have for now is to buy organically-farmed meat and poultry – for a higher price, of course. But if the demand for organic animal farming methods keeps going up, the rest of the industry will eventually respond – or so we can hope.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com

As reported in the New York Times (7/26), genetically altered salmon is about to get the nod from the Food and Drug Administration (F.D.A.). The developer of the salmon – a company named AquaBounty Technologies – is hopeful to begin production within two to three years after final approval.

AquaBounty is confident that their salmon is nutritionally and environmentally safe and equivalent to non-engineered farmed salmon in terms of taste, color, omega-3 fatty acids, proteins and other nutrients.

Genetically engineered food products are by no means a novelty. However, surveys have shown that Americans are more concerned about genetically altered animal products than they are about engineered plant foods, which are widely used already.

The salmon in question has been given a specific growth hormone gene. The goal is not to grow a larger fish, though, but rather to speed up the growth process – thereby shortening the time needed for regular farmed salmon by half.

Critics point out that the F.D.A. approval process is being handled too secretly and without input by consumer protection groups and the general public. There are also concerns that the agency does not require specific labeling for genetically altered foods products. In fact, the law only requires identification of genetically engineered foods if they significantly differ in their “nutritional properties” from the non-engineered versions.

The term “nutritional properties” can mean something very specific – it can also be extremely vague. More importantly, we have to ask why the F.D.A. would not demand full disclosure when it comes to the quality and safety of our food. As consumers, we should be able to make informed choices and not be left in the dark. Instead, we are expected to blindly trust that industry and government act on our behalf and protect us from harm. We know better than that.

We have seen this movie many times before. For food manufacturers, it is always too expensive, technically impossible or otherwise too cumbersome to give consumers more information than absolutely necessary. Whether it’s about nutrition facts labels on packaged foods, calorie disclosure on restaurant menus or warnings against potential health hazards – there is always a big fight to be had.

It is hard to understand why it would be such an unreasonable hardship to disclose the fact that certain foods have been genetically manipulated. If these products are safe and of acceptable quality, we consumers will respond accordingly. But, at least, we should be able to make up our own minds, based on full and truthful information.

Timi Gustafson R.D. is a clinical dietitian and author of  “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog  http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at www.amazon.com