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Seniors who suffer from chronic health conditions like high blood pressure or heart disease often develop a host of other, seemingly unrelated health problems, including cognitive impairment like memory loss and dementia, according to a new study based on data collected by the National Center for Health Statistics.

For the study, the researchers analyzed the medical records of hundreds of thousands of seniors residing in assisted-living facilities and found that most had at least one chronic health condition. What was more alarming, however, was that many had overlapping ailments. While high blood pressure and heart disease were most common, nearly half of the assisted-living residents showed signs of dementia.

“These findings suggest a vulnerable population with a high burden of functional and cognitive impairment,” the authors of the study report wrote.

Many studies have suggested a link between vascular disease and dementia, particularly Alzheimer’s, said Dr. P. Murali Doraiswamy, a professor for psychiatry and behavioral sciences at Duke University’s Institute for Brain Sciences (DIBS). Therefore it may not be possible to treat dementia without treating vascular problems, he added.

But that may be easier said than done. “We don’t universally do a great job of how we treat conditions that overlap, for example Alzheimer’s and high blood pressure,” said Dr. Cythia M. Boyd, an associate professor of geriatric medicine at the John Hopkins University Center on Aging and Health, to the New York Times. “Much of the way we practice medicine is looking at disease by disease. We aren’t doing enough thinking about how to add them together and really integrate care.”

What makes things more complicated is that most doctors are not sufficiently trained in preventing or reducing lifestyle-related illnesses – not in the general public and certainly not in older patients – other than through medicating. For instance, the importance of nutrition as a part of preventive care is rarely ever mentioned in medical schools. The approximate time devoted to nutrition science over the first two years of medical education is six hours, which is clearly inadequate, according to the National Academy of Sciences. The same goes for other health-promoting measures such as exercise, especially for the aging population.

Yet many studies have provided compelling evidence that diet and exercise play a significant role for physical and mental health at any time in life but increasingly so as we age.

For example, a more recent study from Britain concluded that the so-called “Western diet,” which typically includes fried, sweet and processed foods, red meat, refined grains and high-fat dairy products, increases the risk of chronic diseases, which in turn can adversely affect both physical and mental health in later years. Eating a Western diet makes it less likely to have an ideal aging process, says Dr. Tasnime Akbaraly, a researcher at the University College of London and lead author of the study report. Conversely, making dietary improvements can yield multiple benefits in this regard.

There is also further evidence that exercise can give a boost to the aging brain. Scientists at the University of British Columbia found that older women who suffered from mild cognitive impairment could improve their memory through weight training and brisk walking.

The connections between physical and mental decline may not yet be completely understood, but it seems clear that chronic diseases play a major role in the process. While these are widespread, the encouraging news is that many, if not all, are preventable by healthier lifestyle choices.

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Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com).

Two thirds of Americans are overweight. One third is obese. Obesity and a host of illnesses related to weight problems kill more people than any other disease. Experts are scrambling to find answers for what causes the epidemic and seem to come up with new explanations every day, only to be contradicted by the next study. Unsurprisingly, consumers are confused and stop paying attention.

How is it that we are eating ourselves to death, not just here but increasingly around the world? Does the so-called “Western diet,” consisting of cheap, highly processed, highly caloric foods, make us fat? Or is it sugary sodas? Are portion sizes too big? Does the food industry turn us into addicts? Do we just not exercise enough?

So far, none of the countless studies on these subjects have had much impact in practical terms. Lobbying efforts and political gridlock are oftentimes blamed for the maddeningly slow progress. But that may not be the only reason. Some experts warn that despite of all the research, finding definite answers may prove elusive for some time to come.

“If we can find the causes of obesity, we can try to eliminate or counter them,” wrote Christopher Chabris, a professor of psychology at Union College, together with his colleague Daniel Simons of the University of Illinois in an op-ed piece in the New York Times. “Unfortunately, finding causes is easier said than done, and causes we think we see can turn out to be illusions.”

Hoping for a smoking gun that lets us clearly identify causation may not be in the cards, ever. As an example, the authors cite a study that analyzed potential connections between food advertising on billboards and prevalence of obesity in certain parts of Los Angeles and New Orleans. The study results showed that areas with more outdoor food advertisements had a higher proportion of obese people than those with fewer ads. So, there seems to be a direct link.

Not so fast, say the professors. Studies like these have a significant problem: They can show association between separate phenomena but not causation. In this particular scenario, interpretations of the findings could go in totally different directions. Even if you accept the existence of a correlation between food advertisements and obesity, you still have to consider a wide field of possible explanations. One could be that food vendors tend to invest more of their advertising budget in places where they believe food consumption is especially high. Obesity then may be an indicator that this is a good market for them. Which comes first, the chicken or the egg?

So does this mean there is no proof that food advertising influences people’s eating habits, and not necessarily in a good way? Studies like these can at best provide some indication that there may be a link, but they don’t provide evidence for causation, the professors conclude. Only the gold standard of scientific research, which is the randomized controlled trial, could prove such connections, they say. And these standards are often not achievable in the real world.

The question is what does that mean in terms of taking anti-obesity measures. Do we have to remain indolent in the face of this alarming health crisis just because we can’t pinpoint its causes with the highest standards of certainty? Food manufacturers and restaurant operators support that view. But if no compelling evidence can be had that advertising works, why would they keep spending billions of dollars every year on doing just that?

With all due respect for scientific standards, I can’t help but think that calling for more and more studies on the causes of obesity only delays critical action that ought to be taken now. We may not know whether food ads influence everyone’s eating habits, but we still can ban them from children’s programs on TV. We may never be sure whether drinking sugary sodas or consuming sweet snacks cause diabetes, but we still can stop offering them on school campuses. It may be unclear whether posting calorie counts in restaurants will make patrons order smaller portions, but we should at least give them the option, so their choices can be better informed. How many more studies and trials do we really have to conduct before we take at least a few steps in the right direction?

If you liked this article, you may also enjoy reading “How Serious Is the Food Industry About Helping in the Fight Against Obesity?” and “Obesity Must Be Addressed on Multiple Levels.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

Less salt in our food supply could save at least half a million Americans from dying prematurely over the next ten years, according to separate studies conducted at three universities, two American and one Canadian. If the average daily salt intake were to drop to 1,500 milligrams, as recommended by the Dietary Guidelines for Americans, the number of lives saved could more than double. All study results were published in the medical journal Hypertension, a publication of the American Heart Association (AHA).

Americans currently consume on average 3,600 milligrams of salt daily, mostly in form of sodium, widely used as an ingredient in processed foods. Sodium is considered a significant contributor to high blood pressure, which can lead to heart disease, heart attack and stroke, all leading causes of death in the U.S. today.

About a third of American adults, or 68 million, suffer from high blood pressure, a.k.a. hypertension, according to the Centers for Disease Control and Prevention (CDC). The condition was identified as a primary or contributing cause of nearly 350,000 deaths in the U.S. in 2008, the last time the CDC has updated its research on the subject.

Despite of these alarming statistics, there are currently no signs of improvement. Even better treatment has only shown mixed results. Less than half (46 percent) of high blood pressure patients have their condition under control, according to the CDC.

Because the salt content in processed food is already added before it reaches the consumer, there is little opportunity to make changes on an individual basis other than limiting one’s choices to fresh items like produce. This would also exclude many options in restaurants.

“Individuals can’t make this choice easily,” said Dr. Kirstin Bibbins-Domingo, professor of medicine and epidemiology at the University of California, San Francisco (UCSF), to ABC News. “So maybe we should find ways to work with the food industry,” she suggested.

The National Salt Reduction Initiative, a partnership started by the New York City Health Department that has expanded to nearly 100 city and state health organizations across the country, has been trying to get food manufacturers and restaurant operators to cut salt by 25 percent or more since 2008, the year of the organization’s inception. The current goal is to achieve a reduction of 20 percent by 2014.

Critics say that such measures are impractical and would make little difference. Public health advocates have been focusing on hypertension as if no other health threats existed, said Morton Satin, Vice President of science and research at the Salt Institute, a trade association for the salt industry, in response to the recent studies to ABC News. The association warns that low salt intake could produce its own set of health problems, especially for the elderly.

While most experts would agree that multiple factors can be responsible for the development of high blood pressure, including genetic predisposition, gender, age and other non-modifiable components, poor diet and lifestyle choices, which are modifiable and therefore preventable risk factors, usually play a much greater role. In a milestone conference on the connections between sodium intake and blood pressure, sponsored by the National Heart, Lung and Blood Institute (NHLBI), the participating scientists concluded that “an abundance of scientific evidence indicates that higher sodium consumption is associated with higher levels of blood pressure, [as demonstrated in] animal studies, observational epidemiologic studies, and clinical studies and trials.” They were also hopeful that more effective strategies could be developed to improve diet and lifestyles patterns that benefit the larger population.

If you liked this article, you may also enjoy reading: “Too Much Salt in Our Food Creates Serious Health Hazards.”

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog and at amazon.com.  For more articles on nutrition, health and lifestyle, visit her blog, “Food and Health with Timi Gustafson R.D.” (www.timigustafson.com). You can follow Timi on Twitter and on Facebook.

It shouldn’t come as a big surprise. On average, Americans are in poorer health and have shorter lifespans than the citizens of other affluent countries, including most Western European nations, Australia, Canada and Japan. Considering that close to 50 million people, almost 20 percent of the population, are without health insurance and many more with only limited access to medical services, a decline in public health would seem inevitable. Still, the findings of a recent study by the U.S. government are quite shocking.

According to the Institute of Medicine (IOM), America currently ranks at or near the bottom among the 17 richest nations in the world in terms of life expectancy and chronic diseases like heart disease, lung disease, obesity and diabetes as well as injuries and death from violence and sexually transmitted diseases.

What’s even more disturbing is that these statistics not only apply to the poor and the elderly, as experts long expected, but across all demographics, including young adults and those who can afford health care coverage.

“We are struck by the gravity of these findings,” said Dr. Steven Woolf, professor of medicine at Virginia Commonwealth University and chairman of an expert panel that was tasked with the study. “What concerns [us] is why, for decades, we have been slipping behind.”

Even first generation immigrants coming to the U.S. show negative health effects within a relatively short time due to diet and lifestyle changes. According to the National Institute of Health (NIH), obesity rates among immigrants roughly equal those of U.S.-born adults within 10 to 15 years after taking up residence here. One study found that migrants from comparatively poor countries like Mexico or Guatemala are especially prone to develop diseases like obesity, diabetes and heart problems because of dietary changes.

“If you go with the flow in America today, you will end up overweight or obese, as two-thirds of all adults do,” said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC) in an interview with USA TODAY. “Obesity is one of the few things that has gotten worse quickly. It really is a very serious health problem,” he added.

The obesity epidemic is also one of the main reasons why it is so hard to get health care costs under control in this country. It costs $1,400 more per year to treat an obese patient compared to someone who is normal-weight and $6,600 more to treat a diabetic, said Dr. Frieden.

What changed in the U.S. more profoundly than in other countries – although similar trends are now emerging worldwide – is a dramatic shift in our eating habits. We eat more conveniently prepared but highly processed foods and enjoy fewer healthy meals made from scratch. Our portion sizes have gone through the roof. We also have become more sedentary due to progressive automation in the workplace, longer commutes and lack of safe outlets for physical activity.

“What has happened is that the structure of our society has changed in ways that make it difficult to maintain a healthy weight,” said Dr. Frieden. It’s a fertile ground for the diseases we now see on an epidemic scale.

Obviously, there is not one solution that could undo all of these regrettable developments. Multiple measures will have to be put in place and made to work together. Personal responsibility is certainly part of the equation, but so are numerous other components such as better health and nutrition education for the public, further improvements to school lunch programs, reintroduction of mandatory physical education (PE), more effective safety and disclosure regulations of agricultural and food manufacturing industries, to name just a few.

The current deterioration of our public health is not irreversible. On the contrary. Most of our ailments are self-inflicted and therefore in our control if we only muster the will to address them in meaningful ways.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

Eating eggs can almost be as bad for your health as smoking, according to Canadian researchers whose findings reignited a long-standing controversy over the nutritional benefits and detriments of eggs, or more specifically, egg yolks.

For the study, which was published in the journal Atherosclerosis, a team of scientists from the University of Western Ontario’s medical school interviewed over 1,200 participants about their egg consumption as well as smoking habits, and then used ultrasound technology to measure the plaque build-up in their arteries.

Why the combination of egg eating and smoking? To give a better perspective on the magnitude of the effects of high cholesterol intake from egg yolk, a comparison to smoking appeared to be an appropriate marker, the researchers wrote in their report.

Egg yolk is well known for its high dietary cholesterol content – about 185 to 210 milligrams, depending on size. (The recommended limit is 300 milligrams per day.)

Over time, high cholesterol levels can cause plaque buildup in the arteries – as smoking does. In fact, the potential damage from egg yolk is about two-thirds as bad as that from tobacco use, said Dr. David Spence, the lead author of the study report, in a press release.

In response to the study, some critics have rejected its findings, calling the research “flawed.” As an example, Dr. Steven Nissen, chair of the Department of Cardiovascular Medicine at the Cleveland Clinic Foundation, expressed misgivings about the “very poor quality” of the study “that should not influence patients’ dietary choices.” According to Dr. Nissen, the research depended too heavily on participant’s self-reporting, which is notoriously unreliable, and other dietary and lifestyle factors were not or only insufficiently included.

Similar concerns were raised by Dr. David Frid, a cardiologist at the Cleveland Clinic. He didn’t think egg consumption should be equated to smoking, even though both can contribute to ill heart health. Smoking, he said in an interview with ABCNews.com, causes arteries to become inflamed, which can result in the build-up of plaque, however, in a different way than from cholesterol. Moreover, he said, people who like eggs, often have a preference for other fatty foods. That possibility must be taken into account as well, he added.

In defense of the egg’s reputation, the Egg Nutrition Center and American Egg Board have released a statement, emphasizing the wide range of health benefits from essential vitamins, minerals, protein and antioxidants richly provided by eggs, combined with a relatively low calorie count of 70 calories on average. Even the 2010 Dietary Guidelines for Americans recognizes eggs as “a nutrient-dense food that can be part of a healthful diet,” it says in the statement. Canada’s Food Guide also changed its recommendations to allow for higher egg consumption after the Canadian Egg Marketing Agency voiced objections to the originally proposed guidelines.

Unfortunately, this recent controversy still leaves consumers uncertain about the safety of their egg dishes. In the face of all the pros and cons, it would appear that – as it is so often the case when it comes to food – moderation is the best way to go. Discarding the yolk and eating egg whites only is one possibility. Adding healthy items like spinach, mushrooms, peppers and the likes to your omelet can help balance potential downsides. Ultimately, until the experts come to a consensus, using our best judgment is pretty much all we have.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

A growing preference for Western-style fast food in Asian and Southeast Asian countries shows already an impact on their populations’ health, and not in a good way, according a newly released study by the University of Michigan (UM).

Researchers of the university’s School of Public Health found that Chinese residents in Singapore were at a higher risk of developing diabetes and heart disease since fast food restaurant chains like McDonald’s, Burger King and KFC started setting up shop in the 1980s. Prior to that time, American-style fast food was practically unknown there and diseases like these were comparatively rare.

“What we found was a dramatic public health impact by fast food, a product that is primarily a Western import into a completely new market,” Odegaard said in an interview with the Duluth News Tribune (7/5/2012), a local Minnesota newspaper.

According to the study report, which was published online in the journal Circulation by the American Heart Association (AHA), people who consumed fast food even as little as once a week, increased their risk of developing coronary heart disease by 20 percent compared to those who never touched it. The rate jumped to 50 percent for those who indulged two to three times per week, and to 80 percent for those who went beyond that. Regular consumption of fast food also seemed to lead to a substantially higher risk of type 2 diabetes, according to the study.

Until now, there has been surprisingly little research on potential links between fast food and health risks and that was mainly focused on the United States. Andrew Odegaard, a post-doctoral researcher at UM and study leader said he wanted to look at a Southeast Asian population because of the relatively small time frame since fast food was introduced there and also because the population there is quickly becoming a hotbed for diet and lifestyle diseases similar to the U.S.

In cooperation with the National University of Singapore, the UM team analyzed medical records and questionnaires about diet and lifestyle habits of over 50,000 Chinese Singapore residents. During the study’s 16-year follow-up period, 2,252 participants developed diabetes and 1,397 died of heart attacks or heart-related diseases.

Although focused on a relatively small group, the study results could be relevant for future research in public health on a global scale. “The consumption of Western-style fast food is really growing in Asia and South and Southeast Asia, in countries where there are a lot of developing economies,” said Odegaard in the interview. [For the major fast-food chains], “this is their primary engine of growth. What the companies have going on in North America is steady, the market is saturated, but there is real growth in the growing economies.”

Critics of the report have called the results inconclusive because many of the applied data were largely based on self-reporting by participants, which is often considered imprecise and unreliable. Also, critics say that unhealthy eating habits tend to go hand in hand with other poor lifestyle choices, such as smoking, drinking and sedentary behavior. Poverty and lack of access to healthcare may also play a role. Singling out fast food as the one culprit would therefore be unreasonable.

Still, it is undeniable that the growing popularity of Western eating styles is coinciding with a dramatic increase in obesity and related illnesses in many parts of the world. Even in places like Brazil, where the government has made serious efforts to limit access to fast food in schools and residential areas to protect the public’s health, especially of children, the rates of diabetes and heart disease are going up. Apparently even some of the most stringent existing regulations don’t suffice.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

The World Health Organization (WHO) has set a number of targets for reducing so-called non-communicable diseases (NCDs) by 25 percent by 2025. NCDs are chronic illnesses largely caused by dietary and lifestyle factors. They include obesity, heart disease, diabetes, some types of cancers and chronic respiratory illnesses that combined have become the leading causes of death globally, according to the agency.

Chronic diseases account for 36 million deaths annually, over 60 percent of all human mortality. They continue to accelerate globally and are advancing across all regions, affecting all socioeconomic classes. It is expected that almost three-quarters of all deaths will be caused by chronic diseases by 2020.

Chronic diseases are defined as illnesses of long duration and generally slow progression. They are also considered as largely preventable by positive dietary and lifestyle changes.

One of the leading causes is obesity, which has doubled worldwide since 1980. Weight problems are the fifth leading risk factor for all deaths. At least 2.8 million adults die each year as a result from being overweight. In addition, 44 percent of diabetes rates, 23 percent of heart disease rates and up to 41 percent of cancer rates are attributable to weight problems. Obesity is now linked to more deaths worldwide than underweight.

Especially worrisome is the continuing rise of childhood obesity. In 2010, more than 40 million children under the age of five (!) were overweight. Almost 35 million of these live in developing countries. Most impoverished children who have weight problems are also severely malnourished.

Leading causes of unhealthy weight gain are poor diets based on energy-dense foods that are high in fat, salt and sugars but low in nutrients. A worldwide decrease in physical activity due to sedentary lifestyles, increasing urbanization and changing modes of work and transportation also plays a role.

To change the current trends, improvements must take place on several levels, according to WHO recommendations, including individual responsibility, education, social environments as well as quality and affordability of food supply. “Individual responsibility can only have its full effect where people have access to a healthy lifestyle. Supportive environments and communities are fundamental in shaping people’s choices. The food industry can play a significant role in promoting healthy diets by reducing fat, sugar and salt content of processed foods, ensuring that healthy and nutritious choices are available and affordable to all customers and by practicing responsible marketing.”

The “WHO Global Strategy on Diet, Physical Activity and Health,” which was first introduced by the World Health Assembly in 2004, calls for actions needed to support healthy eating habits and regular physical activity. The agency “calls upon all stakeholders to take action at global, regional and local levels to improve diets and physical activity patterns at the population level.” For this, an action plan was developed for the prevention and control of NCDs as a roadmap to establish and strengthen more initiatives on local, national and international platforms.

Although the targets set by the WHO are not binding and lack in many ways specificity, similar initiatives have shown some degree of effectiveness in the past. For instance in 1987, the World Health Assembly created the first “World No Tobacco Day” to draw global attention to the health effects of smoking. It is commemorated every year on May 31 as an occasion to help reduce worldwide tobacco use. In 2005, the agency released the “Framework Convention on Tobacco Control” (FCTC) with similar goals.

Tobacco use is still the second most common cause of death in the world, after hypertension, being responsible for killing one in 10 adults every year. Obviously, we have a long way to go, but progress has been made. Hopefully, WHO’s continuing efforts will increase awareness of the seriousness of chronic diseases as well.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

When Michelle Obama announced “Let’s Move,” her signature initiative to combat childhood obesity, she emphasized that major diet and lifestyle changes were not required in her view to turn this growing health crisis around. “Small changes add up,” she said. “We don’t need to totally evaporate our way of being as we know it today.” In other words, if we just cut a few calories here and there and exercise a bit more, things will be fine before long. A comforting thought.

But that may be wishful thinking, according to Mark Hyman, MD, chairman of the Institute for Functional Medicine and medical director of the UltraWellness Center in Lenox, Massachusetts, and author of several bestselling health books, including his latest, titled “The Blood Sugar Solution.” The way he sees it, we are in the middle of an explosive epidemic of obesity and type 2 diabetes that will touch almost everyone in one way or another. He does not hesitate to call it “the modern plague.”

Obesity, insulin resistance, metabolic syndrome, pre-diabetes, type 2 diabetes, heart disease, dementia and cancer are ultimately all rooted in one and the same problem: Our dismal diet- and lifestyle choices. Diagnosing and treating these diseases separately as if they were not interconnected misses the whole picture. Instead, Dr. Hyman proposes using a more comprehensive term to describe the continuum of which all these health problems are part of: “Diabesity.”

Diabesity can range from slight weight problems and mild insulin resistance to morbid obesity and severe diabetes. Because the disease is not well understood as a continuum, millions of those affected by it remain undiagnosed and untreated. As a consequence, more people all over the world die now from chronic illnesses than from infectious diseases. The real tragedy is that the causes are almost always environmental and lifestyle-related, which would make them perfectly preventable or curable through public education and enough political will to implement the necessary changes.

“This is a lifestyle and environmental disease and won’t be cured by medications,” Dr. Hyman writes. “Billions and billions have been wasted trying to find the ‘drug cure,’ while the solution lies right under our nose. Shouldn’t the main question we ask be why is this happening? Instead of what new drug can we find to treat it?”

Since most of our modern-day ailments are primarily caused by poor diet choices, chronic stress and sedentary lifestyles, as well as toxins and allergens in the environment, we must address these problems from the ground up (literally). Instead of looking for quick fixes through medication and surgical procedures, we can make many important corrections by ourselves and without delay by using the right ingredients that make us healthy again, including whole, fresh food, vitamins and minerals, water, fresh air, exercise, stress reduction, etc. “When we take out the bad stuff and put in the good stuff, the body knows what to do and creates health and disease goes away,” writes Dr. Hyman. Care for the environment is part of that, too. Here, he strongly agrees with Sir Albert Howard, who is by many considered the founder of the organic agriculture movement, when he wrote in his landmark book, “The Soil and Health,” that we must “treat the whole problem of health in soil, plant, animal and man as one great subject.”

Finding our way back to wholesome nutrition is one of the greatest challenges we face today. “In America, we eat more than we ever have, yet we are nutritionally depleted,” writes Dr. Hyman. The epidemic of diabesity and other chronic illnesses is paralleled by an epidemic of nutritional deficiencies. Most of us don’t eat enough the kind of food that protects us from diseases and too much of the kind that makes us sick.

“Food literally speaks to our genes,” he writes in a chapter titled “Nutrigenomics.” “The information your body receives from the foods you eat turns your genes on and off.” Whole-foods and plant-based diets have been shown in clinical studies to be able to turn off cancer-causing genes or turn on cancer-protective genes. No medication can do this. “What you put on your fork is the most powerful medicine you can take to correct the root causes of chronic disease and diabesity,” he writes.

“The Blood Sugar Solution” is a highly informative but, thankfully, also a very accessible book for both professionals and the laypersons. Some readers may find Dr. Hyman’s positions to be somewhat radical, if not utopian, especially where he seeks to offer hands-on solutions. Admittedly, he writes with passion and a sense of urgency – and rightly so. The obesity crisis keeps growing unabatedly worldwide and the time for “small steps” may have passed. Something has to change on a fundamental level. Unfortunately, that makes it so much less likely that we will see significant successes in the near future, if ever.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

February is “Heart Health Month.” Health advocacy groups and organizations like the American Heart Association (AHA), the National Heart Lung and Blood Institute (NHLBI) and the Centers for Disease Control and Prevention (CDC) want to remind us that heart disease is the most common cause of death in America and deserves more of our attention.

Sadly, heart disease has become nothing short of a national crisis in this country. “Heart disease takes the lives of far too many people in this country,” said Department of Health and Human Services (HHS) Secretary Kathleen Sebelius. “With more than two million heart attacks and strokes a year, and 800,000 deaths, just about all of us have been touched by someone who has had heart disease, a heart attack, or a stroke.”

Heart disease is also very expensive to treat. Cardiovascular disease and stroke hospitalizations have cost nearly $450 billion in health care expenses and lost productivity in 2010 alone.

“The sad truth is that these ailments are usually preventable, and in a perfect world I would be out of a job,” said Mehmet Oz, MD, a cardiothoracic surgeon and host of “The Dr. Oz Show.” “Unfortunately, I’m busier than ever,” he added.

Raising awareness is a crucial way to fight back against the spreading disease. In 2011, the HHS, in collaboration with the CDC and other government agencies as well as private organizations, has launched a program named “Million Hearts,” a nationwide initiative aimed at preventing one million heart attacks and strokes over the next five years. Among its many goals, the program wants to “empower Americans to make healthy choices,” such as avoiding tobacco use and reducing the amount of sodium and trans fat they eat, and to “improve care for people who need treatment” by encouraging them to take steps to better control their blood pressure, cholesterol levels and other major risk factors for cardiovascular disease and stroke.

“Million Hearts” is not the only awareness movement in the country. “Go Red for Women” is a nationwide program by AHA “to fight heart disease as the number one killer of women in America.” Observers can express their support by wearing red clothing or pins. “Choose to Move” is another AHA project dedicated to women’s heart health through physical exercise.

Sending the right messages is vitally important, especially for women, said Dr. Oz. “Many women and their health care providers believe that heart disease is less serious in women than in men. This is simply not true. Studies show that more women than men die within a year of having a first heart attack. Women are two to three times more likely than men to die following heart-bypass surgery, and more women than men die each year from congestive heart failure.

In fact, women may suffer from a completely different type of heart disease than men, according to Noel Bairey Merz, MD, director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles, which is not yet fully understood and harder to detect, and therefore can often remain undiagnosed until it is too late.

The good news is that there are only a few causes of heart disease that are out of our control, such as genetic predisposition, family history and aging. The rest is a matter of choice. Even small lifestyle improvements can make a significant difference. Weight control, good nutrition, regular exercise and stress reduction are all part of that. Each one of these is fully achievable for everyone with enough commitment and willingness to make the necessary efforts. Raising awareness is a good start, but it doesn’t end there.

For more information on heart-healthy living, please go to the “Eating Smart for a Healthy Heart“  section of the “Food and Health with Timi Gustafson R.D.” blog.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

If you think your blood pressure is normal, you may want to double-check with your doctor. According to new guidelines, blood pressure of 120/80 mmHg, which was until recently seen as within a healthy range, is now classified as elevated.

Scientists at the University of California, San Diego (UCSD) found that people under the age of 65 who were diagnosed with a condition called “prehypertension” had a 68 percent increased risk of suffering a stroke compared to those with normal readings.

Prehypertension is defined by the National Institutes of Health (NIH) as a systolic pressure (upper number) of 120 to 139 mmHg and a diastolic pressure (lower number) of 80 to 89. Higher readings than 140/90 are considered to be hypertension. Ideally, the normal range should be well below the prehypertension threshold.

When blood pressure rises, the heart has to work harder. If blood pressure remains chronically elevated, the risk of cardiovascular disease increases, which can eventually lead to heart attack, stroke or heart failure.

A primary risk factor is obesity. The greater the body mass, the more blood is needed to transport oxygen and nutrients. The higher volume of blood circulating through the blood vessels puts ever more force on the artery walls.

There are other causes as well. Atherosclerosis, the buildup of fatty deposits in the arteries, is quite common. Other contributing conditions are sleep apnea, kidney disease, thyroid disease and adrenal disease.

Poor diet- and lifestyle choices are most often (at least in part) responsible for high blood pressure to occur. But even some medications, including birth control pills, cold remedies, painkillers and other prescription drugs can play a role. So can recreational drugs like cocaine and amphetamines.

There is no cure for high blood pressure, only treatment through medication and lifestyle measures like diet and exercise.

Prehypertension should be seen as a warning sign, according to Dr. Bruce Ovbiagele, a professor at UCSD and lead author of the study that lead to the revised guidelines. “This doesn’t mean that people with prehypertension should start taking anti-hypertensive drugs. Instead, they should modify their lifestyle, maintain an ideal weight and lower their sodium intake.”

The worst you can do is to ignore the numbers, said Dr. Ovbiagele. “You shouldn’t be deceived because nothing seems to be going on.” Because there are no specific symptoms for prehypertension or hypertension, people tend to think they can live with the condition.

Nothing could be further from the truth. If you are overweight, even moderately, shed the extra pounds as soon as possible. Exercise regularly. Nothing is better for your blood pressure and your heart than a rigorous workout several times a week (consult with your doctor if you already have elevated blood pressure and don’t currently exercise). Eat plenty of fruits, vegetables, whole grains, fish and low-fat dairy products. Avoid foods that are high in sodium like processed and packaged food items. Eat foods that are low-fat, low-cholesterol and free of trans fats and other unhealthy ingredients. Cut back on meat, especially red meat. Drink alcohol in only moderation, preferably red wine. Last but not least, manage your stress and get enough sleep.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.