Heart disease is still the number one killer of Americans.  Nutrition science continues to evolve over the years as we learn more about the mechanism of foods and nutrients.  Unfortunately with the addition of medications, many Americans believe that lifestyle changes are unnecessary which could not be further from the truth.  Medication in addition to diet and exercise significantly decrease heart disease risk.

Expert: Sharon Jacob, Clinical Dietitian at St. Francis Medical Center

Question:  How do I know what to eat for a healthy heart?

The TLC diet or the Therapeutic Lifestyle Changes diet from the National Cholesterol Education program is a great place to start.  These recommendations have remained solid througout the years:  Cut back on Saturated or solid fat, cut back on portions and simple sugars such as candy, dessert and soft drinks, keep total cholesterol to 200mg/day from foods and strive for 1500-2000mg sodium maximum/day.

Question:  Can you clear up the confusion on fats? I recently heard butter is better than margarine and that all of our packaged cookies and crackers have "bad" fats?

It certainly has been confusing which fats or oils are best for our health. The exciting thing is that nutrition science continues to evolve as we learn more from studies.  There is a strong evidence that animal fats such as lard or butter contain a higher proportion of saturated fat, which is associated with increased total and LDL cholesterol, which in turn increases CVD risk.  Packaged cookies and crackers often contain hydrogenated oils or trans fat which are also not heart friendly.  Plant fats such as nuts, seeds, avocados, olives and canola oil tend to have a higher proportion of monounsaturated fats and polyunsaturated fats.  These liquid oils and whole foods with a high fat content may improve cholesterol numbers and insulin sensitivity.

Question:  So should I be eating olive oil on my bread instead of butter?

Exactly!  Always try to use the liquid oils in place of solid fats and even try substituting whole food fats such as avocados as a fat replacer in baked goods such as banana bread.  Also, enjoy nuts more often as a snack and using nut butters such as almond butter in sauces and marinades to add great flavor and a dose of the heart healthy fats, fiber and phytochemicals.

Have you always believed that lung cancer only affects smokers?  Did you know that more women die from lung cancer than breast cancer? Among diseases rife with myths and half-truths, lung cancer is one of the most misunderstood. Whether it’s who is at risk, symptoms to watch out for or what you think of as fact may actually be fiction.

Tune in to Women’s Wellness Wednesdays to learn the truth about common lung cancer myths.  Patty O’Connell, Thoracic Nurse Navigator with the Penrose Cancer Center will tell you what’s fact or fable when it comes to lung cancer.  So, tune in between 7 am and 9 am throughout the month of January for Women’s Wellness Wednesdays.

Question: With so many Americans reaching their prime as Seniors, which supplement should they be focusing on?

There are a number of supplements that can benefit Seniors.  As we age, we also have less acid in our stomachs and so we absorb our nutrients with less vigor than when we are younger.  Vitamin B12 if often one that seniors benefit from taking sublingually (under the tongue).  This allows the absorption to bypass the stomach and get into your body easier.  Taking 500mcg/day will help to optimize levels of B12.

Question: How about those achy older joints?  What can my grandmother take so she can still get in her daily walks?

Glucosamine sulfate and Chondroitin sulfate may help to lubricate her joints to make walking less painful.  Both have been indicated for use in Osteoarthritis.  Chondroitin can slow the breakdown of cartilage and is likely safe. (200-400mg BID).  Glucosamine is a chemical that helps with building the thick fluid that surrounds joints.  The supplements may either help increase cartilage and fluid surrounding joints or help prevent the breakdown of the cartilage and fluid.  The recommended dose of glucosamine is 500mg TID.

Question: Any others to help with joints?

Omega 3 FA’s may help improve arthritis symptoms in some people and also prevent dementia.  In general, Americans do not consume the recommended amounts of omega 3 FA because they are not found in foods we commonly eat. Fatty fish such as salmon, trout, mackerel and sardines are likely the best sources of Omega 3 fatty acids but that is often expensive and hard to get in land-locked Colorado.  Taking a supplement daily can help fill this void. Again, fish oil pills are often large so taking a gel form such as Coromega can be helpful if you have difficulty swallowing large pills.  The recommended dose to start is 1000mg/day of combined EPA and DHA.

Question: Anything else to help with countering the effects of aging?

Pre and Pro-biotics are another supplement often found in foods that can help extend the health span.  Pre-biotics are non-digestible fibers that ferment in the intestine to feed intestinal bacteria.  Pro-biotics are live bacteria that have health  benefits such as maintaining healthy bacteria in the gut.  These supplements can help enhance your immune system, promote regularity and improve the absorption of vitamins and minerals as well as possibly lower cholesterol.  It is recommended to gradually add these items to your diet for best tolerance.  Some common ones on the market today are Activia yogurt, Dan Active shots and acidophilus. 

Question: Can you tell me which supplements I might consider taking as a woman concerned about my health?

If a woman is pre-menopausal, I would recommend a multivitamin with iron to start. After menopause, iron is not usually needed in supplement form.  If someone has a hard time swallowing pills like I do, using a chewable multivitamin is a good idea and may help absorption.  If you are curious if your supplements are dissolving in your stomach, you can test it by dropping your supplement into ¼ cup of vinegar.  It should dissolve fairly quickly as this is the same pH as your stomach.  If it doesn’t dissolve in 15 minutes, buy another brand!

Question: Any other supplements that are of particular importance to women?

Calcium and Vitamin D are 2 very important supplements for women especially if they are not milk drinkers.  Getting in 4 cups of milk/day will meet this need through food but that is often difficult to achieve for most women.
Calcium is a big pill so it is not usually combined with many other nutrients.  To maximize absorption it is best to take calcium  2 hours apart from other pills and to take with a meal. Calcium citrate is the best absorbed compound and is best taken in 500 or 600mg doses for a total of 1000-1200mg /day. An example is the brand name Citracal. 

Vitamin D is also important for bone health as well as many other areas of disease prevention we are just now learning about.  With the increased use of sunscreen, we no longer manufacture adequate amounts of vitamin D in our skin.  Look for Vitamin D3 which is the best absorbed form in a level of 1000 IU/day unless you are vitamin D deficient and then your doctor will prescribe the correct therapeutic dose for you.

How do I choose a supplement?

Question: With so many supplements on the market today, how do I know which ones to take and if they are safe?

The supplement industry is a multi-billion dollar industry because consumers are continually looking for the fountain of youth and to cure disease in a “more natural way”.  A supplement is defined as any product intended to enhance or improve dietary intake. Vitamins and minerals, herbs and botanicals, and protein/ amino acids are some examples.
Question: But how do I know if they are safe?

Many Americans are not aware that the FDA does not regulate supplements in this country.  Unfortunately there is no requirement for proof that the supplement does what the label claims it does or even proof that the supplement is safe.  Vitamins and minerals are generally considered safe if consumed in the recommended doses.  However, megadoses of the fat soluble vitamins such as vitamins A, D, E, and K can be toxic if consumed in excessive quantities.  Herbal supplements also are not regulated and can vary in potency depending on where they were grown or harvested. 
Question: What should I look for on the label to ensure safety?

First, look for the seal that has “USP” indicated on the label.  This stands for United States Pharmacopoeia and means the supplement has passed certain tests for potency, purity and uniformity.  To carry this label, it must be proven that what is on the label is in the bottle, that there are no harmful contaminants and the substance will break down and be absorbed.  Secondly, look for the Consumer Lab seal of Approval.  Consumer Lab.com does independent testing of supplements to determine quality, reliability of the active ingredients and that the supplement is free of contaminants as well.

Question: Which superfoods are good sources of Omega 3 Fatty Acids?

Walnuts are one of the best plant sources of Omega 3 fatty acids.  They are also high in fiber, B vitamins, Magnesium and the antioxidant Vitamin E.  Flax seed and Chia seed are also great sources of Omega 3 fatty acids. Both contain a high amount of soluble fiber as well.
Chia seed??
Yes this is the same seed that formed the “chia pets” of the 80’s. I will elaborate more later. 

Question: Why do we need Omega 3 Fatty Acids?

Omega 3 FA’s may lower the risk of heart disease, improve arthritis symptoms in some people and prevent dementia.  In general, Americans do not consume the recommended amounts of omega 3 FA because they are not found in foods we commonly eat.  Research has shown that in some populations, a handful of walnuts a day may reduce the risk of cardiovascular events by 51%.

Question: Tell me more about the famous “chia seeds”.

Chia seeds are tiny black, gray and white seeds that are flavorless and don’t require grinding making them easy to add to your foods.  They are shelf stable and do not need to be refrigerated. The intact seeds swell when added to liquid and become a soluble fiber helping to lower cholesterol and blood sugars.  They can be added to cereal, yogurt and muffins or bread recipes as a fat substitute. They have a crunchy mouth feel similar to poppy seeds.

Question: Can you tell me which fruits would be considered superfruits?

While many fruits could fit into the category of superfruits, the berries are especially nutrient-dense. Today I am going to focus on Blueberries and Pomegranate which are two popular ones in the supermarket today. 

Question: What are the health benefits of blueberries and pomegranate?
Blueberries high in fiber and the phytochemicals: anthocyanins, flavonoids, and proanthocyanins.  These phytochemicals give blueberries their blue and red hue and help protect the body against the damaging effects of free radicals.  This in turn can help protect against chronic diseases often associated with the aging process such as cardiovascular disease and cancer.  The proanthocyanins may also promote urinary tract health much like cranberries do.

Pomegranate is a very popular superfood right now. The pomegranate seeds are mashed into a juice that also contain high levels of antioxidants.  Some exciting research also shows that pomegranate juice can prevent the oxidation of LDL cholesterol, the bad cholesterol that can lead to plaque formation in the arteries.

Question: How can I incorporate these fruits into my diet?

My favorite form of blueberries are the organic wild frozen blueberries found in the freezer section of the supermarket. They are already washed and ready to be used on your morning cereal, smoothies or as a topping for your frozen yogurt.  They are so much more flavorful than the cultivated varieties.

Pomegranate juice is being added to many items as well.  It is best consumed in a concentrated form as a juice to obtain the most health benefits.  Beware of pomegranate juices that have other fruit juices or sugar mixed in to dilute the pomegranate juice and it’s health benefits.