======================================================================= The Wellness Insider Scientifically Based Health Information from The Cooper Aerobics Center http://www.cooperwellness.com February 18, 2002 Welcome to the February Edition of the Wellness Insider! ======================================================================= PLEASE NOTE: We have recently updated our newsletter sign-up form to a quick pop-up window format. The window will appear on any page that you access through this newsletter. You can choose to turn off the message by clicking on the checkbox that reads, "Do not show this window in the future". ***************** SHOP ONLINE!!! http://www.cooperwellness.com/store/ ***************** If you would like to view the HTML version of this newsletter, please cut-and-paste the following URL into your browser: http://www.cooperwellness.com/Newsletter/ 021402_Vol01_Issue06.htm ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A MESSAGE FROM DR. COOPER ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ As you probably know, cardiovascular disease continues to be our nation's number one killer. No one would like to find a magic treatment for this very complex problem more than me. Unfortunately, no such quick fix is available. CHELATION THERAPY Over the years, I have been asked by numerous patients with heart disease if they should consider chelation therapy. My response has always been, "There is nothing in the scientific literature that justifies that course of therapy." According to a recent article in the Journal of the American Medical Association (January 23/30, 2002), that response is still appropriate. Chelation (pronounced "key-lay-tion") therapy was developed many years ago as an antidote for mustard gas poisoning during wartime. Chelating agents actually bind to toxic metals, like iron or lead, and carry them out of the body. One of the theories behind using chelation therapy in the treatment of heart disease is that it may liberate some of the calcium from the plaques that build up inside the arteries of the heart and cause heart attacks. Another theory is that it acts as a free radical scavenger, keeping the cholesterol from being oxidized, which is a form of cholesterol that causes plaques to develop. Reduction of total body iron stores is another theory that may or may not have a beneficial effect on preventing heart attacks. The problem is there is nothing in the scientific literature to indicate that chelation therapy does any good at all. One recent review concluded that chelation therapy for coronary heart disease should be considered "obsolete." This new study by a group of researchers at the University of Calgary and Calgary Regional Health Authority came to essentially the same conclusion. Looking at exercise time to ischemia (insufficient blood flow), exercise capacity, and quality of life measurements, the Canadian group found "no evidence to support a beneficial effect of chelation therapy." The chelating agent, usually an amino acid mixture called EDTA, is often used in combination with oral vitamins and minerals. The treatment is not cheap. A usual series of EDTA treatments will cost approximately $4,000, but the cost is not a barrier for many patients. When faced with a serious disease, many patients are willing to try (and pay) just about anything if they feel there is even a possibility of cure. MY RECOMMENDATION Believe me, if somewhere down the road we discover a "magic treatment" we will do everything possible to spread the word. In the meantime, I recommend doing everything you can to prevent heart disease. Follow an American Heart Association type diet, get regular exercise, don't smoke, achieve and maintain a proper weight, and make sure to get regular physicals, especially after the age of 40. At the Cooper Clinic, we recommend a maximum stress test for men starting at age 40 and women at age 50. Make sure you know your cholesterol (both HDL and LDL), as well as homocysteine and C-reactive protein levels. Cardiovascular disease is very complex, and the most common first symptom is sudden death, so don't take any chances. Practice good preventive medicine and your chances of living a long and healthy life will be greatly increased. Sincerely, Ken Cooper, M.D., M.P.H. To learn more about Dr. Cooper and The Cooper Aerobics Center, please visit: http://www.cooperwellness.com/Bios.asp NUTRITION ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Lowering Cholesterol the Soluble Fiber Way ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Kathryn Miller, M.S.,R.D., L.D. In addition to cutting back on fat - and cholesterol - containing foods, add foods with soluble fiber to your diet to help lower your cholesterol levels. No food is magic, but when these foods are added to a low saturated fat, low cholesterol diet, you get the greatest dietary effect possible in lowering your cholesterol. The National Cholesterol Education Program recommends 10 to 25 grams of soluble fiber a day from fruits, vegetables, beans, oats and psyllium (total fiber intake should be 20 to 35 grams a day). *Fruits and vegetables - rich in soluble fiber, notably pectin, which lowers LDL cholesterol. Eat five servings a day such as apples, citrus, berries, bananas, carrots, potatoes, green beans. Example: ½ cup broccoli contains 1 gram soluble fiber, ½ cup carrots contains 1 gram soluble fiber, 1 medium apple contains 1 gram soluble fiber, 1 medium orange contains 2 grams soluble fiber, 1 medium pear contains 2 grams soluble fiber. *Beans - excellent source of soluble fiber, namely arabinose, helps lower cholesterol. Eat ½ cup a day of beans such as soy, lima, kidney, black and pinto to add between 2 to 3.5 grams of soluble fiber to your diet. *Oats - contain a type of soluble fiber called beta-glucan, which lowers LDL cholesterol. American Dietetic Association recommends 3 grams daily of soluble fiber from oats to have a significant effect on cholesterol levels. You can either choose ¾ cup dry oatmeal (about 1.5 cups cooked) or ¼ cup dry oat bran (cooked) or ½ cup dry oatmeal mixed with 1/8 cup dry oat bran (cooked). *Psyllium - a soluble fiber supplement which lowers LDL cholesterol. One packet of Metamucil (1 Tablespoon) contains 2.4 grams of soluble fiber and 2 Metamucil wafers contain 3 grams of soluble fiber. The amount needed to lower LDL cholesterol based on American Dietetic Association recommendations is 7 grams daily of soluble fiber from psyllium. If you take psyllium, you will need to drink 1 to 2 extra cups of fluid above the 8 cups of daily fluid intake recommended. To meet your daily soluble fiber needs start with 1½ cups oatmeal for breakfast for 3 grams soluble fiber. Have a whole-wheat turkey sandwich at lunch with a medium apple for 2 grams soluble fiber. Eat an orange in the afternoon as a snack for 2 grams soluble fiber. Add a cup of cooked vegetables at dinner for 2 grams soluble fiber plus an occasional ½ cup serving of beans or medium potato with the skin for 2 grams soluble fiber. As an additional option, take a psyllium fiber supplement. For example, mix a packet of sugar-free Metamucil with water at bedtime for 2.4 grams soluble fiber. Your total soluble fiber for the day would be around 13 grams. Think positive. Find ways to add soluble fiber foods to your diet daily to receive all the potential health benefits they offer. Nutrition consultations are available in person or by phone. Contact the nutrition department via e-mail at nutritionist@cooper-clinic.com or by phone at 972-560-2655 to schedule your appointment. VITAMIN SUPPLEMENTATION ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Fat-Soluble Versus Water-Soluble Vitamins ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Angela Marks, Health Promotion Director, Certified Physical Fitness Specialist, Cooper Concepts, Inc. Vitamins can be grouped into two different categories depending on how the body absorbs them. Today we will review the two categories, which consist of fat-soluble vitamins and water-soluble vitamins. This article will help you learn the difference between these vitamins, when to take them, and which ones can become toxic when taken inappropriately. What are Fat-Soluble vitamins? These vitamins require fat in order to be absorbed by the body. The fat-soluble vitamins include vitamins A, D, E and K. These vitamins need to be taken with food to be absorbed readily. In addition, these vitamins are stored in the body and can become toxic if you take them in high doses. Last month's article discussed vitamin A and beta-carotene in detail, so we will just quickly review this particular vitamin and move on to the others. VITAMIN A includes a family of fat-soluble vitamins. Vitamin A occurs in two forms: retinol and provitamin A (carotene). Vitamin A is essential for an efficient immune system and is important in maintaining the quality of health of your eyesight, skin, teeth, bones, and mucous membranes. Most people get enough of this vitamin through food, so the preferred form of this vitamin is beta-carotene or the natural mixed carotenoids. Most cases of vitamin A toxicity result from an excess intake of vitamin A in supplements. A high intake of carotenoids can turn the skin yellow, but this is not considered dangerous to health. If you are a smoker or drink excessively, it is not recommended that you take more than 5,000 IU of beta carotene in supplement form. VITAMIN D is found in food, but also can be made in your body after exposure to ultraviolet rays from the sun. Vitamin D assists in the bsorption of calcium, helping to form and maintain strong bones. Without vitamin D, bones can become thin, brittle, soft, or misshapen. One important tip to remember is that if you are taking a multivitamin that contains 400 IU of vitamin D, then you do not need to take a calcium supplement with D, unless you have low bone density and your physician has recommended higher levels of the vitamin. Incidentally, calcium citrate or Citrical is the best form of calcium to take. For best absorption, calcium citrate should be taken on an empty stomach (first thing in the morning or right before you go to bed) whereas; calcium carbonate should be taken with food. Consuming too much vitamin D through diet alone is not likely unless you routinely consume large amounts of cod liver oil. It is much more likely to occur from high intakes of vitamin D in supplements. VITAMIN E is a vitamin that is an anticoagulant (blood thinner), as well as a powerful antioxidant that fights the destructive effects of free radicals (unstable oxygen molecules) in the body. According to a new federal survey, 30 percent of U.S. adults are vitamin E deficient, a condition that can raise heart disease and cancer risks, according to the Centers for Disease Control. Vitamin E is available in two forms: d-alpha tocopherol and dl-alpha-tocopherol. D-alpha tocopherol is the natural form of vitamin E and is three to five times more potent than the synthetic form, dl-alpha tocopherol.* One tip to help you remember the difference is "d" stands for "deliver" and "dl" stands for delivers less. Vitamin E has been linked to a reduced risk of cardiovascular disease because of its ability to neutralize the oxidation of "bad" LDL cholesterol. The health risk of too much vitamin E is low. However, it is importantto follow the guidelines from your physician, especially if you are taking blood-thinning medications. VITAMIN K is a fat-soluble nutrient found in the small intestine where it combines with protein to produce clotting of the blood. Vitamin K is also necessary for the synthesis of proteins found in plasma, bone and the kidneys. A recent prospective study of vitamin K intake and hip fractures found that low intakes of vitamin K might increase the risk of hip fracture in women.** We get most of the vitamin K we need (65-80 mcg) through our diet and it is not recommended to take more than 500 mcg in a supplement form. What are Water-Soluble Vitamins? Now that you know about the fat-soluble vitamins, let's focus on the water-soluble vitamins. While fat-soluble vitamins should always be taken with food, water-soluble vitamins can be taken with or without food, it makes no difference. However water-soluble vitamins must be replenished at least twice a day because they flush through the body every 3 to 8 hours depending on the vitamin. This is why you need to take a multivitamin twice a day. Water-soluble vitamins include everything else such as vitamin C as well as three very important B vitamins. VITAMIN C is a water soluble vitamin that plays an important role in the formation of collagen, which is important for the growth and repair of body tissue cells, gums, blood vessels, bones, and teeth. Vitamin C is also an antioxidant that works synergistically with vitamin E. We will discuss these antioxidants and their importance in a future article. Research indicates that you should take 1,000 mg a day. Remember that because this is a high dose of a water-soluble vitamin, the portion that the body cannot use will be excreted. Therefore, you need to split the 1,000 mg into two doses of 500 mg each. VITAMIN B includes a family of water-soluble vitamins. We are not going to discuss all of them, but it is important to know about the importance of vitamins B6, B12, and folic acid. Research has shown that these three B vitamins can help to lower homocysteine levels. Homocysteine is now being referred to as "the cholesterol of the 21st century" and is linked to heart disease, stroke, and cancer. We will devote an article to this topic in a future newsletter. Also, remember that just because these vitamins are water-soluble does not mean that high doses are not harmful. It is not recommended to take 500 mg or more of vitamin B6 as it may cause neurological problems *American Journal of Clinical Nutrition 65: 1997 **American Journal of Clinical Nutrition, 69; 1999 For information on Cooper Complete, the multivitamin and mineral supplement developed by Dr. Cooper and four of the top nutritional doctors in the country, go to: http://www.cooperwellness.com/Overview.html There are three ways to purchase Cooper Complete products. 1) Through the Internet at www.CooperWellness.com. 2) At HEB Grocery stores with the Nature's Harvest sections or any Central Market locations in Texas. For locations, please visit: http://www.cooperwellness.com/wheretobuy.asp 3) Call 1-888-393-2221 PHYSICAL TRAINING ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ It's Time for Some Time Management ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jill Armayor, Cooper Ventures Raise your hand if you still have your Christmas lights fastened to your roof. Raise your hand if you don't think about what to cook for dinner until it's time to eat. Raise your hand if your desk looks like a hurricane came through and wiped out all of your file cabinets. If you are like most, you are probably fighting a losing battle of staying on top of things. You think, "Wouldn't it be terrific to get everything done so that I could get to the gym today?" The New Year is in full swing and you are already starting to skip workouts because of all the other activities that take precedence over exercise. What if there was something that could be done to make more time in the day? For some, organization comes naturally, but for others, a push in the right direction may help. Organization and time management are such important considerations in exercise maintenance and most people are not aware of the difference they can make. Although organization and time management have little to do with exercise itself, mastering your time will make it much easier to maintain your exercise program, even through the extra-busy times. Here are some tips for time management: · Make a "to-do" list. When you think of something that needs to be done, jot it down. You won't be so overwhelmed with thoughts swimming in your head about what you need to be doing. · Learn to prioritize. What are the closest deadlines? What can be rescheduled, delegated, or deleted? How long will each project take? · At the end of each day, save time to review your schedule for the next day. Plan accordingly. (Remember to pack your workout bag the night before.) · Keeping a pad of paper next to your bed may improve your sleep habits. When you think of something important, write it down instead of dwelling on it when you should be getting your Z's. · Develop your own organizational style. Make changes to it if you see inefficiencies. · Use a calendar to keep track of important dates, appointments, and deadlines. Use a different color for each type of engagement. Keep it with you at all times. · Keep track and date all of your correspondence so that you can look back to it when you need it. · Set goals that are specific, measurable, realistic, and achievable. Reviewing them often will give you a sense of purpose and direction. · Be flexible. Allow time for interruptions and distractions, such as phone calls and e-mails. List some things that you can do while you are on the phone (like organizing your desk or filing). · To avoid procrastination, break a large task up into smaller tasks and work on one task at a time. · Learn to say "no" by focusing on the importance of your goals and values. If you have to, schedule time to be with family and friends. · Treat your exercise time as an important appointment. Honestly, this is the most important appointment you can schedule, because it helps you maintain the energy to complete the other tasks on your list. For more information about services provided by Cooper Ventures, go to: http://www.cooperaerobics.com/ven.htm. WOMEN'S HEALTH ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Getting to the Heart of the Problem ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Brought to you exclusively from the women physicians at The Cooper Clinic February is Heart Month so we thought we would take this opportunity to bring you up to date on coronary heart disease in women. Make no mistake about it, coronary heart disease is an equal opportunity killer. In fact, more women die each year from cardiovascular diseases than do men. Whether you are African American, Hispanic or Caucasian, if you are a woman, your number one killer is cardiovascular disease. To put this in perspective, twice as many women die from cardiovascular disease than from all forms of cancer combined. Of these deaths, half will be from heart attack while the remainder will be from stroke, heart failure, high blood pressure and other forms of cardiovascular disease. Heart attacks are caused by the sudden blockage of flow in a coronary artery, which supplies the heart muscle with oxygenated blood. These blockages usually occur because a blood clot forms in the presence of atheroslcerotic plaque or hardening of the arteries. Rick factors that increase a woman's risk for developing coronary artery atherosclerosis include high blood pressure, high cholesterol, diabetes, cigarette smoking, and a family history of premature coronary heart disease, obesity, physical inactivity and menopause. These risk factors are more common than you might think! For example, one out of five Caucasian or Hispanic women have high blood pressure compared to one out of three African American women. Almost one out of four women also smoke cigarettes. Almost one half of all women have cholesterol values greater than 200 mg/dL. Over five million women have been diagnosed with diabetes and it is estimated that another 2.5 million women have diabetes but don't know it. Twenty-seven percent of women report that they engage in no regular physical activity. Reducing these risk factors clearly reduces risk for heart attack but it takes work! Women need to partner with their health professionals and engage their families and friends to minimize their risk. Risk reduction entails both the prevention of heart disease and the diagnosis and treatment of disease once it is present. Common signs of heart attack include chest pain or pressure with radiation to the jaw or arm, shortness of breath, nausea and sweating. The predominant symptom may not be chest pain. It may be shortness of breath or fatigue. Symptoms of a heart attack may be mistaken for a muscle strain, indigestion, anxiety or the flu. Do not take chances by misdiagnosing your own condition. Be safe, not sorry. If you have cardiovascular risk factors or symptoms of coronary heart disease, your doctor may suggest a stress test, electron beam tomography scan or angiogram. The evaluations add in the evaluation of both the presence and severity of coronary artery blockage or stenosis. The most common form of stress testing in women combines treadmill exercise, electrocardiogram and blood pressure monitoring with an imaging test such as echocardiography (sound wave pictures of the heart) or nuclear imaging (x-ray pictures of blood flow). For women, the addition of imaging makes this a better test than treadmill testing alone. If the stress test is abnormal, a cardiac catheterization, in which dye is injected into the coronary arteries directly, is required to define the specific location and severity of the blockages. The time to take charge is now. Identify your risk factors, partner with your health care professional to maximize your wellness and spread the news about cardiovascular risk to all the important women in your life. For information on Cooper Clinic comprehensive examinations, please visit: http://www.cooperaerobics.com/med.htm MEN'S HEALTH ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ High Blood Pressure and Physical Activity ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I can't tell you how many times I have heard, "Doctor I am being treated for high blood pressure. Is it safe for me to start exercising?" The answer is a resounding "YES". The Cooper Institute recently presented data in the American Journal of Cardiology showing that men with high blood pressure who participated in physical activity on a regular basis were much less likely to die prematurely than men with high blood pressure who did not participate in physical activity. In my opinion, if you have high blood pressure and it is properly controlled with medications, regular physical activity is the most important change you can make to improve or maintain your health. Of course with any new lifestyle change, it is best that you check with your doctor to assure increasing physical activity is right for your particular situation. But more than likely your doctor will be thrilled that you are considering increasing your physical activity. There are a number of ways in which regular physical activity improves health. In most people with high blood pressure, an increase in regular physical activity results in a reduction in blood pressure. However, even if you are one of those individuals who does not see a reduction in blood pressure with regular exercise, there are NUMEROUS other positive health benefits which come from the regular physical activity. These include improvements in mood and energy level, increased muscle and reduced fat, increases in the good cholesterol (HDL), increased blood flow, and stronger bones, to name just a few. The ultimate goal is to obtain 30 minutes of moderately intense physical activity per day on at least five days a week. Moderate intensity is best described as a brisk walk and walking is the exercise of choice for most people. Walking provides all the health benefits of jogging without the pounding provided by regular jogging. Remember physical activity does not have to be structured exercise (ie: a visit to the gym). You can accumulate minutes of physical activity throughout the day by walking the dog, walking to the store, or walking a few blocks on your lunch hour. In the beginning start slow and then build up over time. And once again, as noted above, it is important that you inform your doctor of your intention to start increasing your physical activity. Interestingly, for some individuals after a few months of regular physical activity they may start to experience a substantial reduction of blood pressure, resulting in the need to lower the amount of blood pressure medication taken. For more information about the Cooper Institute go to: http://www.cooperinst.org/default.asp KID'S CORNER ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Interested in Kid's Nutrition & Fitness? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In a country where more than 10 million children ages 6 to 17 are considered overweight and almost half of these are severely obese, it's more important than ever to educate young people about the importance of physical activity and a healthy lifestyle. If you would like to receive periodic information on kid's nutrition and fitness, please visit: http://www.cooperwellness.com/signup/ kidinfo.asp?[$email1|email=<**>|] WEEKLY RECIPE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Brownies De-light ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ INGREDIENTS: 1 box brownie mix, any brand 4 oz. non-fat plain yogurt amount of water as shown on box chocolate packet, if included DIRECTIONS: 1. Omit eggs and 1/2 cup oil from recipe directions on box of brownies. Instead, add yogurt to brownie mix and blend together in a mixing bowl. 2. Pre-heat oven to 350 degrees. 3. Pour mixture into a pan sprayed with non-stick cooking spray; bake about 30 minutes, as directed on the brownie package. YIELD: 24 brownies PER SERVING: 120 Calories, 3 g Fat from: The Cooper Clinic Solution to the Diet Revolution written by Georgia G. Kostas, M.P.H., R.D., L.D. -----buy your copy here: http://www.cooperwellness.com/store/ detail.asp?PRODUCT_ID=193 SHOP ONLINE ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The Polar Heart Monitor ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Keep track of your workout time and average heart rate with the Polar Heart Monitor! This is the ideal monitor for beginning exercisers. It features easy to use, single button operation. Heart rate is continuosly displayed along with a visual indicator of exercise time. Recalls both total exercise time and average heart rate for your workout. To purchase, please visit: --------- http://www.cooperwellness.com/store/ detail.asp?PRODUCT_ID=205 --------- ======================================================================= Please feel free to share this information with a friend, post or reprint it... 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