FIGHT BACK! Post-Stroke Rehab

Eating Out? Order “à la SmArT”

Help For Caregivers: Resources You Should Know About

m ay 2 0 0 7

V o l u m e 1

n u m b e r 2H e a r tHealthy Living for Patients, Their Families & CaregiversI n S I g h t

YolAndA KInG:

Martin Luther King Jr.’s Daughter SpeAKS

ouT On Stroke

pluS: Are You At Risk?

wHY

You need

To Know Cpr

Features

may 2007 Volume 1 / number 2

14 When every second countsDo you Know What To Do In a Cardiac emergency? by norra macreaDy

18 yolanda king: creating a neW health legacyThe Daughter of martin luther King, Jr. reaches out To black americans as a Power To End Stroke Campaign ambassadorby anDrea K. CollIer

24 aFter a stroke, then What?How To optimize Post-Treatment recoveryby ruTH PaPazIan

28 help is out thereHome Health Care Programs allow Caregivers To Help loved ones by lIsa FIelDs

� HearT InsIgHT • may 2007 CoVer PHoTograPHy by anTHony-masTerson

HearT InsIgHT • may 2007 �

departmentscontributors

anDrea K. CollIer is a health and food writer who lives in lansing, mich. she is the author of “The black Woman’s guide to black men’s Health” (Warner Wellness, 2007). lIsa FIelDs is a freelance writer based in Westchester County, n.y. she has written about health, and family and lifestyle issues for The Associated Press, Reader’s Digest, Self, Woman’s Day, Prevention, First for Women and Pregnancy. raCHael moeller gorman has written about science, nutrition and health for publications that include EatingWell, Health and Discover. Her article on processed foods, “Faux Food,” in the Decem-ber 2005/January 2006 issue of EatingWell, was nominated for a 2006 James beard Journalism award. she lives and works in mass., just south of boston. norra macreaDy is a book author whose medical articles have appeared in The Economist, Glam-our, Neurology Now and WebMD. alIson PalKHIVala has writ-ten about health and medicine for WebMD, Medscape, MedPage Today and The Lancet, among others, over the past 20 years. she lives and works in montreal, and is an active member of the american medical Writers association (amWa) and the Professional Writers associa-tion of Canada (PWaCs).

CorInne Trang is a food writer, photographer and award-winning cookbook author. Her latest book is “The asian grill: great recipes, bold Flavors” (Chronicle books, 2006).

8 on my mindPatrick T. o’gara, m.D., F.a.H.a., editorial board Chair, on stroke risk and prevention

9 letters

11 three month heart insight calendarJot down prescription refill reminders, questions for your doctor; also heart- related “Health Holidays”

nuTrITIon KnoW-KnoWs

31 menu mineFields What To order—and What To avoid—When eating outby alIson PalKHIVala

nuTrITIon KnoW-HoWs

36 Fresh produce and Food saFetyshopping, Handling, storing & Cooking Tipsby raCHel moeller gorman

THe Hungry HearT: lunCH

40 make it & take it Healthy lunches you can have at home or eat “al desko” ProDuCeD by CorInne Trang

41 Tropical Tuna Hero sandwiches

42 beefy macaroni and Cheese

43 Chicken and Toasted Walnut salad

44 Double spinach Tortellini salad

45 salmon and orzo salad

leT’s geT QuIzzICal

47 hoW heart-smart are you?Take the HEART INSIGHT Quiz and find out whether you’re up on all the latest news about staying healthy

HearT InsIgHT • may 2007 Volume 1 / number 2

photo credits For this issuep. 4: father and son: shari abercrombie; yolanda king: anthony-masterson photography; p. 7: corinne trang (nilsson yellow square bowl and green julep placemat available at crateandbarrel.com); p. 9: portion size: corinne trang; p. 10: tortilla wrap: corinne trang; p. 11-13: all photos istockphoto; p. 14: american heart association; p. 17: philips medical systems; p. 18: yolanda king: anthony-masterson photography, makeup by venita/tyler marcel inc.; p. 19: flip schulke/corbis; p. 20: frank veronsky/corbis; p. 21: yolanda king: anthony-masterson photography; p. 24-26: baylor health care system; p. 26: courtesy of michael bernstein; p. 28-30: shari abercrombie; p. 31-32: all photos istockphoto; p. 33: veer; p. 34-35: all photos istockphoto; p. 36: chris everard/getty images; p. 38: veer; p. 39: michael paul/getty images; p. 40-45: corinne trang; p. 42: citrus bowls by pot luck available at globaltable.com; p. 45: bowl and plate by mud australia available at bluecashew.com, wright flatware (fork) available at crateandbarrel.com, glassware available at globaltable.com; p. 47: pizza: george doyle/getty images; children: istockphoto; p. 48: garlic: istockphoto; rooster: digital zoo/getty images

Look at your LifestyLe. Make changes a LittLe at a tiMe.

Cover Story

the nation first saw photos of a young yolanda King and her three siblings, with their mother, Coretta Scott King, in the days after the as-sassination of her father, civil rights leader and Nobel Prize laureate, Dr. Martin Luther King, Jr.

But some 40 years later, the legacy of service to her com-munity handed down from her parents continues for yolanda King, who is now an ambassador for the Power To End Stroke campaign. She took on this role not only to educate black Americans about stroke risk and prevention, but also to honor the memory of her mother, who suffered a stroke in August of 2005 and died five months later from ovarian cancer.

“Before my mother got sick, I really had no idea how preva-lent stroke was among black Americans,” King, 51, says. “But after her stroke, I think it hit home. I even had two friends who had suffered strokes. But I wasn’t aware that black women are at greater risk because we tend to be more sedentary, and suffer more from high blood pressure, high cholesterol and diabetes than white women,” she says.

yoLanDa king: creating a neW heaLth LegacyThis Daughter Of One Of Our Most Prominent Families Reaches Out

To Black Americans As A Power To End Stroke Campaign Ambassador

By ANDreA K. CoLLIer

King says the education she got while helping her mother recuperate expanded her consciousness. “When the Ameri-can Heart Association approached me later that year to be an ambassador, I knew I wanted to get involved, because so many people in my life were at risk.” King says.

King and her mother had an extremely close relation-ship. “Before I [agreed] to being part of the campaign, I went to my mother to discuss with her what would be involved, including opening up some aspects of her personal life,” she says. King and her siblings shy away from talking about their family or private lives publicly, preferring to concentrate on their parents’ legacy and life work of furthering peace

and equality. “After explaining to her how many people we could help by speaking out, Mother gave me her blessing to do this.”

King says after her mother died in January 2006, “it really has been a healing experience to be able to share what our family went through, and make people aware of how to prevent stroke in their own lives,” King says. She doesn’t hesitate to spread the word wherever she goes.

Sunday dinner Yolanda with her family in 1964 at home in Atlanta, shortly before her father’s historic march in Selma

PHotogrAPHeD By ANtHoNy-MASterSoN HeArt INSIgHt • MAy 2007 19

Cover Story

know your numbers, Manage your risksKing, who is the oldest of the King children, says her very public role in spread-ing the word on stroke pre-vention has strengthened her dedication to her own health. “there was no way that I could be out here encouraging other people to make lifestyle changes without making some of my own. I knew I had to walk the talk.” She says she had already taken a major step in reduc-ing her risks when she stopped smoking in 2002.

Heavy smoking nearly doubles a person’s risk for a stroke and other cardiovascular disease. But like some people who stop smoking, King says she gained weight—decreasing one important risk, but increasing another.

“talking to people about the role that major risk factors for a stroke play, including being overweight, has been a great motivator for me. It is a strong re-minder that losing weight is not about a vanity thing. It is a health thing. I needed to get the weight off,” King says.

As a native of Atlanta, King grapples with the challenges of having been raised on high-calorie, high-fat Southern food. “I have to admit I love good food. Working on the weight and eating healthier has been a process,” King says. She says she didn’t try to do everything all at once. “I started cutting out the fried foods and went from there.”

King is always looking for new and healthy ways to prepare food, and prides herself on being a knowledgeable re-source for someone trying to make changes in the way he or she eats. “I still have some of my favorite foods, but in moderation.” She says she’s still tack-ling some of her food demons: “I still love ice cream, but it doesn’t love me.”

King urges people to know their key health numbers to be able to manage their health risks. “go to your doctor

and see what your risks for high blood pressure, diabetes, and cholesterol are,” she says. “Blacks have the highest hypertension on the planet. So we really have to monitor and check it regularly,” she says.

King adds that many people don’t know they have high blood pressure. “People don’t understand that high blood pressure can occur

without any symptoms. they think that just because they feel fine, that everything is okay.”

“I have always had good blood pressure and normal cho-lesterol numbers, but I have also always had a sugar craving,”

King says. “I could also be at risk for diabetes, which would add to my risk of stroke.”

stress controlKing believes stressful lives can lead to increased stroke risk. “My maternal grandpar-ents lived on a farm. they ate healthy. they lived a much slower paced life, and there wasn’t a lot of stress. I think it contributed to my grandfather living to be 99 years old.”

But King says the stress of leading her life as a public figure, and the demands on her time were just too overwhelming, and contributed to her mother’s stroke. “Mother was never able to fully manage it.”

As an author, actress and head of Higher ground Productions, a multimedia production company, King’s own work schedule is intense. She says she spends her fair share of time in and out of airports, traveling to speaking en-gagements. While she has taken some time off to manage her mother’s estate, she says she plans to get back into acting and other projects in September. But she says she has “definite-

ly learned a lesson from observing my mother’s life,” and has worked hard to find ways to manage the stress in her own life.

She recommends everybody find some kind of outlet for the stresses they face on a daily basis. “Some people might find an outlet in dancing, for others it may be reading. I have always enjoyed walking. It is important to have something.”

20 HeArt INSIgHt • MAy 2007

the high cost of stroken The risk of having a stroke doubles each year after age 55.

n Men are more likely to suffer stroke than women, but more women die from stroke.

n Blacks are twice as likely to suffer a stroke as whites, and are more likely to die from a primary or secondary stroke.

n Stroke is a main cause of severe long-term disability, and Americans will pay $62 billion in stroke-related medical expenses in 2007.

n Transient ischemic attack (TIA or “warning stroke”) can lead to a more severe stroke within a year.

20 HeArt INSIgHt • MAy 2007

The Legacy Yolanda in 1998 (playing the piano) with her mother Coretta Scott King, brothers Dexter and Martin Luther III, and sister Bernice

Studies show that developing and maintaining a routine of moderate physical activity can help maintain a healthy weight, and reduce risk for stroke and other diseases. “My mother had an exercise bike that she rarely used. She didn’t exercise.” But King says she has found walking is not only a way to get calm, but also a great exercise and she tries to add it to her daily rou-tine. “Physical activity can improve health on so many levels.”

King hopes she can spur people of color to action, and play an active role in significantly reducing the numbers of black men and women who die or are severely disabled from a stroke each year. She suggests looking at your life-style and making changes a little at a time. “Decide where you can make adjustments. Diminish things that are not good for you and [that] put your health at risk.”

“I know my mother would be proud that I am doing this work—both for the community and [for] myself.” hi

HeArt INSIgHt • MAy 2007 23

sos: save our selvesStroke can have devastating effects on the mind (personality and mood, for instance) and body (balance, gait, ability to use hands and arms), which can dramati-cally alter someone’s quality of life and sense of self.

Some stroke risk factors can’t be changed, such as your age, gender or race. But you do have control over the most serious risk factors.

know your numbers. Nearly 1 in 3 adults has high blood pressure. Uncontrolled high blood pres-sure is the Number One risk factor for a stroke. High blood cholesterol also increases stroke risk by building up fat in the blood and blocking arter-ies. And low levels of HDL increase the odds of stroke in men; more research is needed to de-termine whether this is true for women, too.

Manage your diabetes. Diabetics often have other risk factors for stroke. Stroke risk doubles when some-one has both hypertension and diabetes, so aim for a target of under 130/80 with diet, exercise and medi-cation, if needed. Diabetes also lowers HDL (“good”) cholesterol levels, which can cause arteries to clog and can result in stroke, so try to keep LDL (bad cho-lesterol) levels below 100 mg/dL, HDL levels above 40 mg/dL, and triglycerides levels below 150 mg/dL.

stop smoking. Cigarettes damage the cardio-vascular system because they can raise blood pressure, diminish ability to perform physical activ-ity and increase the blood’s tendency to clot.

eat a healthy, well-balanced diet. Eating too much saturated fat, trans fat and cholesterol can raise blood cholesterol levels. Most people should limit intake of fats to no more than 25 percent of daily calories. Healthy people should limit cholesterol to 300mg, with 7 to 10 percent coming from saturated fats. People with cardiovascular disease should limit cholesterol to 200mg a day, with less than 7 percent coming from saturated fats. Also, cut back on the salt. Limit intake to no more than 2,300mg, or a teaspoon or less per day. If you have heart disease, limit salt intake to 2,000mg. Finally, eat at least five servings of fruits and vegetables per day. Studies show that antioxidants in produce help reduce risk of ischemic strokes.

get moving—now! Physical activity can reduce the risk of high blood pressure, diabetes and heart disease —and can control these risk factors for stroke. Try to get at least 30 minutes of activity every day, even if you have to break it up into three 10-minute chunks.

HeArt INSIgHt • MAy 2007 23

Cover Story

What To Order—And What To Avoid—When Eating Out

By ALISON PALKHIVALA

Menu Minefields

You’re health-conscious, so nothing goes into your shopping cart until you check the nutrition label. you know exactly how many servings are

in the package, and how many calories and grams of saturated fat and sodium you’re getting per serving. No one can pull the nutritional wool over your eyes!

NUTRITITION KNOW-KNOWS

Unless you’re in a restaurant. you may as well be wearing a blindfold, because you have no idea how many fat grams are in your grilled cheese and tomato sandwich, whether the mound of coleslaw on the side of the plate is a single serving, or whether that deli-cious-looking whipped cream-topped dulce de leche

?

HeART INSIgHT • mAy 2007 31

NUTRITITION KNOW-KNOWS

«Believe it or not an order of General

Tso’s Chicken packs 1,300

calories and

3,200mg of sodium

fats from restaurant food in December 2006—is trying to help consumers make informed choices when they dine out. Starting July 1, 2007, a new Board of Health regula-tion enacted last December will require some restaurants to post the caloric value of each of their standardized dishes on their menu board or paper menu. The number of calories can be listed as a single number or as a range, to take into account optional ingredients or toppings, such as a burger with or without cheese.

Typically, this nutritional information is available on the Internet, in pamphlets, or other ways that are not immedi-ately obvious or available to consumers when they have a menu in their hands and are trying to decide what to eat. The new regulation allows consumers to see how many calories each menu item contains before they order.

“We wanted to look at policy initiatives that could help inform consumer choice, to make people more aware of the calories that they were consuming away from the home,” says Candace young, m.S., director of physical activity and nutrition at the New york City Department of Health.

“This is … similar [to] providing calorie [information] … when you buy a packaged [food],” young tells Heart Insight. “It [should] help people look at their consumption patterns a little bit better, or [at least] in a more informed way. … They might still eat at the same establishments, but they might choose … a little bit smaller portion.”

The regulation targets the roughly 10 percent of

latte contains more calories than you should eat over the course of the entire day (maybe the next day, too).

“you never know what you’re going to get until it’s temptingly placed in front of you,” notes Steven Aldana, Ph.D., a professor of lifestyle medicine at Brigham young University in Provo, Utah, and author of The Stop & Go Fast Food Nutrition Guide (maple mountain Press, 2007). He likens restaurant dining to “the wild, wild West.”

The More You KnowThe Center for Science in the Public Interest (C.S.P.I.) recently reported on Chinese food and found many popular dishes are loaded with fat, sodium and calo-ries. For instance: egg rolls are 200 calories each, with 400mg sodium; eggplant in garlic sauce has 1,000 calories, and 2,000mg of sodium; and an order of gen-eral Tso’s chicken—which is batter-dipped and deep fried—packs 1,300 calories, 3,200mg sodium and 11g of saturated fat.

According to the American Heart Association, a healthy adult should get 30 percent or less of his daily caloric intake from fat, and no more than 8 to 10 percent from saturated fat. The average 2,000 calorie-a-day diet, should include no more than 600 calories of fat, with just 140 of those fat calories coming from saturated fat. And the daily limit of sodium is 2,300mg or less.

Now, New york City—which famously banned trans

?

32 HeART INSIgHT • mAy 2007

A 1999 U.S. Department of

Agriculture (U.S.D.A.) study

found that full-service restau-

rant meals tend to be lower in

saturated fats than fast food

meals, but are often higher in

fat, cholesterol and sodium

than fast-food fare.

Even when you’re at a

white tablecloth restaurant,

you can lighten up on fat, cho-

lesterol and calories by choos-

ing entrées that are steamed

or poached, instead of deep

fried or sautéed in butter,

swimming in a cream sauce or

topped with cheese. Steering

clear of sodium is a bit trickier.

In general, the saltiest foods

on the menu are likely to be

soups, sauces, dressings and

anything with cheese.

Tufts University nutrition

professor Alice Lichtenstein

shares 10 tips on eating out

without pigging out:

1. Try to stay away from

the bread basket—most

restaurants ask whether you

want bread on the table. If

you’re famished and must

indulge, ask for a whole

grain bread and skip the

butter or dipping oil.

2. Don’t rely on menu de-

scriptions to figure out which

selections seem to be less

fat-and-calorie packed than

others. It’s best to ask your

waiter how an item is pre-

pared, and whether butter,

cream, cheese or trans fats

are used. Sometimes, the

chef can use alternate ingre-

dients and cooking methods

to suit your nutritional needs.

3. Knowing that you will be

served more than you should

eat at one sitting, split an

entrée with your dinner com-

panion or ask for a doggie

bag. Some restaurants offer

half portions of entrées—

though they sometimes

charge full price.

4. Ask your waiter to hold

the sauce or salad dressing

—or to serve it on the side, so

you can control the amount

you use.

5. Ask your waiter if a starchy

side dish, such as rice or po-

tatoes, can be replaced with

vegetables. But you’ll need

to be flexible and allow the

chef to substitute whatever

vegetable dish is on hand that

evening.

6. Ask that vegetables be

prepared without butter or

drizzled in olive oil, to keep

the calorie count down.

7. Take the skin off chicken,

duck and other fowl, no mat-

ter how it is prepared.

8. Avoid highly marbled meat,

and cut any visible fat off.

9. If you must eat dessert,

choose fruit instead of a fruit

tart, or sorbet instead of ice

cream.

10. If you go to a restaurant

where the waiter is helpful,

the chef is accommodating

and the food is healthy and

delicious, it pays to become a

regular and to develop a rela-

tionship with the staff.

Getting what you want

and how you want it in a

restaurant takes creativity,

self-control, choosing the

right menu items and a chef’s

willingness to accommodate

small requests, says Lich-

tenstein. “Even if you’re in a

place that [serves only] fried

chicken, you [can] slip that

skin and coating off and just

eat the chicken. … If worse

comes to worst, just decrease

the amount of food you eat.”

And remember that

when you’re making special

requests, “service with a

smile” means you smile so

you’re more likely to get

good service.

You’re More in Control Than You Think

HeART INSIgHT • mAy 2007 33

restaurants (mainly chains) that have already been voluntarily providing nutritional information about the standardized items they serve since march 1 of this year. As a practical matter, the regulation will apply to these restaurants because they have already done the required nutritional analysis of their offerings, explains young. In addition, chain restaurants typically standard-ize the type and amount of ingredients used, as well as preparation techniques, for their menu offerings. Fancier restaurants or hole-in-the-wall diners often alter their reci-pes at the whim of the chef, depending on the freshness

of available ingredients—and even his or her mood. A survey by the California Center for Public Health

Advocacy conducted in April had people look at a group-ing of menu items from Chili’s, Denny’s, macaroni grill and mcDonald’s and asked which dish in each chain restau-rant’s grouping was lowest in calories, salt and fat.

Not one of the 523 survey respondents got all four questions right, and 68 percent of them got every question wrong. Not surprisingly, 84 percent of those participating in the survey favored requiring restaurant chains to post nutritional information.

34 HeART INSIgHT • mAy 2007

Alice Lichtenstein, DSc, gershoff Professor of Nu-trition, Science, and Policy at Boston’s Tufts University, applauds the new regulation. “you’ll see how many calories it’s going to cost you to go from a medium to a large fries or to choose those fries over a side salad. In some cases [customers] might get some education, [for instance] that the fried fish fillet is not really saving them any calories relative to the hamburger.”

But the regulation has its opponents, too. “We cer-tainly understand the Board of Health’s intentions in providing information to the people of New york, and we certainly support that,” says Sheila Weiss, R.D., a registered dietician and director of nutrition policy at the National Restaurant Association. The trade group takes issue with the regulation’s “inflexibility” on how caloric information is presented. Weiss explains some restaurants offer so many customization options that a calorie range would be meaningless.

young counters that restaurants may submit their own method to display the caloric content of their offerings for approval.

A new bill introduced to the New york City Board of Health on February 28 by New york City Council-man Joel Rivera would amend the current regulation by simply requiring that calorie counts be provided in a conspicuous location at the point of sale, leaving com-pliance details to the restaurants.

NUTRITITION KNOW-KNOWS

«Most people don’t know which has

more calories,

country fried steak and eggs or

a stack of pancakes

with margarine and syrup

new York’s not AloneWashington, D.C. At-Large Councilmember Phil men-delson has proposed requiring restaurant chains with 10 or more outlets to print the caloric, fat, carbohydrate and sodium content of their standardized dishes. Chicago is also considering a similar calorie-consciousness mea-sure. Alderman edward m. Burke (14th Ward) would like menus and menu boards in Chicago restaurants that gross $10 million or more in annual sales to display the number of calories each item contains—along with the sodium, saturated fat and trans fat content.

“Firms large enough to have $10 million in gross annual sales would likely have that nutritional infor-mation available,” says Donal Quinlan, a spokesper-son for Alderman Burke. The proposal is currently under review by the Council License Committee. If it passes, it goes to the Council Floor, where it will need a majority vote to become law. As of yet, no date has been scheduled for this vote.

Other cities and states are looking into mandating nutritional labeling of restaurant food. C.S.P.I.’s Web site includes a summary of pending state and local bills relating to nutritional labeling of restaurant food: www.cspinet.org/nutritionpolicy/pending_statebills.pdf.

When you go out to get a good meal, you can also get a good-for-you meal—if you have the information you need to choose wisely and well. HI

?

HeART INSIgHT • mAy 2007 35

When you go out to eat, you

know exactly how much a

meal is going to cost you in

dollars and cents—but no

idea what it’s going to cost

your heart health.

A Pennsylvania restaurant

is proudly submitting paper-

work to the “Guinness Book

of World Records” to have

its 123 lb. burger—which

wedding parties or other

large groups can order right

off the menu—officially

recognized as the largest

in the world. For those who

aren’t that hungry, the eatery

will serve up a three-pound

burger. That’s three pounds.

Of meat.

While this is an extreme

case, a 2002 New York Uni-

versity study found that portion

sizes doled out at eateries

have increased dramatically

since the 1970s. A typical

serving of pasta is now nearly

twice the healthy portion size

recommended by the Food

and Drug Administration and

nearly five times the portion

size recommended by the

United States Department of

Agriculture.

According to Brigham

Young University’s Steven

Aldana, “almost without

exception, [restaurants are]

going to serve you pretty

close to twice what you

should really eat. Don’t hesi-

tate to take [it] home and

have it for lunch tomorrow.”

Portion sizes of foods

eaten outside the home have

been so out of whack for

so long that people can no

longer tell what a “regular”

portion looks like. In a 2006

study at Rutgers University

participants helped them-

selves to nearly 20 percent

more cornflakes with 30 per-

cent more milk and 40 per-

cent more orange juice than

participants did in a similar

1984 study.

“The amount of food

served determines, to a

certain extent, how much

[someone] will eat. Hence,

the trend towards increased

portion size of meals eaten

outside the home has likely

contributed to the obesity

epidemic currently occur-

ring in the United States,”

adds Alice Lichtenstein, of

Boston’s Tufts University.

The New York University

study revealed that since the

1970s our waistlines have

been expanding right along

with our serving sizes.

Back then, obesity rates

were under 20 percent

nationwide, according to the

Centers for Disease Control

and Prevention. By 2005,

only four states had obesity

rates under 20 percent—

and in 17 states at least

one-quarter of the popula-

tion is obese.

The Bloated Burger And The Plentiful Pasta

Restaurants generally serve

twice the amount you should eat

Is your head in the right place when it comes to your heart? Take the Heart InsIgHt Quiz and find out whether you’re up on all the latest news about staying healthy.

1. If your kids still live at home with you, your diet is likely to include more saturated fat than if you are an “empty nester.”

T ® F ®

2. Taking folic acid supplements lowers both coronary heart disease and stroke risk.

T ® F ®

3. Your odds of suffering a heart attack or stroke are much higher in the morning than at any other time of day.

T ® F ®

4. Eating raw garlic—but not taking garlic supplements—lowers LDL (“bad”) cholesterol levels.

T ® F ®

5. Your height as a toddler or teen may predict whether you will have elevated LDL levels when you grow up.

T ® F ®

how heart smart areYOU?

LET’s gET QUIzzIcaL

{TUrn pagE FOr ThE answErs}

hEarT InsIghT • maY 2007 47

LET’s gET QUIzzIcaL (continued)

48 hEarT InsIghT • maY 2007

1. TRUE adults who live with children younger than 17 years old eat more total fat and saturated fat than adults without children in the home, according to a study published in the Journal of the American Board of Family Medicine. adults whose children still live with them are more likely to eat such foods as cheese, ice cream, beef, pizza and salty snacks than those without children—which adds up to an extra daily fat intake of 4.9g, of which 1.7g is saturated fat.

2. falsE people who have a history of cardiovascular disease do not reduce their heart risk by taking folic acid supplements, according to an analysis of 12 studies that included a total of 16,958 partici-pants published in the Journal of the American Medical Association. The incidence of coronary heart disease and stroke among those who took folic acid supplements was comparable to those who did not take them.

3. TRUE heart attacks and strokes occur most frequently in the early-morn-ing hours. The body’s own 24-hour clock regulates temperature and metabolism—and new research suggests that circadian rhythm also explains why blood pressure spikes in the morning. This rise in blood pressure is more dramatic in patients who already have high blood pressure, increasing their risk of heart attack and stroke in the morning.

4. falsE garlic may keep vampires at bay but six months of eating raw garlic or taking garlic supplements did not lower levels of low density lipoprotein cholesterol, ac-cording to a study published in Archives of Internal Medicine. The study participants were 192 adults aged 30 to 65 who had moderately high LDL levels (130 to 190 mg/d). They were divided into four groups: one group ate raw garlic; one group took a powdered garlic

supplement; one group took an aged garlic supplement; and the last group took a placebo (dummy pill). LDL levels stayed about the same in all of the groups taking garlic in one form or another, and there was no effect one way or the other on levels of tri-glycerides, hDL (“good” cholesterol) and total cholesterol–high density lipoprotein cholesterol ratio, either.

5. TRUE a British study found that toddlers and teens who are taller than their peers tend to have lower LDL lev-els at middle age. In the study, which tracked some 3,000 people who were born in march 1946, re-searchers measured heights and weights of study participants at ages 2, 4, 7, 15, 36 and 53. re-

searchers found that the bigger the growth spurt that occurred before age 2 and after age 15, the lower the cholesterol level at age 53. however, those who gained weight between the ages of 15 and 53—and had higher body fat levels at the ages of 36 and 53—were the likeliest to have higher LDL and total cholesterol levels.

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