Heart Health on a Budget

The cost of heart medication may be rising, but there are ways to save on costs associated with maintaining good heart health.

 

Taking care of your heart health doesn’t have to be an expensive proposition — your heart will benefit whether you exercise at home or at a gym and whether you eat inexpensive canned fish or costly wild salmon. Here are some ways to save on essentials, from heart medications to your next heart test.

Go for Generic Heart Medication
 
While not every brand-name heart medication has a generic equivalent, there are alternatives your doctor can prescribe. “A generic may not be ideal, but you can go to a discount pharmacy and get a three month supply for $12,” says board-certified cardiologist Robert M. Jarrett, MD, associate clinical professor of medicine at Yale University School of Medicine in New Haven and in private practice in Brookfield, Conn.

Walmart, Target, Costco, and many chain pharmacies may offer generic pricing on heart medications and other drugs. Also, check the Web site of any brand name prescription you are considering taking; recent special offers from Lipitor and Crestor have included free one-month trials.

Get a Health Fair Heart Test
 
Many towns and municipalities offer health fairs that might be sponsored by hospitals or insurance companies. Health fairs are frequently held in malls, community centers, hospitals, and YMCAs. Take advantage of the inexpensive or free test screenings and information made available at these local events. Call your community center, department of health, and local hospitals to find out whether there are health fairs near you.

Services may include health screenings for blood pressure, cholesterol, hearing, vision, and skin cancer, as well as vaccinations. You may also have the chance to meet with and ask questions of experts in various fields, including practitioners like nutritionists, exercise specialists, and representatives from hospitals and community health organizations in your area.

Local Pharmacies
 
Vaccinations and some screenings, including those related to heart health, may be available at your local pharmacy or supermarket. Some types of medical attention and screenings are also available at pharmacy-based health clinics, like the Minute Clinics at CVS stores and the Take Care Clinics at Walgreens. Services may be less expensive than if you were to go to a traditional doctor’s office appointment without insurance; locations and prices are listed on their Web sites. An important caveat is that you must follow up with a medical practitioner if the results from any of these screenings point to a problem, says Dr. Jarrett.

Exercise Your Initiative
 
“You don’t have to join a gym or have a piece of equipment in your house to exercise,” says nutritionist Barbara Schmidt, MS, RD, lifestyle specialist at Norwalk Hospital in Connecticut whose practice includes patients in cardiac rehab. “Walk as far as you can for 15 minutes, then turn around and come back. See how far you get in 30 minutes. In inclement weather, go to the mall or a store like Home Depot and walk the aisles.”

Though not free, low-cost exercise classes are offered at many hospitals and may include choices like yoga and tai chi. And don’t forget the YMCA or YWCA and programs at your town’s community centers. Local park and recreation departments often have classes for adults and kids at far lower costs than health clubs.

Rediscover Home Cooking
 
A heart healthy diet doesn’t have to break your budget. “Buy foods on sale — read your supermarket’s sale flyer, make a shopping list, and plan your menu around what’s on special,” advises Schmidt, who says the real problem is that people aren’t cooking enough. “Cooking at home is the cheap way — fast food is not cheap. You can end up spending $15 to $20 at McDonald’s when you could buy a roasting chicken for $3.” Homemade food is not only more economical and heart healthy, it usually tastes better.

There’s also a big difference between the low-nutrition value of a greasy fast food meal and the heart health benefits of a hearty, homemade chicken soup or one made with fiber-rich lentils, onions, garlic, and carrots — two of Schmidt’s favorite one-pot dishes. She likes to finish each off with a can of crushed tomatoes for flavor, color, and the antioxidant lycopene.

If fresh produce is too expensive, buy large bags of frozen veggies and berries. And as for fish, Schmidt says you don’t always have to go for the expensive types. When she’s counseling patients, she reminds them that the cheapest option, sardines, is the best choice when it comes to getting heart-healthy omega-3 fatty acids. Schmidt suggests serving them on whole-wheat toast.

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Vitamin D and Calcium: Are We Getting Enough?

A new report revises daily intake guidelines for these nutrients, based on a thorough review of existing research.

A rash of claims about the health benefits of vitamin D — and the health risks of vitamin D deficiency — has fueled a dramatic increase in sales of supplements and prompted many people to up their intake of this nutrient, but a new report from the U.S. Institute of Medicine (IOM) says that most people are getting plenty of vitamin D.

Nearly all Americans get enough vitamin D through diet and exposure to sunshine, the report says, and there isn’t yet enough evidence that vitamin D offers protection against cancer, diabetes, and heart disease, or plays a role in a host of other ailments such as multiple sclerosis, as some studies have suggested. The IOM report, which sets new dietary recommendations for calcium as well as vitamin D, warns that some people may face health risks from getting too much of these nutrients.

The IOM is the expert group within the National Academy of Sciences that provides independent, evidence-based advice on major health issues to policymakers, professionals, and the public. This IOM study was sponsored by the U.S. departments of Health and Human Services, Agriculture, and Defense, and by Health Canada, a department of the Canadian federal government.

As the vitamin D trend took hold, many doctors began routinely testing their patients for vitamin D deficiency and recommend vitamin D supplements. Many people take 1,000 or 2,000 international units (IUs) of vitamin D a day, and some take as much as 5,000 or 10,000 IUs.

“It’s all over the Internet. There are now 5,000 IU capsules you can find in WalMart. You can get anything you want,” says IOM vitamin D committee member Clifford E. Rose, MD, senior scientist with the Maine Medical Research Institute in Scarborough.

The trend has been fueled by research suggesting that vitamin D deficiency may play a role in a range of diseases and conditions, including autism, mental illness, cancer, heart disease, diabetes, fibromyalgia, and autoimmune diseases. But, the committee warns, high levels of vitamin D could cause long-term harm to your health.

“Increasing your blood level of vitamin D not only doesn’t offer you protection against cancer or heart disease, it may increase your risk of those diseases,” Dr. Rose says. “The idea that more is better is wrong, and the idea that it’s not harmful to take all these supplements may also be wrong.

Rose notes that he and other committee members were “totally surprised” by their findings because many of them had bought into the idea that extra vitamin D could improve health.

“I went into this with very preconceived ideas that we are all vitamin-D deficient,” he says. "We all believed it. We were very aggressive about supplementing. We were very surprised to see that the higher levels may cause some problems.”

How Much Vitamin D and Calcium Do You Need?
 
Most people up to age 70 need only 600 international units (IUs) of vitamin D per day; those older than 70 may need up to 800 IUs, the committee determined. Taking more than 4,000 IUs of vitamin D per day may be associated with a higher risk of death and chronic disease.

Guidelines for calcium intake vary by age.

Children and adolescents should get:

• 700 milligrams (mg) per day – ages 1 through 3
• 1,000 mg per day – ages 4 through 8
• 1,300 mg per day – ages 9 through 18

Adults should get:

• 1,000 mg per day – ages 19 through 50 for women and 19 through 71 for men
• 1,200 mg per day – age 51 and older for women and 71 and older for men

In the United States and Canada, only adolescent girls may not be getting enough calcium, while older women may be getting too much, the committee says.

“There is abundant science to confidently state how much vitamin D and calcium people need,” says Catharine Ross, chair of the committee that issued the report, and chair of the department of nutritional sciences at Pennsylvania State University, University Park.

Faulty Laboratory Testing Procedures?
 
The IOM group also took issue with vitamin-D deficiency testing in labs. Test procedures are not standardized, and results vary widely among laboratories. As a result, many people are wrongly told they are vitamin-D deficient. Many laboratories find people deficient in vitamin D if blood levels are below 30 nanograms (ng) of vitamin D per milliliter of blood. The cutoff should be closer to 20 ng per milliliter, says committee member Glenville Jones, MD, head of the biochemistry department at Queen’s University in Kingston, Ontario. “In the past three or four years, there’s been a slow ramping up of the threshold or cutpoint.”

In addition, says committee member Steven K. Clinton, MD, professor of internal medicine at Ohio State University in Columbus, routine vitamin D testing is largely unnecessary because most people are getting enough of these nutrients.

As vitamin D and calcium are added to more prepared foods and rates of supplement use continue to rise, chances are increasing that some people will take too much of these nutrients. Too much calcium has been associated with kidney stones, while excessive vitamin D can damage the kidneys and the heart.

Vitamin D and Calcium: More Clarity From Further Research
 
The IOM committee examined nearly 1,000 studies on the possible protective effects of vitamin D and heard testimony from scientists and others with an interest in the topic. The committee found that study results to date have been conflicting and mixed, and that more research is needed.

“We are still very enthusiastic about this molecule [vitamin D] that regulates hundreds if not thousands of genes in the body," Dr. Clinton says. “What’s missing is the translation of basic science into a public health recommendation. We can’t make that leap at this time.”

Plenty of evidence supports the role of vitamin D and calcium in promoting skeletal growth and maintaining bone health, the committee found. The body produces vitamin D from exposure to sunlight; vitamin D and calcium are found in some fish, dairy foods, and fortified foods such as cereal, juices, and milk.

The IOM committee hopes the new report will reduce confusion about vitamin D and calcium needs, and discourage doctors from relying too heavily on laboratory tests to recommend vitamin D supplements until new testing standards have been developed.

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Eat This, Not That!

The book "Eat This, Not That!" is a guide to avoiding hidden fats and calories in restaurant food. Find out if that's enough of a lifestyle change to create the weight loss you want from a diet.

Eat This, Not That! by David Zinczenko, the editor-in-chief of Men’s Health magazine, is more of a guide to uncovering hidden fat and calories in restaurant foods than an actual diet. The subtitle boasts that the Eat This, Not That guidelines can help you lose anywhere from to 10 to 30 pounds just by swapping better food choices for your fatty favorites.

But that’s a lofty goal for a plan that focuses on calories and only offers substitution suggestions, not nutrition or fitness tips. “It’s a good GPS navigation system for the gut,” says Sari Greaves, RD, CDN, a dietitian with the Step Ahead Weight Loss Center in Central, N.J. “It’s a diet tool for people who dine out frequently. It helps you make good food choices when faced with a variety of options — like a navigator to save calories.”

Eat This, Not That Diet: How Does It Work?
 
The book helps dieters pick the lower-calorie, lower-fat option among similar menu choices, like burgers and chicken meals. The Eat This, Not That Diet guidelines display menu options, helping readers figure out what to choose. “It focuses mainly on calories, and looks at restaurant and convenience store items,” says dietitian Kerry Neville, MS, RD, a spokesperson for the American Dietetic Association. “It suggests lower-calorie processed foods or takeout food options.”

Eat This, Not That Diet: A Sample Substitution
 
As a surprising example of the Eat This, Not That substitutions, eating a McDonald’s Quarter Pounder with 410 calories, 19 grams of fat (7 of them saturated), and 730 milligrams of sodium is actually not as bad for you as the chain’s Premium Grilled Chicken Club, weighing in at 570 calories with 21 g of fat (7 of them saturated) and 1,720 mg of sodium.

Eat This, Not That Diet: Pros
 
The guidelines warn readers not to take anything for granted when ordering food. “It shows you that a salad [and soup] can be as artery-clogging as a cheeseburger,” says Greaves. At Cosi, the Signature Salad served with a cream-based soup can total 870 calories and 69 g of fat, while a Bombay Chicken Salad with fat-free vinaigrette and a broth-based soup is only 5 g of fat and 294 calories.

Another handy feature of the Eat This, Not That book is the chapter on how to decode menus. “It tells you to look for terms like ‘roasted’ or ‘steamed’ vs. ‘fried,’ for example,” says Greaves. “It talks about which cuts of meat at a steakhouse have more artery-clogging fat, which pasta sauces to avoid, and hidden fat and calories in seemingly healthy foods such as spicy tuna rolls, which are made with mayonnaise.”

The guidelines also give you some practical tips, says Greaves. For example, in acknowledging that dining out is a part of life for many people, Zinczenko includes choices like a thin-crust pizza with veggie toppings, something people are likely to eat. “Encouraging small changes can mean slashing as much as 100 calories a day for some people,” says Greaves. “That may mean losing 10 pounds in a year.”

Keep the book in your car, briefcase, or purse so that you can have it on hand when you’re ordering food or drinks. Says Greaves, “You can just open up the beverage chapter and find a lower-sugar variety.”

Eat This, Not That Diet: Cons
 
The guidelines show you how to switch one food item or dish for another, but experts say that isn’t enough. “It gives you the lesser of two evils,” says Neville, “but to lose belly fat and build lean muscle, which the book claims you can do with these substitutions, you need strength training. Just making swaps is not going to help you lose weight.”

Another problem: The substitutions may not necessarily be healthy or low-calorie choices. “There is no bigger picture,” says Neville. “If you eat only the ‘eat this’ items, you’d be in trouble nutritionally.”

Also, consumers should be wary of some of the health claims, such as that following these tips will help rev up metabolism. “None of the claims are scientifically based,” says Greaves.
There is no information on exercise, no discussion about how to learn what to eat and lifestyle choices to weight and improve health. “The book can be an effective and fun way to cut calories, but it’s not the only way,” says Greaves. “It would be better to use it in conjunction with other weight-loss measures, such as paying attention to portions and quality, and lifestyle and exercise.”

Eat This, Not That Diet: Short-Term, Long-Term Effects
 
In the short term, someone can lose weight by following the lower-fat, lower-calorie substitutions. “If you eat out a lot, it can result in some weight loss,” says Greaves.

Maintaining that weight loss simply by following this book, however, can be more difficult to accomplish. “To expedite a weight-loss plan, exercise is a must,” notes Greaves.

The bottom line: The guidelines don’t factor in nutrition when suggesting substitutions, which means possible nutritional deficiencies in the long run. “The ‘eat this’ option isn’t always the healthy option,” says Neville. “A smoothie has calcium, but could be on the ‘don’t eat’ list because the book forgets about nutrients.”

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Your Diet, Your Health

Nutrition is essential not only for life, but for a healthy life. Learn about the connection between what you eat and how you feel.

We've all heard the old saying “you are what you eat.” And it's still true. If you stick to a healthy diet full of vitamins and minerals, your body reflects it. You feel healthy, energized, and just all-around great. However, people who limit their diet to junk foods will undoubtedly suffer the consequences of not giving their bodies what they need to thrive. The result is not only fatigue and low energy, but poor health as well. Understanding this clear connection between your health and your diet may spur you to make better dietary choices.

Your Diet and Your Health: What Your Body Needs
 
"Food is essential. People take it for granted, but we need nutrients," says Anne Wolf, RD, a researcher at the University of Virginia School of Medicine. Wolf cites as one example the old days when sailors crossed the ocean for months without proper nutrition. As a result, they ended up with scurvy because of a lack of vitamin C from citrus fruits. Vitamin C and other vitamins and minerals are necessary to keep all the different parts of the body healthy and functioning — otherwise, we get sick.

Every little thing that you do happens because of the nutrients that you give your body. Says Wolf, "Food gives us the fuel to think and the energy to move our muscles. The micronutrients, the vitamins, the minerals are there so that our bodies can function. You need food not just to sustain health, but to feel better."

And the only way the body will get the many nutrients needed to stay healthy and function is by eating a wide variety of healthy foods.

Your Diet and Your Health: The Guidelines
 
The U.S. Department of Agriculture's food pyramid and the daily food recommendations were established after extensive research and continue to be updated as more is learned about the role of nutrition in good health. Their goal is to make sure that people understand all the different nutrients their bodies need to stay healthy.

Food went from being a necessity to simply function to being the key to enabling the body to be at its functional best, says Wolf. Research shows that the right nutrition optimizes health and that getting enough of certain vitamins and minerals can also lower disease risk.

Your Diet and Your Health: Poor Diet, Poor Health 
 
Many foods have a huge impact on heart health. Research has long shown that fruits and vegetables and a diet rich in whole grains and low in saturated fats can help protect the body from heart disease and high blood pressure, while a diet high in saturated and trans fats without enough fruits and vegetables can actually cause those diseases.

Even small diet deficiencies can have an enormously negative impact on your health. The most common health problem due to a lack of nutrients in the United States is iron deficiency, says Wolf. Menstruating women and girls need plenty of iron in their diets to replace what they lose each month during their periods. Iron is also an essential nutrient for infants, children, and growing teens.

Another example is calcium, needed to keep bones strong and healthy, says Wolf. Without it, the body can develop osteoporosis, a health condition characterized by weak and brittle bones.

Eating a well-rounded and varied diet will go a long way toward making sure you have all the nutrients you need. Remember that our body uses everything we put into it, and what we give it determines how it's used — for good health, or for bad.

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