VARICOSE VEINS CAN BE A SIGN OF SERIOUS VASCULAR PROBLEMS

Varicose veins and their precursors, spider veins can signal serious vascular problems.  Full-blown varicose veins appear as twisted, enlarged veins close to the surface of the skin while milder varicose spider veins appear as sunbursts of small blue or red vessels near the surface of the skin.  Spider and varicose veins are often misunderstood as merely a cosmetic problem.  However, if left untreated, spider and varicose veins can progress to a more serious form of vein disease called chronic venous insufficiency (CVI). 

Veins are the vessels that return blood to the heart from the body.  To keep the blood flowing up from extremities, and not back down, the veins contain one-way valves. Failure of  leg veins’ valves to hold blood against gravity leads to swelling in the lower legs and ankles, aching or tiredness in the legs, new varicose veins, leathery-looking skin on the legs, and/or flaking , itching, or ulceration on the skin of the legs or feet.

Varicose veins and vein valve damage is more likely among women, persons over 50, and persons with a personal or family history of leg clots (known as deep vein thrombosis).  Obesity, smoking, sedentary lifestyle, and sitting or standing for long periods have also been found to increase the risk of varicose veins and vein disease.  To prevent and reduce the progression of venous diseases try to maintain a healthy weight, avoid smoking or quit if you already smoke, exercise regularly, and avoid long periods of standing or sitting.  Elevating your legs to the level of your heart when sitting or lying down as well as wearing compression stockings can also support  venous blood flow in the lower extremities.

It is estimated that more than 40 million Americans suffer from vein disease but less than 3% get treated.  Because varicose veins are a potential risk factor for vein disease, persons with varicose veins, should have their risk for CVI assessed and be treated when indicated.  A vascular ultrasound can examine the blood circulation in the legs.  Non-surgical treatments for existing varicose veins and spider veins include sclerotherapy in which an injection into the veins causes them to collapse and disappear and endovenous thermal ablation in which laser or high-frequency radio waves create intense local heat in the affected vein causing it to close.  For more severe cases, surgical venous stripping or ligation may be necessary.

What to do:  To maintain healthy veins in the legs aim for good cardiovascular health by not smoking, maintaining a healthy weight, and exercising regularly.  Also, try to avoid long periods of sitting or standing.   If you are traveling or will be sitting for a long time, flex and extend your legs, feet, and ankles about 10 times every 30 minutes to keep the blood flowing in the leg veins. If you need to stand for long periods of time, take frequent breaks to sit down and elevate your feet.  If you are experiencing varicose veins or other symptoms of leg vein disease, discuss assessment and treatment options with your provider. 

Sources:  “Chronic venous insufficiency.” Vascular Web. Society for Vascular Surgery, Jan. 2011. Web. http://www.vascularweb.org/vascularhealth/Pages/chronic-venous-insufficiency.aspx and Gloviczki P, Comerota A, Dalsing M, Eklof B, Gillespie D, Gloviczki, M, et al.  The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May; 53(5 Suppl): 2S-48S.

RESEARCHERS PINPOINT HOW A LACK OF VITAMIN D MAY INCREASE THE RISK OF ALZHEIMER'S AND VASCULAR DEMENTIA

Researchers have found that low blood levels of vitamin D are associated with an increased risk for a host of health problems ranging from cardiovascular disease, susceptibility to infections, and diabetes, to osteoporosis, dental cavities and periodontal disease.  Vitamin D deficiency is also known to be linked to an increased risk of Alzheimer’s and vascular dementia.   For example, recently, a study from the large Third National Health and Nutrition Survey (NHANES III) in the U.S. showed a marked association between vitamin D deficiency and risk of dementia.   According to the latest estimates, 5.3 million Americans have Alzheimer's disease and it is the seventh-leading cause of death in the U.S

In 2009 it was reported that vitamin D3 appears to stimulate the immune system to clear harmful amyloid beta proteins, the main component of plaques associated with Alzheimer's disease.  But, the researchers didn't know how it worked.  Now researchers have identified the cellular mechanisms regulated by vitamin D3 that help the body clear the brain of amyloid proteins.

For the study, scientists drew blood samples from Alzheimer's patients and healthy controls and then isolated critical immune cells from the blood called macrophages, which are responsible for gobbling up amyloid beta and other waste products in the brain and body.  The team incubated the immune cells overnight with amyloid beta. An active form of vitamin D3 which is made in the body was added to some of the cells to gauge the effect it had on amyloid beta absorption.  They found that vitamin D3 activates key genes and cellular signaling networks to help stimulate the immune system to clear the amyloid protein. 

To determine whether vitamin D supplementation may help to treat dementia, clinical trials are still needed.  It is too early to know whether supplementation with vitamin D can reverse or slow the course of dementia.

What to do:  To reduce your risk of inflammatory diseases such as Alzheimer’s and heart disease, aim to maintain a healthy weight and lifestyle as well as adequate vitamin D.  For vitamin D, consume food sources rich in vitamin D such as lowfat/nonfat milk and oily fish such as salmon.  Also, next time you get blood work with your regular doctor, you can request your vitamin D level be checked.   This way you can know if you are deficient or not and how much to supplement with.  Vitamin D3 is widely available in supplements.  To maximize uptake of vitamin D, it is best to take it along with calcium.  Persons with some conditions should not supplement with vitamin D so check with your doctor before starting supplementation.  

Adapted from content in:   Journal of Alzheimer's Disease, 2009 17:1 & 2012;29:51-62, Science Daily at http://www.sciencedaily.com/releases/2009/05/090526140747.htm and Medscape at  http://www.medscape.com/viewarticle/760305.

EVEN IN THE ABSENCE OF WEIGHT GAIN, SUGAR-SWEETENED DRINKS INCREASE HEART HEALTH & DIABETES RISK FACTORS

Drinking two or more sugar-sweetened beverages a day boosts a woman's risk for developing heart disease and diabetes -- even if this habit isn't causing her to pack on extra pounds, a new study says.

Sugary sodas and other sweetened beverages are frequent targets in the war on obesity as their consumption often leads to increases in caloric intake and weight gain. Now it appears that even when the consumption of sweetened drinks does not result in weight gain, they may still be detrimental to heart health. 

For the study, researchers at the University of Oklahoma assessed the drinking habits of nearly 4,200 women aged 45 to 84 from various ethnic groups via questionnaires. The researchers measured weight gain, waist circumference, cholesterol levels, triglycerides and glucose (blood sugar) during three follow-up exams conducted over a five-year span.

Researchers found that compared to women who drank one or less sugar-sweetened beverage, those who drank two or more sugary beverages a day were four times as likely to have high levels of unhealthy blood fats called triglycerides and elevated fasting blood sugar levels (known as "prediabetes').  What's more, among women of similar weight, those who drank two or more sweetened drinks had more belly fat than those who drank one or less each day.  Unfortunately, belly fat has been found to be the fat that is most detrimental to health. 

What to do:  Aim to avoid consumption of sweetened drinks including soda, sweet ice tea, and juice.  These are high in calories and tend not to be filling.  Opt for water, seltzer, and tea instead. 

 

Adapted from articles available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_118658.html and http://newsroom.heart.org/pr/aha/sugar-sweetened-beverages-may-217750.aspx

TIPS TO CUT BACK ON SODIUM

It’s clear that Americans have a taste for salt, but a diet high in salt (sodium chloride) contributes to water retention, high blood pressure, stroke, and kidney disease. The average American consumes about three to four times the recommended amount of sodium. For health, everyone, including kids, should reduce their sodium intake to less than 2,300 mg of sodium a day (about 1 teaspoon of salt). If you have heart health risk factors, aim to consume less than 1500 mg of sodium each day.  This means getting less than 2/3 of a teaspoon of salt from all dietary sources. 

Even if you do not add salt while cooking or do not use the salt shaker at the table, you are probably eating too much sodium. That is because we eat packaged foods, like deli meats, frozen dinners, boxed noodle and rice dishes, canned soups, canned vegetables, bottled dressings & sauces, breakfast cereals, bread, and snack foods. Approximately 75% of our intake of sodium is derived from salt added by manufacturers to food products long before they appear on our tables. Even some foods that do not taste salty are high in sodium.  For example, bread is the leading source of salt in most American’s diets but you don’t necessarily taste all that sodium because it’s “baked in” rather than on the surface of the food like with chips where the salty taste is more distinct. 

10 Tips to Cut Back on Sodium in Your Diet:

·         Think fresh - Most of the sodium Americans eat is found in processed foods. Choose highly processed foods less often and in smaller portions—especially cheesy foods, such as pizza; cured meats, such as bacon, sausage, hot dogs, and deli/luncheon meats; and ready-to-eat foods, like canned chili, ravioli, and soups. Fresh foods usually have little or no added sodium, allowing you to better regulate sodium intake.

·         Enjoy home-prepared foods - Cook more often at home—where you are in control of what’s in your food. Foods prepared in restaurants and fast food locations are often very high in sodium with many dishes having more than a day’s worth of sodium!

·         Fill up on veggies and fruits—they are naturally low in sodium - Eat plenty of vegetables and fruits—fresh or frozen or canned with no sodium added.  Aim to eat a vegetable or fruit at every meal.  Fresh fruits and vegetables are high in potassium which helps to somewhat counteract the increases in blood pressure caused by sodium.

·         Choose dairy and protein foods that are lower in sodium - Choose more fat-free or low-fat milk and yogurt in place of cheese, which is higher in sodium. Choose fresh beef, pork, poultry, and seafood, rather than those with salt added. Deli or luncheon meats, sausages, and canned products like corned beef and fish like sardines are high in sodium.  Look for canned tuna without added sodium. Choose unsalted nuts, seeds, and nut butters like peanut butter.

·         Adjust your taste buds - Cut back on salt little by little—and pay attention to the natural tastes of various foods. Your taste for salt will lessen over time.

·         Skip the salt shaker - Skip adding salt when cooking. Keep salt off the kitchen counter and the dinner table. Use spices, herbs, garlic, vinegar, and lemon juice to season foods or use no-salt seasoning mixes. Try black or red pepper, basil, curry, ginger, rosemary, dill, and many others to add flavor to dishes.

·         Read the label - Read the Nutrition Facts label to find packaged and canned foods lower in sodium. These list the amount of sodium in one serving of the food.  The % Daily Value (%DV) is the percentage of the daily sodium limit in one serving of the food.  If the %DV is less than 10% than the food is not so high in sodium but if it is 25% or more, try to choose a lower sodium option.

·         Ask for low-sodium foods when you eat out – Restaurants’ foods are usually loaded with sodium but often they can prepare dishes with less added sodium at your request and will serve sauces and salad dressings on the side so you can use less.

·         Pay attention to condiments - Foods like soy sauce, ketchup, pickles, olives, salad dressings, and seasoning packets are high in sodium. Choose low-sodium soy sauce and ketchup. Have carrot or celery sticks instead of olives or pickles, or if you are using these for salads replace them with low-sodium options such as unsalted roasted red peppers, unsalted sun-dried tomatoes, horseradish, and more lemon/vinegar.  Mix up dressings at home or dilute store bought ones with added lemon/vinegar to control the sodium.  Use only a sprinkling of flavoring packets instead of the entire packet.

·         Boost your potassium intake - Choose foods rich potassium, by emphasizing fruits, vegetables, nuts, beans, whole grains, and low-fat/non-fat dairy in your diet.  Intake of foods rich in potassium can help to counteract the effect that sodium has on blood pressure. Some of the fruits and vegetables highest in potassium include oranges, melons, bananas, kiwis, potatoes, yams, tomatoes, spinach, beans, and artichokes.

BPA EXPOSURE MAY RAISE RISK OF HEART DISEASE

A new study has found that exposure to bisphenol A (BPA), a controversial chemical commonly used to make plastics, increases a person's risk of developing heart disease later in life.

BPA is a building block of plastic that is in the epoxy resin used to line most cans, some plastic bottles that have a #7 recycling code as well as other hard plastic containers, older dental sealants, receipts, and receipts. There are concerns that BPA mimics estrogen in the body interfering with endocrine function and fetal development.  Animal studies have found that exposure to BPA early in life may alter behavior and may increase the risk of cancer, diabetes, and heart disease.

For this study, which found an association between BPA exposure and heart disease, researchers gathered urinary BPA levels of healthy adults at the start of a large long-term population study in the U.K.  After 10 years, 758 people developed heart disease. The study found that the subjects who developed heart disease had significantly higher levels of BPA in their urine at the start of the study than those who did not develop the disease.

The findings of another recent study emphasize just how much consumption of products that have been in contact with BPA can increase urinary BPA levels.  Here, researchers fed 12 ounces of fresh or canned (Progresso) vegetarian soup to 75 people at lunch every day for five days.  They found that several hours after lunch, compared to those who had fresh soup, those who consumed the canned soups had urinary BPA levels that were 12 times higher.

What to do:  Scientists don’t yet know is BPA is truly harmful. In the meantime, to play it safe it may be wise to try to avoid BPA as much as possible, particularly among persons who are pregnant, breastfeeding, or under age 18.   To minimize exposure avoid #7 plastics and use glass or stainless steel to store foods.  Avoid freezing, microwaving, or dish washing plastics with BPA as these degrade the plastic allowing more BPA to leach into your foods.  Choose drinks packaged in glass and instead of canned items, look for these products packaged in cartons, pouches, or as frozen items.  There are also now some cans such as those used by Eden Organic that are made BPA free.  Also, when possible, discard of receipts and try not to mix them in with groceries.

Adapted from article at: http://www.nlm.nih.gov/medlineplus/news/fullstory_122396.html, report by  Nutrition Action Healthletter Jan/Feb. 2012, and Peninsula College of Medicine and Dentistry, news release, Feb. 23, 2012.

RED MEAT INTAKE ASSOCIATED WITH INCREASED RISK OF CHRONIC DISEASE

A large new analysis has found that eating red meat, especially processed red meat, may shorten your life, while consuming more fish and poultry may extend it. 

Although red meat is rich in protein, iron and other nutrients, it is also one of our main sources of unhealthy saturated fats that have been found to increase blood cholesterol, cardiovascular disease, and inflammation.    Like previous studies, this research found that red meat is associated with a higher risk of dying from heart disease, cancer, and other chronic diseases.

Dr. Frank Hu and his team at Harvard University tracked the diets and health of more than 120,000 adult men and women in the U.S. over 28 years.  Researchers calculated participants average daily intake of red meat and other foods. Hu's group calculated that for every daily serving of red meat (i.e. 3 oz. cooked), the risk of dying increased 12%. 

The researchers also found that replacing a daily serving of red meat with a serving of fish, poultry, nuts, legumes, low-fat dairy products or whole grains decreased the risk of dying during the study period.  The risk of death decreased by 7% for fish (3oz.), 14% for poultry (3 oz.), 19% for nuts (1 oz./1/4 c.), 10% for legumes (1/2 c.), 10% (1 c.) for low-fat dairy products and 14% (1 oz/1/2 c.) for whole grains.

Processed red meats appear to be even more detrimental than unprocessed meats. The researchers found the risk dying during the study period increased to 20% for each serving of processed meat consumed.  Processed red meat such as cold cuts, bologna, sausage, and hot dogs are especially unhealthy because they are high in sodium which can increase blood pressure and are often preserved with nitrites which have been found to increase the risk for cancer as well as other health problems.  Of note, another recent study, revealed an additional drawback to consuming processed red meats.   In this study, researchers found that processed meat products can worsen symptoms of airway diseases like emphysema and chronic bronchitis. These diseases, which cause inflammation of the lungs make it difficult for a person to breathe.  Researchers reported that the nitrates used as preservatives in cured meats produce reactive nitrogen species that could damage lung tissue, and consumption of these food items can raise the risk of hospitalization among patients with lung problems. 

What to do:  Try to cut back to eating red meat, especially processed meat, to once or twice a week.  On other days, substitute chicken, fish, beans, soy, eggwhites, or nonfat dairy for your protein sources.  When you do eat meat, choose lean cuts lower in the unhealthy saturated fats of meats.  Trim off the fat around your cuts before cooking.  When having processed meats, aim for items that are reduced in sodium.  Also, check the ingredients list and choose items that do not have nitrite preservatives. 

Diet & Lifestyle to Prevent Cancer

People who are diligent about keeping their heart healthy have a good chance of staving off cancer as well.  Research shows that a large percentage of cancer-related deaths as well as heart related deaths are directly linked to lifestyle choices such as smoking, drinking, a lack of exercise, and an unhealthy diet. Want to minimize your risk for cancer? Firstly, make sure you keep up with recommended cancer screenings. Avoiding cigarettes, minimizing alcohol, and getting regular exercise are a great start to an anti-cancer heart healthy lifestyle but it is also important to maintain a healthy weight with a diet rich in fruits, vegetables, and legumes. 

Excess weight increases the likelihood that a person will get cancer.  Inflammation has been found to increase one’s risk for cancer and heart disease. Overweight and obesity increase fat cells which contribute to bodily inflammation.  Extra weight may also contribute to cancer due to other factors affected by excess fat cells.  For example, researchers have found that fat cells in post-menopausal women produce estrogen which is known to increase breast cancer risk at this stage of life.  Also, overweight tends to lead to insulin resistance which results in increases in the body’s production of insulin, which, in high levels may also promote tumor growth.   So, maintaining a healthy weight is very important. 

It is also important to consume a healthy diet.  In general, a cancer-prevention diet emphasizes consuming a variety of fruits, vegetables, and beans and minimizing intake of red meat and other foods high in unhealthy saturated fats.  Here are some dietary tips to decrease your odds of getting cancer: 

Boost your antioxidants. Antioxidants are important nutrients that protect against cancer. Fruits and vegetables are the best sources of antioxidants such as beta-carotene, vitamin C, vitamin E, and selenium. Because many of these nutrients are lost with cooking, consume some of your fruits and vegetables raw.

Eat a wide range of brightly colored fruits and vegetables. Colorful fruits and vegetables are rich in phytochemicals & antioxidants, potent disease–fighting and immune–boosting nutrients. Try to include a rainbow of colors of fruits and vegetables to get the variety of cancer preventing phytonutrients.

Flavor dishes with immune-boosting, anti-inflammatory spices and foods. Garlic, ginger, curry powder, and rosemary not only add flavor, but they add a cancer-fighting punch of valuable nutrients. Other good choices include turmeric, basil, rosemary, and coriander.

Regularly consume oily fish rich in omega-3 fatty acids such as salmon, mackerel, and sardines.  These fats help to reduce inflammation which can promote tumor formation and growth.

Avoid processed meats with nitrite preservatives and reduce your intake of fatty meats.  Nitrites, preservatives used in deli meats, have been found to increase risk of cancer so check the ingredients list and avoid foods preserved with nitrites.  Also, fatty meats are rich in pro-inflammatory saturated fats.

Use moist cooking methods instead of high heat methods such as grilling and frying. Carcinogens can form during the cooking process of meats, poultry, and other proteins as well as starches such as potatoes.  Instead of cooking these foods in oils at high heat, opt for healthier methods such as baking, boiling, steaming, or broiling that do not generate carcinogens. When grilling try not to overly char the meat as this also promotes the formation of carcinogens.

Lifestyle Factors Research Has Found Influence Risk for Different Types of Common Cancers

The preventative measures described below are general guidelines.  Everyone’s health situation is unique.  Work with your doctor to decide what changes in diet, activity, and supplementation are appropriate for you.
Type of Cancer	Dietary and Lifestyle Factors that Increase Risk:	Dietary and Lifestyle Factors that Decrease Risk:	What to Do:
Breast	•Overweight & obesity •Diets high in fats, especially saturated fat •Alcohol, even 1 drink per day raises risk, & risk increases with more frequent intake	•Deep orange and dark green veggies appear to reduce risk •Adequate intake of vitamin D may help •Regular activity, the more you do, the lower your risk	•Maintain healthy weight •Get regular activity •Moderate your intake of fat especially saturated meat and dairy fats •Avoid alcohol or consume only occasionally •Eat a healthy diet rich in fruits & vegetables •Take a supplement with 400-1000 IU of vitamin D
Colon & Rectum	•Overweight and obesity •Red processed meats	•Regular activity •Consuming lean dairy products so that you get 800-1200 mg of calcium daily	•Maintain healthy weight •Get regular activity •Include 3-4 servings of dairy/ dairy substitute, or consider taking a calcium supplement twice daily •Limit intake of red meat & avoid meats preserved with nitrites
Esoph-agus	•Smoking •Heavy drinking • Overweight & obesity •Uncontrolled acid-reflux		•Maintain healthy weight •Do not smoke •Drink in moderation only •Avoid reflux triggers such as acidic foods, high fat meals, and large meals
Lung	•Smoking & second-hand smoke	•Adequate intake of vitamin B-6	•Do not smoke •Include foods rich in B-6 such as poultry, seafood, cottage cheese, & whole grains
Pancreas	•Overweight & obesity		•Maintain healthy weight
Prostate		•Regular physical activity, vigorous activity appears especially helpful •Possibly eating more of the carotenoid lycopene found in cooked tomatoes	•Get regular activity •Eat cooked tomatoes regularly
Uterus	•Overweight & obesity		•Maintain healthy weight
Note:  Smoking increases the risk for many cancers as well as heart disease, so, if you smoke, it is vital to your health to work on quitting!