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Healthy Heart ProgramProvided by Matria WellCare

Healthy Heart Program •

Heart disease remains one of the most dangerous health conditions for Americans.

It doesn’t have to be. High cholesterol, high blood pressure, andother high-risk heart conditions can be managed and even turnedaround with simple changes in lifestyle. By following this program youcan take steps to significantly reduce your risk.

Using the program is easy! Each week we’ll provide you with a specific goal and information and resources to help you achieve it. Then during theweek one of our expert coaches will provide you with personalized advicebased on your current situation. Just knowing that you have someone on your sidechecking in on your progress will give you added motivation to stay with it.

If you’re able to use the Internet, you can log on for more support and personalized tips on-line. Here is anoverview of the program:

Week One: First Steps to a Healthy HeartLearn the basics about heart disease and assess your risk.

Week Two: Heart Health by the Numbers Find out what your cholesterol and blood pressure levels mean.

Week Three: Easy ExerciseGetting active is one of the keys to reducing your risk.

Week Four: Weight ControlDon’t let extra pounds cause strain on your heart. We can help!

Week Five: Think Stress-Free!Learn about the effects stress can have on your heart.

Week Six: A Heart Healthy LifeLearn more ways you can protect your heart for the long-term.

Healthy Regards!

Welcome to the Healthy Heart Program!


Week 1: First Steps to a Healthy Heart

Your Goals This Week:

• Know the basics about heart disease and assess your risk.

• Learn the benefits of eating heart-heathy “superfoods.”

• Start a food and exercise journal to track your progress (see page 17).

Welcome to your program! For thenext six weeks you’ll learn simpleways to improve your heart health.Your coach can help!

Fast Facts: Heart DiseaseHeart disease is the No. 1 killer of both men and women. Learn the facts and how you can reduce your risk. by Robert A. Barnett

One of the most important ways you can reduce your risk for heartdisease is to stay informed. If you know what causes heart conditions,you’ll be more motivated to make changes to reduce your risk. Starttoday!

What You Need to Know • Arteriosclerosis (“hardening of the arteries”) is the major cause

of heart disease. It results from cholesterol-containing plaque forming on the artery walls.

• The major risk factors are high blood levels of LDL cholesterol and triglycerides, high blood pressure and smoking.

• Dietary risk factors include: too many calories, particularly from fat and refined carbohydrates; too much saturated and hydro-genated fat; too few fruits and vegetables; and low intake of B vitamins, particularly folate.

• Physical inactivity promotes heart disease by weakening the heart muscle, making arteries less flexible, raising blood pressure, forcing the heart to work harder, and raising blood cholesterol and triglyceride levels.

• Obesity, from both diet and a lack of exercise, contributes to heart disease risk.

• Stress may increase your risk of heart disease, along with unhealthy responses to stress, like smoking or overeating.

Tips to Reduce Your Risk• Don’t smoke!• Eat at least five (preferably, seven to 10) daily servings of fruits

and vegetables.• Limit calories, particularly from foods that are high in fat and

refined carbohydrates.• Limit foods that are high in saturated and hydrogenated fats.

These include butter, margarine, fried foods, commercial baked goods and full-fat dairy products.

• Cook with monounsaturated olive and canola oils rather than butter, margarine and solid vegetable shortening.

• Limit your consumption of red meat. Replace it with legumes, skinless poultry and fish as often as possible.

• Replace refined grains — white bread, highly refined cereals and white rice — with whole grains such as oatmeal, whole-grain breads and cereals, and brown rice.

• If you drink, do so in moderation, preferably with meals.• Strive for a combination of regular aerobic exercise and strength

training.• If you feel stress impairs your life, consider management

strategies like relaxation techniques, behavioral therapy or yoga.• If you’re older than 35 and currently not exercising, see your

physician before you begin.

Start YourWeekly Journal!Go to page 17 andstart logging the

foods you’re eatingand your daily exercise.This will help you see

patterns and problemsin your habits.

KNOW YOUR RISK FACTORS!Learn what factors may put you at risk for heart disease, and which you can change.

Factors you CANNOT change:• Men age 45 and older; women age 55

and older• Have a parent or sibling with heart

disease• Have a parent or sibling who has had a

heart attack before age 60• Have diabetes

Factors you CAN change:• Cholesterol levels not optimal• Inactivity (exercise fewer than three

times a week)• High blood pressure (>140/90 mmHg)• Smoking• Overweight (BMI 25 or over)

Source: American Heart Association


Superfoods for Heart HealthEating colorful fruits and veggies and whole grains helps fight America’s No. 1 killer.by David Heber, M.D., Ph.D., Director of the UCLA Center for Human Nutrition

While all foods provide calories and some nutrition, scientists in recent years have identified some “superfoods” that can do much more. Thesefoods not only nourish you, but work with your body to improve yourhealth and prevent common diseases, including heart disease. Thesefoods harness the power of phytochemicals — compounds that occurnaturally in fruits, vegetables, beans and whole grains.

Fruits and VegetablesFruits and vegetables are great for heart health, which we now know is affected by some of the same oxidation processes involved in aging and cancer. If you thought heart disease was only about cholesterol, you are behind the times.

Studies show that the phytochemical lutein reduces the process of athero-sclerosis (hardening of the arteries) by about 15%. Lutein-rich spinach is also a good source of folic acid, which has been shown to reduce the risk of heart disease when homocysteine levels are high — common in individuals who are genetically predisposed to heart disease.

To get the phytochemicals you need, eat one fruit or vegetable from each of the seven color groups (Red, Green, Yellow/Green, Orange, Orange/Yellow, Red/Purple and White/Green) every day. Each color provides uniquesubstances; eating one from each group every day makes the most of theirprotective, nutritional properties. Another benefit: Fruits and vegetables fill youup on fewer calories. A cup of red cabbage, for example, has only about 40calories; a cup of white rice or mashed potatoes has 250. It might not becolorful, but garlic is another superfood. It has been known for centuries to begood for blood pressure and the heart. Eating one or two cloves a day in foodscan help.

Whole GrainsAbout 57 million Americans have high cholesterol. Foods with soluble fibers, including whole grains such as oatmeal and soy cereals, can bring cholesterol numbers down. Your body wants 25-35 grams of fiber per day, but most Americans manage to eat just 10-15g. Whole grains, along with fruits andvegetables, help you reach the desired goal. Fiber also helps reduce cholesterol, fills you up, and supports a healthy weight.

ProteinThe next superfoods are rich sources of protein, especially soy. Time and again, studies have shown that when soyprotein is substituted for meats, cholesterol has gone down. The Food and Drug Administration permits a heart-healthyclaim on the label of any soy food with more than 6.25 grams of soy protein.

While all proteins have amino acids as their building blocks, some protein foods, such as red meat, are very high in fatand calories. Soy, including soy meat substitutes, is a better bet for the same quality of protein. Soy foods are low in fatand rich in a superfood called isoflavones. Soy protein with naturally occurring isoflavones lowers cholesterol, helpsprevent heart disease and may help prevent cancer.

WaterAmericans’ most popular drink is cola — a mixture of sugar, caffeine and phosphoric acid that provides calories withoutnutrition. All of the major soft drink companies now own fruit juice and bottled water companies as well, and some herbsfor health are finding their way into new categories of tonics and waters. But nothing improves upon water — try to drinkat least 6 cups per day.

Know Your Colors!

Tomatoes, tomato juice, tomato soup, watermelon, pink grapefruit

Broccoli, Brussels sprouts, cabbage

Spinach, avocado, kale, collard greens

Carrots, butternut squash, pumpkin

Oranges, pineapple, banana, cantaloupe

Garlic, onions, chives

Blueberries, strawberries, raspberries

Red:

Green:

Yellow/Green:

Orange:

Yellow/Orange:

White/Green:

Red/Purple:


Week 2: Heart Health by the Numbers


• Learn the importance of heart screenings to ensure good health.

• Get tips on how to avoid high blood pressure.

It might seem like you need to be a mathematician to understand your key heart factors. You don't! Read on and get help from your coach.

How Heart Screenings Can Save Your LifeFind out which screenings are important and why you need toknow your key heart numbers.by Carrie A. Ackerman, M.P.H.

Heart disease is one of the leading causes of death in the UnitedStates. According to the Centers for Disease Control and Prevention,approximately 950,000 Americans die of each year of cardiovasculardisease. But by getting a set of basic screenings, you can know yourspecific risks and be able to understand what steps you should take toimprove your heart health. Here's an overview of the most importantscreening tests.

Blood Pressure High blood pressure (hypertension) is often called the “silent killer” because often there are no symptoms. But the consequences can be severe; high blood pressure can lead to heart attack, heart failure, stroke, kidney disease, and other serious chronic conditions. A normal blood pressure reading is 120/80 mmHG.

CholesterolCholesterol is a fat-like substance that occurs in your body naturally and is needed to function normally. The body only uses a small amount, so any excess is deposited in the arteries, which can then narrow and block blood flow, potentially leading to heart disease. These are the numbers that you should be paying attention to:

• Total Cholesterol: includes your LDL, HDL and all other lipoproteins.• Low-Density Lipoprotein (LDL): considered the “bad” cholesterol

because it transports most of the cholesterol through the body and drops damaging deposits.

• High-Density Lipoprotein (HDL): considered the “good” cholesterol because it can reduce your risk of heart disease by transporting cholesterol away from arteries.

• Triglycerides: hormones regulate the release of these fats to meet the body's energy needs between meals. High levels can increase your risk for heart disease.

Take Action!

1) Get Your ScreeningsYou can get your blood pressure and cholesterol checked by your doctor or by other health professionals at health fairs, mobile screening units or local wellness centers.

2) Change Your LifestyleAfter you get your screening results, ask your doctor what actions you can take to reduce your risk. There are three tipsthat apply to everyone:

• Achieve or maintain a healthy weight.• Get regular exercise.• Don't smoke!

If your blood pressure is high, your doctor will emphasize reducing your sodium intake, and possibly getting morepotassium in your diet. If your cholesterol levels are high, your doctor will most likely emphasize changes in diet such asreducing saturated and trans fat (found in red meat, vegetable oils), and consuming more monounsaturated fats (found inolive oil and canola oil) and omega 3 fatty acids (found in fish and some nuts).

KNOW YOUR NUMBERS

Total Cholesterol Desirable — Less than 200 mg/dLBorderline high risk — 200 to 239 mg/dLHigh risk — 240 mg/dL and over

LDL Cholesterol Desirable — Less than 130 mg/dL Borderline high risk — 130 to 159 mg/dL High risk — 160 mg/dL and over

HDL Cholesterol Desirable — 40mg/dL

Triglycerides Desireable — Less than 150 mg/dL Borderline high risk —150 to 199 mg/dLHigh risk — 200 mg/dL or over

Blood PressureDesirable — Less than 120/80 mm HgBorderline high risk (“Prehypertension”) — 120 to 139/ 80 to 89 mm HgHigh risk — 140/90 mm Hg or higher

Source: American Heart Association


Five Ways to Avoid High Blood PressureA leading expert on nutrition and heart-health weighs in on the topways to avoid high blood pressure.by David Heber, M.D., Ph.D.

High blood pressure — also known as hypertension — has become a silent epidemic. Roughly thirty percent ofAmericans have high blood pressure; by age 75, ninety percent have it. The good news is there are steps you can taketo protect yourself. If you can stay on top of these controllable lifestyle factors, you'll go a long way towards improvingyour heart health:

1) Watch your weight! Achieving and maintaining a healthy body weight and getting rid of fat around the middle shouldbe your first steps. Use your program to set goals and track your progress. Obesity-associated hypertension occurs dueto increased levels of insulin; this in turn leads to salt and water retention and activates a mechanism of the centralnervous system that elevates blood pressure.

2) Get moving! Regular exercise improves the tone of the blood vessels and reduces stress hormone levels. People who are well-conditioned often have very low resting heart rates.

3) Eat fruits and veggies: Fruits and vegetables contain high ratiosof potassium to sodium and high levels of magnesium, both of whichhelp maintain normal blood pressure.

4) Know your fats: Besides leading to weight gain, a high-fat diet containing polyunsaturated n-6 fatty acids such as those found in vegetable oils can increase inflammation in the small blood vessels,which promotes hypertension.

5) Limit sodium: Doctors generally recommend that individuals limit their daily sodium intake to no more than 2,300 milligrams (2.3 grams) per day. If you have a higher risk, your doctor may recommend restricting your sodium to as low as 1,500 milligrams per day. Talk to your doctor to get more specific recommendations about sodium in your diet.

Quick Tipson GettingMorePotassium

1) Get your “five a day” servings offruits and vegetables, all of which aregreat sources of potassium. Betteryet, shoot for seven to 10 a day.

2) Load up on legumes. Beans arevery rich sources of potassium,ranging from 700 to 800 mg per cup,depending on the type of bean.

3) Don’t forget tofu. Made from soy-beans, tofu is rich in potassium.

4) Dig into the potatoes. They’reloaded with potassium — about 800mg in a one-potato serving.

5) Don’t boil your food. Boiling,especially in large amounts of waterthat you pour down the drain, leachesout potassium. A boiled potato, forexample, loses up to half itspotassium.

Sodium and Potassium in Unprocessed and Processed Foods

Sodium(mg)

Potassium(mg)

Apple, 1 medium 0 80

Apple pie, 1/8 pie 327 122

Peas, fresh, 1/2 cup cooked 2 217

Peas, canned, 1/2 cup 214 147

Corn on the cob, 1 ear 14 245

Corn flakes, 1 cup 330 35


Week 3: Easy Exercise


• Learn why exercise is one of the keys to heart health.

• Make a plan to incorporate cardio-vascular exercise into your daily life.

Getting regular exercise is one of the best things you can do for your heart. Talk to your coach about how youcan make it happen!

Exercise: The Cholesterol KillerRegular workouts boost “good” HDL cholesterol — and may be especially good for women.by Royce Flippin

For a healthy heart, sometimes you want more cholesterol. HDL is the “good cholesterol.” It whisks dangerous fat out of your system, lowering your risk of heart attack and coronary heart disease. (LDL is the “bad cholesterol,” which slaps harmful fatty plaques on artery walls.)

Medical trials suggest that daily exercise — walking, biking, jogging, swimming — is the best way to raise HDLs.Increasing activity is even more effective if it helps you lose weight.

20% Reduction in Heart Attacks By raising their HDL levels just 8%, participants in the HDL Intervention Trial reduced their risk of death related to heart disease, as well as non-fatal heart attacks, by more than 20%.

There’s very good evidence that people who maintain an active lifestyle have HDL levels about 10% higher than those of a sedentary person, says Dr. Richard Stein, chief of cardiology at the Brooklyn Hospital Center in New York. “The biggest gains come to people who move from being completely inactive to being moderately active,” he adds.

How Much Exercise? Dr. Stein says the Surgeon General’s recommendation of 30 minutes of activity per day is a good start, but he advises doing more to raise HDLlevels.

“I tell my patients to set aside a full hour for exercise each day, and to make sure that at least 45 minutes of that time is spent actually exercis-ing at a brisk pace,” Dr. Stein says.

On a 1 (extremely easy) to 10 (very hard) scale of perceived exertion, Stein advises keeping your effort level around 6 or 7.

A Woman’s Edge The effect of exercise on HDL holds for both men and women, but Stein notes one intriguing study at Bowman Gray School of Medicinein Winston-Salem, N.C., that indicates women may get the better deal.

“After one year of regular exercise, the male and female participants had comparable gains,” he says. “But over the nextfour years, the women showed larger and more sustained gains in HDL cholesterol than the men.”

After five years, the cholesterol ratio (total cholesterol divided by HDLs) — a key indicator of heart disease risk — was38% lower in women, 14% lower in men.

Get a Checkup!If you haven’t been exercising regularly,

see your physician before you begin a fitness program.


A Cardio Fitness Plan That WorksFollow these eight steps for a heart-health program that’s habit-forming.by Royce Flippin

Developing a cardio-fitness program takes more than good intentions — it requires a workable plan. Follow these eight steps to create a regular aerobic exercise schedule that’s built to last.

1) Pick aerobic activity that’s enjoyable and available.Don’t force yourself to do an exercise you can’t stand simply because “it’s good for you.” If you don’t like it, you won’t do it for long. The most popular exercises — walking, jogging, bicycling and aerobics — all require minimal equipment, and can be done almost anywhere.

2) Plan your workouts in advance.Mark all your planned exercise days for the month on a calendar with an asterisk or the letter “E,” and keep the calendar in a place where you’ll seeit every day. After you exercise, be sure to enter what you did in Your Weekly Journal (page 17).

3) Set aside an hour for each exercise session.This allows for a 5-minute warm-up, 30-45 minutes of actual exercise per workout (the duration needed for optimal health), a 5-minute cool-down and a shower. If you’ve been sedentary until now, start with 10 minutes of actual exercise per session and build up slowly.

4) Exercise at the same time every day.This predictability will make you less likely to skip workouts, and also allows you to plan your day around your exercise sessions. Plus, your body rhythmswill fall into a routine, enhancing your energy level and performance.

5) Treat exercise time as a high-priority appointment.If something comes up that you absolutely can’t avoid, switch the workout to one of your prescheduled rest days.

6) Make each workout invigorating, but stop before you feel fatigued.There’s no need to train like an Olympic athlete — in fact, exercising too intensely depresses your immune system and increases your risk of getting hurt or quitting.Walk away from each workout with the feeling that you could have gone a few minutes more, if necessary.

7) Reward yourself each month for successfully completing your workouts.Give yourself a pat on the back for your own success. Your reward should always be something you really enjoy — amovie or dinner at a nice restaurant. Another proven motivator: Tell others about your plan, and encourage them to checkup on you on a regular basis.

8) As a short-term goal, aim for three solid months of regular exercise.Studies show that if you can stick to a new exercise program for three months, regular exercise becomes an ingrainedhabit, and takes on a momentum of its own.

Note: We suggest you consult your physician before beginning any new exercise program.

When setting a weight-loss goal, keep in mind that the number glaring back at you from your scale reflects many factors, including bone size and density, body water, the size of your muscle mass and, last but not least, body fat. Losing bodyfat is your primary goal.

Your true ideal weight is the weight at which you feel good, and your body fat, blood cholesterol profile and blood pressure all fall within a healthy range.

Getting StartedTo successfully lose weight, you need to do two things: Cut the calories you take in, and increase the amount you burn.

• Plan to lose a half or one pound a week over the next six months until you’ve lost 5-10% of your body weight. It may seem like a slow pace, but extensive research reveals that this is the best rate for losing weight and keeping it off.

• A pound of body fat is about 3,500 calories. Cut 500 calories a day to drop about a pound a week.

• At first, most of this caloric “deficit” will come from dietary changes — until your fitness level allows you to burn more calories. Consider that a 150-lb. person burns about 240 calories during a full hour ofbrisk walking — and most people need to build up to this level of exercise. It’s more efficient to subtract about 500 calories from your usual intake, and use exercise to increase calorie-burning muscle mass to help sustain weight loss over the long run.

Thinking Thin • The good news: Subtracting or burning an extra 50 to 100 calories

a day can lead to weight loss of 5 to 10 pounds a year. The bad news: Eating an extra 50 to 100 calories a day can lead to a weight gain of five to 10 pounds a year.

• One common pitfall for dieters is to fall off the wagon and think, “I’ve been bad, so it doesn’t matter how bad.” It matters. If you overate at lunch, don’t throw in the towel and overeat at dinner. Pick up with a normal, calorie-controlled dinner and move on.

• Cutting calories too severely and ignoring hunger signals won’t help you control eating. You may learn to tolerate hunger, but when you start eating you may be less able to stop.

• One of the best ways to increase your baseline calorie burning (basal metabolic rate) is to increase your muscle mass through strength training, because muscle tissue burns more calories than fat — even at rest.


Week 4: Weight Control


• Commit to managing your weight to take stress off your heart.

• Get tips to help you keep a healthyweight for the long-term.

Maintaining a healthy weight is one of the best things you can do for yourheart. Talk to your coach to develop aweight management strategy.

How to Manage Your WeightLose weight the right way and you’ll increase your chances of keeping it off. Here’s how.by Heather S. Zeitz, R.D., C.D.N.

Successful weight management begins with a realistic goal. If you’re overweight, shedding just 5-10% of your weight can significantly boost your health and sense of well-being. But be patient. Weight that’s lost quickly through crash dieting almost always comes back.

Maintaining YourHealthy Weight

If you’re currently at a healthy weight, it’s still a good idea to keep an eye

on the scale and watch what you eat.

Body types can change over time and many people begin to add extra pounds as they get older.

Use Your Weekly Journal (page 17) to track the

nutritional value of your diet.

Don’t Skip Breakfast!

It really is the most important meal of the day. A healthy breakfast will give you an energy boost and keep you full until lunch-time.

Before you leave the house each morning, fill up on fiber — try a bowl of oatmeal or cold cereal like bran flakes, topped with high-fiber fruit like raspberries or blue-berries.

Try fruit spreads on your toast and waffles instead of butter.


Supermarket TourHere’s a look at a few food categories to help you cut through the clutter and make quick, meaningful comparisons when shopping. by Heather S. Zeitz, R.D., C.D.N.

Keeping a healthy diet is a challenge. But it’s much harder when youhave the wrong foods in the house. Use this guide to make smartdecisions when shopping. Don’t forget to check the label when you buy!

Breads, Cereals and Grains

Dairy Products

Snacks: Popcorn, Chips and Cookies

Salad Dressings


Week 5: Think Stress-Free!


• Learn about the effects stress can have on your heart.

• Make a customized plan to handle stress.

Serious stress can have serious con-sequences. Talk to your coach about ways you can take action to reduce your stress level.

The Stress/Heart ConnectionGet the facts on stress and heart disease risk, and find out how you can maintain a healthy heart even with a hectic life.by Katherine Raymond

When you think of the stereotypical heart attack candidate, you might picture an overachieving executive who’s always on the go, furiously barking orders at subordinates. But does chronic stress really cause cardiac episodes? Is the average person who’s overworked, over-scheduled and sometimes emotionally overwhelmed at risk for cardio-vascular disease? Find out how stress may be affecting your heart and what you can do to manage it.

Effects of StressCertainly, as anyone who’s ever overslept an alarm knows, a stressful experience can get your chest pounding. “Stress can have damaging effects to your heart and blood vessels,” says Lori Mosca, M.D., Ph.D., author of Heart to Heart: A Personal Plan for Creating a Heart-Healthy Family. “Your body releases hormones in response to stress that increase your heart rate, and that demand on your heart can constrict your blood vessels.”

But the long-term effects of a stressful lifestyle are still being examined. In research, it’s difficult to isolate stress from its attendant unhealthy behaviors.“The stressed person is often times also a person who has other risk factorsfor heart disease,” explains Dr. Fletcher. In other words, that executive’s behavior (three-martini lunches, chain-smoking, and unused gym membership) might put him at risk for heart disease, so it’s hard to know the effects of his high-stress lifestyle.

Negative Emotions and the HeartYet, gradually, scientists are piecing together clues about the demonstrated links between stress and heart disease. A 2004 Duke University study of coronary artery disease patients found a link between exposure to negative emotions and the body’s ability to control heart rate. Researchers tracked the electrical activity of individuals for two days with portable electrocardio-gram machines. “Monitors showed that during periods of mental stress and negative emotions, the hearts showed a reduced capacity to respond,” said Duke researcher Dr. Simon Bacon. This potential might explain how chronic stress, left unchecked, could contribute to heart disease risk.

So, your fast-paced job is not a proven health hazard. But if you’re concernedabout maintaining a healthy heart, stress management is clearly an importantpart of the big picture. Now, how do you get started? First, look at what’s stressing you out, and think about how you might lighten the load. “I believe we can actually prevent a lot of the stress that we have in our lives,” declares Dr. Mosca. “We underestimate a lot of the control that we do have over our lives and our schedule.” Adjusting your attitude might mean the difference between hyperventilating when something goes wrong and just laughing it off.

Of course, as Dr. Fletcher says, “we’ll never be able to totally rid ourselves of the stress of American society.” But by becoming aware of your own response to stress, you can control it rather than letting it control you.

Did You Know?Your body releases hormones in response to stress

that increase your heart rate and can constrict your blood vessels.

Six Ways to De-stress1) Exercise2) Address negative feelings3) Get help4) Find time for yourself5) Cultivate friendships6) Laugh often

Feeling Stressed? Take a Walk!

If you have a problem you can’t figure out, plan a therapeutic walk.

You’ll learn to savor this private time with yourself to regain a sense of perspective, while you bathe your brain in oxygen that can help you function at your best.

Walk outside in the sunshine whenever possible, especially in the morning. Natural light is an anti-depressant.


Your Plan to Handle StressCan you reduce the stress in your life with one piece of paper?by Katherine Raymond

Most people don’t think about managing stress as an active thing they can do: Stress happens, and you deal with it. What can you do?

Turns out you can do a lot. Below are some guidelines on how you can create a one-page personalized worksheet (seepage 16) to manage the major stressors in your life. Fill it out as you go through these easy instructions. In just a fewminutes you’ll have a customized plan for managing your stress. The worksheet has three parts:

Step One: Set Your GoalThis should be just one sentence and should focus on a specific result.The key is to think about what you want to get out of stress management.

Examples: “I want to be able to unwind enough to enjoy downtime with my loved ones”; “I want to keep my cool during pressure-cooker work situations”; “I don’t want stress to break down my health.”

Step Two: Determine Your TriggersList the major parts of your life that cause stress. These are “triggers” because they set off a specific reaction for you. Throw in everything you can think of here, even the kitchen sink (clogged drains can be stressful!).

Step Three: Your Stress-Busting StrategiesAfter you’ve listed your stress triggers, review them and see which ones jump out at you as major sources of agitation. Circle one to five of these as priority issues to work on. Then write the cool-down strategy you’ll use next to each stressor.Use the Notes field to add more detail about your plan of action. Examples could go from: “My spouse always leaves dirty dishes in the sink” to larger concerns, such as: “My spouse’s job might be moving across the country.”

Check in With a Stress JournalOnce you have your Stress Worksheet filled out, consider starting a stress journal to keep track of how you handle stressful situations on a day-to-day basis. Refer back to the triggers you identified in Step Two and start paying attention when theycome up.

More Tips• Try starting with a minor, manageable stressor (those dishes in the sink) rather

than major life events that bring up deeper feelings.• Be patient with yourself. It takes time to change long-standing patterns in the

way we act, think and react. If you feel your fuse getting short, treat yourself to some downtime free of cell phones, computers or TV.

If you’re experiencing chronic physical or psychological symptoms of stress and you feel they are beyond your control, please seek help from a healthcare profes-sional or psychological counselor.

Stress Worksheet

Create your own plan to manage

stress in your life. Go to page 16

and get started!

If work issues are leading you to a meltdown, Darrin Zeer, author of Office Yoga, suggests trying this quick routine:

• Take five slow, deep breaths down into your belly.

• Let your shoulders relax.

• Close your eyes for a few moments.

• Feel your face soften!

• Try to remember that it’s not the end of the world.

Congratulations for reaching the end of your program! We've given you a lot of information in six weeks. To make sure you make the most of it, here is a quick wrap-up that highlights the most important things you can do to protect your heart. You can post these tips on your refrigerator, in your appointment book, or near your desk atwork.

1) Improve your diet: Remember that the choices you make when you're eating have a direct impact on your heart health. Cut down on saturated and trans fat, eat more fruits and vegetables and limit your salt intake.

One great way to improve your eating habits is to eat out less and prepare your own foods whenever possible. Make it easy for yourself by buying healthy options such as pre-washed greens.Smart choices at the supermarket can lead to healthier choices at home!

2) Maintain a healthy weight: If you're overweight, refocus your efforts on a smart weight-management plan. This is particularly important if you have excess weight in your mid-section. Focus on controlling your portions and substituting a few healthier options in your meals. If you're currently at a healthy weight, rememberthat excess pounds can come later in life; so keep an eye on the scale from time to time.

3) Get more active: This is something you can do any time! Find someone else that's also looking to get active and keep each otheron track. Remember, you don't need to start a rigorous program orjoin a gym to improve your heart-health. Just walking more everyday can make a difference!

4) See your doctor: Quick, do you remember what a lipid profileis? If not, that's what your doctor is for! Be sure to make regular appointments to get your key screenings annually. When you're at the doctor, ask questions about your specific situation to learn howyou can maximize your health.

5) Be positive! Keeping a positive outlook can help ease your stress level. When you're less stressed, you feel healthier; plus you're less likely to engage in behaviors (smoking, poor eating habits) that could put you at risk.


Week 6: A Heart HealthyLife


• Learn how to build on your new habits for the long-term.

• Review the most important points from your program.

• Take your final assessment with your coach.

Congratulations for finishing your program! Talk to your coach about strategies to improve your heart-health for the long-term.

Five Ways to Reduce Your Heart Disease RiskRemember these five key tips and you're on your way to a healthier heart for the long-term.by Heather Zeitz, R.D., C.D.N.

Try Soy Foods!

The American Heart Associationrecommends getting 25 grams of soyprotein a day. Here are some ideas to getstarted:

Edamame: These soybeans make greatsnacks. Buy a frozen package and steamsome.

Grilled tofu: Try your favorite marinade withtofu, then throw it on the grill!

Veggie burgers: Most veggie burgersinclude soy protein; try one for a quick andhealthy meal.

Oh My, Omega!

Omega-3 fatty acids arefound in fish, flax,canola oil, walnuts andgreen leafy vegetables.These fats reduce thetendency for blood to clotwhen you don't want it to, prevent disturbances in heart rhythm, and can lowerblood levels of triglycerides, which are linkedto heart disease.


Eat Your Vitamins — On a Plate!Make a plan to get your vitamins and minerals from foods instead of pills. by Beth Gold, R.D.

As meals on the run become the norm rather than the exception, some people have turned to supplements to get the Recommended Dietary Value (RDV) for certain vitamins and minerals. While multivitamins might be beneficial for some, a large body of research confirms that getting nutrients from foods provides more of a boost to your health.

By eating a balanced diet — including protein from plant (soy foods, nuts, seeds, legumes) and/or animal (fish and leanpoultry) sources, colorful fruits, vegetables, and whole grains — you get disease-fighting benefits that you just can’t getfrom supplements.

Don’t Give Up the PhytochemicalsFruits, vegetables and whole grains deliver an array of phyto-chemicals — natural plant compounds that, along with vitamins and minerals, work to help keep you healthy. Phytochemicals are abundant in the pigments of fruits, vegetables and whole grains.

The chart to the right shows a few powerhouse foods that provide all or a substantial percentage of the RDV for specific vitamins and minerals, and help fight diseases, too. As you can see, different types of foods cover different nutrients.

For instance, it’s relatively easy to get a full day’s vitamin C and beta-carotene (which the body converts to vitamin A) from a diet rich in fruits and vegetables. The greater the variety of foods you eat, the greater your nutritional coverage.

Maximizing Nutrients From FoodThe way food is prepared and its freshness can also affect its nutritional punch. Here are some tips for getting the maximum benefit from nutrient-rich fruits and vegetables.

• Buy fresh, local produce. When produce in the grocery store has traveled a great distance, nutrients break down due to exposure to light, time, etc. Your next best bet is frozen fruit and vegetables; freezing preserves the nutrients.

• Don’t cook veggies in water. Cooking vegetables in water significantly lowers the nutrient content because vitamins leach out. You wind up with very nutritious cooking water that generally is poured down the drain.

• Try it raw or steamed. Eating food in its most natural state keeps the nutrient content high. Steaming is your best option for cooking vegetables, as nutrient loss is minimized.

• Build a rainbow. Fill your plate with a variety of colors. The more colors, the better the combination of vitamins, minerals and protective phytochemicals. Choose a daily variety of red, orange, yellow and green fruits and vegetables, along with legumes and whole grains.


Heart-Friendly MenuTry these simple meal suggestions to incorporate more heart-healthy foods into your diet.

Breakfast

Instant Oatmeal Prepare according to directions on package: • 1 packet instant hot oatmeal with calcium-fortified low-fat soymilk (plain or vanilla) Add water to achieve desired consistency and top with: • Honey, to taste • Fresh berries (or other favorite sliced fruit)

Snack Ideas

• Nonfat pudding cup• Favorite fresh fruit

Lunch

Citrus Chicken Salad Toss together: • Grilled or baked skinless chicken breast • Mixed dark salad greens • Fresh orange sections • Pepper slices (any color) • Fresh sliced snow peas • Crushed walnuts • Splash of orange juice • Balsamic vinegar Serve with: • Crusty whole-wheat bread

Dinner

Heart-y Honey Mustard Salmon • Salmon fillet Combine and drizzle over fish: • 2 tsp. honey • 2 tbsp. Dijon mustard Broil 3 to 4 inches from heat, for 3 to 4 minutes on each side or until done, then serve with: • Steamed, chopped spinach (or another favorite vegetable, either fresh or frozen) • Whole-wheat couscous, prepared with water only (no added fat), according to package Finish with:• Nonfat plain yogurt sweetened with honey

Coach Recipe/Food Suggestions:

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Food Tips

The basics of heart-healthy cooking aren’t that complicated:cut down on fat, and incorporate more vegetables and whole grains. Here are some guidelines:

• Stick to a diet low in animal (saturated) fats. Choose low-fat or fat-free dairy products and poultry (breast cuts, no skin). Choose other low-fat proteins, such as beans and soy foods.

• Limit foods with hydrogenated oil as a primary ingredient (e.g., processed snack foods and fast foods).

• Serve fish as an entree at least two times per week.• Choose fiber-rich foods. For example, enjoy whole fruits

and vegetables with skins, add beans and peas to salads and entrees, and serve whole-grain breads, rice and pasta in place of the enriched white varieties.

• Try to have at least one serving of a soy-based food each day. Soy foods have demonstrated cholesterol-lowering effects.

• If you are overweight (BMI >25), weight loss will bring down your total cholesterol and help you control your blood pressure.

• Watch your sodium! Limit processed foods and go easy with the salt shaker. Make sure to include potassium-rich fruits and veggies in your diet to help control blood pressure.


Commute

Work

Family

Home

Relationships

Money

Health (your own and loved ones’)

Environment (noise, mess, lighting, etc.)

Life changes and uncertainties (moving, getting married, changing jobs, etc.)

Other

Your Stress Worksheet

Step 1 Set Your GoalDetermine what your overall goals are in trying to reduce your stress.

This is your guide to getting stress under control — instead of letting it control you! Use this worksheet to identify themajor sources of stress in your life, develop a personal plan to manage stress and track your progress.

Step 2 Determine Your TriggersThe following are some common life areas that tend to bring up stress. List the major stress triggers you experience ineach category.

Step 3 Your Stress-Busting Strategies

Stress (e.g. traffic)

Coping strategy (e.g. mantra, breathing)

Notes (e.g. repeat “relax”)

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healthy heart program€¦ · healthy heart your goals this week: • know the basics about heart...

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