Lenore S. Greenstein: Yale
professor's book a must-read for healthy hearts
In "The Expert Guide to Beating Heart Disease," Dr. Harlan M.
Krumholz translates the best research about heart disease and its treatment
into clear language that can be easily be understood by the average reader.
By LENORE S. GREENSTEIN, special to the Naples Daily News
February 22, 2005
The 200-page paperback is crammed with valuable information on key strategies
that researchers have found work best to beat this No. 1 killer.
Dr. Krumholz is a professor of medicine (cardiology), epidemiology and public
health at Yale University School of Medicine, and the author of more than 250
articles on how to improve the care of individuals at risk for, or with,
cardiovascular disease. In his treatise, Krumholz discusses lifestyle changes
to reduce your risk of heart disease, medications and unproven methods you
should avoid.
In a recent interview, Krumholz explained:
"I wrote this book to provide people with the essential information they need
to participate actively in their care and reduce their risk of future heart
problems. The lifestyle strategies can be remarkably effective," he said.
"It is true that modifying your lifestyle is not easy, but there are ample
rewards and I have seen many examples. It is a paradox that some heart
patients – those who became more active, improved their diets and adopted
healthier habits after their diagnosis – are healthier now than they have ever
been in their lives.
"It seems that every week there is news about some breakthrough in
medicine and many of them never really bear fruit. Yet we have many, very
effective approaches that are largely ignored even though we know that their
beneficial effect is enormous."
The heart of his book is the section on seven key strategies for taking charge
of heart disease. Each includes a detailed explanation of the causes of the
problem, as well as ways to combat it, including managing blood pressure,
cholesterol, fitness, weight, exercise, blood sugar, smoking and medications.
Guidelines to treat problems such as hypertension and high cholesterol are
outlined, as well as lifestyle changes that can give drug-free strategies a
chance to work. Each section also offers answers to commonly asked questions.
In the section called "Taking charge of your cholesterol," Krumholz
advocates knowing your cholesterol numbers, and lowering them through diet by
limiting overall fat intake and especially saturated fats.
"Cutting fat works: researchers have shown that a low-fat diet can lower
LDL cholesterol levels by 7 to 9 percent in people with high cholesterol. The
American Heart Association experts also recommend increasing your consumption
of vegetables that contain LDL cholesterol-lowering monunsaturated fatty acids
and fiber."
He also explores the use of statins and other cholesterol lowering drugs, and
helps sort through the maze of medications.
Fitness advice covers the amount of calories you need to lose weight according
to your body type, the importance of exercise, and dieting strategies that the
author has found to be successful.
People who are still hooked on cigarettes should read "Taking charge of
your smoking," and the link to heart disease it poses, as well as helpful
suggestions on how to quit.
I was particularly interested in the chart of ways to beat heart disease, the
probable benefits from eating fatty fish, and the possible benefits from
reducing stress. Krumholz points out that taking vitamin E has shown to have no
effect on reducing heart disease, and that hormone replacement therapy may be
harmful.
This is one manual that I highly recommend for those who are at risk for, or
have heart disease. Or for those who simply want to keep their hearts in good
shape, which I suspect includes all of us.
Lenore S. Greenstein is a registered and licensed dietitian in private
practice in the Naples area.