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Fiber and heart health


February is American Heart Month and information about heart health is everywhere. There are many messages related to heart health and at times it can all seem daunting. There’s information about cholesterol, fat, fiber, sodium, cardiovascular exercise, strengthening exercise, portions, calories, eggs, saturated fats… whew. It is a lot to take in at once.

Trying to change a dietary behavior, especially one that we have been doing for most of our life can be hard. It is possible though; you just have to give it time and focus on one behavior change at a time. For now, let’s focus on fiber.

What is fiber? Fiber is the indigestible part of foods that pushes through our digestive system absorbing water along the way.

Why fiber? Dietary fiber is found predominately in fruits, vegetables, legumes (beans, etc.) and whole grains. Dietary fiber helps regulate our digestive system, prevents or relieves constipation, lowers cholesterol and improves glucose control.

There are two types of fiber:

  • Soluble fiber which slows digestion, and lowers LDL (“the bad”) cholesterol. Soluble fiber binds to and lowers cholesterol in the blood. Soluble fiber rich foods include flax seeds, barley, oat bran, beans, among others.
  • Insoluble fiber which acts as a stool bulking agent and promotes regularity. Insoluble rich foods include whole wheat products, wheat bran, seeds and nuts to name a few.

How much? The recommendation is to aim for 14 g dietary fiber per 1,000 calories consumed per day. This is equivalent to about 25g of fiber per day for adult women and 38g for adult men. The usual intake of dietary fiber in the United States is only 15g/day. We’ve can do better!

The daily recommendations for most healthy adults are:

  • Men ages 50 years and younger: 38 grams of fiber
  • Men ages 50 and older: 30 grams of fiber
  • Women 50 years and younger: 25 grams of fiber
  • Women ages 50 and older: 21 grams of fiber

How to add fiber to your eating plan: You can start by slowly increasing the number of fiber rich foods you eat at every meal and snack, choosing from a variety of foods that include fruits, vegetables, legumes and whole grains. For example:

  • Eat whole fruit rather than drinking juice (you’ll reduce your sugar intake as well)
  • Enjoy a variety of grains, focusing on 100% whole grains (brown rice instead of white rice, baking with whole grains, etc.)
  • Eat more vegetables; add these to your meals, in soups, on a sandwich, or eat them as a snack, etc. Colorize!
  • Add fiber to foods you already enjoy such as sprinkling oat bran or rice bran on cereal, adding almonds to salads, mixing flaxseed into muffins, etc.
  • Include more legumes into your meals such as lentils or beans, etc.

Note: When increasing fiber in your diet, please be aware that you may experience more intestinal gas and bloating. Therefore, slowly increase the amount of fiber gradually over the course of two to three weeks to give your body time to adapt to the added fiber. As you increase your fiber intake also increase your fluid intake.

Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. National Academy of Sciences. Institute of Medicine. Food and Nutrition Board. 2006.

Author: Julia Salomon

Julia is a nutrition educator and corporate dietitian with Affinity Health System.

New Dietary Guidelines Released

New Dietary Guidelines Released


Today, about half of all American adults have one or more preventable, chronic diseases, many of which are related to poor quality eating patterns and physical inactivity.

The new Dietary Guidelines have recently been released by the United States Department of Health and Human Services and Department of Agriculture.  The guidelines are updated every 5 years to reflect the most recent recommendations on how we should eat.

While the recommendations included in the guidelines are ultimately intended to help individuals improve and maintain overall health and reduce the risk of chronic disease, the focus is on disease prevention, not treatment.

The components of eating patterns can have interactive and potentially cumulative effects on health. They can be tailored to an individual’s personal preferences, enabling people to choose the diet that is right for them.

The Guidelines follow a healthy eating pattern across the lifespan. Previous editions focused primarily on individual dietary components such as food groups and nutrients.

Here are some of the recommendations to meet nutrient needs within calorie limits:

  • Choose a variety of nutrient-dense foods across and within all food groups in recommended amounts.
  • Limit calories from added sugars and saturated fats and reduce sodium intake.
  • Consume an eating pattern low in added sugars, saturated fats, and sodium.
  • Cut back on foods and beverages higher in these components to amounts that fit within healthy eating patterns.
  • Shift to healthier food and beverage choices.
  • Choose nutrient-dense foods and beverages across and within all food groups in place of less healthy choices.
  • Consider cultural and personal preferences to make these shifts easier to accomplish and maintain.

Healthy eating patterns and regular physical activity can help people achieve and maintain good health and reduce the risk of chronic disease throughout all stages of the lifespan. The Dietary Guidelines are designed for all individuals’ ages 2 years and older and encourage families to consume a healthy, nutritionally adequate diet.

All food and beverage choices matter when developing your healthy eating pattern. Choose an appropriate calorie level to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease. Pay particular attention to variety, nutrient density, and amount.

Key Recommendations for your eating pattern:

Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level: All forms of foods, including fresh, canned, dried, and frozen foods, can be included in healthy eating patterns.

  • A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other Fruits, especially whole fruits Grains, at least half of which are whole grains
  • Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages
  • A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products oils

Key things to limit for your eating pattern:

Saturated fats and Trans fats, added sugars, and sodium, specifically:

  • Consume less than 10 percent of calories per day from added sugars
  • Consume less than 10 percent of calories per day from saturated fats
  • Consume less than 2,300 milligrams (mg) per day of sodium
  • If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.

Key things to consider about beverages:

  • When choosing beverages, both the calories and nutrients they may provide are important considerations.
  • Beverages that are calorie-free, especially water, or that contribute beneficial nutrients, such as fat-free and low-fat milk and 100% juice, should be the primary beverages consumed.
  • Milk and 100% fruit juice should be consumed within recommended food group amounts and calorie limits.
  • Sugar-sweetened beverages, such as soft drinks, sports drinks, and fruit drinks that are less than 100% juice, can contribute excess calories while providing few or no key nutrients.

Americans of all ages—children, adolescents, adults, and older adults—should also meet the Physical Activity Guidelines for Americans to help promote health and reduce the risk of chronic disease.

Everyone has a role in helping to create and support healthy eating patterns in multiple settings in our community. This includes home, school or work and these guidelines can help you develop eating patterns that promote overall health and prevent chronic disease.

To read more about the 2015 guidelines, please visit health.gov/dietaryguidelines/2015/guidelines.

Hope Williams, RD, CD, CDE, CLS, is a Health & Wellness Specialist with Ministry Medical Group

Cholesterol 101

Cholesterol 101

I was recently visiting with a patient who said she was told her bad cholesterol was too high and her husband’s good cholesterol is too low. She was confused as she thought all cholesterol was bad and wanted to know what exactly is “good” and “bad” cholesterol and what they could do with their diet to prevent the need from taking cholesterol-lowering medications commonly known as statins.

Total cholesterol is the sum of all the cholesterol in your blood.  When your total cholesterol is high, your risk for heart disease goes up as well.  Having total cholesterol less than 200mg/dL is desirable.  Cholesterol is then broken down into two groups, LDL and HDL.

LDL most often called bad cholesterol can be dangerous when levels are too high.  LDL cholesterol is what builds up in your arteries and may block the flow of blood.  Having a level less than 100mg/dL is optimal.  If the level is above 130mg/dL, your doctor may recommend lifestyles changes or even starting a statin to help lower the level of LDL cholesterol in your blood, and reduce your risk of heart disease.

HDL cholesterol is the good form of cholesterol and it helps protect from heart disease.  It carries cholesterol from parts of your body back to the liver, where it can be broken down and removed.  For HDL cholesterol higher numbers are better.  Having a level of 60mg/dL and above is protective and lowers your risk for heart disease.

There are numerous food items that can affect your levels of both LDL and HDL cholesterol.  High levels of LDL cholesterol are correlated with a diet that is high in saturated fat and trans fats.  Saturated fats are mainly found in high fat animal foods, such as red meat, chicken, butter, and whole-milk dairy products.  Trans fats are found in stick margarine, solid shorting, and many prepared foods, such as crackers, cookies, doughnuts, snack foods, and commercially fried foods.

High levels of HDL cholesterol are correlated with a diet that is high in unsaturated fats.  Unsaturated fats, like monounsaturated and polyunsaturated, can be found in some fish, nuts, peanut butter, avocadoes and plant-based oil such as peanut, canola and olive oil.  Other factors, like exercise, and quitting smoking can help increase your level of HDL cholesterol.

A simple blood test called a fasting lipid profile measures these various types of cholesterol in your blood. While someone may have a total cholesterol level that is desirable, the breakdown of LDL and HDL cholesterol may not be desirable.  That is why it is important to have a complete lipid profile.  After age 20, everyone should have a fasting lipid profile at least every 5 years, sooner if you have elevated cholesterol or are taking a statin.  If you have a strong family history for heart disease, talk to your primary care clinician about having the test performed more often.

For more information on cholesterol and testing options, please visit ministryhealth.org.

Author: Sally Andersen

Sally Andersen is an advanced practice nurse practitioner (APNP) at Affinity Medical Group’s Greenville Clinic.




Staying active in winter

winter exercise, healthy, fit

Outdoor activities are a great way to get some fresh air and stay active during our long winter months. Following some safety tips can help minimize your risk of injury while still enjoying cold weather activities.

Before participating in winter sports such as skiing, skating, hockey or sledding, you should do a short warm up. Cold muscles are more likely to become injured. This warm up should consist of some light exercises and gentle stretching. Each stretch should be held for at least 30 seconds. Before, during and after your activity, you should drink plenty of water.

You should also wear protective gear including goggles, helmet, gloves and padding. In addition, wear several layers of light, loose and water resistant clothing. This allows you to accommodate your body’s changing temperature. Proper footwear that provides warmth and dryness is also very important.

When people are exposed to cold temperatures for extended periods of time, your body can lose heat faster than it can be produced. Hypothermia affects the brain and is a condition of abnormally low body temperature. It can cause unclear thinking and may inhibit body movement. Elderly people with inadequate food, clothing or heating, babies sleeping in areas and people who remain outdoors for extended periods of time are some of the most common victims of hypothermia.

Frostbite is a seasonal concern for those who live in a cold environment. Frostbite is an injury to the body due to freezing and causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers or toes. Frostbite can permanently damage the body; severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation and those who are not dressed properly for extremely cold temperatures. Frostbite and hypothermia often go hand-in-hand and should be evaluated by a healthcare clinician right away. Taking preventive action is your best defense against extreme cold-weather conditions. By preparing your home and car in advance for winter emergencies, and by observing safety precautions during times of extremely cold weather, you can reduce the risk of weather related problems.

Many slips, trips and falls outdoors occur during the winter months from November through February. A simple way to avoid this is to tread safely and walk like a penguin to prevent snow and ice related injuries. Walk flat footed and take short steps; wear footwear that provides traction; step down, not out from curbs; use your arms for balance and carry only what you can to make it easier to navigate.

Snow shoveling, although not a sport can also be a great form of exercise but it comes with some safety concerns. Snow removal is one of the most common causes of back injuries during the winter months. Improper body mechanics can cause painful muscle sprains, strains or worse. There are, however, ways to help prevent such injuries. Invest in an ergonomic shovel. This is a shovel with a curved handle or adjustable handle length and will help reduce the amount of stress you put on your back. You should also use proper lifting techniques. Always bend at the hips and lift with your leg muscles, not your back. Do not try to lift loads that are too heavy for you. Whenever possible, use a snow blower instead of a shovel. Use the power of your legs to propel the machine forward, keeping your back upright and knees slightly bent.

Exercise and fresh air are great ways to stay healthy. By following some simple safety tips, you can enjoy the Wisconsin winters.


Author: Rhonda Repinski, ANP-BC

 Rhonda Repinski is an adult nurse practitioner at Ministry Medical Group in Tomahawk.

Losing weight doesn’t take perfection


Losing weight doesn’t take perfection. It takes preparation, patience and persistence. Here are some tips to help you get started on your goal.

  • Find out what motivates you – ask yourself “why” seven times. Each time you answer the question, answer at a deeper level to find your true purpose. This reason will motivate you for the long-term.
  • Start with a smaller goal. Studies show losing just five or ten percent of your body weight can reduce blood pressure, lower diabetes risk, lower your risk of sleep apnea, reduce joint pain and improve other conditions.
  • Eating 500 fewer calories a day can result in you losing one pound each week without increasing activity. This is good news for people whose weight makes it painfully hard to move.
  • But, it’s not just about counting calories; it’s about making your calories count. Eating 1,500 calories from fruits, vegetables and lean protein will satisfy you. Eating 1,500 calories of fried chicken, fries, cookies and donuts may leave you craving more.

If you’re ready, these changes will help create positive results.

Author: Olga Barchugova, MD

Dr Barchugova is a family medicine physician and medical weight loss specialist with Ministry Medical Group in Weston.

Disclaimer: The information found on Affinity's blog is a general educational aid. Do not rely on this information or treat it as a substitute for personal medical or health care advice, or for diagnosis or treatment. Always consult your physician or other qualified health care provider as soon as possible about any medical or health-related question and do not wait for a response from our experts before such consultation. If you have a medical emergency, seek medical attention immediately.

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