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HEART Insight:
doi: 10.1097/01.HEARTI.0000414787.30372.d3
Departments: Life's Simple 7

Modest Lifestyle and Behavioral Changes That Can Improve Your Health

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Be aware of “white-coat hypertension”

You're at your regular checkup and you tell your doctor you're feeling fine—you've lost weight, are eating healthy and exercising five times a week. You check your blood pressure regularly with a home blood pressure monitor and your readings are always within the proper range. Things are looking good, right? The nurse comes in and measures your blood pressure—and tells you that the high reading indicates you might have high blood pressure, or hypertension. You can't believe it. What gives?

You may be experiencing what's called “white-coat hypertension,” or “white-coat syndrome.” Some people get nervous when they're visiting the doctor (who often wears a white coat), which can lead to temporarily higher readings in their blood pressure. If you experience this, you're not alone—studies show that 10 to 20 percent of patients may experience white-coat hypertension when they visit their doctors.

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So as long as your blood pressure readings are fine when you get home you should have no problems, right? Most of the time, yes. But while a case of the jitters may cause your blood pressure to rise during a visit to the doctor, recent studies have shown that white-coat hypertension may indicate more than just nervousness. It may help identify those at a serious risk for hypertension. Two studies from 2005 and 2009 found that a higher percentage of people who experienced white-coat hypertension progressed to actual hypertension compared to those who didn't experience it. This may be an indicator that people with white-coat hypertension are more susceptible to stress, which can lead to increased blood pressure over time.

More studies are needed, but talk to your doctor if you experience white-coat hypertension. You'll most likely be asked to periodically monitor your blood pressure at home to see if it's just being at the doctor's office that's raising your blood pressure. You may be given a 24-hour ambulatory blood pressure monitor, which will periodically measure and record your blood pressure throughout the day. If your doctor suggests using a home blood pressure monitor, bring it to your doctor to make sure it's accurate and you know how to use it properly. If your home blood pressure readings start to rise, talk to your doctor about ways to reduce your blood pressure.

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How much exercise does it take to burn off a Krispy Kreme?

Those Krispy Kreme doughnuts that your colleagues brought into work certainly are tempting. How many calories can be in one little doughnut, right? Well, you might want to think twice before you reach for that sugary snack—you'll have to work pretty hard to burn it off.

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Although the amount of calories you burn depends on your weight and the type of exercise you do, you could spend up to an hour in the gym burning off the calories that are in just one Krispy Kreme. You like your doughnuts simple and sweet? Their original glazed doughnut has 190 calories. If you weigh 160 pounds, you'd have to use a rowing machine for a half hour just to burn it off. More of a chocolate lover? Krispy Kreme's chocolate iced glazed doughnut with sprinkles will set you back 270 calories—get set to do high-impact aerobics for a half hour. And their Caramel Kreme Krunch doughnut is a whopping 390 calories, which will take you a whole hour of swimming laps to work off.

So instead of reaching for that doughnut, suppress your inner Homer Simpson and grab a lower-calorie alternative. Try four Hershey's kisses, which add up to only 88 calories, or a 100-calorie snack pack of cookies. And don't forget about sweet fruits such as an apricot (only 17 calories!), a peach (38 calories), a small box of raisins (90 calories) or an apple (95 calories). They'll satisfy your sweet tooth and you won't have to spend as much time at the gym—and they'll provide you with more healthy nutrients than a doughnut could ever offer.

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Life's Simple 7 in a Nutshell

Cardiovascular health encompasses two basic components: ideal health behaviors, and ideal health factors.

The behaviors include not smoking, maintaining a healthy weight, meeting or exceeding AHA recommendations for physical activity and eating a healthy diet.

The health factors include blood pressure, fasting blood glucose and total cholesterol levels that are within the AHA's recommended range—preferably without needing medication to keep them there.

Modest lifestyle or behavioral changes can move you in the right direction. And those who make behavioral changes before developing any serious health risks can look forward to a better quality of life and moving toward excellent heart health.

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Why gaining weight pushes up cholesterol levels

It's obvious that eating foods high in fat causes us to gain weight, increasing the levels of fat in our bodies. But as we gain weight from eating fatty foods, our cholesterol levels go up as well. Why?

There are two kinds of cholesterol: LDL (low-density lipoprotein) and HDL (high-density lipoprotein). LDL is often called the “bad” cholesterol because it's made up mostly of fat and raises your risk of heart disease. LDL cholesterol is affected by diet, so certain foods that you eat can increase the levels of this dangerous cholesterol in your body.

Eating foods that are high in saturated fats, trans fats and dietary cholesterol can raise the levels of LDL cholesterol. Since these same foods are the ones that tend to make us gain weight, your LDL cholesterol levels rise along with the number on the scale. Knowing which foods contain these types of fats can help you avoid them and you'll not only lose weight but lower your cholesterol levels as well.

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The AHA recommends limiting your saturated fat intake to less than 7 percent of your total daily calories and your trans fats to less than 1 percent of your total daily calories. Saturated fat is found mostly in foods from animals, such as beef, veal, lamb, pork, poultry fat, butter, cream, milk, cheeses and other dairy products. Trans fats are found in fried foods and lots of commercial baked goods that are found on grocery store shelves such as cookies, snack cakes and crackers. Look for the words “partially hydrogenated” in the ingredient list—that's a dead giveaway that trans fats are in there.

So what do these percentages actually mean when you're planning meals? To use an example, a sedentary woman between the ages of 31 and 50 needs 2,000 calories each day. This means that she should eat no more than 16 grams of saturated fat and less than 2 grams of trans fats per day.

You should also limit your dietary cholesterol intake to less than 300 mg per day. Cholesterol can be found in organ meats, egg yolks and whole milk products.

By watching your saturated fat, trans-fat and dietary cholesterol intake, you'll not only lose weight but lower your cholesterol levels as well, reducing your risk of heart disease.

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Can eating veggies make it easier to stop smoking?

What if you could make cigarettes taste so terrible that it could help you stop smoking? Well, according to a new study, all you have to do is eat your veggies and drink your milk.

Researchers at Duke University in Durham, N.C. took a look at how eating certain foods could make cigarettes taste bad, making it a bit easier to quit. They found that just about half of the smokers surveyed who ate fruits, vegetables, non-caffeinated drinks such as water and juice, milk and dairy foods such as cheese said eating these foods made their cigarettes taste terrible. While the researchers don't exactly know why these foods affect the taste of cigarettes, they see it as a stepping stone to a possible “quit smoking diet” that could help those trying to quit make it just a bit easier.

However, if you're determined to quit smoking there are certain foods that you'll want to avoid as well. The researchers in the Duke University study found that certain foods actually made cigarettes taste better. About 70 percent of smokers who consumed caffeinated drinks such as coffee, cola and tea, alcoholic drinks and meat said that these foods increased the tastiness of their cigarettes.

So if you're trying to quit, it couldn't hurt to up your intake of water, fruits, veggies and milk. It may help you put down those terrible-tasting cigarettes for good and improve your health at the same time.

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How losing weight can lower your blood sugar

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High levels of blood sugar can be dangerous and lead to type 2 diabetes, which can then increase your risk for heart disease. If your doctor has indicated that your blood sugar is a bit high, losing weight can help you get that number down and prevent you from developing diabetes.

Sugar in the blood comes from two sources—the carbohydrates that you eat and your liver. Carbohydrates are found in foods such as bread, cereal, potatoes, rice, sugar and candy. Eating too many carbohydrates can cause sugar to build up in your blood. Your liver creates extra sugar when your body can't move enough sugar into your muscles. This happens if you develop insulin resistance, which is when the insulin in your body isn't working properly. Body fat, especially around your waist, can add to insulin resistance. Losing weight can help you get your insulin back on track and stop your liver from producing extra sugar. If you're overweight and your blood sugar is high, losing just 5 percent to 10 percent of your weight will improve blood sugar levels. Losing just 10 or 15 pounds can get your blood sugar down to a healthy level.

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If your doctor is concerned about your increasing blood sugar levels, work together to come up with a meal plan that limits the carbohydrates you eat and reduces calories. Increasing your physical activity can also help you get your blood sugar levels down. Exercise lowers insulin resistance and helps move sugar from the blood into your muscles.

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Resources

Life's Simple 7¯ Assessment

To understand the steps you may need to take to improve heart health and quality of life, visit heart.org/mylifecheck

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Track your blood pressure at home

Use the AHA's online blood pressure tracking tools at heart360.org

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Quit smoking

Get tips on ways to break the habit at smokefree.gov

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Get physically active

For ideas on how to incorporate physical activity into your life, visit startwalkingnow.org

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Body Mass Index Calculator

heart.org/BMI

© 2012 American Heart Association, Inc.

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