>> GOOD AFTERNOON, EVERYONE.

I WANT TO THANK YOU YOU GUYS FOR

COMING OUT.

I'D LIKE TO WELCOME YOU TO OUR

MONTHLY FOCUS ON YOUR WELLNESS

LECTURE SERIES.

AND I'D LIKE TO INTRODUCE TO YOU

MS. JANET DE JESUS, THE

NUTRITIONIST FROM THE NATIONAL

HEART, LUNG AND BLOOD

INSTITUTE.

AND TODAY'S LECTURE WILL BE ON

EATING FOR A HEALTHY HEART.

THANK YOU.

>> THANKSES, CHRIS.

THANK YOU FOR ORGANIZING THE

SEMINAR.

I REALLY APPRECIATE THIS.

I HOPE ALL OF YOU LEARN A LOT

TODAY.

AND WELCOME TO ALL OF YOU IN THE

ROOM AND ALSO THOSE OF YOU WHO

MAY BE WATCHING ON YOUR

COMPUTER.

TODAY, I'M GOING TO TALK ABOUT

EATING SMART FOR A HEALTHY

HEART.

SO I'M GOING TO TRY AND KEEP IT

REALLY PRACTICAL AND HOPE THAT

YOU CAN LEARN SOME GOOD

TAKE-HOME MESSAGES.

I'LL START OFF WITH SOME BRIEF

HEALTH STATISTICS AND THEN

REALLY GET TO THE MAIN POINT.

SO THESE ARE THE OBJECTIVES.

I'M GOING TO DISCUSS THE IMPACT

OF HEART DISEASE IN THE U.S.

I WOULD LIKE YOU TO LEARN ABOUT

THE RISK FACTORS FOR HEART

DISEASE.

AND THEN, MOST IMPORTANTLY,

LEARN ABOUT HOW GOOD NUTRITION

CAN DECREASE YOUR HEART DISEASE

RISK FACTORS.

OKAY?

SO YOU'VE PROBABLY HEARD ABOUT

THE ALARMING TRENDS OF HEALTH IN

THE U.S. THESE DAYS.

IT'S ALL OVER THE MEDIA.

SO JUST TO GIVE YOU A QUICK SNIP

IT, THESE ARE THE TEN LEADING

CAUSES OF DEATH IN THE U.S., AND

HEART DISEASE STILL REMAINS TO

BE THE NUMBER ONE KILLER,

UNFORTUNATELY.

EVEN FOR WOMEN, A LOT OF PEOPLE

THINK BREAST CANCER MAY BE THE

NUMBER ONE KILLER, BUT IT'S

STILL HEART DISEASE.

THERE WAS A QUESTION ABOUT THE

TWO DIFFERENT COLORS ON THIS

BAR.

I KNEW SOMEONE WAS GOING TO ASK

ME THAT QUESTION.

LET'S SEE HERE.

I KNOW.

SORRY, I DIDN'T HAVE A CHANCE TO

RESEARCH THAT.

BUT I WILL GET BACK TO YOU AFTER

THE TALK.

SO WHY THE INCREASE IN ALL OF

THESE RISK FACTORS?

THERE'S MULTIPLE CAUSES.

LIFESTYLE, ENVIRONMENT, ON THE

SMALL SCALE, GENETICS.

FOR WEIGHT, THERE'S DEFINITELY A

CALORIE IMBALANCE.

SO WE'RE EATING MORE, WE'RE

MOVING LESS, THAT'S NO

SURPRISE.

THERE'S HOW WE'RE REMOVING

CALORIES.

WE'RE EATING OUT MORE often.

Eating in ess.

There's been increases in soda

and candy consumption.

And, to add to that, we're

burning up fewer calories.

There's declines in physical

activity levels and increases in

screen time.

Screen time used to be just

television.

But, as you all know, now we

have lots more screens.

Way too many for adults and

children.

So are you at risk for heart

disease?

I'm hoping that all of you

participating today can learn

about your risk factors so you

can take some actions.

So the good news is there are

risk factor that is you can

change, all right.

There's something that you can

do about these things.

And the ones in red are the risk

factors that I'm going to cover

today.

First of all, overweight, high

blood pressure, high blood

cholesterol, diabetes, physical

inactivity and smoking.

And, unfortunately, the risk

factor that is you can't change

are your age -- we all wish you

could freeze in time.

It's not possible.

So, for example, a risk factor

for heart disease is the age 45

or older for men and 55 or older

for women.

And family history.

So if you have a father or a

brother with heart disease

before the age of 55 or a mother

or a sister with heart disease

before the age of 65.

So the risk factors that I'm

going to discuss today are, as I

mentioned, they multiply their

effects.

So, for example, if you have no

risk factors, that's in the

first bar.

If you have one risk factor, you

can see how your level of heart

disease risk increases.

Two risk factors and three or

more.

So that's why you really want to

pay attention to how many risk

factors you have.

So this has been a surprise.

These are the numbers for

children and adolescents who are

obese.

So this isn't overweight, this

is actually obese.

And it is definitely increased

over the years.

There's been a sign that it's

leveling off and we really hope

that it has and it continues to

level off and, perhaps, get

lower.

This is sea real crisis.

And these are the numbers for

adults.

As you can see, way back in

1990, there were, you know, just

the blue colors and then now we

had to add, you know, up to

2007, there were new colors

added because the obesity trends

were really increasing for

adults.

You've probably seen this

before.

So for overweight, definitely

people pay a heavy price.

There's so many risk factors or

problems related to being

overweight.

Type II diabetes, high blood

pressure, cardiovascular

disease, you know, even at least

low self esteem, poor body

image.

I won't read all of these tw to

you, but there are severe

effects.

So the good news, hopefully we

can talk about the good news for

the rest of this talk.

Heart disease can be prevented

or controlled.

Treatments include lifestyle

changes, and, if needed,

possibly medication.

So nutrition tips for weight

loss.

So I tried to put together my

best tips, you know, that are

also evidence-based that I've

learned.

And practical tips that you can

kind of take home.

My first main one is don't drink

your calories.

So I don't know if you know that

there's a lot of beverages out

there that have way too many

calories.

So, for example, there's a lot

of, like, fruity drinks, even

the coffee, you know, mixed

drink can contain a lot of

calories.

So, for example, your favorite

place, if you do get your coffee

out, you can ask for the

nutrition information to really

find out how much calories are

in those drinks.

Sodas, of course, contain a lot

of calories.

And I'll show you an example of

that today.

So my best tip is to eat your

calories instead of drinking

your calories, if possible.

Fruit juice, in moderation, I

would say.

I would definitely not say don't

have fruit juice, but in a

smaller portion.

So the gentleman next to me has

a, you know, small bottle of

hundred percent fruit juice.

When there's a much larger size

of fruit juice, so definitely in

moderation.

So if you can, bring your

lunch.

Or, when you eat out, you know,

I'm going to give you some

tips.

So for example, the NIH

cafeterias have some great

choices.

There's a beautiful salad bar

and some other great choices.

There's also some tempting

choices.

If you can, go to the good

ones.

The dietitians have been really

working hard to get a variety of

choices.

So I know when I don't have time

to make my lunch, I can always

find something healthy.

I just have to stay away from

the pizza line because it looks

so good.

And read the nutrition facts

labels.

When you're buying your food in

the grocery store, compare

things.

There is a large different type

of calories in different types

of foods.

If you really pay attention,

it's an eye opener.

If you are trying to lose weight

or make changes, keep a food

journal.

It keeps you honest.

It makes you think when you're

eating, okay, do I really want

to write that down?

And if you look at the end of

the day or the end of the week,

you can really see what kinds of

foods you're eating.

So that's been shown and

researched to be successful and

to help people and lose weight.

Use smaller cups, bowls,

plates.

It seems like -- I'll show you

an example that plates have

gotten bigger, especially when

you eat out.

Sometimes they bring you, you

know, a platter instead of a

plate.

So especially when you're at

home and you can control it, eat

in smaller cups and bowls.

So try to eat slower.

I know we're in a rush, rush

society.

And I'm guilty of that.

I think I'm always in a hurry.

But if you can, eat slower and

really savor and enjoy your

food.

Enjoy each bite, especially if

it's something, you know, like a

special desert or something that

should really be enjoyed.

People who tend to eat faster

could potentially eat more

calories.

So eat only when you're hungry.

I know a lot of people eat by

schedule and, you know, just to

eat.

Or eat because of the, you know,

social occasion or something.

So really try and listen to your

stomach and your body of when

you are actually hungry and not

just eat to eat.

So this is a sample showing you

one can of soda.

So I'm going to give you a

quiz.

If you drink one regular soda,

which is about a 12-ounce can,

every one each day for a year,

how much sugar do you think that

is?

And this is in pounds.

>> 12-ounce?

>> Yeah, 12-ounce.

I should have brought a sample.

There's about 40-grams.

Someone is trying to do their

math here.

Do you want me to give you the

answer?

Okay, the answer is 30 pounds.

So this is always shocking.

There's about 40-grams of sugar

in one 12-ounce soda.

So you can see cumulative.

And this is if you just have one

soda.

For example, I know some people

have more than one soda.

Or more than one, you know,

sugar-sweetened beverage or

coffee, you know, the mixed

drink.

So, in general, how much weight

would you lose if you switched

from soda to a, you know,

sugar-free beverage or water?

How much -- how many pounds?

These guys are thinking hard.

Anyone else?

About 15.5.

So I actually saw this happen.

My eighth grade teacher, she was

my home economics teacher, she

switched from soda to water and

she lost about this amount.

It was interesting.

So it's before my nutrition

days.

It shows you how -- what I'm

hoping to emphasize today is

that small changes can make a

big difference.

So you don't have to do

everything at once.

Today, I'm going to talk about a

lot of, you know, a few

different risk factor, but a lot

of different changes.

You can just pick one, start off

with one and make it a lifestyle

change and not just make it a

diet because we all know that

diets aren't fun.

They're hard to be successful,

long term.

So this is about making, you

know, lifestyle changes.

For long term.

So this just shows you, just an

example of how serving sizes

have changed.

You know, way back when, I know

when I was in kindergarten,

these eight ouncer, those were

kind of in vogue.

And now I see little kids

walking around with the

20-ouncers.

It gives me heart palpitations.

So I don't think anyone -- this

is my personal opinion, but I

don't think anyone needs regular

soda.

I think there's a lot of other

good, tasty drinks, you know,

flavored water or plain water.

So tips for eating out.

I know everyone likes to eat

out.

It's social.

It's relaxing.

These are some tips for

controlling calories and eating

healthier.

It seems like, you know, when we

go out, we're always tempted

with a lot of choices and

sometimes, in general, people

may eat more when they eat out.

So if you can order an appetizer

or only eat half the entree,

perhaps avoid buffets if you're

trying to lose weight or control

your weight because it's just so

tempting.

I don't know anyone who can go

to a buffet and just really

control it well.

Don't be afraid to ask for

substitutions.

So, for example, if your meal

comes with fries, you can ask

them to give you steamed

vegetables.

I do that all of the time.

And they never say no.

Share an entree with a friend.

If you order salads, order with

the dressing on the side because

salads aren't automatically

healthy.

They can include a lot of

dressing which adds calories.

So just an example of larger

portion sizes.

This was a paper done by Young

and Nestle showing the changes

in dinner plate size.

So these are just the plate that

is you buy at the store.  So,

for example, when I got

married -- how many years?

SecSeven years ago and we

registered for our dishes, I

couldn't believe it.

They're literally this big.

So I had opted for the little

desert plates.

Really, if you eat off of that

big plate, that's a lot of

food.

It's definitely too large.

I use the larger ones for

platters.

They really are the size of a

latter.

So on the NIH web site, there's

an activity called portion

distortion.

So it demonstrates in general

how portions have changed over

the last 20 years.

So I'm going to give you one

sample here.

So 20 years ago, a turkey

sandwich was about

320-calories.

So, today, how many calories do

you think?

I heard 1,000.

1250.

1700.

So this -- yeah.

And I guess the answer is you're

probably all right.

For those of you listening on

the web cast, there were --

there's a variety of numbers.

I mean, it can get really high.

We probably were conservative

with the 820.

We went with the average.

But it can be really high.

I mean, if you get those with

lots of cheese, and, you know,

dressing or mayo.

So the calorie difference is

about 500-calories.

So if you think about, okay, if

I eat more, if I want to

maintain my weight, what am I

going to have to do now?

I'm going to have to exercise or

get moving.

Do some physical activity.

So how long will you have to

bike to burn up about

500-calories?

>> One hour.

>> I heard one hour.

So this, for a small -- this is

for 130-pound person, sorry,

that's small.

It's about 1 hour 25 minutes.

I should have brought prizes for

the people in the room.

I apologize.

So if you can see, when we eat

more, you know, if you want to

maintain your weight or not

gain, then we're going to have

to be more active.

In my mind, it's easier just to

eat less.

With my busy life, I don't have

time to be as active as I'd like

you to be.

And I sit all day.

So here's the nutrition facts

label.

So I'm just going to give you a

quick tour of it.

So, at the top, you start with

the serving size.

So you should know that just

because it's in a packet doesn't

mean it's one serving.

So, like, for example, a bag of

chips could have ten servings.

I should have brought my little

samples.

So always look at the serving

side.

It doesn't mean that you should

only eat one serving.

So, for example, cereal, the

serving may be one cup.

It's okay that you have two, but

the calories are going to be

multiplied.

Times two.

So you have your calories.

And then the nutrients that you

want to limit are the saturated

fat and transfat and we'll talk

about that more.

Now, daily value on the right

side, this is confusing to a lot

of people.

Basically, what this is, this is

for a 2,000-calorie diet.

Daily value is telling you, so

for example, this food, you look

at the saturated fat, it has 15%

of saturated fat for the whole

day.

So, for example, say this is a

breakfast item and you're going

to have this.

That means this is 15% of your

sat fat that is recommended to

have in a day.

So if you compare food labels of

two different items, like a

high-fat meat compared to a

lower one, you may want to

choose the lower one to be

healthier.

You'll be surprised at the

numbers, if you start looking at

the daily value, how high some

of them can be, especially for

sodium.

And another point to know is

that 5% or less is considered

low.

So if you're looking for a

low-sodium food, look for the 5%

or less.

In 20% or more, it's high.

So, for example, here, the

sodium is on -- is right at

high.

And we'll talk more about

sodium.

So next I'm going to move from

weight control to cholesterol

treatment.

So these are just some of the

trends.

Over the years, this was from

'88 to about 2008.

Cholesterol levels have gone

down.

And we're definitely happy about

that.

There's still a lot of people

with uncontrolled high

cholesterol.

So some tips to control high

cholesterol.

Definitely reduce saturated fat,

transfat and cholesterol.

I would say saturated fat and

transfat are definitely the most

important.

And all of these things, I'm

going to give you examples.

Increased soluble fiber.

And I'll show you what that is.

Also, keep a healthy weight.

Healthy weight and physical

activity really affect most

cardiovascular risk factors.

If you are able to get to a

healthy weight and be active,

it's going to affect a lot of

your risk factors.

So saturated fat.

These are some of the foods that

are high in saturated fat.

Think about your meats, dairy

products, milk, cheese, ice

cream, your poultry with the

skin on it is also high, your

lard, butter, those types of

things.

You can see the marbling that's

on the steak, it's high in

saturated fat.

So if you do have high

cholesterol, it's something that

you really want to watch.

So foods that are lower in

saturated fat, I always want to

give you the positive.

Fish, vegetable oil, you know,

all of your fruits and

vegetables being your tub

margarine, your lower-fat milk.

I think a lot of people are

surprised about the milk.

They don't realize how much

saturated fat is in milk.

So if you're still at the whole

milk or 2%, it's time to move to

the lower fat.

It's not only lowering your

saturated fat, but will also

lower your calorie intake.

So transfat, this kind of became

in vogue a few years ago.

It's a different kind of fat

that was found to negatively

impact cholesterol levels.

So these are in fried foods, for

example.

It used to be in stick

margarine, but I think the food

processors are trying to take it

out of stick margarine now.

So this was added to the food

label I believe in 2006.

So now you can actually look on

your food label and see how much

transfat is in there.

But when that policy was

enacted, a lot of the food

companies started taking out the

transfat of the food.

So that's definitely a good

thing.

And there's also a lot of local

policies where restaurants are

encouraged to use a different

type of oil that's transfat

free.

So, really, transfat is an

issue.

I would say saturated fat is

probably more of an issue

because, you know, we still eat

a lot of -- I think in the

dietary survey, it's pizza was

the number one food that's high

in saturated fat.

So increased soluble fiber,

you've probably seen those

Cheerio's commercials, you know,

oatmeal marketing that says that

it lowers your cholesterol and

it actually does.

I would probably encourage more

of the whole oats, though, you

know, oatmeal, oat bran probably

have more of the oat.

So this is soluble fiber.

So there's two types of fiber,

insoluble fiber which you may

have heard your grandma or your

mom call roughage, and then

soluble fiber.

Soluble fiber is the one that's

good for your cholesterol.

It's in oats, it's in beans,

legumes and several types of

fruits.

As you can see, your citrus

fruits, your apples.

So, again, we're seeing another

theme.

You want to keep a healthy

weight, you want to be active,

and then, also, fruits and

vegetables.

You probably heard this so many

times, but it really is

effective in making you

healthier.

Now I'm going to switch over to

high blood pressures.

This is another major risk

factor for heart disease.

So my stat that you may not be

able to read at the bottom of

the screen, about 30% of adults

have high blood pressure.

Okay.

And this was in the 2005-2008

survey.

So that's definitely a large

number.

So, normal blood pressure is

considered 120/80.

So some tips that I'll go over

today to help prevent or control

high blood pressure are to

decrease sodium intake, limit

alcohol, watch your weight.

And, if needed, you know, take

blood pressure medication.

We've heard just through, you

know, surveys, that sometimes

people with high blood pressure,

they start taking their

medication and then, you know,

it will get better and then

they'll stop taking it.

So work with your doctor.

I mean, if they encourage you to

take a medication, you really

need to take it every day to

make it work.

So instead of going on

medication, it is possible to

control blood pressure with

lifestyle and healthy eating.

And one way is to reduce salt

and sodium.

So I'm going to give you some

tips.

The tip on the bottom may be one

of the most important eating

more meals at home, and I'll

show you an example.

But when we eat out, the amount

of sodium is really high.

I'll go over the other tips,

first.

So if you can, buy fresh or

frozen vegetables.

And fruits for snacks instead of

like your chips or crackers.

If you use can products, look

for no-salt added versions.

Choose fewer processed or canned

foods.

So, like, hot dogs, sausage,

bacon and lunchmeat, those are

all pretty high in sodiums.

And if you can try different

herbs and seasonings instead of

salt.

So, first of all.

Packaged meals.

Just to give you a reference for

this, the recommended amount on

the food label right now for

someone to eat in a day for

sodium is 2300 or less.

So you want to be below that

number.

So, for example, in a Hungryman

Carved Turkey, it's about 5400.

So this is more than double the

daily limit.

Let's see, Boston Market Meat

Sirloin with Noodles.

2200.

So that's about the highest

level.

So you can see these Oscar Meyer

Lunchbles, 1940.

I know a lot of busy parents

feed their kids Lunchbles.

I would advise against doing

so.

They're not really healthy.

They'rI'm probably not supposed

to say brand names, but they

have a lot of sodium in them.

So sodium in restaurants.

These are some examples.

So cheese fries with ranch is

about 4800.

A large sandwich, 4500.

Let's see here.

Like a house lo mein, 3400.

So you can see, you know, this

is way over a daily limit.

So one meal, you know, eaten out

can completely blow you out of

the water for sodium.

So it's pretty difficult,

unfortunately, when you eat

out.

So here's some tips for grocery

shopping for heart health.

So if you can, you know, shop

the perimeter, you may have

heard this before.

If you think about it, most of

the healthy and fresh foods are

around the perimeter.

And buy fruits and vegetables

when they are in-season.

They're likely to be cheaper and

there's a different variety.

I know we all love our spring

and summer produce, but the

winter is actually not too bad.

There's actually some good

variety.

If you can, plan weekly meals.

Planning will help you, you

know, plan ahead your meals, you

know, have a healthy meal,

either made ahead of time or you

know what you're going to cook

when you get home.

So I think what happens is that,

you know, we're all so busy,

we're on our way home, we don't

feel like cooking and, you know,

we pick up fast food or

something like that.

So if you can really plan, maybe

do some cooking on the weekend,

maybe do some crock pot meals,

that can help you eat healthier.

Shop with a list.

It's so tempting when you see

lots of other items.

But if you have a list, you

know, stick with it.

It will help you buy healthy

items.

Look for sales and shop on a

full stomach.

You know, when I was pregnant

and I used to go shopping, I

used to tell my husband don't go

shopping when you're pregnant.

I would just come home with all

of this food.

It was just not appropriate.

(Laughter)

>> so my joke of the day, be

physically active.

I can't even imagine this

picture.

I actually heard that if you

have a dog, it increases

people's physical activity for

those that walk them.

so it's a great strategy.

so the physical activity

guidelines for Americans, they

encourage children to be active,

moderator vigorous.

so that's really, you know,

moving one hour a day.

for adults, they say two and a

half hours per week at a

moderate level, and then one

hour, 15 minutes vigorous.

so vigorous is really like, you

know, cycling or really walking

fast or jogging or playing a

game or something.

so try and think, you know, in

your life, if you're meeting

these physical activity

recommendations.

it is hard.

I know with working.

I've heard the best time to get

in your physical activity is the

morning.

so it's done -- I know, it

doesn't work for me.

I see people in the audience

saying I have a two- and a

five-year-old.

so mornings for me are not

pleasant.

but when I was in college, I

worked out in the morning, and

that was great -- or when I was

single.

so do what works for you.

if you can find one time each

day, if you're able to get some

exercise in at lunch, you know,

go to the -- the NIH has these

fitness centers.

they have these great classes if

you're able to participate in

those.

you know, find a buddy.

find a partner that you can go

walk with.

I know it's hard getting it in,

but, really, you just have to

think what works for you and

what you like.

for an example, in my life, I've

always been successful when I

have, you know, a partner.

so I like to run.

so if I find, like, a friend in

the neighborhood that I can do

it with and you make each other

accountable, that's really

helpful.

so even if one of you doesn't

feel like it that day, you can

drag the other one outside.

and if you do have kids, you

know, try and make it a family

affair.

you know, after dinner, you

know, go for a walk.

you know, play outside.

in fact, if the weather is

yucky, put on some music and

dance.

we do that a lot.

I'm sure my neighbors are

probably looking in the window

thinking that we're crazy.

and we like to dance.

it actually works up a sweat.

>> question.

in terms of physical activity

guidelines, can you discuss two

and a half hours a week?

that can be broken down to 30

minutes a day.

the point being is that as

you're going through the day, if

you look at breaking down the

two and a half hours to 30

minutes a day.

and then you can break it down

further during the course of the

day.

>> yeah, that's a great point.

and I'll repeat it just in case

those others didn't hear.

so Chris was saying that you can

break up your physical activity,

even down to 10-minute

increments.

and that's absolutely correct.

so, really, the point is getting

this total in and figuring out

how to do it you know, even if,

you know, you're not able to

take a longer break, you know,

take a ten-minute, you know,

fast-paced walk outside, or even

in the hallways or go up and

down the stairs.

do different types of

activities.

even, you know, think about -- I

know your morning is crazy, but

if you're able to have 15

minutes to yourself on an

exercise bike or doing a yoga

routine, it's definitely a great

strategy.

I used to be so -- I wanted to

do an hour.

and if I didn't do an hour, it

wasn't successful and my husband

would say just go.

even if it's 30 minutes or 20

minutes, it's better than

nothing.

so I think that's a great tip.

so whatever you can do, you

know, is going to be helpful to

you.

so thanks, Chris, it's a good

point.

so talking about your heart

disease risk factors.

hopefully, you know, working

with your primary care doctor

and getting, like, an annual

physical.

have a heart-to-heart with your

doctor.

ask about your risk for heart

disease.

have some list of questions

before you visit.

and we probably have a goodiest

on the NIHL web site.

you can write down or perhaps

even tape record, if you doctor

lets you, you know, what they

say.

I know sometimes when I leave

the doctor, I'm like "What did

she say?"a  so, you know, really

bring your pad and paper.

they'll be fine with that.

you know, talk to your doctor

about lifestyle behaviors, such

as smoking, being physically

active.

so key tests for heart disease

risks.

blood pressure, of course.

hopefully, you're getting that

annually.

blood cholesterol, which is

actually lipid profiles.

you can have a nonfasting one.

they do those at health fairs

and things like that.

that can be a good measure.

and the important part of

cholesterol is your L.D.L.

cholesterol.

that's your bad cholesterol.

and then your H.D.L. cholesterol

is your good cholesterol.

so those two numbers are

important to know.

the total cholesterol isn't as

important.

so you really want to know your

break down.

so if you want the write that

down, your L.D.L. and your HDL

are important to find out.

so you want to have a fasting

plasma and glucose taken.

so this is your blood sugar.

so test for diabetes.

there's a -- I don't have stats

right in my head, but, you know,

there's a large number of

undiagnosed, you know, people

with diabetes.

it can be dangerous and have

negative effects.

so talk to your doctor about

that if you've never had a

glucose test as an adult.

also, B.M.I. and weight

circumference.

this is just a measure if your

weight is in the healthy weight

category or in the overweight or

obese category.

and, hopefully, your physician

is, you know, weighing you when

you go to your visit.

and, so, for high-risk tests,

and this would be, you know,

recommended by your doctor, they

may recommend, like, an E.K.G.

or a stress test.

so if they think you're a higher

risk and they want to see about

your heart function, they may

suggest this.

so just briefly, I just want to

give you a quick run down of

some NHL tools that we have on

the web site.

they're all free.

we have a We Can program and it

stands for ways to enhance

children's activities.

so if you have kids or you're a

grandparent and you're seeing

your kids caring for your grand

kids, this is tips for keeping,

you know, kids at a healthy

weight.

so lots of tips, posters, you

know, tool kits to really help

you and your family be

healthier.

I'm sorry about these blurry

pictures.

so we have a number of other

resources and there's NIH recipe

books, we have our deliciously

healthy dinners, deliciously

healthy family meals.

and these are all free.

so you can go -- there's a link

at the top.

or if you google NHLBI healthy

eating, it will come upright

away.

and all of these recipes are

free.

so you can down load the entire

book, but you can also look at

different categories, so, for

example, entrees or brunch

items.

we've worked with the NIH

cafeteria feature items.

I think they feature some for

American heart month, so you may

have tried some of them in the

cafeteria.

so please take advantage of

these.

these new publications were

actually created by a chef, a

professional chef.

and he really worked with us to

create, like, new recipes that

were kind of in vogue and

different and diverse but also

healthy and good.

and the family meals are pretty

simple.

so thing that is you can

actually cook with your kids and

get them involved.

and they were also tested by

kids.

so we really wanted the kids to

like the family meals.

so some other resources that may

be helpful to you.

we have NHLBI Your Guides.

and what this is, these are kind

of in-depth guides.

we have long versions and

shorter versions of guides.

for example, how to lower your

blood pressure with a dash

eating plan, how to lower your

cholesterol with our therapeutic

lifestyle changes.

living with heart disease.

so if you know someone who is --

who has heart disease or has had

a heart attack, it gives you

tips to kind of maintain your

heart health or get back to your

heart health.

so please visit the NHLBI web

site.

there's a lot of great

resources.

I believe you can receive, like,

one copy of different items if

you request it.

so this is about it.

this is the link to the NHLBI

web site.

and if there's any questions in

the room, I'd be happy to answer

them.

>> I get the idea that eating a

bran muffin is better for you

than eating a regular muffin?

>> so the question in the room

was he asked if eating a bran

muffin rather than another type

of muffin is better.

the answer is yes and no.

muffins are tricky.

depending on where you get them,

they can be healthy or they

could have a lot of fat and a

lot of calories.

so definitely bran is, you know,

higher in fiber.

so where the other muffins

probably don't have a lot of

fiber.

but depending on where you get

it and the size of it,

sometimes, muffins just can be,

you know, really high in fat and

calories.

so that's a great question.

but it's definitely a good

start.

I know a lot of restaurants are

starting to serve them.

and they're a smaller size.

so that's a good way to start.

anymore questions from the room?

>> oh, that's a great question.

I'm going to repeat it for those

who may be watching on the web

cast.

so the question in the room was

I had encouraged using other,

you know, types of herbs and

spices instead of salt.

some of them do contain, those

mixes, do contain -- so for

example, garlic salt, instead of

onion powder, there's onion

salt.

so definitely go for the one

that is don't have the salt.

so they do have a garlic powder,

you know, as opposed to the

garlic salt.

and I think the spice seasonings

and mixes that you can buy, you

can buy ones that are lower in

sodium.

so that's where you want to read

the label.

but that's a great question.

because I use my garlic powder

on everything.

I just sprinkle it on.

it actually makes a big

difference.

it doesn't have any sodium, it's

flavorful, it gives you great

breath for the evening.

(Laughter)

>> so great question.

we actually have in our

education materials when we go

out in the community.

so any other -- hmm hmm?

I know.

yeah.

>> yeah, so I can definitely

talk to that.

the question, for those of you

who may not have heard was, for

example, the frozen meals, you

know, you think they're healthy

but then they may be higher in

sodium.

and there's also lots of

different diets out there.

there's lots of different

nutrition information.

I completely agree with you.

it's like once there's a study

about one thing, people say this

is good for you and it can be

very confusing.

so my best tip, first, to your

point about the frozen meals,

some of them aren't too bad.

for example, the healthy choice

to have the word healthy on it,

they have to have certain

parameters.

and I think the sodium may be a

little bit high.

but it's not terrible.

I think it's a good strategy for

portion control.

so I think the calorie range is

really good.

and, you know, they're trying to

include, you know, more fiber.

and they're not high in fat or

anything.

so if that works for you, I

don't think it's a bad thing.

you know, the Lean cuisines are

really controlled.

they even have store brands

now.

Safeway has their own healthy

version.

if that works for you and you

like it, you know, perhaps watch

your sodium in other areas.

if you're going to have

something with that, just have

some, you know, fruits, you

know, or carrots on the side or,

you know, something that doesn't

have sodium.

but I think it's an okay

strategy.

I keep them in my fridge so that

if I'm not able to cook, my

husband can have one.

and I don't feel so guilty.

so, you know, you just have to

figure
(

plan.

and gu

menu.

so it real

okay, if I want to get to 2300

or 1500, what are the types of

foods?

and it's a lot of whole grains.

it's lots of fruits and

vegetables, low-fat dairy, lean

meats.

it's not only good for blood

pressure, but it's also good for

cholesterol and perhaps, you

know, weight control if it helps

you lower your calories.

>> that's a great question.

the question was if someone is

on high blood pressure

medication, how easy is it to

get off the medication or if you

actually could.

I think it is possible to

control all of these risk

factors with lifestyle.

so for blood pressure control,

you know, weight is important.

so even a small weight loss can

help, you know, keep your blood

pressure under control.

watching your sodium,

definitely.

another tip is potassium

intake.

so that's where, you know, the

dash eating plan comes in.

so, in general, if you lower

your sodium intake, your

potassium is going to go up.

so that's in fruits and

vegetables.

that's the basic point.

you kind of see the theme with

eating, you know, more fruits

and vegetables and less

processed food.

you're going to get more of the

good things and, you know, less

of the bad.

so I, you know, firmly believe

that people can control, you

know, these risk factors.

I mean, you have to think about

family history.

>> hypertension, for some

groups, it's more prevalent.

it's definitely more prevalent

in African Americans.

it's a higher risk.

so it may be harder.

so for example, even in

cholesterol, there's something

called factors mea father and

mother Melia hypercholesterol.

in my family, we have that

program.

so we have to work really hard

with lifestyle.

but hypertension is one of

those -- it is, some groups

unfortunately are at higher risk

for it and you may have to work

harder at it, you know,

especially with weight control.

physical activity also helps.

so, you know, being physically

active, losing weight, keeping a

healthy weight, you know,

watching sodium, increasing

potassium.

so definitely check out your

dash eating plan.

and even if you want to write

down your e-mail, you know, I'd

be happy to send you links.

we've gotten testimonials from

people in the public that have

written in and said I went on

the dash eating plan or I've

changed my lifestyle and I

lowered my blood pressure and,

you know, that really makes me

happy, too.

we like to help people.

so, if possible to do it, you

know, without drugs.

not saying medication is bad,

but, you know, if you can do it

by lifestyle and it's not only

good for your blood pressure,

but it's good for so many

things.

you know, for all of your other

risk factors.

yes, I wouldn't recommend going

off the medications.

oh, yeah.

um-hmm.

absolutely.

great.

so the question is, for, if

you're in like a pre-hypotensive

area, you know, if you could

start with lifestyle.

and I would definitely recommend

that.

so see what you can do, you

know, with eating, you know,

being more physically active.

and, you know, so it's a great

accomplishment, if you can do

that.

so -- and get, you know, the

rest of your family involved.

get your friends involved.

don't be afraid to tell someone,

hey, you know, my blood pressure

is getting high.

I need your help.

you know, and I'm sure they'd be

glad to help you because they

love you.

did you have a question?

>> such a great question.

the question is if there's an

application that you can find

out what's in your food when

you're eating.

there's a lot of them now in the

government and non-government.

so for example, the U.S.D.A. has

the My Plate and they have a

calculator in there where you

can enter in all of your foods.

it's great because you have a

log in and have your favorite

foods.

if you have yogurt every day,

that's already in there and you

can add that in.

check that out.

I know there's a lot of other

sites.

I know on Lance Armstrong's

Livestrong site, there's a

calculator.

and depending on what type of

phone you have, if you have a

fancy phone, there's lots of

applications where you can enter

in your foods.

and that's helpful.

I recommend when people are

watching things or they're

trying to lose weight or, you

know, make some changes, you

know, that knowing you have to

know first, like, what you are

eating.

how do we know how many calories

we're eating?

that's a tough question.

so, really, keeping a log or

doing it online where it

calculates it for you is a great

strategy.

so good question.

any other questions in the

room?

okay.

well, you guys have been

fantastic.

and thank you all for coming.