Dr. Sinatra's Daily Heart Health Blog

Dr. Sinatra wrote about airport angina in an issue of Heart, Health, and Nutrition years ago. For those of you who missed it, here is a synopsis of his tips for heart patients:

1. Know your bag: Select luggage that’s user-friendly. There’s a great selection of bags with easy moving wheels under them, so you don’t have to carry unchecked bags under your arms (like in the old days so many of us remember), and smaller ones with handy shoulder straps. And you can loop the strap of a smaller bag into the extended handle of a larger wheeled one to lessen your load.

2. Know your options: Employ shoulder straps when you can. Most loaded computer bags are eight pounds or less, and can be carried without much effort by the shoulder strap. But caution to you efficiency experts: don’t carry two and three bags with straps on each shoulder!

3. Know your limits: We also give our cardiac patients individualized weight limitations for lifting heavy objects, especially if they have angina, or have had a recent heart attack or heart surgery that’s still healing. Ask your cardiologist. If you are in a cardiac rehab program, you can inquire about your specific guidelines for lifting weights based on your present level of safe exercise, which is prescribed to stay well below your “anginal threshold,” or the “rate pressure product (RPP)” that may provoke symptoms for you. There are weight lifting parameters that coincide with your safe level of exercise.

4. Relax and breathe: I know it is easier said than done, but try to roll with the punches as you travel, and stay as relaxed as you can. You may need to release the outcome of your journey—especially time urgency—even when traveling for business. No matter how “important” your trip, it’s never worth dying for! You don’t want to provoke angina if it can be avoided. And it can…

5. Let go: It’s gripping the handle of your suitcase tightly, or pressing that carry-on bag up into the overhead compartment that will be negatively affecting your RPP, because both are isometric activities—pushing or exerting against resistance. So, remember to be conscious of keeping a loose hold on the handle of your rolling suitcase, so the effort is more dynamic, or isotonic, meaning that the muscle moves through the effort without resistance.

You see, when you squeeze down on a handle, or push against an object that needs your effort to move, the muscle tension is transferred to the chest, where it also puts a squeeze on your heart, impeding circulation as well as making the heart work harder—yet another “double handcuff” situation.

Both your heart rate and blood pressure rise sharply with these kind of maneuvers, and you have the added stress of having the muscles around the heart apply external pressure to the large arteries that lie right there on the surface of the heart.

6. Exhale on the effort: Remember to breathe. If you are lifting something—be it luggage or a child—always breathe through the effort on the exhaled breath. Most of us are unaware that we’re holding our breath—especially during inhalation, so we force our diaphragms up and into the heart: another big squeeze on those coronaries!

Folks with heart disease must be especially aware to relax, and exhale with effort—like lifting bags—to avoid overtaxing their hearts. Don’t lift anything over 25 pounds by yourself, even if that means surrendering to someone else’s assistance. And remember to anticipate. If you have a prescription for nitroglycerine; by all means take it with you when you travel. It can save your heart, even if you have to dial 911 far from home.

7. Surrender: Should you have serious heart disease, let some one else deal with the luggage. Even I ask for help to hoist a heavy bag into an overhead compartment—I often have no choice!

Asking for help may not be your forte, but you’d be surprised how kind people are, how much they want to help, and how it can connect you in a positive way with other travelers.  In a way, you are giving them the unspoken lead to engage you should they need assistance with something you can provide: “what comes around goes around” as they say!

I really hope these tips help you to enjoy your travels all year ‘round and take measures to safeguard your heart. Hopefully “airport angina” won’t be something you will ever have to deal with.

For more information on angina and other cardiovascular problems, visit Dr. Sinatra’s Web site.

Let me start out by saying that I realize it may feel strange to discuss cardiovascular problems in the context of your emotions. Your feelings are probably not something you ever thought of as heart risk factors.  This is why I want to make you aware of how the “lesser known” heart risk factor—your mind—affects your body. And I want you to take advantage of new information that could dramatically improve your healing process.

I’m not surprised that your doctor or even your holistic practitioner may not have told you much about heartbreak’s role in heart disease. Heartbreak is not considered a medical “condition” because love is not a recognized physical function. Until recently, physiology has limited itself to the mechanics and chemistry of how organs work and has ignored the impact of various emotional states on those functions. Science is necessarily confined to phenomena that can be measured and quantified.

Although the feeling states lie outside the realm of science, I think it’s a mistake to exclude them from our understanding of the human body. Love is a tremendously vital force in human behavior, and I firmly believe that we must try to understand its nature and the role it plays in our emotional and physical health.

I want to make it clear that love and intimacy cannot “cure” heart disease. But if you learn to cope with heartbreak, anger, or resentment, rather than suppressing the feelings, you’ll be doing your heart a world of good. You will harness the power of your emotions to heal your body. Honesty, tears, and smiles have as much to do with recovering from heart disease as eating well, exercising, and taking vitamins.

For more information on how the role between emotions and heart risk factors, visit www.drsinatra.com.

Fibrinogen is a coagulation-type protein that determines the stickiness of your blood by enabling your platelets to stick together.

You need adequate fibrinogen levels to stop bleeding when you’ve been injured, but higher-than-normal fibrinogen levels have been associated with too much blood clotting and are an independent heart risk factor. You see, by itself, a high fibrinogen level can cause a heart attack.

If you have a family history of cardiovascular problems, you must check your serum fibrinogen level to predict your risk. And because the tendency toward a high fibrinogen level can be a genetic trait, be sure to assess your fibrinogen level if any close relative has coronary atherosclerosis.

Women who smoke, take oral contraceptives, or are postmenopausal usually have higher fibrinogen levels and should also get this simple test done. Fibrinogen levels rise with falling estrogen levels, and research suggests that natural estrogen replacement therapy can significantly reduce fibrinogen levels.

As with all heart risk factors, you increase your chances of having a healthy fibrinogen level when you exercise regularly, minimize stress, and adhere to a good cardiovascular nutrition program.

For more information on circulatory problems, preventing blood clots, or other cardiovascular problems, visit www.drsinatra.com.

More people vacation during the summer months than at any other time of year. And the topic of “airport angina”—an old cardiology phrase—may be getting tossed around now more than usual. But what, exactly, does it mean?

Essentially, “airport angina” is a phrase coined to describe heart symptoms of ischemia (lack of oxygen to the heart) that are provoked by hauling and lifting luggage. And getting angina when you’re far from home is always an unsettling experience.

Of course, we all know that there’s more to traveling than lugging luggage, regardless of your mode of transportation. But airports are fraught with a few more built-in stressors than other forms of travel, including:

• scheduling and weather concerns;
• airport security;
• flight delays;
• cancelled flights and rerouting;
• tight connections and time urgency;
• dread about lost luggage; and so on.

So, the psychological stress combined with the isometric physical work of carrying your bags is sort of “like being in double handcuffs,” as Dr. Sinatra would say.

And, let’s face it, all traveling and vacationing has the potential for some family and other unpredictable stressors, in addition to the physical exertion of lifting bags onto “trains, planes, and automobiles.”

Dr. Sinatra will be addressing the topic of safe air travel for cardiac patients in an upcoming issue of Heart, Health, and Nutrition. And in a few days, I’ll post another blog on how heart patients can manage their luggage from a physical exertion standpoint. So, stay tuned!

For more information on angina and other cardiovascular problems, visit Dr. Sinatra’s Web site.

C-reactive protein (CRP) is a marker for inflammation that is directly associated with atherosclerotic plaque. It’s a blood protein that, when found in elevated levels, may indicate you could be at risk of heart attack and stroke.

Multiple studies have identified CRP as a potent predictor of future cardiovascular problems—and one that is far more reliable than elevated cholesterol levels.

Biological characteristics that are associated with high CRP levels include trauma, infections, high blood sugar, excess weight, and hypercoagulability of blood (sticky blood). Any one of these situations literally feeds pro-inflammatory mediators, ratcheting up the chances that you’ll develop atherosclerosis.

If you have heart disease concerns, other cardiovascular problems, or you’ve had trauma or an infection that could cause inflammation, you should have your CRP levels tested. Just make sure your doctor uses the high sensitivity test (hs-CRP). This test doesn’t take much time; typically, blood is drawn from a vein located either on the forearm or from inside your elbow. The blood is then analyzed in several tests to determine the level of CRP present.

For more information on heart risk factors or cardiovascular problems, visit www.drsinatra.com.

• C-reactive protein, 
• interleukin-6, 
• homocysteine,
• fibrinogen, 
• lipoprotein (a) or Lp(a), and
• ferritin (iron).

These blood elements are helping to explain why people with “normal” blood profiles and no obvious risks sometimes turn up with serious heart disease, and more than two of them can produce an increase in risk of heart disease.

Fortunately, these heart risk factors can be detected with a blood test, and most are extremely responsive to good cardiovascular nutrition, nutritional supplements, and other healthy lifestyle changes.

For more information on what I consider to be healthy levels of these blood elements, along with a summary of my recommendations to achieve these healthy levels, visit www.drsinatra.com or subscribe to my monthly newsletter, Heart, Health & Nutrition.

No matter what time of year, seems like we are always looking to detox and to manage our weight! Through the winter months, I convince myself that weight management will be easier in the warm weather when I can work in the yard; walk about more freely without ice, snow, and storms to contend with; enjoy longer days and more light and natural vitamin D; and so on.

Then, from my midsummer night’s dream I awaken to realize that longer days mean the joy of more social activities; more meals out with family and friends; more grab ‘n go food on our jaunts to be out of doors more; and on it goes.

This summer, Dr. Sinatra and I were mindful to create healthy, farm stand meals at home to balance dining out during vacation and business trips. And we added daily juicing to offset our dietary indiscretions.

Dr. Sinatra’s sister, Dr. Maria Seidel, got us jumpstarted. She stayed with us after taking her nursing students to Costa Rica. There, her local hosts made her fresh juice from their organically grown gardens every morning for three weeks. Maria came home feeling like a million bucks, and juiced us every morning of her visit. Now, we are all hooked!  

Instead of an occasional juice meal to detox, Dr. Sinatra and I have made juicing a regular breakfast ritual. In fact, we both feel so much better physically and mentally that we got motivated to maintain the “habit” even when we are on the road. If we feel we have overindulged, we compensate by juicing for dinner as well.  All those live enzymes are nature’s way of cleansing and restoring your GI tract, nurturing all the cells in your body, and boosting your immune system, as well as your overall energy.

Traveling in your own car with a cooler is the easiest way to maintain a juicy life. You can pack some organic fruits and veggies to juice along with your Vitamix, Cuisinart blender/food processor, or juicer. We actually find the Vitamix and Cusinart less messy, easier to clean, AND you don’t lose all the nutrients in the pulp strained and discarded in traditional juicers. The juice is more of a textural experience as well, which we enjoy—and there’s more fiber included to boot.

When staying in hotels, we looked for those with a kitchen set up or a counter with an available electrical outlet. If we can find a Jamba-juice kind of place when we travel by air, that’s a big plus too!

There are plenty of juice recipes out there to get you started if you are new at it, but feel free to be creative and have fun too! Pick the ingredients you like to eat. Dr. Sinatra’s favorite is to combine leafy greens with fresh fruit, beets, and a splash of ginger.

Here is one if his favorites. Combine one or all from each category:

• Berries: strawberries, blueberries, raspberries, blackberries
• Other fruit: apple, banana, kiwi (no citrus)
• Vegetable: Beets are our breakfast favorite (but mixed veggie juices are great for lunch and dinner) 
• Ginger: skin and add fresh ginger to taste
• Greens: Swiss chard, baby spinach, parsley, kale, broccolini
• Add water or ice to get consistency for easy pouring

To prepare:

1. Just wash and cut fresh, hopefully organic, produce in chunks.
2. To liquefy in blender/processor, we use “chop” setting, then use food processor setting to make finer. If you use juicer, just turn it on.
3. Enjoy.

Note: These juices don’t keep long or store well, so make just enough for your meal.

For more great recipes and other cardiovascular nutrition tips, visit Dr. Sinatra’s Web site.

About six months before my scheduled hip surgery, I started to “train” for it, much as I trained for wrestling matches during my athletic heyday. Here’s the 5-step plan I followed:

Step 1: Think Positive. Recovery from surgery starts in the mind. Rather than getting down, I reframed everything for myself, the same way I encourage my patients to do. I visualized a scenario of total success. I thought about coming out of surgery and walking the very first day. And that’s just what happened.

Step 2: Get Fit. Surgery recovery will go much more smoothly if you’re in good physical condition. I exercised every day, incorporating Pilates, stretching, and strength training so I would be well conditioned going into surgery and have the greatest possible chance for a successful outcome.

Step 3: Eat Right. My pre-surgery diet looked very much like my normal healthy diet of lean protein, whole grains, and lots of vegetables and fruit.

Step 4: Supplement Smart. My regular supplement routine consists of my daily multivitamin and mineral formula; the Awesome Foursome of CoQ10 (200 mg), broad-spectrum carnitine (1 g), magnesium (200 mg), and ribose (5 g); and my anti-inflammatory supplement program that includes fish oil (2 g), bromelain (100 mg twice a day), 3 tablets of Wobenzym digestive enzymes, and nattokinase (100 mg). A couple of months before the surgery, I doubled my vitamin D intake to 10,000 IU daily to strengthen my immune system and bones.

A week before my surgery, I stopped taking my fish oil, multivitamin/mineral complex, and nutritional anti-inflammatories due to the possibility of thinning my blood too much during recovery from surgery. But, my surgeon, anesthesiologist, and I agreed that I should continue with my CoQ10 right up until the surgery. I also continued to sleep grounded, as I do every night.

Step 5: Balance Mind, Body, and Spirit. Before my surgery, I also listened to The Surgery Companion, a CD program by Dr. Olga Stevko and her husband Mitchell Stevko, which employs mind-body techniques used by the Mayo Clinic and other top hospitals to promote successful surgery by making patients feel more positive about surgery, reduce pain, and speed healing.

To learn more about my five-step plan for successful surgery recovery, visit my Web site. If you would like to the whole story of my journey through hip replacement surgery, check out the September 2010 issue of my newsletter, Heart, Health & Nutrition.

And to see pictures of my recovery from hip replacement surgery and to share what worked for you, join me on Facebook.

For years, I’ve been telling my readers and my patients to avoid acetaminophen—especially the extra-strength variety—because of the potential for liver problems. I’ve also told them to avoid NSAIDs because of the potential for gastrointestinal bleeding, liver damage, and kidney dysfunction. Now there’s yet another reason to avoid these analgesics, as recent studies suggest that they can also make it difficult to maintain healthy blood pressure levels.  So…

If you take painkillers regularly, please inform your doctor or holistic health practitioner. He or she may have some safer recommendations. You can also talk to your doctor about trying my recommendations for pain control, which include:

• White willow bark (180 mg twice a day); or
• Low-dose aspirin (325–650 mg a day as tolerated, but discontinue if you experience abdominal discomfort); or
• The nutritional supplement SAM-e (200–400 mg, once or twice a day as needed).

These options are safe for almost everyone, including people with cardiovascular problems.

For more information on how pharmaceuticals can lead to cardiovascular problems, visit www.drsinatra.com.

There has been some controversy about the effectiveness of medicinal footbaths. Dr. Sinatra and I have experienced several of them in exhibit halls at major health expos. You can imagine the numerous venders who propose many health benefits from using their products, particularly detoxification. The concept involves sitting with your feet in a small tub of water. Then, devices and solutions are added to promote detoxification.

Sodium chloride salt is usually sprinkled in the warm water and an electrode added with a positive and negative electronic charge to create a high energy complex in the water. Proponents claim that the color changes noted in the water colors represent different toxins being drawn out of the body through the feet—toxins coming from the liver, lymph glands, joints, fatty tissue, etc.

Now, while it’s true that the water does change color in these footbaths, it would do so even if your feet were not placed in the water. However, those colors do appear darker and thicker when the feet are immersed. So, what could possibly be going on?

Some proponents of the medicinal footbath claim that the highly charged water creates an energy complex that acts on the acupuncture meridians in the feet, reaching multiple systems in the body. Now remember, Dr. Sinatra is from Missouri, so you gotta show him! 

At one such anti-aging conference years back, Dr. Sinatra looked at these foot baths with a very skeptical eye. Although the theory seemed plausible, we were both thinking it a bit of a parlor trick that it could energize the body at the same time, despite positive testimonials from people who feel better after using the bath. Then one distributor offered some science: a live visual of microscopic serum analysis of blood viscosity pre- and post- footbath. 

The pre-treatment blood showed red blood cells stacked on one another like poker chips, known as rouleaux (pronounced rooo- low). Rouleaux formation indicates clumpy, sticky blood and increased blood viscosity, a risk factor for cardiovascular problems, such as heart attack and stroke. The post-foot bath blood analysis revealed red blood cells that were not sticking together; they were flowing freely in the microscopic field.

Mildly impressed, but still skeptical, Dr. Sinatra and I joined two another MD colleagues and tried the footbath for ourselves—and had the same blood results. For my husband, there was even relief of his right hip pain. The intervention had also included drinking a solution called Ioncleanse, a mixture of silver chloride and other minerals. The internalization of the minerals and the external charge are supposed to raise the overall energy field, thus making the detoxification and energetic process even more profound.

Needless to say, we all ordered footbaths for our own homes.

That was back in 2004. Flash forward to today, and many health professionals endorse footbaths and are convinced they may be a vital tool in energizing and detoxifying the body. Even the prestigious Townsend Letter described how the footbath works.

For now, we continue to have an open mind that the footbath may even be a viable intervention to reduce blood viscosity and inflammation—two factors that contribute to developing and worsening of heart disease. And the benefits of detox cannot be underscored; inflammation is the root of many illnesses.

We have the most experience with B. E. S. T. (Bio-Electric Stimulating Technique) footbath, and there are many others in the marketplace. Some companies offer electrodes that can be placed in your own bathtub. Many alternative medicine practitioners offer footbath treatments in their office or clinic if you want to experience one yourself.

For more information on cardiovascular problems, as well as new ways to reduce heart risk factors, visit Dr. Sinatra’s Web site.

Reference:
Walker M, Walker R.  IonCleanse detoxification—getting the issues out of tissues. Townsend Letter for Doctors & Patients. 2004:101-104.

Research has found a connection between high blood pressure levels and non-aspirin painkillers. A report from the Harvard School of Medicine’s ongoing Nurses Health Study concluded that women are at increased risk for high blood pressure levels if they take daily doses of painkillers such as acetaminophen (Tylenol) and ibuprofen (Advil and Motrin).

The Harvard study involved 5,123 women age 34 to 77, each of whom had healthy blood pressure at the onset. Here are the results:

1. For women not taking painkillers, the risk of developing high blood pressure levels was about 1 to 3 percent a year.
2. Women taking an average daily dose of more than 500 mg of acetaminophen (one extra-strength tablet) had a 93 to 99 percent increased risk of developing high blood pressure levels within three years, compared to women taking less than 500 mg.
3. Women taking more than 400 mg a day of over-the-counter NSAIDS (the equivalent of two ibuprofen) had a 60 to 78 percent increased risk of developing high blood pressure levels, compared to women taking less than 400 mg.

For more information on high blood pressure levels and other cardiovascular problems, visit www.drsinatra.com.

With the summer starting to fade into fall, Dr. Sinatra and I are getting in all the grilling we can while the weather is still warm and the days are still long. So, in the spirit of great grilling and healthy heart nutrition, here are a few of our favorite recipes.

Grilled Chicken Teriyaki
(Makes 2 servings)

• 8 to 10 oz. boneless, skinless chicken breast, split and pounded thin
• 2 Tbsp. low sodium soy sauce
• 1 tsp. honey
• 1 Tbsp. dry sherry
• ½ cup unsweetened canned pineapple juice
• 1 tsp. ginger, grated
• 2 slices canned pineapple
• 1 scallion, slivered

Place chicken breast in a shallow glass or ceramic pan. Combine soy sauce, honey, sherry, pineapple juice, and ginger, and pour over chicken breast. Cover with plastic wrap and marinate in refrigerator for 2 to 4 hours. Heat grill pan and cook chicken for 4 to 5 minutes on each side or until cooked through. Discard any remaining marinade. Grill pineapple briefly if desired. Garnish with scallions and pineapple.

Nutrition Facts per Serving: Calories 220; Total Fat 3 g Sodium 786 mg Total Carbohydrate 21 g Fiber 1 g; Protein 25 g

Grilled Red Snapper
(Makes 4 servings)

• 1 lb. red snapper fillet
• 1 Tbsp. olive oil
• 1 Tbsp. lemon juice
• Fresh ground pepper

Preheat broiler. Combine olive oil and lemon juice and brush on filet. Season both sides of snapper with pepper. Grill five inches from broiler for 5 minutes or until fish flakes easily.

Nutrition Facts per Serving: Calories 140; Total Fat 6 g Sodium 75 mg Total Carbohydrate < 0.5 g Fiber 0 g; Protein 49 g

Chickpea Salad with Rosemary
(Makes 2 servings)

This salad is a great accompaniment to either chicken or fish. I like to use rosemary and parsley right from my herb garden!

• 1 (15 oz.) can unsalted or low sodium chickpeas, drained and rinsed
• 2 Tbsp. red onion, chopped
• 2 tsp. fresh rosemary, chopped
• 1 tsp. extra virgin olive oil
• 1 tsp. balsamic vinegar
• 1 Tbsp. fresh parsley, chopped
• 1 small tomato, diced
• 1 tsp. fresh lemon juice

Combine all ingredients in a medium bowl and chill for several hours or overnight.

Nutrition Facts per Serving: Calories 290; Total Fat 15 g Sodium 56 mg Total Carbohydrate 133 g Fiber 13 g; Protein 42 g

For more information on healthy heart nutrition or some of Dr. Sinatra’s famous recipes, visit his Web site at www.drsinatra.com.

If you’re working hard to prevent heart attack and stroke, as well as the occurrence of other cardiovascular problems, you need to beware of the dangers associated with salt. 

As any decent doctor or holistic practitioner will tell you, having too much salt in your system can make it difficult for you to maintain healthy blood pressure levels, as well as healthy cholesterol levels.  In fact, too much salt can severely compromise your overall health and force you to deal with a myriad of serious heart risk factors you’d do well to avoid.

Here are four things you may not know about salt consumption:

1. Your body requires sodium (a component of salt) to regulate fluid balance and distribution, as well as nerve and muscle cell function. Although you need some sodium, the standard American diet includes way too much. That’s why I urge my patients to try what I often refer to as "the healthiest diet of all." You'll be amazed at how effective it can be.
2. The current recommendation for salt consumption is less than 2,400 mg of sodium a day, which amounts to about one teaspoon of salt. Recent research suggests that people ingesting less than 1,500 mg of sodium a day are better able to keep their blood pressure low. If you have high blood pressure, you should definitely aim for that kind of level. Don’t use salt from the shaker, and read labels to add up the amount you’re taking in.
3. Many items at fast food restaurants are high in salt, so you can easily exceed the recommended level with one serving.
4. You can easily make up for the reduced salt in your diet by cooking with fresh herbs and spices such as basil, garlic, oregano, rosemary, chives, parsley, and onion. What’s more, all of these flavorings contain natural substances that are good for your health. Garlic, in particular, has been shown to have a positive effect on blood pressure when consumed on a daily basis.

I hope you'll share this information with your friends and loved ones. It's just another example of how you can do something simple to help control your cardiovascular health.

For more information on blood pressure levels and other cardiovascular problems, visit www.drsinatra.com.

One of the common conditions we cardiologists treat has nothing directly to do with the heart itself, but rather with blockages of blood vessels going to and from the kidneys, stomach, arms, legs, and feet. We call this condition peripheral vascular or arterial disease. You may know it as “poor blood circulation.”

An estimated 12 million Americans are affected by the disease, and its incidence increases with age—about one-fifth of people age 70 and older have it. The condition is sometimes called a smoker’s disease because it’s particularly prominent among people who have smoked at some point in their lives.

Most doctors and holistic health practitioners agree that blood circulation problems are typically due to the buildup of plaque in the affected blood vessels—similar to the kind of buildup we see in the coronary arteries that feed the heart or the carotid arteries leading to the brain. The result is restricted blood flow, discomfort, tiredness, heaviness, and, often, cramping.

To combat the condition, doctors often use drugs, angioplasty, or surgery. My approach takes a different tack. I focus on the muscle cells and how to get rid of their metabolic by-products, which become increasingly toxic because of the poor blood circulation.

The solution is to help remove the toxins. To do this, I suggest taking glycine propionyl-L-carnitine (GPLC), a recently developed form of L-carnitine that can help improve blood circulation, as well as blood pressure levels. Like other forms of carnitine, GPLC gets quickly into the muscle cells’ mitochondria (the part of the cell where energy is produced). There it acts as a ferry, ushering in the fatty acids that are burned as fuel, and escorting out the toxins that otherwise would build up inside the cell.

GPLC has also been shown to increase the primary enzyme responsible for nitric oxide production in the arteries. Nitric oxide, as you may know, helps regulate the dilation of blood vessels. Proper dilation is necessary to keep blood circulation problems at bay.

For more information on poor blood circulation, ways to improve blood circulation, or other cardiovascular problems, visit Dr. Sinatra's Web site.

Dr. Sinatra has long believed in the famous words of Hippocrates, the Greek physician of centuries past who is now recognized as the “Father of Medicine.” Hippocrates employed food to assist his patients in healing their physical ailments. With all our high tech medical approaches and complex pharmaceutical agents, it is amazing how much we have forgotten that simple approach!

After years of applying nutritional solutions to the myriad faces of heart disease—high blood pressure levels; chronic hypertension; high triglycerides; elevated L(p)a; angina; and heart attack and stroke—Dr. Sinatra has finally answered his patients’ many requests for a book that they can have as a reference at home. His research and personal experiences with his family, friends, and cardiac patients has continually impressed my husband that Hippocrates was so right on—and provided the foundation for this effort.     

Dr. Sinatra has collaborated with former pro athlete and health editor Jim Healthy, as well as recipe queen Rebecca Bent to write Bottom Line’s The Healing Kitchen. The Healing Kitchen is a strategic resource for making healthy grocery selections and healing meal planning guidelines, as well as specific recipes to assist you in selecting the right healthy foods to meet your specific health and fitness needs.

Subscribers to Heart, Health, and Nutrition have been reading Dr. Sinatra’s take on which foods, herbs, and supplements can help with their cardiovascular problems (not to mention cancer and other diseases caused by inflammation) for many years. Now all that information and more is the basis for this one reference to help guide you to foods that can heal your body.

For instance, the omega 3 essential fatty acids—especially those found in squid and fish oils—assuage cardiac arrhythmia, lower blood pressure levels, reduce LDL cholesterol levels, and even prevent plaque rupture.

Garlic is a potent blood thinner and, like onions which are rich in quercetin, helps you prevent the oxidation of LDL cholesterol. Garlic and onions are both superb foods for lowering blood pressure levels. And, speaking of hypertension, Dr. Sinatra also recommends sardines and wakame seaweed as natural blood pressure lowering foods.

And that’s just the beginning! Did you know that the right diet can help alleviate your migraines headaches, or that non-inflammatory foods can heal your arthritis?

Foods can also protect women from menopausal symptoms, as well as heal and protect us from cancer. The lutein in tomatoes along with pumpkin seeds and other fine herbs and spices can help men with their prostate concerns. From heart disease and diabetes to sleep and sex, The Healing Kitchen will educate you about natural, tasty remedies for many of the illnesses that afflict the 20th century. 

If you are looking to use simple, healthy foods, herbs and spices to get your body back on track, and keep it there, you will love this book!

For more information on healthy heart nutrition or some of Dr. Sinatra’s famous recipes, visit his Web site at www.drsinatra.com.

I worry about the fact that so many women still think that cardiovascular problems, like heart disease and stroke, is primarily a problem for men. The truth is that heart disease is a major health risk for women, but many physicians did not realize this until recently, so they’ve done little to encourage their female patients to take steps to protect their heart health.

I also worry because much of our knowledge about heart disease describes how the condition affects men. This leads many physicians, including some holistic practitioners, to diagnose and treat women as if heart disease affected them the same way. Nothing could be further from the truth. Heart disease affects men and women very differently and I’ve written about that here in this in newsletter articles, books, and here in this blog.

For example, if a 45-year-old woman and a 45-year-old man both come into the emergency room with chest pain, most physicians will probably admit the man and tell the woman her symptoms are due to stress and anxiety. Not many physicians realize that the incidence of coronary events among women quadruples as they reach middle age.

What You Can Do About It

I want you to understand that much of this, in both women and men, is related to lifestyle and the choices you make.

• Choose to seek natural ways to lower blood pressure if that’s a problem for you.
• Choose to adhere to good cardiovascular nutrition, which may include increasing the amount of fresh vegetables you consume and lowering the amount of breads and other starches you eat each day.
• Choose to do what you need to do to maintain good cholesterol levels, improve blood circulation, and healthy triglycerides.
• Choose to exercise so that you can more easily prevent blood clots and maintain a healthy weight.

In short, while it may be difficult at the start, choose to live a healthy lifestyle.  Choose life.

For more information on women and cardiovascular problems or tips for good cardiovascular nutrition, visit Dr. Sinatra's Web site.

The dangers of excess refined carbohydrate and sugar consumption are downright endemic in our society. Sugar causes a myriad of health concerns from obesity and diabetes to high blood pressure levels and cardiovascular problems. Excess sugar is even a major culprit in anxiety, depression, fatigue, and pain.

As Dr. Sinatra has warned in lectures, books, newsletters, e-letters, and blogs, elevated blood sugar stokes inflammatory processes that fuel disease. In fact, his concern for the overconsumption of sugar is what led Dr. Sinatra co-author Sugar Shock in 2006 with Connie Bennett.

Dr. Sinatra also recommends Beat Sugar Addiction NOW! (Fair Winds Press, March 2010), the newest book from one of Dr Sinatra’s “top docs,” Jacob Teitelbaum, MD.  In the book, Dr. Teitelbaum reveals four types of sugar habits and their hidden causes. “Understanding your sugar addiction type, you can take steps to beat it and in the same stroke improve your overall health,” says Dr Teitelbaum. “Knowing the type of sugar addict you are also helps to solve many other chronic medical problems.”

By understanding your metabolic makeup, you are more likely to succeed in kicking your sugar habit. See if you recognize yourself as one the types Dr. Teitelbaum describes:

• Type 1. Sugar addiction driven by fatigue. This is characterized by being hooked on so-called “energy drinks,” which are in reality energy loan sharks.
• Type 2. Sugar addiction driven by adrenal exhaustion. This is when your body's stress handlers (the adrenal glands) are exhausted by the stresses of modern life. It is characterized by intermittent feelings of “feed me now or I'll kill you!”
• Type 3. Sugar addiction driven by yeast/Candida overgrowth. In addition to fatigue and sugar cravings, this is often associated with digestive problems (irritable bowel syndrome/spastic colon) and chronic nasal congestion or sinusitis.
• Type 4. Sugar addiction driven by depression and anxiety caused by hormonal shifts. These include PMS, perimenopause and menopause in women, and andropause (testosterone deficiency) in men.

The best part of his down-to-earth approach is that Dr. Teitelbaum doesn’t give you some insurmountable goals to achieve. He doesn’t wasn’t you to obsess about it! Rather, he shows you how to simply make sugar your dessert, instead of the main course!

For a good chuckle, and an introduction to the four sugar addiction types defined in the book, check out the animation promo on YouTube.

And for more information on proper nutrition or other health concerns, visit Dr. Sinatra's Web site.

Though you wouldn’t know it based on today’s obsession with cholesterol levels, cardiology has been slowly veering away from the narrow view of cholesterol as a primary cause of coronary artery disease (CAD).

The field is finally realizing that although good cholesterol levels can help deter the biochemical process that creates damage in arterial walls—which in turn leads to plaque, occlusions, and clots—it’s a relatively minor one. In other words, they’ve realized that even though they may find cholesterol at the scene of the crime, it’s not necessarily the perpetrator.

An excellent example of this is shared in a population study that showed how the French have the highest total cholesterol levels in Europe—about 250—but the lowest incidence of cardiovascular problems, including heart disease.

This being said, I continue to encourage you to find natural ways to maintain healthy cholesterol, including adhering to a smart, cholesterol lowering diet.  I just want you to also realize that cholesterol is just one of many heart risk factors, and is not necessarily the most deadly.

For more information on reducing cholesterol and other cardiovascular problems, visit Dr. Sinatra's Web site.

C-reactive protein (CRP) is a marker for inflammation that is directly associated with atherosclerotic plaque.

It’s a blood protein that, when found in elevated levels, may indicate risk of heart attack and stroke.  Multiple studies have identified CRP as a potent predictor of future cardiovascular problems—and one that is far more reliable than elevated cholesterol levels.

Biological characteristics that are associated with high CRP levels include trauma, infections, high blood sugar, excess weight, and hypercoagulability of blood (sticky blood). Any one of these situations literally feeds pro-inflammatory mediators, ratcheting up the chances that you’ll develop atherosclerosis.

If you currently have cardiovascular problems or you’ve had trauma or an infection that could cause inflammation, you should have your CRP levels tested. Just make sure your doctor or holistic health practitioner requests the high sensitivity test (hs-CRP). This test doesn’t take much time; typically, blood is drawn from a vein located either on the forearm or from inside your elbow. The blood is then analyzed in several tests to determine the level of CRP present.

For more information on heart risk factors and cardiovascular problems, visit Dr. Sinatra's Web site.

I have long considered myself to be the farmers’ market queen. There is nothing more appetizing to me than going to a local farmers’ market and selecting from the bright display of fresh produce—and even some cascading flowers to make your dinner table colorful and engaging.

Well, imagine my delight one evening as I entered a restaurant in nearby Providence, Rhode Island, to see a photo of the book above on a marquee display. I may not have been invited to the goings-on that night, but I quickly jotted down the name of the book with the cover that appealed to my summer-lovin’ soul—The Santa Monica Farmers’ Market Cookbook—and later ordered myself a copy.

Author Amelia Saltsman is a well-known journalist and television personality in the Santa Monica area who has put together a great resource you may want to know about. After over 20 years of shopping at this famous southern California farm stand, talking with its farmers, and cooking up it’s cornucopia of fruits and vegetables, she has compiled what her subtitle promises: seasonal foods, simple recipes, and stories from the market and farm. If the content doesn’t have you jumping in your car to find a local farmer’s market, the photography will.

Though she doesn’t discuss how to avoid genetically modified produce, she does help the novice navigate the market and plan ahead.

Additionally, some of her recipes need be to tweaked a bit for health (i.e. substituting organic low-fat yogurt for the heavy cream in a dessert). But short of a few minor healthy heart nutrition adjustments, the book is a real winner.

Best of all, most of the recipes align nicely with Dr. Sinatra’s PAMM guidelines. (For a quick and engaging video of Dr. Sinatra discussing Top 12 healing foods—most of which you can find in the laid back atmosphere of a local farm market—take a look at his video discussion on the subject.

Also, check back in a week or so to read about Dr. Sinatra’s newest book on how to use healing foods to get your health back, or to keep from losing it in the first place. You won’t want to miss it!

In the meantime, for more information on cardiovascular nutrition or great heart-healthy recipes, visit Dr. Sinatra’s Web site.