spring 2011 vol - better living...

Spring 2011 Vol.VIII

In This Issue:

185 Oser Avenue • Hauppauge, NY 11788 © 2011 Better Living Now, Inc.

Forging new relationships with doctors offices, medical centers, and educators, we strive to provide you with

the finest education support and medical products at the lowest cost to you.

- Elyse Montalvo, Nick Malerba, Kelly Abromowitz Better Living Now Sales Team

We’re Here For You

Fact or Fiction 2

Diabetes & Heart Disease 2

Heart Healthy Eating 3

Delicious & Nutritious 3

Lifestyle Works 4

What’s Your Diabetes Knowledge? 5

Upcoming Events 7

News You Can Use: Facts 7

Health Links 8

Letter From the President 8

Spring2011

©2011 Robin Pedersen, BLN Employee

2 www.BetterLivingNow.com 1-877-BET-LIV-NOW (238-5486)

Having prediabetes increases an individual’s risk of having a heart attack.

Fact. The American Heart Association estimates that 59.7 million Americans 20 years and older have prediabetes. People with impaired fasting glucose and impaired glucose tolerance (prediabetes) are at increased risk for developing type 2 diabetes, heart disease and stroke. Long-term damage to the vessels of the heart may occur while a person has prediabetes, and a recent study indicates that prediabetes more than doubles the risk of death due to heart attack.* Erectile dysfunction in men with type 2 diabetes is NOT an early warning sign of coronary (heart) artery disease.

Fiction. Recent studies have shown that erectile dysfunction in men with type 2 diabetes was an early sign of coronary disease. The association is because high blood sugar damages the blood vessels of both the reproductive organs and the heart. The signs of erectile dysfunction usually are present years before the symptoms of heart disease appear. However, the risk of heart disease was lowered significantly in men who were taking medications that lower cholesterol levels. LDL cholesterol levels are the same in people with diabetes as those without.

Fact. The difference is that people with diabetes have LDL particles that are smaller and denser. This type of LDL particle is more likely to cause the plaque deposits that cause coronary artery disease. An elevated LDL cholesterol, low HDL cholesterol and high triglyceride levels have been termed “diabetic dyslipidemia.” This heart disease risk is estimated to be equal to an LDL cholesterol level of 150–220 mg/dl (goal is less than 100 mg/dl).

FACTFICTION?

or Heart disease is the leading cause of hospitalization and death in people who have diabetes. People with diabetes are 2 to 3 times more likely to have heart disease compared to those without diabetes. The reason why this happens is because high blood sugars damage the blood vessels in the body including those that lead to the heart. The good news is that the risk of heart disease can be lowered by making simple lifestyle changes such as increasing physical activity, reducing stress and making healthy food choices among others.Test your heart disease knowledge with the quick quiz below:1. Coronary artery disease is

caused when:a) blood vessels become narrow or are

blocked by fatty acid depositsb) blood supply to the brain is blockedc) narrowing or blockage prevents

your heart from receiving nutrients it needs

d) a and ce) all of the above

2. The following are signs of a

heart attack:a) shortness of breathb) indigestion or nauseac) sweating or light headednessd) a and ce) all of the above

3. All of the following are ways to prevent coronary artery disease EXCEPT:a) don’t smokeb) be active everydayc) maintain a healthy weightd) reduce your HDL cholesterole) maintain a healthy blood pressure

4. All are true about blood pressure EXCEPT:a) measures the force of blood inside

the blood vessels of the heartb) smoking increases your blood

pressurec) the recommended blood pressure is

below 140/90d) the recommended blood pressure is

below 130/80

5. All are true about blood lipids (or fat) EXCEPT:a) triglyceride is a kind of lipid that

increases risk of heart attackb) LDL cholesterol is sometimes

called the BAD cholesterolc) decreasing intake of animal fat can

help reduce cholesterol levelsd) fats from certain plants can lower

cholesterol levelse) certain fatty fish will increase

cholesterol levels

1) The brain’s main source of energy is glucose (or sugar). If you have diabetes, the minimum recommended carbohydrate intake for normal brain function is 130 grams per day. This is equal to:

a) 4 slices of bread, 1 cup of pasta, 1 medium orange, 8 oz milk

b) 2 slices of bread, 1⅓ cup of pasta, 1 medium orange, 8 oz milk

c) 2 slices of bread, ½ cup of pasta, 1 small orange, 8 oz milk

d) 1 slice of bread, ½ cup of pasta, 1 small orange, 4 oz milk

2) All of the following are considered sources of healthy fats EXCEPT: :

a) olive, peanut, canola oils, walnuts (monounsaturated fats)

b) salmon, tuna, mackerel, sardines (omega 3 fatty acids or DHA)

c) palm and coconut oil, snack foods with hydrogenated oil, stick margarine (saturated and trans fats)

d) safflower, sunflower or corn oil (polyunsaturated fats)

3) The following are foods that help lower cholesterol EXCEPT:

a) green beans, corn c) beans, legumes b) rolled oats, oat d) strawberries,

bran, rye oranges, apples

What’s Your Diabetes Knowledge? Answers on page 5

Diabetes &Heart Disease

Continued on Page 6

3185 Oser Avenue • Hauppauge, NY 11788

Learning to make wise food choices will help keep your heart and blood vessels healthy. See ideas below for general guidelines. Talk with a registered dietitian if you would like a meal plan designed to meet your specific needs. Cook using low-fat methods

Baking, roasting, boiling, sautéing or ●grilling foods using nonstick pans and cooking sprays Cook with fats that can help lower your ●cholesterol, such as olive oil or canola oil Add margarines that contain plant stanols or ●sterols to foods everyday (these have been effective in lowering LDL cholesterol)

Eat less animal or saturated fat and cho-lesterol

Limit fatty meats and pork, poultry skin, ●egg yolks

Decrease butter, 2% or whole milk, ice ●cream, cheese

Avoid palm or coconut oils, products that ●have trans fats, hydrogenated oils, lard, and shortening Limit intake of bakery goods that are high ●in saturated and trans fatsChoose more lean meats and meat ●

substitutes such as soySelect low-fat or fat-free dairy products ●

Have a meal with fish two or three times a week. Certain fish contain heart healthy fats called DHA or omega 3 fatty acids.

Albacore tuna, herring, mackerel, rainbow ●trout, sardines, and salmon

Select foods that contain heart healthy plant fats

Almonds, walnuts, peanuts, pistachios, ●cashews

Sunflower or pumpkin seeds ●Olives, avocados ●

Select whole grains and beans that are high in fiber

Aim for 5 servings of fruits and vegetables ●each day

Oatmeal, oat bran, rye ●Dried beans and peas like kidney beans ●

Choose foods with less salt and try dif-ferent spices instead

Heart HealthyEating

&Delicious NutritiousEating healthy doesn’t mean you have to sacrifice great taste.

Salmon with Horseradish Mayonnaise

4 – 3½ oz Salmon fillets 2 tbsp shallots ¼ cup white wine or vermouth 2 tbsp lite mayonnaise

2 tbsp lite sour cream2 tsp lemon juice, fresh2 tsp horseradish 2 tsp capers (optional)

1) Preheat the oven to 450 degrees F. Prepare a shallow roasting pan or baking dish with nonstick pan spray.

2) Place the salmon fillets, skin side down, in the pan. Sprinkle the shallots over the slices; pour wine evenly over all. Bake 6 to 8 minutes, or just until the fish is opaque.

3) While the fish is cooking, combine the mayonnaise, sour cream, lemon juice, horseradish and capers, if desired, in a small bowl; mix well.

4) Transfer the salmon and shallots to warm serving plates with a slotted spatula. Top each serving with a heaping tablespoon of horseradish mayonnaise. Garnish with capers, if desired.

Per Serving: Calories 231, Total fat 13g, Saturated fat 2g, Sodium 121mg, Carbohydrate 2g, Protein 25g

From: The New Family Cookbook for People with Diabetes

Makes 4 (3-1/2 oz servings)


Women and Heart Disease

One in 2.6 of women’s deaths are from heart disease, stroke and other cardiovascular heart diseases, compared with one in 30 who die of breast cancer. The good news is that making a few simple lifestyle changes can significantly reduce risk factors for heart disease and stroke.Janet is 63 years old and has had prediabetes for 2 years. Before she was diagnosed she made some effort to lose weight, and had quit smoking 4 years before. She has a check up at her doctor’s office twice a year so that her hemoglobin A1c, blood cholesterol and triglyceride levels and blood pressure are monitored.

In this issue’s section, we will discuss women and heart disease.

Lifestyle W rksThis section of emPOWER highlights small lifestyle changes that over time result in permanent weight loss and better health.

Because she has prediabetes her risk of a heart attack doubles. However, because she quit smoking, she has already reduced this risk by half. Also, her blood pressure is improved because she quit smoking. When she was diagnosed with prediabetes, Janet attended classes on making healthier food choices. The CDE (certified diabetes educator) teaching the class instructed them to start with basics:

The Plate method (pictured to the left) where half of the plate is •filled with vegetables, one quarter is a lean protein and the other quarter is a starch such as pasta, potato or rice. Limit frequency dining out or ordering food in. •Prepare more foods at home so you have control over the type of •fats and amount of salt in your meals. (see Heart Healthy Eating on Page 3)Be consistent with the physical activity – at least 30 minutes 5 days •a week. Janet finds it’s easier to break this up into 15 minutes during the day and another 15 later in the afternoon.

Doing the above helped her lose 10 pounds in 4 weeks. Find healthy ways to reduce and cope with stress. The instructor

suggested walks, talking to a friend, hobbies, a diabetes support group (also on-line support), speaking with clergy or a behavioral health specialist among others.Finally, Janet learned the warning signs of a heart attack as they present differently in women than in men. Almost all who experience a heart attack will have chest discomfort in the middle of the chest that lasts more than a few minutes, or goes away and returns. It can feel like uncomfortable pressure, squeezing (like a golf ball is traveling slowly down your chest) or pain. Women are more likely to experience pain or discomfort in the back, neck, jaw or stomach.

Other signs include shortness of breath, nausea and breaking out in a cold sweat, or light-headedness.

Diabetes Education

The Plate MethodWhat is the Plate Method?

One method for planningmeals is the Plate Method which requires no measuring.

Use this visual plate toIMPROVE understanding and encourage portion control

when eating your meals.

A way to IMPROVE your health and

trim your waistline for better diabetes

management is to change the proportions

of food on your plate.

This visual dietary control is referred

to as the PLATE METHOD. With the

Plate Method, you will reshape your

meals, making them higher in fiber and

lower in saturated fat, cholesterol, and

carbohydrates.

Salad

Fruit (optional)

oNE serving

Call 1-800-854-5729

OR visit us @ BetterLivingNow.com

ED01-PLATE 88222 9000 11

Reviewed by Better Living Now’s

Medical Panel: Oct.20.09

The Plate Method -- 1 cup or more of non-starchy

vegetables, 30 to 60 grams of carbohydrates and 3 ounces of meat, poultry, f ish or meat

replacements.

The Plate Method


1) The brain’s main source of energy is glucose (or sugar). If you have diabetes, the minimum recommended carbohydrate intake for normal brain function is 130 grams per day. This is equal to: b) 2 slices of bread, 1-1/3 cup of pasta, 1 medium orange, 8 oz milk .

There is a misconception that people with diabetes cannot have carbohydrates. As this statement shows, carbohydrate is the only fuel the brain can use. Severely limiting carbohydrate intake increases risk of low blood sugars (hypoglycemia) and diabetic coma in people with type 1 diabetes. Although this occurs less often in people with type 2 diabetes, it can happen. The example above represents the minimal amount of food from carbohydrates per day. One serving of carbohydrate equals 15 grams. A serving of carbohydrate equals 1 slice of bread or ⅓ cup rice or pasta or 1 small piece of fruit or 8 oz of low-fat milk

2) All of the following are considered sources of healthy fats EXCEPT: c) palm and coconut oil, snack foods with hydrogenated oil, stick margarine (saturated and trans fats).

Saturated and trans fats that are found in the oils listed above, bakery goods and stick margarine raise cholesterol levels. There are certain fats that are considered heart healthy because they not only lower LDL (bad) cholesterol levels, but they also raise HDL

(good) cholesterol. These are the monounsaturated fats that are found in plant sources of fats such as nuts, seeds, olive, peanut and canola oils. Omega 3 fats (or DHA) are also helpful in decreasing triglyceride (a type of bad fat) and cholesterol levels. These are found in fatty fish listed in the examples above. The polyunsaturated fats lower cholesterol levels, but do not raise the HDL cholesterol, so the monounsaturated fats are recommended more frequently.

3) The following are foods that help lower cholesterol EXCEPT: a) green beans, corn.

All of the foods listed in choices b through d contain fiber that may help lower LDL cholesterol. Not all fibers have the same cholesterol-lowering benefits. The difference is that the fiber these foods contain ‘attach’ to the bad cholesterol thus helping to lower cholesterol levels. For example, green beans, corn and other foods similar to it contain fiber and are healthy for the lining of the intestine but do not help lower cholesterol.

What’s Your Diabetes Knowledge?

Get recipes & instructions for making the specialty dishes below plus a whole second week’s worth of recipes for just $2.99BLN Order # 88222000202

Shaking the Salt HabitThe United States Dept of Agriculture (USDA) recently released its revised dietary guidelines for Americans. Besides recommending limiting intake of saturated fats, it also included further reduction in sodium intake from 2300 milligrams (mg) to 1500 mg for most Americans. Sodium is an important nutrient that is needed by the body in small amounts. There is a strong body of research that confirms that as one’s salt intake decreases so do blood pressure. Keeping blood pressure in the target range significantly reduces an individual’s risk of heart (cardiovascular) disease, congestive heart failure, and kidney disease.

The Majority of Americans Consume More Sodium Than They Need. The estimated average intake of sodium for all Americans ages 2 years and older is approximately 3,400 mg per day (the equivalent of 7 small salt packets). Salt added at the table and in cooking provides only a small proportion of the total sodium that Americans consume. Most sodium consumption comes from processed foods. The rising sodium intake is also due to frequent consumption of foods that contain lower amounts of sodium such as breads containing yeast, pizza and mixed chicken dishes.

The new dietary guidelines for reducing sodium are based on results from several research studies, includ¬ing data from the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial. The Institute of Medicine noted that in the DASH-Sodium trial, blood pressure was lowered when target sodium intake was reduced to 2,300 mg per day, and lowered even further when sodium was targeted to the level of 1,200 mg per day.

•ReadtheNutritionFactslabelforinformationonthesodiumcontent of foods and purchase foods that are low in sodium keeping in mind the 2300 to 1500 mg sodium target.

•Eatmorehome-preparedfoods,whereyouhavemorecontrolover sodium, and use little or no salt or salt-containing seasonings when cooking or eating foods.

•Experimentwithherbsandspicesotherthansaltincooking.

•Choosemorefreshfoodsthatarelowerinsalt.

•Decreaseconsumptionofprocessedfoodsthatarehighinsodium.

•Selectlowsaltalternativestoprocessedfoodssuchassoups,snacks, condiments, and so forth.

•Wheneatingatrestaurants,askthatsaltnotbeaddedtoyourfoodor order lower sodium options, if available.

There are several simple ways to reduce consumption of sodium:


In addition to lowering LDL cholesterol, identifying individuals at risk for metabolic syndrome has been recommended by the National Cholesterol Education Program as a secondary target group to lower heart disease risk. The metabolic syndrome is a group of risk factors that together increase one’s risk of developing heart disease. The presence of 3 or more in the table is a diagnosis of metabolic syndrome.

Clinical Identification of the Metabolic SyndromeRisk Factor Defining LevelAbdominal obesity (waist circumference) Men > 102 cm (> 40 inches)

Women > 88 cm (> 35 inches)HDL cholesterol Men < 45 mg/dl

Women < 55 mg/dlBlood pressure > 130/85 mmHgFasting glucose > 110 mg/dlTriglycerides > 150 mg/dl

1. If you smoke, find ways to quit. Smoking and high blood sugar levels together increase damage to the blood vessels especially to the lungs and heart.

2. Maintain your target blood pressure. Your blood pressure number measures the force of blood inside your blood vessels. When your blood pressure is high, your heart has to work harder than it should. It is recommended that you keep your blood pressure below 130/80 (said as “130 over 80”) mmHg. Ask your doctor if you don’t know what your target blood pressure is. The lifestyle changes discussed in this newsletter will help you reach your blood pressure goals.

3. Lower and maintain a normal cholesterol (also called blood lipids). Sixty percent of individuals with diabetes do not believe they are at risk for cholesterol problems. This value tells you the amount of fat in your blood. Our bodies normally make small amounts of the different types of cholesterol. Typical lipid pattern for people with diabetes is elevated triglycerides and low HDL cholesterol. This combination increases one’s risk for heart disease. See the News You Can Use section on page 7 for a description of the types of blood lipids.

Besides losing weight and physical activity, making heart healthy choices will lower cholesterol levels. See page 3 for heart healthy diet ideas.

4. Maintain a healthy weight. Studies have shown that even a small amount of weight loss significantly decreases complications from diabetes especially high blood pressure and heart disease risk.

● Physical activity Start with simple changes such as walking 5 to 10 minutes a day and add more time as you get use to the activity. Before starting a new physical activity program, check with your diabetes care team to find out which activities are safe for you. Come up with activities that are fun for you. Think of ways to add physical activity into your daily routine. ● Choose and prepare healthy foods Making small changes in our eating habits can go a long way towards reaching your health goals. See page 4 and 5 for Heart Healthy Ideas. Although many suggestions are listed, start with the ones that are easiest for you. As these good habits become part of your daily routine, add new ones.

5. Take your medications as prescribed by your health professional. In addition to medications for diabetes, your doctor may prescribe several medications depending on whether you also have high blood pressure, high cholesterol and/or heart disease.

See the chart to the right so see what effects certain medications will have on your system.

How did you do? Knowing the answers to these questions are key to preventing or decreasing your risk of developing coronary artery disease.Coronary artery disease is caused when blood vessels become narrow or are blocked usually by fatty acid deposits. This narrowing prevents the heart from receiving the nutrients such as oxygen that it needs. When the blood supply to the heart is cut off by this blockage, the heart muscle dies (also called a heart attack). This is different from a stroke which is a similar type of blockage except the blood vessel leading to the brain is cut off. When the blood flow to the brain is blocked, brain tissue damage occurs. Often the result is problems thinking, speaking or difficulty using one side of the body. It’s important to get immediate medical attention if you have the warning symptoms of a heart attack. These include chest pain or discomfort, pain or discomfort in the arms, back, jaw, neck, or stomach, shortness of breath, sweating or light-headedness, indigestion or nausea and feeling of tiredness.The good news is that by making simple lifestyle changes, heart disease risk can be decreased or prevented altogether.

Answers: 1. d, 2. e, 3. d, 4. c, 5. e

Diabetes &Heart Disease(continued)


UseNewsYou Can

Self-Monitoring Blood Glucose Targets

Hemoglobin A1c <7%

Glucose: Pre-Meal 90-130 mg/dl Post-Meal* 140-180 mg/dl *(2 hours after finishing the meal)Source: Diabetes Care 27(1):s19, 2004

FACTSFACTS

Medication Examples of Generic Names*

What it Does

Aspirin Helps keep blood vessels clear, prevents cardiovascular (heart) disease

ACE inhibitors Ramipiril, Lisinopril, Captopril, Enalapril

Reduces cardiovascular events, high blood pressure and microalbuminuria (protein in the urine) by keeping blood vessels relaxed.

ARB Candesartan, Olmesartan Medoxomil, Valsartan

Reduces high blood pressure and microalbuminuria. It also keeps blood vessels relaxed.

Beta (ß) blockers

Atenolol, Metoprolol, Nadolol, Propanolol

Reduces cardiovascular events and blood pressure by relaxing the heart, allowing it to beat slower.

Diuretics (water pills)

Furosemide, Spironolactone

Reduce stroke, congestive heart failure and high blood pressure by helping your body get rid of extra water and sodium through the urine.

Statins Atorvastatin, Lovastatin, Rosuvastatin, Simvastatin

Lower cholesterol level

Types of Blood Lipids: •LDLCholesterol is sometimes

called BAD cholesterol because at high levels it can narrow or block your blood vessels. Reaching your target LDL is the best way to protect your heart and blood vessels. The ADA recommends a level below 100 mg/dL.

•HDLCholesterol is known as the GOOD cholesterol because of its role in removing fatty deposits from the insides of your blood vessels. This keeps them from getting blocked. The higher this number the more it protects you from heart disease. The current HDL goals are above 45 mg/dL for men and above 55 mg/dL for women.

•Triglycerides are another kind of lipid. High triglyceride levels increase your risk of a heart attack or stroke. The ADA recommends a target level of below 150 mg/dL.

* does not include all available

Diabetes Expo 2011April 9 Georgia World Congress Center, Atlanta, GA

April 16 Navy Pier, Chicago, IL

April 16 Connecticut Expo Center, Hartford, CT

April 30 Seattle Convention Center, Seattle, WA

Tee Up to Cure DiabetesJune 9 Tee Up to Cure Diabetes

JDRF Golf Classic, Twin Creeks Country Club Austin, TX

Ride to Cure Diabetes March 7 Registration Opens More info: www.ride.jdrf.orgCruise Toward a CureMay 22 Book through CruiseOne, West Windsor, N.J. More info: www.jdrf.org

Be sure to visit www.diabetes.org and www.jdrf.org to find out more about these and other events in your area. Participating in these events not only raises awareness, but needed funds for research and an eventual cure!

Get Involved!

American Diabetes AssociationCure • Care • Commitment

Better Living Now: 1- 877-BET-LIV-NOW www.betterlivingnow.com

For all diabetic supply needs:

For educational information about diabetes:

American Diabetes Association: 1-800-Diabetes www.diabetes.orgAmerican Dietetic Association: www.eatright.orgJuvenile Diabetes Foundation: www.jdrf.orgJoslin Diabetes Centers: www.Joslin.orgWeb MD: www.WebMD.comBayer Care Diabetes www.bayercarediabetes.comAbbott Diabetes www.abbottdiabetescare.com

All Recipes www.allrecipes.comADA Virtual Grocery Store vgs.diabetes.orgHealthy Meals Resource healthymeals.nal.usda.govMyRecipes myrecipes.com

Nutri-Facts www.nutri-facts.comFastFoodNutrition.org www.fastfoodnutrition.orgNutrition.gov www.nutrition.govNutritionData www.nutritiondata.comCalorieKing www.calorieking.com

For nutrition food facts:

For recipe ideas:

A Letter From The PresidentDear Valued Friends and Customers,

Spring is a great time to focus on a healthy lifestyle. Just like we tackle spring cleaning in our home, I urge you to do what you can to help your body function at its best. Take advantage of the warmer weather and go for a walk. Get plenty of sleep. Throw out any expired medication in your medicine cabinet. Try some healthy recipes.

This newsletter has a lot of tips about healthy living. Check out our Web site at www.betterlivingnow.com for products that will help you prepare nutritious snacks and meals – from cook books to juicers to rice steamers. We also have a wide variety of vitamins and supplements available at a low cost. Not sure what you can take with your current medications? Call one of our pharmacists before you buy.

Spring cleaning often means reorganizing, which is something that we at Better Living Now have been doing a lot of lately. We are proud of our company’s continued growth, but the progress meant that we were starting to feel too cramped in the building we had occupied for 18 years. So, we recently moved to a larger location (still in Hauppauge and still using the same phone number). This not only gives our employees a nicer workspace, it also allows us to continue to stock all of the products and medications you may need, so we can always ensure fast and accurate delivery.

We have also used this opportunity to expand our on-site Mastectomy Boutique. Call us at 1-800-854-5729 ext. 127 for more information about a private fitting with a Certified Mastectomy Fitter.

Have a wonderful spring, and don’t spend too much time indoors cleaning and organizing your home. Be sure to attend to your health, as well.

Daniel Pope, CEO

Warm Regards,

Daniel S. Pope and Family

Better Living Now185 Oser AvenueHauppauge, NY 11788

spring 2011 vol - better living...

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