"Why African-Americans May Benefit the Most From a Vegan Diet?"

 

Black Veganism:

To some, this may sound like an oxymoron. Many people may assume that a Black/African American vegan is actually very rare.

But this isn’t necessarily true. I recently discovered this website called Black 

Vegans Rock. This site is essentially a bible for Africans Americans who are 

vegan or “vegan curious,” because apparently, there aren’t many resources 

which specifically cater to black vegans. 

One of the contributors to Black Vegans Rock created a list of 100 Black 

Vegans to Check Out. 

 

You may be surprised to know that Coretta Scott King (wife of Dr. Martin 

Luther King, Jr.) was reportedly a vegan for more than 10 years before her death. Other black vegans include singer Erykah Badu, Senator Cory Booker, 

entrepreneur and record executive Russell Simmons and more.

To clarify, a vegan diet is a plant-based diet, completely void of animal foods like meat, seafood, eggs and dairy. Even honey is off the list of acceptable vegan foods. Vegans eat a lot of fruits, and vegetables, legumes and whole grains. Eating vegan eliminates many processed foods in the American diet, like donuts and baked goods, which may contain butter, milk and eggs. And, of course, a vegan diet eliminates high cholesterol foods such as red meat.

There are many reasons why some people may go vegan. Some of these reasons may include a concern for the environment, passion for animal rights or even spiritual. But perhaps the biggest reason of all is for better health.

According to a recent study published in The Journal of Nutrition, people who followed a vegan diet were overall healthier with higher levels of unsaturated fats and antioxidants in their blood and lower levels of saturated fats.

Not to mention, a vegan diet, which as mentioned is rich in whole foods such as fruits and veggies, is rich in nutrients (magnesium, zinc, calcium, selenium, copper and vitamins A, C and E - just to name a few) that have protective effects against cardiovascular disease, cancer and other major illnesses. 

Furthermore, another recent study from the Journal of the American Heart Association found evidence which showed that plant-based diets are associated with a lower risk of incident cardiovascular disease, cardiovascular disease mortality and all-cause mortality in a general population of middle-aged adults.

So, it’s pretty clear that diet plays a major role in cardiovascular disease and that eating more plants can definitely lower the risk of CVD. And although the black vegan population is becoming more visible, heart disease in the African American community is a major concern. 

Check out these facts and statistics:

• Black Americans have a shorter life expectancy than whites partly due to higher rates of heart disease and stroke (American Heart Association).
• African Americans ages 18-49 are two times as likely to die from heart disease than whites (Centers for Disease Control and Prevention).
• African-Americans are disproportionately affected by obesity (a major risk factor for heart disease and stroke). Among non-Hispanic blacks age 20 and older, 63 percent of men and 77 percent of women are overweight or obese (American Heart Association).
• African Americans ages 35-64 are 50 percent more likely to have high blood pressure (another major risk factor for heart disease and stroke) than whites (Centers for Disease Control and Prevention).
• Around 75 percent of black men and women develop high blood pressure by age 55, compared to 55 percent of white men and 40 percent of white women of the same age (American Heart Association).
• Nearly 44 percent of African American men and 48 percent of African American women have some form of cardiovascular disease that includes heart disease and stroke.

Interestingly, a recent study found that a vegan diet may decrease heart disease 

and stroke risk in African Americans. Study participants included 50 African Americans who were instructed to only eat prepared vegan meals delivered to 

their homes for a duration of five weeks.

 

“A cardiovascular risk calculator was used to assess their risk of heart attack 

or stroke over the next 10 years,” according to one report discussing the study.

 

“For 36 participants who had pre- and post-diet risk scores, their risk fell by 

about 19%—from 10.83% to 8.74%.”

 

Although more research is needed (including with a larger population of African American people), this is still a major finding after just five weeks.

 

Furthermore, the results revealed that a vegan diet in African Americans 

reduced bad cholesterol levels by 14 percent and the diet reduced systolic 

blood pressure by 10 points. 

 

In addition to all this, there is evidence that “African-Americans may carry a 

gene that makes them more salt sensitive, increasing the risk of high blood pressure,” according to the American Heart Association.

 

(Also know that Afro-Caribbeans need to be very mindful of high blood pressure).

 

A vegan diet really cuts the salt since it eliminates a lot of sodium-rich, processed foods.

 

So, should African Americans jump on the vegan bandwagon?

 

I wish this question was easier to answer. Diet really needs to be tailored to the individual (despite race, gender and age). Speak with a competent healthcare professional about going vegan if you have existing heart disease or other 

metabolic or health issues. And, of course, you need to seek advice if you are pregnant or breastfeeding.

 

If you decide to be vegan, it is imperative to avoid nutritional deficiencies and imbalances. So, it is extremely important to get professional advice regarding nutrition and supplementation.

 

What I can say for sure is that it may be beneficial to at least be a part-time 

vegan or significantly reduce your consumption of meat. If going 100 percent 

vegan is too overwhelming at the moment, try going meat-free or dairy-free 

for one day a week and then increase that to two days a week and then three, etc. 

 

You can also make your portions of meat smaller or aim to not have meat at 

every meal. Or maybe give up pork and steak and just eat fish and poultry. 

No matter what you decide, always make nutrient-dense fruits and veggies the “stars” of your plate. Meats and cheeses should play “the supporting roles.”

 

What about the holidays?

 

It may sound crazy, but the holidays are a great time to adopt healthier lifestyle habits and share them with your loved ones. Add some vegan dishes to the next holiday dinner you host. 

 

Enjoy your healthy life!

By: Joy Stephenson-Laws, J.D., Founder, Proactive Health

The pH professional health care team includes recognized experts from a 

variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes 

the members of the pH Medical Advisory Board, which constantly monitors all 

pH programs, products and services.

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the pH Proactive Health and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the pH Proactive Health and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the pH Proactive Health and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. pH Proactive Health and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by pH Proactive Health, pH Proactive Health employees, others appearing on the Site at the invitation of pH Proactive Health, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.   

“Women of Color Die of Cancer at Higher Rates Than White Women—Here's What Experts Say We Should Do About It?

 

A troubling cancer death gap has long existed—but closing it is within reach.

 

Before she walked into the office, Adrienne Moore already knew what doctors were going to tell her: her cancer had returned. Thirteen years after beating ovarian cancer, she now had endometrial cancer. What Moore was not prepared to hear was that it was at an advanced stage 3, and treatment would be difficult. This was shocking because for nine months, Moore had insisted that doctors take her list of health concerns seriously. These included having a menstrual cycle that vacillated between absent, spotty, and so heavy she needed a rolled-up towel to help soak up blood, as well as pelvic pain. She also attended every appointment with copies of her medical file, and she let all her physicians know that she was a cancer survivor. Moore was told—repeatedly—by doctors that she had no reason to worry. "I'd ask, 'Should I be concerned?' And they'd say, 'No, you're a Black woman, you get fibroids. You're a Black woman, you might have thickening of the uterus,' says the 50-year-old respiratory therapist.

Some could hear Moore's story and chalk it up to one woman's unfortunate experience. But the truth is that what happened to her mirror’s reality for many Black women in the United States. At times she was uninsured—meaning diagnostic tests were not ordered by physicians because she could not afford to pay for them out of pocket. And many of her doctors were white men who, she says, "spoke at, not to" her. Moore's situation also echoes another dangerous reality for Black and other women of color: when her cancer diagnosis came, it was in the later—harder to treat—stages. "They might be diagnosed once the cancer has already metastasized, or it's a more complicated kind of surgical procedure or chemo or whatever other kinds of treatments are available for particular cancer," Tina Sacks, PhD, an associate professor at UC Berkeley's School of Social Welfare and author of Invisible Visits: Black Middle-Class Women in the American Healthcare System, tells Health.

The numbers support this in a way that initially sounds counterintuitive. Women of color have lower rates of cancer diagnosis, but higher rates of cancer-related deaths. The reason: "Black women, Latinx women, as well as Indigenous women have a harder time accessing health care, and so tend to be diagnosed at a later stage, and that is one of the major reasons that the mortality rates are higher," explains Sacks. Black women have a 7% lower chance of getting a cancer diagnosis than white women, but a 13% higher chance of death. These numbers jump to a 41% higher death rate for breast cancer and 98% for uterine corpus (aka, the body of the uterus) cancer. In fact, Black women have the highest rates of death for uterine cancer of any racial/ethnic group. Compared to white women, other racial groups in the United States also have disproportionately high rates of cancer incidence or death. Vietnamese-American women have higher rates of cervical cancer than white women, and Asian/Pacific Islander women are twice as likely to have stomach cancer. Latinx women are 20% more likely to die from cervical cancer than white women. Compared to white women, Native American women have higher rates of liver, stomach, kidney, colorectal, and cervical cancer, according to the CDC.

While the reality of higher cancer-related deaths holds true generally for women of color, medical experts stress that Black women's alarmingly high rates of cancer-related deaths (the highest for any women in the United States) are for reasons that are specific to being Black in America. "The health experiences of Black people are quite distinct from other people of color," says Sacks. "The history of discrimination, structural discrimination, the way our society is arranged is a society that is fundamentally racist, and it is fundamentally anti-black. That means that Black people are living with and essentially dying from racism all the time. It's not something that is speculative. It's just a fact." Alongside the reality of these disproportionate numbers, there is a growing body of work—from studies to government programs to initiatives by organizations—to reverse this dangerous trend. Here, experts weigh in on the reasons behind race-based cancer disparities, as well as solutions that have (or should be) put in place.

HOW THINGS BECAME SO BAD:

A number of factors are behind this health disparity. "A huge component of this are the social determinants of health, which is essentially a catch-all term that includes structural racism," Fumiko Chino, MD, a radiation oncologist at Memorial Sloan Kettering Cancer Center, tells Health. "It includes things like food deserts leading to obesity. It includes things like access to care and insurance." Cancer survival increases significantly as a result of preventative care. Yet many Americans of color do not have health insurance, meaning that preventative care is also cost prohibitive. According to the US Department of Health and Human Services, 75% of white Americans had private health insurance in 2017, compared to 55% of African Americans, 51% of Native Americans, and 49% of Latinx people. Poor health care not only leads to not getting screenings, but also—as was the case with Adrienne Moore—doctors not doing costly detection services such as ultrasounds and biopsies.

Economics plays another critical role. People with lower socioeconomic status (in 2017, 21% of Blacks compared to 9% of whites were living below the poverty level) are more likely to engage in behaviors or live in communities that increase cancer risk or rates for survival. This can include having less chance for physical activity or limited access to fresh fruits and vegetables. It can also mean living in neighborhoods that lack clean water or air that may contain cancer-causing substances. A 2018 EPA report found that African Americans are more likely to reside near landfills and industrial plants that pollute water and air. And Black Americans are three times more likely to die from exposure to air pollutants than whites. Living at or below the poverty line can also impact a person's ability to get care, even if they have health insurance. They may not be able to afford gas money to drive long distances to screening sites for cancer detection. Those without unpaid time off of work may be unable to go to non-urgent medical appointments.

A biological element also puts Black women at greater risk for dying from breast cancer. Triple-negative breast cancer is breast cancer that is negative for estrogen receptor, progesterone receptor, and human epidermal growth factor 2 receptor. According to the American Cancer Society, this type of cancer is twice as common for Black women than white women in the United States. "Triple-negative breast cancer tends to be a more aggressive form of breast cancer, and it doesn't have the typically more successful treatment options like tamoxifen or an AI or something like trastuzumab," Onyemaechi Okolo, MD, an oncologist at The University of Arizona Cancer Center and an integrative medicine fellow at The University of Arizona Andrew Weil Center for Integrative Medicine, tells Health.

WHAT IS HAPPENING TO ADDRESS THE CANCER GAP, AND WHAT SHOULD BE DONE?

The answer on how to end cancer disparities—and all other health disparities—is clear: end systemic inequalities. Yet this is also the pie-in-the-sky answer, the one which seems unlikely to happen in the near future. However, experts and initiatives are chipping away at the crisis in ways that are making strides. Says Dr. Chino: "It's really such a complex problem. But I always say that the good thing about complex problems is that they have many, many solutions." Major ones include:

LESSEN THE FINANCIAL BURDEN OF CANCER CARE:

When Dr. Chino's husband was diagnosed with cancer in 2005, she learned firsthand about the destabilizing effects of high health care costs. After his death, she left her career in children's television and went to medical school to study oncology. She also focused her research on the financial toxicity of cancer care costs. According to 2017 research published in JAMA Oncology, cancer care—even for people with health insurance—can cost up to one-third of a household income. While any individual can experience financial toxicity in care, it disproportionately impacts Black and other people of color in the United States. A 2018 study found that 4.7% of Black women and 6% of Latinx women lost their homes as a result of paying for treatment for early-stage breast cancer. "Our treatments are costing so much money that they're actually causing homelessness for some of our patients," says Dr. Chino. "My specific focus is on costs [of treatment], but you also have to consider the costs of time away from work—for example, if you are in a job that doesn't have sick leave, or if you're in a job that's an hourly wage where any time when you're not at work, that's not income coming in." In order to offset the high costs of cancer care, some patients will take less pain medication (for example, only swallowing half a pill to stretch the prescription). Chino has had patients take every other dose of their chemotherapy pill or not fill entire prescriptions. "They said, 'You know what? I went to the pharmacist. It was going to cost $5,000. It's that or my car note and my mortgage and my food for the month.' And so, we all know what happened."

There are systemic as well as organizational changes that can be made to alleviate financial toxicity. Bringing down the cost of treatment and medication is the most obvious way to make cancer cost less. But beyond the unlikelihood of this systemic overhaul, there are a number of changes that hospitals and treatment centers can make. These include free parking; scheduling appointments when it is convenient to the patients work schedule (not to the doctor's); making free food available while in the waiting area; telehealth; and limiting the time that people are waiting for their appointments, so they don't have the whole day off of work. "It's not making their balance zero. It's not health care for free, but it's just making it a little easier," says Chino. "The tragedy of financial toxicity is that it can push people over, into a hole. And once you're in the hole, it's hard to get out of that hole."

IMPROVE ACCESS TO SCREENING:

Screenings are a critical tool for detecting certain cancers in early stages, such as breast, cervical, and colorectal cancers. Yet Black women typically are getting screened less than other groups. For that reason, Dr. Okolo sees increasing access to screenings as the biggest action that can save lives. The passage of the Affordable Care Act (ACA) in 2010 was a major federal step in increasing access to screening. It requires all health insurance plans to fully cover mammography screening everyone to two years for women over 40. As groundbreaking as this was, the ACA (aka, Obamacare) was not the first landmark federal program to focus on screenings. In 1990, the CDC launched the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program funds screening and diagnostic services at centers across the country so that lower income, uninsured, and underserved women have access to breast and cervical cancer screening. Some states have also taken on the challenge of improving screening rates. In 2004, Delaware committed to providing free colorectal cancer screenings for residents who could not afford it. Within five years of the program's launch, the number of Black residents getting screened rose to equal the number of white residents—suggesting that if a service is made available, the disparity gap can be closed.

BRING MORE DIVERSITY TO CLINICAL TRIALS:

The focus on how to lessen health disparities tends to be on what happens in the doctor's office, but much can be done on the research side. Between 1993 and 2013, less than 2% of cancer studies had enough racial and ethnic diversity to produce relevant results. There is also a stark lack of women of color enrolled in clinical trials for drugs to treat various forms of cancer. "These new drugs that are being approved, they may not work in the same way with different biology for a Black woman with triple negative breast cancer, as it does on a white woman. They may have different side effects profiles. When we have a diversity of clinical trial enrollees, then we will actually get better real world outcomes when that drug has been delivered," says Dr. Chino. There are a number of ways to address this. One is to have clinical trials at locations within communities of color, to alleviate the barrier of travel costs and travel time. Second, trials can be created in ways that are more responsive to diverse groups of people. Says Dr. Chino: "For a Latinx population, how do we offer clinical trials in languages that they understand, so that they can enroll with truly informed consent? How are we doing outreach to reach populations that are underrepresented?" Third, in order to address how certain cancers target certain groups disproportionately (such as Black women and triple-negative breast cancer), trials can also be more targeted. "Some of that is designing trials specifically with them in mind, but also having more Black women enrolling women in trials. Having more Black physicians, having more Black leaders within cancer centers," explains Dr. Chino.

DIVERSIFY WORKPLACES—AND COMMUNITY OUTREACH:

Studies show that when Black people see Black nurses and physicians, their health outcomes tend to improve. "When you have a Black patient and a Black physician, there is kind of that already removed barrier of cultural difference, but also, it's easier to build trust amongst each other," says Dr. Okolo. Yet oncologist Karen Winkfield, MD, PhD, the executive director of the Meharry-Vanderbilt Alliance, tells Health she does not believe that diversity should be limited to physicians and nurses. "It takes a decade to create an oncologist; it takes a long time to create nurses as well, so that's not going to help solve our immediate problems," she says. "When I say workforce diversity, I'm talking about who are the individuals at an institution that can be pulled in, that could be trained, that can be leveraged to help support the communities around their cancer journey?" Dr. Winkfield has put this theory into practice. Prior to joining Meharry-Vanderbilt Alliance, she was a co-principal investigator of the Lazarex-MGH Cancer Equity program in Boston. She was responsible for community outreach in the program designed to improve clinical trial access and enrollment in vulnerable populations. "We were very successful in training up individuals who do not have a nursing or any medical background, providing them some basic information about healthcare," she says. "For the [Latinx] community, I had somebody who was bilingual, bicultural. For the Black community, I had someone who was Black. You can create workforce diversity without having stacks of degrees." Outreach is exactly what Adrienne Moore credits with helping to save her life. As she was undergoing cancer treatment, she remembers, "I said, "God, this pain isn't for me. Everything that I went through, it wasn't for me, it's for somebody else. And you have to show me how to use my story.'" The answer soon came to her: She took an online survey from the group Endometrial Cancer Action Network for African-Americans (ECANA), and group founder Kimi Doll, reached out and asked her to become a patient advocate. Today, Moore speaks to women about risk factors, symptoms, and the signs of cancer. "I can't do a whole lot to change someone's circumstance once they're inside of being treated for cancer," she says. "But I can support you. I can listen to you. I can be there for you."

BY: Ayana Byrd, Health Magazine, April 23, 2021

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the Health Magazine and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the Health Magazine and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Health Magazine and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. Health Magazine and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by Healthy Magazine, Health Magazine employees, others appearing on the Site at the invitation of Health Magazine, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.  

 

“Heart Disease: Signs, Symptoms, Treatments and Tips”

 

Heart Disease is the No. 1 Killer of U.S. men and women, accounting for 40% of all U.S. deaths! That's more than all forms of Cancer combined! Why is Heart Disease so Deadly? One reason is that many people are slow to seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to call 911. But heart symptoms aren't always intense or obvious, and they vary from person to person and according to gender. Because it can be hard to make sense of heart symptoms, doctors warn against ignoring possible warning signs, toughing them out, waiting to see if they go away, or being quick to blame them on heartburn, muscle soreness, or other less serious, non-cardiac causes. That's especially true for men and people over 65, as well as for people with other cardiac risk factors, such as high cholesterol or blood pressure, obesity, smoking, diabetes, or a family history of Heart Disease.

"The more risk factors you have, the higher the likelihood that a symptom means something is going on with your heart," says David Frid, MD, a cardiologist at the Cleveland Clinic. "People often don't want to admit that they're old enough or sick enough to have heart trouble. Putting off treatment for other medical problems might not be so bad, but a serious heart problem can mean sudden death. It's better to go in and get it evaluated than to be dead."

Here are a dozen symptoms that may signal heart trouble:

1. ANXIETY: Heart Attack can cause intense anxiety or a fear of death. Heart attack survivors often talk about having experienced a sense of "impending doom."

2. CHEST DISCOMFORT: Pain in the chest is the classic symptom of a Heart Attack, and "the No. 1 symptom that we typically look for," says Jean C. McSweeney, PhD, RN, Associate Dean for research at the University of Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer in research on heart symptoms in women. But not all Heart Attacks cause chest pain, and chest pain can stem from ailments that have nothing to do with the heart. Heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. The pain has been likened to "an elephant sitting on the chest," but it can also be an uncomfortable sensation of pressure, squeezing, or fullness. "It's not unusual for women to describe the pain as a minor ache," McSweeney says. "Some women say the pain wasn't bad enough even to take a Tylenol." Women, more so than men, can also experience a burning sensation in their chest, rather than a pressure or pain.  "Sometimes people make the mistake of thinking that the pain comes from a stomach problem," says Nieca Goldberg, MD, Clinical Associate Professor of medicine at the NYU Langone Medical Center in New York City and another expert on women's heart symptoms.

3. COUGH: Persistent coughing or wheezing can be a symptom of heart failure -- a result of fluid accumulation in the lungs. In some cases, people with heart failure cough up bloody phlegm.

4. DIZZINESS: Heart Attacks can cause lightheadedness and loss of consciousness.  So can potentially dangerous heart rhythm abnormalities known as Arrhythmias.

5. FATIGUE: Especially among women, unusual fatigue can occur during a Heart Attack as well as in the days and weeks leading up to one. And feeling tired all the time may be a symptom of heart failure. Of course, you can also feel tired or fatigued for other reasons. How can you tell heart-related fatigue from other types of fatigue? "If you don't feel well and all the wind is knocked out of your sails, don't try to figure it out on the Internet or from a book," says Goldberg.  "Wasting time is dangerous."

6. NAUSEA OR LACK OF APPETITE: It's not uncommon for people to feel sick to their stomach or throw up during a Heart Attack. And abdominal swelling associated with heart failure can interfere with appetite.

7. PAIN IN OTHER PARTS OF THE BODY: In many Heart Attacks, pain begins in the chest and spreads to the shoulders, arms, elbows, back, neck, jaw, or abdomen. But sometimes there is no chest pain -- just pain in these other body areas.  The pain might come and go. Men having a Heart Attack often feel pain in the left arm. In women, the pain is more likely to be felt in both arms, or between the shoulder blades.

8. RAPID OR IRREGULAR PULSE: Doctors say that there's nothing worrisome about an occasional skipped heartbeat. But a rapid or irregular pulse -- especially when accompanied by weakness, dizziness, or shortness of breath -- can be evidence of a Heart Attack, heart failure, or an arrhythmia. Left untreated, some arrhythmias can lead to stroke, heart failure, or sudden death.

9. SHORTNESS OF BREATH: People who feel winded at rest or with minimal exertion might have a pulmonary condition like asthma or chronic obstructive pulmonary disease (COPD). But breathlessness could also indicate a Heart Attack or heart failure. "Sometimes people having a Heart Attack don't have chest pressure or pain but feel extremely short of breath," Goldberg says. "It's like they've just run a marathon when they haven't even moved." During a Heart Attack, shortness of breath often accompanies chest discomfort, but it can also occur before or without chest discomfort.

10. SWEATING: Breaking out in a cold sweat is a common symptom of Heart Attack. "You might just be sitting in a chair when all of a sudden you are really sweating like you had just worked out," Frid says.

11. SWELLING: Heart failure can cause fluid to accumulate in the body. This can cause swelling (often in the feet, ankles, legs, or abdomen) as well as sudden weight gain and sometimes a loss of appetite.

12. WEAKNESS: In the days leading up to a Heart Attack, as well as during one, some people experience severe, unexplained weakness. "One woman told me it felt like she couldn't hold a piece of paper between her fingers," McSweeney says.

However, the BEST Advice of all: TALK TO YOUR DOCTOR CONSISTENTLY!

By David Freeman, WebMD Feature, Reviewed by Robert J. Bryg, MD  

TIPS FOR AVOIDING HEART DISEASE:

SIMPLE STEPS TO LOWER CHOLESTEROL: Has your doctor said you have high cholesterol? Then you know you need to change your diet and lifestyle to lower cholesterol and your risk of heart disease. Even if your doctor prescribed a cholesterol drug to bring levels down, you'll still need to change your diet and become more active for cardiovascular health. These simple tips can help you keep cholesterol levels in check.

CHOLESTEROL, GOOD AND BAD: Your body needs a small amount of cholesterol to function properly. But we may get too much saturated fat and cholesterol in our diet -- and both raise levels of LDL "bad" cholesterol. LDL cholesterol can cause plaque to build up in arteries, leading to heart disease. HDL "good" cholesterol, on the other hand, helps clear bad cholesterol from your blood. You want to lower LDL cholesterol and raise HDL cholesterol, starting with your diet. 

PORTION CONTROL: Lend a Hand: Most Americans eat super-sized meals, with portions that are twice the size recommended for good health. That can contribute to weight gain and high cholesterol. Here's an easy way to practice portion control for a meal: Use your hand. One serving of meat or fish is about what fits in the palm of your hand. One serving of fresh fruit is about the size of your fist. And a serving of cooked vegetables, rice, or pasta should fit in your cupped hand. 

SERVE UP THE HEART-HEALTHY FOOD: Load your plate with fruits and vegetables -- five to nine servings a day -- to help lower LDL "bad" cholesterol. Antioxidants in these foods may provide the benefit. Or it may be that when we eat more fruits and veggies, we eat less fatty foods. Either way, you'll also help lower blood pressure and maintain a healthy weight. Foods enriched with plant sterols, such as some margarine spreads, yogurts, and other foods, can also help lower LDL cholesterol. 

FOR HEART HEALTH, LOOK TO THE SEA: A heart-healthy diet has fish on the menu twice a week. Why? Fish is low in saturated fat and high in healthy omega-3 fatty acids. Omega-3 fatty acids help lower levels of triglycerides, a type of fat in the blood. They may also help lower cholesterol, slowing the growth of plaque in arteries. Go for fatty fish, such as salmon, tuna, trout, and sardines. Just don't drop the filets in the deep fryer -- you'll negate the health benefits. 

START YOUR DAY WITH WHOLE GRAINS: A bowl of oatmeal or whole-grain cereal has benefits that last all day. The fiber and complex carbohydrates in whole grains help you feel fuller for longer, so you'll be less tempted to overeat at lunch. They also help reduce LDL "bad" cholesterol and can be an important part of your weight loss strategy. Other examples of whole grains include wild rice, popcorn, brown rice, barley, and whole-wheat flour. 

GO NUTS FOR CARDIOVASCULAR HEALTH: Need a snack? A handful of nuts is a tasty treat that helps in lowering cholesterol. Nuts are high in monounsaturated fat, which lowers LDL "bad" cholesterol while leaving HDL "good" cholesterol intact. Several studies show that people who eat about an ounce of nuts a day have lower risk of heart disease. Nuts are high in fat and calories, so only eat a handful. And make sure they're not covered in sugar or chocolate. 

UNSATURATED FATS PROTECT THE HEART: We all need a little fat in our diet -- about 25% to 35% of our daily calories. But the type of fat matters. Unsaturated fats -- like those found in canola, olive, and safflower oils -- help lower LDL "bad" cholesterol levels and may help raise HDL "good" cholesterol. Saturated fats -- like those found in butter and palm oil -- and trans fats raise LDL cholesterol. Even good fats have calories, so eat in moderation. 

MORE BEANS, FEWER POTATOES: You need carbohydrates for energy, but some do your body more good than others. Whole grains, such as brown rice or quinoa, whole-wheat pasta, and beans have more fiber and raise sugar levels less. These help lower cholesterol and keep you feeling full longer. Other carbs, like those found in white bread, white potatoes, white rice, and pastries, boost blood sugar levels more quickly, leading you to feel hungry sooner, and may increase risk for overeating. 

MOVE IT!: Even 30 minutes of physical activity five days a week (20 minutes three times a week for vigorous exercise, such as jogging) can help lower LDL cholesterol and raise HDL cholesterol -- although more exercise is even better. It also helps you maintain an ideal weight, reducing your chance of developing clogged arteries. You don't have to exercise for 30 minutes straight -- you can break it up into 10-minute increments. 

WALK IT OFF: If you're not used to exercising -- or hate the thought of going to a gym -- just go for a walk. It's easy, healthy, and all you need is a good pair of shoes. Aerobic or cardiovascular exercise such as walking lowers risk of stroke and heart disease, helps you lose weight, and keeps bones strong. If you're just starting out, try a 10-minute walk and gradually build up from there. 

WORK OUT WITHOUT GOING TO THE GYM: If exercise sounds like a dirty word to you, here's some good news: You can boost your heart health by incorporating physical activity into your day. Any kind of cardiovascular activity counts -- gardening, dancing, or taking the stairs instead of the elevator. Even housework can qualify as exercise -- as long as you're doing serious cleaning that gets your heart rate up and not just light dusting. 

TAKE CHARGE OF YOUR HEALTH: If you have high cholesterol, you and your doctor may be using a number of strategies to lower cholesterol levels. You may be working on your diet, losing weight, exercising more, and maybe taking cholesterol drugs. There are other actions you can take, too, to make sure you stay on the right track. 

WHAT TO DO WHEN EATING OUT: If you're eating healthy food at home to keep cholesterol in check, don't blow it when you eat out. Restaurant food can be loaded with saturated fat, calories, and sodium. Even healthy choices may come in super-size portions. Try these tips to stay on track: 

• Choose broiled, baked, steamed, and grilled foods -- not fried.
• Get sauces on the side.
• Practice portion control by asking for half your meal to be boxed up before it’s brought out.

LOOK FOR HIDDEN TRAPS: A close look at nutrition labels is essential for a low-cholesterol, heart-healthy diet. Try these tips:

• Check serving sizes. The nutrition info may look good, but does the package contain two servings instead of one?
• If it says "whole grain," read the ingredients. Whole wheat or whole grain should be the first one.
• A food with "0 grams cholesterol" could still raise your LDL cholesterol. Saturated fat is the other culprit to watch for.  

DON'T STRESS OUT: Chronic stress can raise blood pressure, adding to your risk of atherosclerosis, which occurs when plaque from cholesterol builds up in arteries. And research shows that for some people, stress might directly increase cholesterol levels. Reduce your stress levels with relaxation exercises, meditation, or biofeedback. Focus on your breathing and take deep, refreshing breaths. It's a simple stress-buster you can do anywhere. 

WHEN LOSING MEANS WINNING: Losing weight is one of the best things you can do to fight cardiovascular disease. Being obese increases the risk of high cholesterol, high blood pressure, and type 2 diabetes. These all affect the lining of your arteries, making them more prone to collect plaque from cholesterol. Losing weight -- especially belly fat, which is linked to hardening of the arteries -- helps raise HDL "good" cholesterol and reduce LDL "bad" cholesterol. 

FOLLOW YOUR DOCTOR'S ADVICE: Managing your cholesterol is a lifelong process. See your doctor regularly to keep tabs on your health. Follow your doctor's recommendations on diet, exercise, and medication. Working together, you and your doctor can lower your cholesterol levels and keep your heart going strong. 

SURPRISING THINGS THAT HURT YOUR HEART:

GET THE HEART FACTS: You know that a bad diet and too little exercise can hurt your ticker. But there are lots of sneaky sources of heart disease that you may not be aware of. Here are some you need to know about, and heart-smart steps to help you keep healthy.

DENTAL PROBLEMS: Need extra motivation to brush and floss every day? People with gum disease are more likely to have heart disease, too. The connection isn’t clear, but some experts think bacteria from your gums may move into your bloodstream, leading to inflammation of the blood vessels and other heart problems. See your dentist every 6 months for checkups. Make an appointment right away if you spot redness or soreness on your gums, or changes in your teeth.

SHIFT WORK: Working at night or irregular hours raises your risk of a heart attack, according to a recent study from Western University in Canada. Researchers say shift work has a bad impact on the body's circadian rhythm (a.k.a. your "internal clock"), and they think that harms your heart. So, if you don't work regular day hours, take extra steps to lower your risk of heart disease: Get exercise, eat a balanced diet, and see your doctor for regular checkups.

TRAFFIC DELAYS: Anyone who’s ever been stuck in bumper-to-bumper traffic will tell you it's stressful. That may be why research links spending a single hour in traffic to higher odds of having a heart attack. High noise levels -- like the kind you hear on a freeway -- are also linked to heart disease. If you can’t avoid traveling during rush hour, squash stress by listening to relaxing music. Or share the ride and chat with your fellow passenger.

EARLY MENOPAUSE: If you’re a woman and you go into menopause before you turn 46, your odds of having a heart attack or stroke may be twice as high as those who go through it later. A drop in estrogen, a hormone with ticker-friendly effects, may play a role. Ask your doctor to test you for heart disease risk factors (like high cholesterol).

SNORING: If your partner says you regularly snore or you sound like you’re gasping for air while sleeping, see your doctor. You might have a serious condition called apnea. It can happen when your airway is partially blocked and it causes you to have pauses in your breathing. The disorder is linked to high blood pressure, an irregular heartbeat, strokes, and heart failure. Treatments can help you breathe easier and lower your risk for heart disease, too.

HEPATITIS C: If you have this liver infection, you’re more likely to have low cholesterol and low blood pressure than people who don't have the disease. But even so, you still have a higher risk of heart disease. Researchers think hep C may cause inflammation of the body’s cells and tissues, including those in the heart. Work closely with your doctor to keep tabs on any heart symptoms.  

NOT GETTING GOOD SLEEP: When you routinely get less than 6 hours of shut-eye a night, you raise your risk of higher blood pressure and cholesterol. It increases the odds you’ll become obese and get diabetes, too (both of which can hurt your heart). That doesn’t mean you should sleep your way through the day. When you spend more than 9 hours horizontal on a regular basis, it raises your odds of getting diabetes and having a stroke -- major risk factors for heart disease. Baby your brain, body, and heart -- aim for 7 to 9 hours of slumber a night.

AN UNHAPPY MARRIAGE: A good match makes your heart happy and healthy. Older adults who are content in their unions have a lower risk of heart disease than those who aren’t, according to a recent study from Michigan State University. The likely cause? Stress. When you’re stressed, you’re more likely to make bad diet choices and do other things that can hurt your ticker, like drink too much alcohol. What’s more, stress hormones may have a negative effect on the heart. So, consider seeing a couples’ therapist or clergy member together if your marriage isn't a happy one.

LONELINESS: When you spend time with loved ones, it thwarts stress and helps you stay active. Lonely folks may be more likely to have heart disease. If you’re not near family or close friends, get connected by helping someone in need, or adopt a dog or cat. Volunteers and dog owners might enjoy better heart health and live longer, too.

BELLY FAT: Any extra weight is hard on your heart, but the kind around your midsection is especially dangerous. It may trigger your body to make hormones and other chemicals that can raise blood pressure and have a bad effect on your blood vessels and cholesterol levels. If you’re a woman and your waist is more than 35 inches around, or 40 inches if you’re a man, talk to your doctor about a diet and exercise plan. Research shows that yoga and short bursts of high-intensity exercise are great ways to whittle your middle.

TOO MUCH TUBE TIME: Couch potatoes, stand up! People who park themselves in front of the television a lot are more likely to get heart problems than those who limit their TV time. Every hour you spend watching TV on a daily basis may increase your risk by almost 20%. Sitting is the most likely culprit; it’s linked to problems like high blood pressure. Until researchers know how and why TV and heart trouble are connected, try to limit your time in front of the tube.

TOO MUCH EXERCISE ALL AT ONCE: Exercise is great for your heart. But if you’re out of shape or only work out occasionally, start slowly and build your endurance. When you exercise too long or too hard, it may put you at risk for heart attack and other problems, research shows. Not sure what’s safe for you? Start with a gentle exercise like walking. If you have a high risk of heart disease, talk to your doctor, and consider using a heart monitor while working out.

REVIEWED BY: James Beckerman, MD, FACC   

SOURCES:
 

American Academy of Cardiology: “Study Bolsters Link Between Heart Disease, Excessive Sitting” American Heart Association: “Sleep Apnea and Heart Disease, Stroke.” Boutcher, S., Journal of Obesity, November 2010. Butt, A., Clinical Infectious Diseases, [NO MONTH] 2009. The Cleveland Clinic: “Oral Health and Cardiovascular Disease.” Dahabreh, I.J., JAMA, March 2010. Dunstan, DW., Circulation, January 2010. Nieca Goldberg, M.D., medical director of the Joan H. Tisch Center for Women’s Health at New York University in New York City. Grandner, M., Sleep Medicine, January 2014. Halonen, J., European Heart Journal, June 2015. Harvard Medical School: “Belly Fat Can Signal an Unhealthy Heart,” “Why Having a Pet is Good For Your Health,” “Volunteering May Be Good for Your Body and Mind.” Lee, J.A., Menopause, April 2012. Liu, H., Journal of Health and Social Behavior, December 2014.

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