“Why Cholesterol Matters for Women?”

 

Ah, cholesterol and triglycerides. We hear about them all the time. Even foods that might seem good for you on the surface, like fruit-filled yogurt or bran muffins, can contribute to abnormal levels if they contain too much saturated fat or refined sugar, says Erin Michos, M.D., associate director of preventive cardiology at the Ciccarone Center for the Prevention of Heart Disease. What’s more, many women are at risk for high cholesterol and don’t realize it. “Approximately 45 percent of women over the age of 20 have a total cholesterol of 200 mg/dl and above, which is considered elevated — but a survey by the American Heart Association found that 76 percent of women say they don’t even know what their cholesterol values are,” Michos says. Scarier still: Triglycerides, a type of blood fat typically measured alongside cholesterol, are even more risky in women compared with men. This is a problem because women’s cholesterol levels can fluctuate quite a bit after menopause and tend to increase with age, putting us at greater risk of heart disease and stroke. Knowing your cholesterol numbers and how to control them is a big step toward staying healthy.

UNDERSTANDING THE HIGHS AND LOWS OF CHOLESTEROL: You know that too much is dangerous. But what is cholesterol, anyway? Where does it come from? And is it all bad? Cholesterol is a waxy substance that is found in every cell in the body. It’s either made by the body or absorbed from food. Your body needs cholesterol to make important steroid hormones such as estrogen, progesterone and vitamin D. It’s also used to make bile acids in the liver; these absorb fat during digestion. So, some cholesterol is necessary — but bad cholesterol is something you can do without. Excess bad cholesterol in the bloodstream can deposit into the body’s arteries. These deposits are called plaques and result in atherosclerosis or hardening of the arteries. This is the major cause of heart attacks, strokes and other vascular problems. Your total cholesterol level is a measure of the total amount of cholesterol circulating in your bloodstream, which includes several components:

LDL CHOLESTEROL: LDL stands for “low-density lipoprotein.” This is known as the “bad” cholesterol, which directly contributes to plaque buildup in the arteries. Very low-density lipoprotein, or VLDL cholesterol, is another type, which is a precursor to LDL.

TOTAL CHOLESTEROL is VLDL cholesterol plus LDL cholesterol plus HDL cholesterol.

HDL CHOLESTEROL: HDL stands for “high-density lipoprotein.” Experts think at optimal levels (around 50 mg/dl) it might help the body get rid of LDL cholesterol.

SO, BITS OF THIS STUFF CIRCULATE THROUGH YOUR SYSTEM, AND HERE’S WHAT HAPPENS: The bad parts – the LDL particles – like to stick to the lining of your arteries, like soap scum in pipes. As it sticks there, it generates an inflammatory response, and your body starts converting it into plaque. Plaque in your blood vessels makes them stiffer and narrower, restricting blood flow to vital organs such as your brain and heart muscle, leading to high blood pressure. Additionally, chunks can break off and cause a heart attack or a stroke. And guess what? This buildup can start as early as your 20s.

WHAT TO KNOW ABOUT TRIGLYCERIDES: In addition to cholesterol, you might hear about your triglycerides, another kind of fat found in the bloodstream. Women should pay particular attention to this. “A high level of triglycerides seems to predict an even greater risk for heart disease in women compared with men,” says Michos. When you take in more calories than you need, your body converts the extra calories into triglycerides, which are then stored in fat cells. Triglycerides are used by the body for energy, but people with excess triglycerides have higher risk of medical problems, including cardiovascular disease. Drinking a lot of alcohol and eating foods containing simple carbohydrates (sugary and starchy foods), saturated fats and trans fats contributes to high triglycerides. High levels may also be caused by health conditions such as diabetes, an underactive thyroid, obesity, polycystic ovary syndrome or kidney disease. Triglycerides also circulate in the bloodstream on particles that may contribute to plaque formation. Many people with high triglycerides have other risk factors for atherosclerosis, including high LDL levels or low HDL levels, or abnormal blood sugar (glucose) levels. Genetic studies have also shown some association between triglycerides and cardiovascular disease.

WHAT’S YOUR CHOLESTEROL LEVEL, ANYWAY? A standard lipid blood test usually measures the concentration of total cholesterol, HDL cholesterol, and triglycerides levels. The LDL-cholesterol level is typically estimated from these numbers using a well-established formula that has been more recently revised and improved by researchers at Johns Hopkins. So, what are your target numbers? According to Michos, an ideal LDL cholesterol level should be less than 70 mg/dl, and a woman’s HDL cholesterol level ideally should be close to 50 mg/dl. Triglycerides should be less than 150 mg/dl. As Michos notes, total cholesterol levels well below 200 mg/dl are best. 

WHY CHOLESTEROL AFFECTS WOMEN DIFFERENTLY? In general, women have higher levels of HDL cholesterol than men because the female sex hormone estrogen seems to boost this good cholesterol. But, like so much else, everything changes at menopause. At this point, many women experience a change in their cholesterol levels — total and LDL cholesterol rise and HDL cholesterol falls. This is why women who had favorable cholesterol values during their childbearing years might end up with elevated cholesterol later in life. Of course, genetics and lifestyle factors can play big roles, too. 

HOW TO LOWER YOUR CHOLESTEROL? If you’ve been told that you have high cholesterol — or you just want to prevent it — what can you do? There are several ways to manage it, including:

MEDICATION: Depending on your overall cardiovascular disease risk, you might be treated with a cholesterol-lowering medication, such as a statin. The decision to use a statin is based on a woman’s overall risk for heart attack and stroke including all these factors and the LDL cholesterol value. If you already have vascular disease or evidence of atherosclerosis, or if you are at high risk for cardiovascular disease, a statin for prevention is strongly recommended because this treats the plaque in the arteries, and lowers LDL cholesterol, Michos says.

DIET AND LIFESTYLE: “Diet and lifestyle are very important to help maintain healthy cholesterol levels. Even for women who are recommended to take cholesterol-lowering medications, a healthy lifestyle helps these drugs work better,” says Michos. Here’s how to maintain a lifestyle that promotes healthy cholesterol levels:

Maintain a healthy body weight.

Don’t smoke.

Exercise for at least 30 minutes five or more days per week.

Eat a diet rich in fruits, vegetables, lean protein and high amounts of soluble fiber such as beans and oats, which can reduce LDL.

Avoid sugar-sweetened drinks and fruit juices — opt for water and unsweetened tea instead — and minimize your intake of other simple carbohydrates like baked goods and candy.

Drink alcohol in moderation, especially if you have elevated triglycerides.

Consider the Mediterranean diet, which is rich in fruits, vegetables, grainy breads and fish. Use olive oil (instead of butter) and spices (instead of salt).

Eat monounsaturated and polyunsaturated fats — such as those found in olive oil, nuts and fatty fish like salmon. They can actually have a positive effect on cholesterol, Michos says, by reducing the amount of LDL in the blood and reducing inflammation in the arteries, especially when they replace saturated fats in the diet.

Add these to your shopping list:

Fatty fish such as salmon, trout, mackerel, sardines and albacore tuna

Nuts, including walnuts, pecans, almonds and hazelnuts

Olive oil to drizzle lightly over your salads and vegetables

While nobody wants to have high cholesterol, there are plenty of ways to keep it in check.  “With regular checkups and attention to what you eat, it’s possible to manage your cholesterol and blood fats to keep your heart healthy,” says Michos.

REVIEWED BY: Erin Donnelly Michos, M.D., M.H.S.; Johns Hopkins Medicine

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“Foods to Help Improve Your Circulation”

 

CIRCULATION IS KEY: Blood is like your body’s superhighway. It carries nutrients and oxygen to everything from your heart and brain to your muscles and skin. A healthy diet is one way to optimize your circulation, or blood flow. Combined with exercise, hydration, weight management, and not smoking, some foods can help improve circulation. Next time you head to the grocery store, consider including these items in your shopping cart.

CAYENNE PEPPER: This bright red pepper does more than just spice up your food. Thanks to a compound called capsaicin, cayenne pepper can help your arteries work well. It can also help relax the muscles in your blood vessels so blood can flow easily. And that’s good for your blood pressure.

BEETS: This root vegetable is rich in nitrate, which your body can convert to nitric oxide. Nitric oxide helps to naturally loosen up your blood vessels and improve the flow of blood to your tissues and organs. Researchers have found that beet juice can lower your systolic blood pressure (the first number in a blood pressure reading), too.

BERRIES: They’re rich in antioxidants, including one that’s particularly good for your blood vessels: anthocyanin. It’s the compound that gives red and purple produce that deep-colored hue. Anthocyanin can help protect the walls of your arteries from damage and keep them from becoming stiff. Plus, anthocyanin spurs the release of nitric oxide, which helps to lower your blood pressure.

FATTY FISH: If you’ve always wondered why fish is good for your heart, here’s one reason. Fatty fish like salmon, mackerel, trout, herring, and halibut are full of omega-3 fatty acids. Studies suggest that these compounds are good for your circulation. Eating fish not only lowers your resting blood pressure; it can help keep your arteries clear and unclogged, too. 

POMEGRANATES: The tiny juicy red seeds inside a pomegranate are packed with nutrients, in particular antioxidants and nitrates. These can boost your circulation. And they widen (dilate) your blood vessels and lower your blood pressure. That means that more oxygen and nutrients are delivered to your muscles and other tissues. And for active people, greater blood flow may bring along a performance boost, too.

GARLIC: Garlic is good for more than keeping vampires away. It contains a sulfur compound called allicin that helps your blood vessels relax. Studies show that in people who eat a diet rich in garlic, blood flows more efficiently. That means the heart doesn’t have to work as hard to move blood throughout the body, which helps keep your blood pressure down.

WALNUTS: Go nuts for nuts, especially walnuts. These crinkly-skinned nuts are rich in alpha-linolenic acid, a type of omega-3 fatty acid, which may help blood move smoothly. A study found that eating walnuts regularly for 8 weeks improved blood vessel health, helped those vessels stay elastic, and brought down blood pressure.

GRAPES: They’ll help keep your arteries healthy and improve blood flow -- all while tasting naturally sweet. A study found that the antioxidants in grapes encouraged blood vessels to relax and work more efficiently. Plus, grapes curb inflammatory and other molecules in the blood that could make blood sticky, which can get in the way of circulation.

TURMERIC: The golden yellow spice is known for its anti-inflammatory properties, thanks largely to curcumin, a compound found in turmeric. Studies suggest that curcumin may boost production of nitric oxide, which can help make your blood vessels wider. That, in turn, makes it easier for blood to flow and get to your muscles and other tissues.

SPINACH: Nitrate-rich foods like spinach may improve your circulation. These compounds help enlarge your blood vessels and create more room for blood to move through. Also, a study found that a diet rich in spinach helped keep arteries flexible and helped lower blood pressure.

CITRUS FRUIT: Vitamin C isn’t the only reason to make citrus fruit part of your diet. The antioxidants found in the fruit may help lower inflammation, prevent blood clots, and improve blood circulation. And if you’re an orange juice fan, you’re in luck. A study found that regularly drinking OJ lowered blood pressure.

REVIEWED BY: Kathleen M. Zelman, MPH, RD, LD on WebMD, March 18, 2020

SOURCES:

Go Red For Women, American Heart Association: “Exercise to Prevent Heart Disease.”

PLoS One: “Elevated Sodium and Dehydration Stimulate Inflammatory Signaling in Endothelial Cells and Promote Atherosclerosis.”

Canadian Journal of Cardiology: “Obesity and Atherosclerosis: Mechanistic Insights.”

Arteriosclerosis, Thrombosis, and Vascular Biology: “Smoking and Cardiovascular Disease: Mechanisms of Endothelial Dysfunction and Early Atherogenesis.”

Journal of Nutrition and Metabolism: “Capsaicinoids Modulating Cardiometabolic Syndrome Risk Factors: Current Perspectives.”

The Journal of Nutrition: “Inorganic Nitrate and Beetroot Juice Supplementation Reduces Blood Pressure in Adults: A Systematic Review and Meta-Analysis.”

Food & Nutrition Research: “Anthocyanidins and anthocyanins: colored pigments as food, pharmaceutical ingredients, and the potential health benefits.”

Nutrients: “The Effect of Anthocyanin-Rich Foods or Extracts on Vascular Function in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.”

Circulation: “Omega-3 Fatty Acids and Heart Health.”

European Journal of Sport Science: “Effects of pomegranate extract on blood flow and vessel diameter after high-intensity exercise in young, healthy adults.”

Pharmacological Research: “Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials.”

The Anatolian Journal of Cardiology: “Effects of garlic on brachial endothelial function and capacity of plasma to mediate cholesterol efflux in patients with coronary artery disease.”

The American Journal of Clinical Nutrition: “Effects of chocolate, cocoa, and flavan-3-ols on cardiovascular health: a systematic review and meta-analysis of randomized trials.”

Diabetes Care: “Effects of Walnut Consumption on Endothelial Function in Type 2 Diabetic Subjects: A randomized controlled crossover trial.”

The Journal of Nutrition: “Grape Polyphenols Reduce Blood Pressure and Increase Flow-Mediated Vasodilation in Men with Metabolic Syndrome.”

Aging: “Curcumin supplementation improves vascular endothelial function in healthy middle-aged and older adults by increasing nitric oxide bioavailability and reducing oxidative stress.”

Clinical Nutrition Research: “Effect of Spinach, a High Dietary Nitrate Source, on Arterial Stiffness and Related Hemodynamic Measures: A Randomized, Controlled Trial in Healthy Adults.”

Food Chemistry: “Citrus flavonoids: Molecular structure, biological activity and nutritional properties: A review.”

The American Journal of Clinical Nutrition: “Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers.”

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“Blood Pressure Often Differs Widely Between Arms”

 

Blood pressure readings between the two arms can be different, and that disparity can sometimes be a warning sign of heart trouble down the road. That's the finding of an analysis of 24 past studies: When people have at least a 5-point difference in blood pressure between the two arms, their risk of heart attack, stroke or premature death inches up. And the greater the difference, the more those risks climb. Experts said the findings give more support to something that's been advocated, but not commonly done by doctors and nurses: Checking patients' blood pressure in both arms. "Unfortunately, blood pressure is not routinely measured in both arms," said Dr. Jeffrey Berger, a cardiologist who was not involved in the study. "But I think it should be." Berger directs the Center for the Prevention of Cardiovascular Disease at NYU Langone Health in New York City. He said he always checks blood pressure in both arms and thinks it should be a matter of routine in all patients. "It's such a simple thing to do," Berger said. It's not that the blood pressure difference, itself, is the problem. But a discrepancy between arms might be a sign of early atherosclerosis that is developing asymmetrically, Berger explained. Atherosclerosis refers to a hardening and narrowing in the arteries that, eventually, could lead to heart disease or stroke. Measuring blood pressure in both arms gives doctors "a simple way of noticing possible arterial stiffening," said Dr. Christopher Clark, lead researcher on the new analysis.

There's no way to "fix" between-arm discrepancies, but that's not the point, said Clark, a clinical senior lecturer at the University of Exeter Medical School in the United Kingdom. Instead, he explained, doctors can consider between-arm differences one "marker" of a patient's heart disease risk. And then what? Berger said it depends on a patient's overall health. Eating more healthfully and getting regular exercise is always wise, he said, but some people might need medication, like a statin to ward off cardiovascular trouble.

The findings, published online Dec. 21 in the journal Hypertension, are based on 24 studies from around the world, involving almost 54,000 adults in all. Over 10 years, 11% had a fatal or non-fatal heart attack or stroke. It's normal, Clark said, to have a few points of variation in blood pressure between the two arms -- due to anatomy and the fact that one hand is typically dominant. "Our interest was to identify when that difference is large enough to be regarded as signifying more than this," Clark said. "When is the difference large enough to suggest a change in the arteries that might signify additional risk of strokes or heart attacks?" Overall, his team found, people's risks started to climb when the two arms showed at least a 5-point difference in systolic blood pressure (the "top" number in a blood pressure reading). For each 1-point increase, the risk of dying from heart disease causes in the next 10 years rose by 1% to 2%. Meanwhile, the odds of suffering a first-time heart problem or stroke also crept up. Those increases were small, but the researchers said that a 10-point difference in systolic pressure between arms should be considered the "upper limit of normal."

Between-arm differences are more common in people with high blood pressure, Clark said, but people with normal readings can have them, too. The phenomenon matters more for someone with high blood pressure or other risk factors, like diabetes and high cholesterol, he added. Berger said that it's not clear why so few health care providers measure blood pressure in both arms. "This is not a new finding," he said of the current study. "It's been shown many times." For now, Berger suggested patients ask questions the next time they have a blood pressure check: If it's not being done in both arms, why not? As for home blood pressure monitoring, he said, if people repeatedly detect a significant difference between the arms, they should tell their doctor.

Clark was also in favor of doctors checking both arms, at least once -- in part to get a more accurate gauge of patients' blood pressure. If one arm has a higher reading, he said, then future measurements should be taken on that arm.

BY: Amy Norton, HealthDay Reporter

MORE INFORMATION:

The American Heart Association has more on blood pressure readings.

SOURCES: Christopher Clark, MD, PhD, clinical senior lecturer, University of Exeter Medical School, Exeter, U.K.; Jeffrey Berger, MD, director, Center for the Prevention of Cardiovascular Disease, NYU Langone Health, New York City; Hypertension, Dec. 21, 2020, online

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"Controlling Hypertension and Lowering Cholesterol"

Today my Doctor said “My pressure is up and I seem to be fine”…That is a recurring theme that I hear often when people are talking about their blood pressure after leaving a doctor's office.
But what is Blood Pressure? It’s something everyone has and it’s something that we can’t do without. As blood is pumped through your body's arteries, it creates force against the inside walls of your blood vessels. The amount of blood the heart pumps and the resistance of the arteries determines your blood pressure.
A "silent killer," ………..High blood pressure usually has no symptoms, but yet it can lead to serious and even life-threatening problems if left untreated. The good news is that there are ways to manage Hypertension.
Why me, why now? There are a number of reasons why people have Hypertension. In the majority of cases, hypertension is caused by a combination of inherited and environmental factors. Certainly, a family history of hypertension predisposes you to the disease. Other risk factors are Chosen, such as smoking, eating too many fat-laden foods, and not getting enough exercise.
But there is good news and some bad news! There are factors You Can Control and others you can't. Look at the list below to find out what you CAN do about lowering your blood pressure.
Factors You Can Control
SMOKING: Cigarette smokers are at least twice as likely as non-smokers to develop heart disease. If you smoke, talk to your doctor about breaking the habit. Give up the habit, it will help reduce your chances of getting heart disease and help keep your blood pressure under control. REDUCE ALCOHOL CONSUMPTION: Excessive alcohol can raise your blood pressure and reduces your heart's ability to pump blood. EXERCISE: Let’s work that body more! Doing just 30 to 45 minutes of mild to moderate exercise such as brisk walking or biking three times a week can bump your blood pressure down a few points, especially if you are losing weight as well. For those of you who want to lower your risk of hypertension further, try some vigorous exercise, such as riding a stationary bike for 40 minutes, running for 30 minutes or doing laps in the pool. Vigorous exercise can lower blood pressure by more than 10 points. Note: Please check with your doctor before you undertake vigorous exercise. EATING A LOWER FAT, BALANCED DIET: It is well documented that many people who have high blood pressure are also overweight. Try controlling your weight with both exercise and diet to maintain a healthy weight. Seek help from a registered dietitian in your area to gain more insight to better eating habits.

REDUCE SALT INTAKE: This is a must do! We salt our food before we even taste it! Many people consume far more salt than their bodies actually need. Eating too much salt can be dangerous to those with a history of high blood pressure because sodium intake can increase blood pressure. While not everyone must cut down on salty chips, pickles and popcorn, African Americans and people of African descent and women older than 65 seem to benefit when they lower their daily salt intake to no more than 2,400 milligrams a day - or about one teaspoon. The best thing that we can do for ourselves is to take the salt shakers and high sodium seasonings off of the dinner table and control the salt intake with better cooking practices.

Below are a few hints and suggestions on what you can do to help reduce your salt intake during the day:

·         Moderate your sodium intake gradually if you are accustomed to eating salty foods

·         Enjoy plenty of fresh fruits and vegetables instead of consuming salty snacks

·         Choose other foods within a food group that don’t have as much sodium i.e. meats , fish , poultry

·         Season with herbs and spices, herbed vinegar, and fruit juices instead of salt

·         Learn to prepare food with less salt or high-sodium ingredients

·         Go easy on high sodium foods (canned soups, processed foods)

·         Read the Nutrition facts information on your food label and understand where the sodium is coming from

·         If cutting back on sodium, look for reduced sodium products in the store

·         Be “salt “ conscious when eating out

·         Purchase lightly salted snacks, and nuts

·         When eating out move the salt shaker off the table, When at home do the same thing

·         Recognize terms that describe salty foods: Pickled, smoked, au jus, soy bases

·         Go easy on condiments, they tend to be salty

·         Reduce the consumption of processed and luncheon meats

Above all, remember that these changes must be gradual. Setting a goal too high will set you up for great disappointments. You can take control of your health by taking one step at a time.

LOWERING CHOLESTEROL

Death rates from heart disease are higher for African Americans than for Whites and heart disease is the leading cause of death for African American women. By living a healthy lifestyle, you can significantly reduce your likelihood of developing heart disease. Monitoring (and reducing if necessary) your cholesterol is an extremely important part of “living healthy.” A large body of research has shown that elevated blood cholesterol is a major risk factor for the development of heart disease.

Heart disease refers to the condition in which there is an insufficient amount of blood flow to the heart, resulting in damage to the heart muscle. A common cause of this is a blockage of the coronary (heart) arteries due to the accumulation of cholesterol deposits. These cholesterol deposits narrow the arteries and slow down blood flow.

 Let’s learn more about cholesterol and see how we can battle against it!

WHAT IS CHOLESTEROL?

Cholesterol is fat like material present in the blood and in most tissues of our body. It is an important component of cell membranes and serves as a building block for some hormones. Our liver produces all of the cholesterol that we need, but we also take in cholesterol by eating meats, dairy foods, egg yolks, poultry, and fish.

Key components in your cholesterol or “lipid” profile include Total Cholesterol (TC), Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), and Triglycerides. The lipoproteins (LDL and HDL) help to transport cholesterol through the blood stream.

WHAT ARE DESIRABLE CHOLESTEROL LEVELS?

TOTAL CHOLESTEROL: In general, increased cholesterol levels correlate with increased risk of heart disease. The following table will provide basic guidelines to assess the significance of your total cholesterol level.

TOTAL CHOLESTEROL MG/DL SIGNIFICANCE 
<200 Desirable - 200-239 Borderline High. Some increased risk of heart disease. >240 High Cholesterol. Twice (2x) the risk of heart disease as compared with a person with Total Cholesterol <200.

LDL: In general, the lower the LDL the better! The most desirable level for any individual must take into account a person’s past medical history. For example, a person with a history of heart attack, who smokes, and has a family history of heart attacks, should have LDL levels even lower than what the following table suggests. You should discuss your individual case with your doctor.

LDL LEVEL MG/DL SIGNIFICANCE

130-159 Borderline High. Some increased risk of heart disease. >160High LDL level. Associated with considerably higher risk of heart disease.

HDL: The higher the HDL level the better. High HDL levels actually have a protective effect against heart disease. A HDL level less than 35 mg/dL increases your risk for heart disease.

TRIGLYCERIDES: Several, but not all, population studies have shown that increased triglycerides are independently correlated with increased risk of heart disease. Triglyceride levels >400 mg/dL are considered high.

HOW OFTEN SHOULD CHOLESTEROL BE CHECKED?
All adults age 20 and over should have their total cholesterol checked at least once every 5 years. The test requires a simple blood sample taken from your arm or finger. Your doctor may or may not check your HDL and LDL levels at the same time. If you have not had your cholesterol checked in the last 5 years, I urge you to talk with your doctor soon!

WHAT CAN I DO TO LOWER MY CHOLESTEROL LEVELS?
The good news is that you can make lifestyle and dietary changes to improve your cholesterol profile! The two most important things that you can do are (1) to monitor your diet and (2) increase your physical activity.

Your diet should be low in total fat, saturated fat, and cholesterol. 

Foods traditionally used in the African American diet (chitterlings, sausage, bacon, fat back, pigs feet) are high in fat and must be eaten sparingly, if it all. 

Increase the amount of fiber in your diet by eating more fruits, vegetables, and whole-wheat grains. 

Please check out the National Heart, Lung, and Blood Institute web site www.nhlbi.nih.gov and look under their guidelines for heart healthy living.

Resources:
www.nhlbi.nih.gov
www.hebni.com
National Cholesterol Education Program Resource Kit - http://hin.nhlbi.nih.gov/cholmonth/

(By: Roniece Weaver, MS, RD, LD and David Pryor, MD)

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"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 Self-Care With Dr. Shermaine Site and its resouces, such as text, graphics, images, and other material contained on the site 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 this site!

If you think you may have a medical emergency, call your doctor or 911 immediately. 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 site. Reliance on any information provided by this site or other visitors to the site is solely at your own risk.