How Can I Develop a Healthy Eating Pattern?

Updated on Feb 26, 2024 | Cardiology, Diet and Nutrition, Your Health

Hypertension, cholesterol, diabetes, and obesity—these are all drivers for heart disease, the leading cause of death in the United States. Treating each individually often means seeing multiple specialists. But one thing is clear: If you reduce excess body fat with a healthy lifestyle, your cholesterol, blood pressure, and risk for diabetes or prediabetes will likely drop, and so will your risk for heart disease.

Jeffrey I. Mechanick, MD

Jeffrey I. Mechanick, MD

In this Q&A, Jeffrey I. Mechanick, MD, Professor of Medicine and Medical Director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Fuster Heart Hospital, explains how adopting a healthy eating pattern, rather than restrictive or fad dieting, can reduce your risk for heart disease and other chronic illnesses.

How do I know if I am at risk for heart disease?

Your body mass index (BMI) should be 18.5 to 24.9 (for Asian Americans, a healthy BMI is 18.5 to 22.9). Keep in mind that for some people, such as those who are more muscular or have a lot of swelling, BMI may not be accurate. Your goal should not be to lose weight but to be healthy and enjoy your life. Instead of going on a diet or eliminating certain foods or food groups, focus on developing a healthy eating pattern.

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What is a healthy eating pattern?

First, do not think about a single food as being good or bad. Rather, consider how the pattern of foods you eat over the course of 24 hours—the total aggregate of the foods and the nutrients that are in them—are affecting your risk for heart disease. A healthy eating pattern is one that reduces your risk.

How do I develop a healthy eating pattern?

Here is what I often tell my patients:

  • An ideal plate is a healthy food plate, the majority of which should consist of hi-fiber plants.
  • If you include meat, make sure it is lean meat.
  • Keep in mind that quantity (portion size) is not as important as the quality of the food (whole, high-fiber foods).
  • Try to get in at least five to seven servings of fresh fruits and vegetables (one serving fits in the palm of your hand), as well as beans, lentils, nuts, and whole grains, every day.
  • Include a good quality protein—such as poultry, fish, or vegetable protein such as beans and lentils—with every meal.
  • Avoid processed foods, and eat treats only on occasion.
  • Instead of baked goods, have whole grain breads or even Ezekiel breads, which are made out of sprouts and lentils (this will help you transition your eating pattern to those healthier whole grains).
  • Limit alcohol as much as you can—no amount is considered healthy.
  • Do not skip meals.

If you’re having trouble, seek out a professional, such your primary care physician, heart specialist, or registered dietitian, who can help structure an eating pattern for you to achieve a healthy weight.

Learn how to meal plan for heart health and weight management.

What should I look for in food labels?

Look for foods that are high in fiber but lower in calories, fat, sodium, and simple sugars. Be aware that these numbers are often listed on Nutrition Facts labels as “per serving” and not per the total amount in the food product.

Dietary fiber: The more fiber, the better. Both soluble and insoluble fiber are good for gut health and decrease your risk for chronic diseases, such as heart disease and cancer. Fiber also decreases appetite and helps you feel full, so you are not as tempted to snack on high-calorie foods.

Sodium: The official recommendations are to have only about two grams of sodium a day—roughly one teaspoon of table salt per day. If you are already at risk for heart disease, you may need to limit sodium even more.

Saturated fat, trans fats, and simple sugars: While the data on how much saturated fat is safe is unclear, you should stick to foods that have little to no saturated fat. Avoid trans fats and simple sugars—again, you can find the amount on the Nutrition Facts labels of packaged foods or just by looking up information online.

What should I look for in restaurant menus?

Here’s a trick I give my patients: Don’t ask for the menu. Research the restaurant online at a time when you’re not hungry (such as after a meal at home) and decide what you will eat before you go, or ask the server about specific items they might have—the fish of the day, lean proteins that are cooked without sauces, salads and raw or steamed vegetables, plant-based entrees and side dishes, and even berries for dessert. This way, you won’t be tempted by the less healthy options on the menu or enticing specials.

Will dietary supplements reduce my risk for heart disease?

There is really no need to take dietary supplements unless there is a medical reason. If you are following a healthy eating pattern, you will reduce your risk for deficiencies. If you have any question or doubt, definitely discuss it with your physician.

What else will help me reduce my risk for heart disease?

Get sufficient amounts of physical activity, including a mix of aerobic exercise and strength training, especially progressive resistance training. Sleep a minimum of seven hours a night. Do not smoke or do drugs, and reduce stress as much as possible. If you are overly worried or struggle with addiction, don’t delay—seek help from a mental health professional or counselor.

Learn how to create a weight loss program that works for you.
Learn more about Your Health.

Your Guide to Colorectal Cancer Awareness and Prevention

Updated on Sep 11, 2024 | Community, Your Health

A colorectal cancer awareness event at The Mount Sinai Hospital. Click here to learn more about colorectal cancer and early screening with Mount Sinai’s CHOICE Program. To discuss your screening options or if you have a referral, call 212-824-7887.

Colorectal cancer is the second leading cause of cancer deaths in both men and women in the United States. Although this cancer is highly treatable and preventable, about 140,000 Americans are diagnosed and more than 50,000 people die each year, according to the Centers for Disease Control and Prevention (CDC). In 2021, the United States Preventative Task Force updated its guidelines and lowered the starting age of screening from 50 to 45.

More than 93 percent of colorectal cancer cases occur in people 45 years old or older. More than 75-90 percent of colorectal cancer cases can be avoided through early detection and removal of pre-cancerous polyps, and as many as 60 percent of colorectal cancer deaths could be prevented if men and women over the age of 45 were screened routinely.

In the United States, more than half (55 percent) of all cases of colorectal cancer are attributable to lifestyle factors, such as an unhealthy diet, insufficient physical activity, high alcohol consumption, and smoking. Increasing screening to 80 percent of people could reduce the number diagnosed with colorectal cancer by 22 percent by 2030. But survey data indicates that screening prevalence among adults remains low in those aged 45 to 54.

In an effort to increase awareness and screening, Mount Sinai has expanded colorectal cancer awareness initiatives across all eight hospital sites during March to provide patients with access to health professionals to discuss prevention, screening options, and risk factors. Mount Sinai experts will be available to answer questions on diet, genetic counseling, the colonoscopy procedure, and ways to schedule and offer support after diagnosis.

Here are some prevention tips:

Schedule a Screening

A colonoscopy is the preferred screening method as it allows for both detection and removal of precancerous polyps during the same procedure. Other screening options include a flexible sigmoidoscopy, CT colonography, and home-based stool tests, including the fecal occult blood test (FOBT), fecal immunochemical test (FIT), and a combined fecal immunochemical test with DNA test (FIT-DNA test). Individuals should discuss all of these options with their doctor to find which method works best for their lifestyle.

Know Your Risk Factors 

Age: More than 90 percent of colorectal cancer cases occur in people 45 years old or older and death rate increases with age. In New York, 44 percent of those 45 to 54 are up to date with colorectal screening.

Family history:  As many as 1 in 3 people who develop colorectal cancer have other family members who have been affected by this disease. The risk is even higher if a relative was diagnosed under age 50 or if more than one first-degree relative (parent, sibling, or child) has been affected.

Racial and ethnic background: Colorectal cancer affects people of all races and ethnicities. However, colorectal cancer disproportionately affects the Black community, where the rates are the highest of any racial/ethnic group in the United States. Black individuals are most likely to be diagnosed with late-stage colorectal cancer. The incidence of this cancer in Black individuals is 15 percent higher than in white individuals. Death rates have declined in Black individuals by 3 percent. Colorectal cancer screening rates are now lowest among Asian Americans and Hispanic/Latino communities.

Lifestyle factors: Common lifestyle factors that may increase colorectal cancer risk include obesity; cigarette smoking; lack of exercise; overconsumption of fat, red, and processed meats; not eating enough fiber, fruits, and vegetables; and drinking alcohol excessively.

Pre-existing health conditions: Inflammatory bowel diseases (IBD), such as ulcerative colitis or Crohn’s disease, and less common genetic syndromes, such as familial adenomatous polyposis (FAP) or Lynch syndrome, significantly increase the risk of developing colorectal cancer. These patients are recommended to start screening at a younger age and more frequently.

Warning Signs and Symptoms 

  • A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, lasting for more than a few days.
  • Rectal bleeding, dark stools, or blood in the stool.
  • Cramping or abdominal pain.
  • Weakness and fatigue.
  • Unintended weight loss.
To learn more about colorectal cancer and early screening, visit Mount Sinai’s CHOICE Program.
To discuss your screening options or if you have a referral, call Mount Sinai's Choice Program at 212-824-7887.
Read more about the benefits of a colonoscopy

How Does Heart Disease Affect Women?

Updated on Mar 9, 2024 | Featured, Your Health

Roxana Mehran, MD

Heart disease is the leading cause of death for women in the United States. Unfortunately, awareness about this fact remains low, with many believing breast cancer is the leading cause of death for women. Underestimation of heart disease risk in women has been an issue not only among women themselves but also among the health care community. However, positive change has occurred, with numerous campaigns and initiatives to increase women’s heart health awareness over recent years.

In this Q&A, Roxana Mehran, MD, Director of Interventional Cardiovascular Research and Clinical Trials at the Icahn School of Medicine at Mount Sinai and a world leader in women’s cardiovascular health, explains why it is important for women to know more about heart disease and to take control over their health.

What are the risk factors for heart disease?

Important and well-known risk factors for heart disease in women and men include high blood pressure, high cholesterol, and diabetes. However, there is increasing evidence about risk factors that exclusively affect women. For example, certain conditions related to pregnancy have been associated with the development of heart disease later on in life. These include high blood pressure or elevated blood sugar during pregnancy and delivery of a smaller baby than usual for the number of weeks of pregnancy. Women are also more likely than men to be affected by risk factors that are still underrecognized, such as depression, abuse, and intimate partner violence. And lastly, women are overrepresented among those living in less wealthy areas with less access to healthy food, exercise, and education, resulting in increased risk for heart disease.

Are there other differences in heart disease between women and men?

Yes. The underlying mechanisms of certain aspects of heart disease differ between women and men. Unfortunately, most of our study data on heart disease are derived from male populations. Therefore, diagnosis and treatment of heart disease are mainly based on data from male patients. Luckily, the differences in heart disease between women and men have gained the attention of researchers and become the focus of an increasing number of research studies. Although scientific evidence on the optimal diagnosis and treatment of heart disease in women is increasing, we still have a lot to learn about why and how heart disease develops and presents differently in women and men.

What are the signs of heart disease in women?

When there is insufficient blood supply to the heart muscle due to a blocked artery or other reasons, the most common symptom will be chest pain. However, the limited blood flow to the heart muscle can also cause other symptoms, such as extreme fatigue, nausea, and pain in the jaw, neck, and shoulder. These can be signs of a heart attack and are more commonly observed in women compared to men.

Is heart disease preventable?

The good news is that healthy lifestyle changes can prevent 80 percent of premature heart attacks and strokes. A healthy diet, regular exercise, and not using tobacco products (including vaping) are key to lowering your heart disease risk. In addition, screening and treatment of risk factors such as the ones mentioned above are essential to keep your heart healthy. Therefore, at Mount Sinai, we provide women with a comprehensive assessment of their heart health and heart disease risk. We help with initiating the important steps to a healthy lifestyle and recognizing and addressing heart disease risk factors, including those unique to women.

What is your advice to women about heart disease?

It is never too early and never too late to think about heart disease and learn how to prevent what is preventable. We are here to help when you start taking control over your heart health.

Learn more about Cardiology services at Mount Sinai
Read about a patient who thought she had asthma but found out she had heart failure
Read more about the Go Red for Women campaign from the American Heart Association

Four Key Takeaways About Osteoporosis for Women and Men

Feb 9, 2024 | Bone Disease, Rheumatology, Your Health

Osteoporosis is a medical condition that causes bone loss in older adults, and many may not even know it’s happening. Osteoporosis affects almost one in five women in the United States aged 50 or over, and it about five percent of men of the same age.

People with osteoporosis are more likely to break bones, most often in the hip, forearm, wrist, and spine, according to the U.S. Centers for Disease Control and Prevention. The condition can weaken bones to the point that a break can occur more easily, even if someone coughs or bumps into something. And as you get older, recovering from broken bones becomes harder.

In this Q&A, Ira Khanna, MD, a rheumatologist at Mount Sinai Morningside and Mount Sinai West, explains who is most at risk for osteoporosis, how you can slow the progression of the condition if you have been diagnosed, and the benefits of Mount Sinai’s Osteoporosis Program. Dr. Khanna is also an Assistant Professor of Medicine (Rheumatology) at the Icahn School of Medicine at Mount Sinai.

Ira Khanna, MD, is a rheumatologist at Mount Sinai Morningside and Mount Sinai West. To schedule an appointment at the Osteoporosis Program, call 212-241-1671.

 

I have been diagnosed with osteoporosis, what can I do to slow progression?   

Talk to your doctor about the right medication for you, as osteoporosis treatments are very effective in not only slowing progression but improving your bone density. Make sure you are taking enough calcium in your diet with milk, yogurt, soy, green leafy vegetables, orange juice. You need 1,200 mg of calcium every day.

For reference, 300 mg of calcium is found in each of the following foods:

  • 1 cup (8 fl oz) of milk
  • 6 oz of yogurt
  • 1.5 oz of natural cheese (such as cheddar)
  • 2.0 oz of processed cheese (such as American)

Vitamin D supplementation according to your blood levels is very important for bone health. So is weight bearing exercises like walking, yoga, and light weights (no more than 10 pounds) above the neck.

Who is at higher risk of developing osteoporosis and what are the risk factors?   

Women age 65 and older and men 70 and older should be screened for osteoporosis. Those at higher risk include:

  • Postmenopausal women with other risk factors such as family history of hip fractures, certain hormone abnormalities with their thyroid, or parathyroid glands.
  • Patients on medications such as steroids, seizure medications, certain HIV medications.
  • Patients with eating disorders such as anorexia/ bulimia, or a history of gastric bypass surgery, inflammatory bowel disease, or excessive alcohol intake.
  • Patients with autoimmune conditions such as lupus, rheumatoid arthritis, or psoriatic arthritis.

How often should I have bone density tests, and what factors may influence changes in my bone health over time?   

Bone density monitoring is usually done every two years. But your doctor may repeat after one year if they are starting or changing your treatment.

Other factors that may affect your bone health include:

  • Your diet
  • Making sure you are getting enough calcium and vitamin D, which is essential for good bone health.
  • Continuing regular weight-bearing exercises, which help increase bone density and build muscle strength and balance, preventing falls

What resources does Mount Sinai offer to support and assist patients in managing their osteoporosis?  

Mount Sinai offers highly trained endocrinologists and rheumatologists who can help you manage your osteoporosis across. In addition, our Osteoporosis Program, based at Mount Sinai Morningside, offers same-day bone density scans, as well as blood work to evaluate for other factors that could be contributing to low bone density, counseling on weight bearing exercises, and referrals to physical therapy. Your doctor will evaluate your individual needs based on your bone density numbers and medical conditions to pick the best medication for you.

Learn more about the Osteoporosis Program at Mount Sinai Morningside

Why Getting a Good Night’s Sleep Is Essential for Heart Health

Updated on Mar 22, 2024 | Featured, Your Health

When we think about how to improve our heart health, we usually focus on eating right and exercising regularly. But getting a good night’s sleep can make a real difference as well.

“If you’re trying to improve your heart health, think about diet, exercise, and sleep,” says Deepak L. Bhatt MD, MPH, MBA, Director of the renowned Mount Sinai Fuster Heart Hospital.

In this Q&A, Dr. Bhatt explains how insufficient sleep can cause a wide range of symptoms and what steps you can take to remedy that.

Why is sleep important for heart health?

Not getting enough sleep, or not having good quality sleep, can cause increases in blood pressure and blood sugar levels. Chronically insufficient sleep can predispose you to weight gain and obesity. That could be because if you’re up until midnight binge watching and snacking, you might put on some extra pounds. But there are also more fundamental biological pathways by which insufficient sleep can increase cardiovascular risk. One of those might be by inducing inflammation, which is now known to be part of the pathophysiology of heart attacks and strokes.

Deepak L. Bhatt MD, MPH, MBA

What constitutes a good night’s sleep?

Sleeping seven to nine hours is ideal. For adults, more than nine hours isn’t necessarily better; it’s not like with exercise, where more is generally better. However, sleeping less than seven hours is not a good thing. Many people get less than six hours of sleep a night and think that’s sufficient. But with only six hours, you’re probably not as fully functional as you would otherwise be. Over the long term, a pattern of insufficient sleep increases the risk of cardiovascular disease. There is even some emerging data that it might be associated with an increased risk of dementia.

What about interrupted sleep?

Continuous sleep is better. But a lot of people sleep three hours, then get up and walk around, and then go back to sleep. The key is to not start watching TV or check your iPhone or electronic device, because that stimulates the brain. The light makes the brain think it’s daylight and time to wake up. As you go from being a bad sleeper to being a good sleeper, you don’t want to just hop into bed at 8 pm when you’re wide awake. That’s not going to work. Instead, you want to establish good sleep hygiene over time. That means trying to go to bed at the same time and wake up at the same time every day. Ideally, that would extend into weekends as well. It’s difficult to set a good plan for the week if you’re up until 2 am on Saturday night and sleep until 9 am on Sunday. It will make it hard to wake up on time on Monday morning.

How can you help yourself fall asleep?

Avoid excess stimulation right before going to bed, like binge watching TV or late-night snacking, which are bad for your health in any number of ways. Don’t check an email from your boss at 11 pm or binge-watch Netflix at 1 am. Also, you don’t want to eat a heavy meal, then go right to bed. Some people find that relaxation, meditation, and listening to gentle music right before going to bed can help them fall asleep. Exercise can be useful, because you’ve exerted yourself and are tired. But if you exercise right before going to sleep, your adrenaline is surging, and that can backfire. There is also an element of common sense and trial and error to figure out what works best for you. For some people, a glass of warm milk before bed might help—but that’s not going to work if you have lactose intolerance.

What does insufficient sleep do to your body?

Not getting enough sleep can increase your blood pressure, weight, blood sugar, predisposition to diabetes, and inflammation. These can raise your risk of heart problems. Inflammation isn’t often thought of in the context of cardiovascular disease, but the latest evidence shows that inflammation in artery plaque can trigger blood clots—and that’s what leads to the majority of heart attacks.

Does sleep apnea affect the heart?

Sleep apnea is different than having trouble sleeping. If you are not sleeping well, or you wake up feeling really fatigued despite the fact that you’ve been in bed for seven to nine hours, it might be worth getting checked out. People with sleep apnea wake up multiple times a night and have a much higher risk of high blood pressure, elevated heart rate, and heart rhythm problems like atrial fibrillation. Treatment for sleep apnea can really improve your quality of life and reduce some cardiovascular risks.

Can you talk about recent sleep research?

There has been a fair amount of work done on sleep, though there needs to be a lot more research. We still don’t understand a lot of fundamental things about sleep. But we do know that sleep seems to be important for organizing memories. Chronic sleep deprivation can lead to an accumulation of certain types of proteins, like tau and beta-amyloid, which are associated with Alzheimer’s disease. To sum up: Always remember that sleep, in addition to diet and exercise, is crucial to the health of your heart and your overall health.

Learn more about Cardiology services at Mount Sinai

Three Winter Weight Loss Salads

Updated on Jan 25, 2024 | Recipes, Your Health

Low in calories and high in fiber, kale is a nutritious, and tasty, superfood. Whether you want to lose weight, eat healthier, or both, these kale salads are a great way to reach your goal. Enjoy!

Kale Caesar Salad

Ingredients

1 bunch kale
1 bunch romaine lettuce
1 lemon, juiced
4 teaspoons red wine vinegar
4 teaspoons Worcestershire sauce
1/4 cup Dijon mustard
3/4 cup mayonnaise
1 1/3 cup oil (olive oil, other vegetable oil)
2 teaspoons salt
2 teaspoons black pepper

Preparation

Rinse and dry the kale and lettuce. Place in a large salad bowl and set aside. To make the dressing, in a separate bowl or jar whisk together the lemon juice, vinegar, Worcestershire sauce, mustard, mayonnaise, and oil. Add the salt and pepper to taste. Mix again. Pour dressing over the greens. Toss gently to mix well without bruising the lettuce.

Serves six

Nutritional Information per Serving
Approximately 648 calories
Fat: 71.5 grams
Carbohydrates: 3.8 grams
Protein: 2.3 grams

I love to make this elegant salad for family and friends during any gathering. My family is Mexican, and this salad has been a great way to add fresh greens to our other traditional foods. My recipe is a simple salad. The ingredients can be found in almost any market. – David, Food Services, Mount Sinai Brooklyn

Is Bariatric Weight-Loss Surgery the Best Option for Me?

Kale and Brussels Sprout Salad

Ingredients

1/4 cup fresh lemon juice
2 tablespoons Dijon mustard
1 tablespoon shallot, minced
1 small garlic clove, finely grated
1/4 teaspoon salt, plus more to taste
Black pepper, freshly ground
1/2 cup extra virgin olive oil, divided
2 large bunches (1 1/2 lbs) Tuscan kale, center stem removed and leaves thinly sliced
12 ounces of Brussels sprouts, trimmed and finely grated or shredded
1/3 cup almonds with skins, coarsely chopped
1 tablespoon of the olive oil
1 cup pecorino cheese, finely grated

Preparation

The dressing, greens, and toasted almonds can be prepared 8 hours ahead. Cover dressing and greens separately and chill. Cover almonds and let stand at room temperature.

For the dressing: Combine lemon juice, Dijon mustard, shallot, garlic, salt, and a pinch of pepper in a small bowl. Stir to blend; set aside to let flavors meld. After letting the ingredients rest, slowly whisk the remaining olive oil into the lemon-juice mixture. Season dressing to taste with salt and pepper.

Spoon 1 tablespoon of the oil into a small skillet and heat on medium-high. Add almonds to skillet and stir frequently until golden brown in spots, about 2 minutes. Transfer nuts to a paper towel lined plate, and sprinkle almonds lightly with salt. Set aside.

Mix thinly sliced kale and shredded Brussels sprouts in a large bowl. Set aside.

To assemble: Add dressing and cheese to the kale mixture; toss to coat. Season lightly with salt and pepper. Garnish with almonds. Toss and serve.

10 servings
154 calories per serving

This recipe was shared with me by my mother-in-law Idy Sherer. She is a health coach and eats extremely “clean” and healthy foods. This delicious salad can make a meal special as a side dish, and can be enjoyed on its own, too. – Maria, Registered Dietitian, Certified Diabetes Educator with The Diabetes Alliance, Mount Sinai Health System

How Do I Create a Weight Loss Program That Works for Me?

Kale and Romaine Salad With Lemon Dijon Dressing

Ingredients

Salad
1 head of romaine lettuce, washed, dried, and chopped
2 cups kale, washed, dried, and chopped
2 tablespoons Parmesan cheese, grated
1/2 lemon
Ground pepper to taste

Dressing

2 tablespoons of Dijon mustard
3 tablespoons of olive oil, divided
1 clove of garlic, finely minced

Preparation

Add Dijon mustard and 1 tablespoon of olive oil to a mixing bowl, whisk together. Whisk in the remaining 2 tablespoons of olive oil until the mixture becomes creamy. Add the garlic. Let the dressing sit and marinade for 30 minutes or longer before using. Place the chopped romaine and kale in a large salad bowl. Pour the salad dressing over the greens and toss. Add the grated parmesan cheese and lemon juice, and toss again. Season with pepper.

Makes 4 serving

130 calories per serving

Moments of Gratitude and Running When I wake up, I like to take note of three things I am grateful for in my life before I begin the day. After this moment of gratitude, I start my day with strong black coffee and a large glass of ice water with lemon and a tablespoon of chia seeds. I typically listen to a brief podcast as I walk to Madison Square Park. During the week, I run for 25-35 minutes in the Park, and I end my run with five or so sprints. On the weekends, I run for 60 minutes on the bridle path and along the reservoir in Central Park. Combining exercise with family, I also love to play tennis with my 83-year-old father who is still going strong! – Abby, Vice President, Disease Management, Director of Mount Sinai Fit, Mount Sinai Health System

Click here for more healthy recipes in Mount Sinai's Calm & Fit Wellness Cookbook.

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