How Can I Shake the Salt Habit?

Q: I know too much sodium is bad for me, so are there any alternatives I can cook with that will add a similar flavor boost and be healthier for me?

A: You are absolutely right—we eat far too much sodium in this country, and cutting back on sodium intake is a wise nutrition move. In fact, the American Heart Association dietary and lifestyle recommendations suggest we keep our intake of sodium under 2,300 mg per day (that’s the amount of sodium chloride found in about 1 teaspoon of salt) and under 1,500 mg for middle-aged and older adults, African Americans and those with diagnosed hypertension. Why worry about getting in too much salt—even if your blood pressure is normal? A high sodium diet has been linked to excessive loss of calcium from bones, an increase in kidney stone formation, reduced vitamin D and an increased risk of stroke, to name but a few of the adverse health effects linked to sodium overload.

Here are a few tips to help you shake the salt habit:

• Most of the salt in our diet comes not so much from the salt shaker but from processed and restaurant foods. Therefore, make an effort to choose less processed, natural whole foods. Be sure to read the nutrition facts label with the knowledge that 2,400 mg/day is your upper limit.
• If you dine out frequently, order the least processed menu options and add your own seasoning at the table. A salad bar is a great way to start your meal with a splash of heart-healthy olive oil, balsamic vinegar and a touch of lemon juice . . . and practically salt-free (but beware of pre-made salad dressings—notoriously high in salt).
• When cooking, learn to cook salt-free by using antioxidant-rich herbs and spices to give your food a surefire flavor boost. One of my favorite ways to flavor vegetables like broccoli or spinach is to sauté fresh garlic in extra virgin olive oil; add in the vegetable, then sprinkle with a touch of fresh lemon juice, yum! Dill is another one of my favorite herbs. I chop fresh dill and garlic, spread it on salmon and roast until done. Sprinkle with fresh lemon juice and you’ll never miss the salt!

Why Are Nuts Important In a Woman’s Diet?

Q: Why are certain foods like Brazil nuts important in a woman’s diet? What are some others?

A: It is important for all women to eat a heart-healthy diet to protect themselves against heart attacks and stroke (cardiovascular disease)—the leading cause of death and disability in American women—and nuts are a highly nutritious, heart-healthy food that should be a daily addition to one’s diet. Nuts contain a treasure chest full of nutrients such as protein, fiber, antioxidants (such as vitamin E and selenium), cholesterol-lowering plant sterols, and “good” fats such as the omega-3s and monounsaturated fats.

One caveat regarding nuts is that nuts are not created equally. The FDA has allowed a heart health claim for only seven types of nuts: almonds, walnuts, hazelnuts, peanuts, pecans, pistachios and some pine nuts. This is because these nuts all contain less than 4 grams of saturated fat per 50 grams of nuts. Notice that Brazil nuts did not make the cut. Brazil nuts are a nutritious food, exceptionally high in selenium and magnesium, but are also among the types of nuts that are high in saturated fat. Saturated fat is the most potent cholesterol-raising substance in our diet, so we need to cut way back on our intake. Thus, these nuts would not be your best bet.

Just remember not to go too nuts for nuts, as they are a very concentrated source of calories (due to their high fat—albeit good fat—content). Try and get about 1.5 ounces of nuts (about a handful) daily from one of the “magnificent 7” to help keep the cardiologist away!

How Can I Prevent Cramping While Exercising?

Q: How can I prevent cramping while exercising?

A: No doubt about it, muscle cramps hurt! So what are they and how can we prevent them? A muscle cramp (aka a “charlie horse” if it occurs in the leg) is an involuntary, sustained and forceful muscle contraction that can last a few seconds to what seems like a lot longer! Skeletal muscles are the type of muscles that are most likely to cramp, with calf, thigh and muscles in the arch of the foot as notoriously common spots. Although the exact cause of muscle cramping during exercise is unknown, four major contributing factors have been identified:

• Dehydration.
• An imbalance in the electrolyte level of the body fluids (most notably sodium and potassium).
• Lack of a proper warm-up and cool-down.
• Muscle fatigue.

The best way to prevent muscle cramps is to prevent the four major contributing factors:

1. Drink lots of fluid before, during and after your workouts. A good rule of thumb to determine how much fluid to drink during your workout is to gauge your “sweat rate” and try to match fluid loss with fluid intake. There are calculations to determine your exact sweat rate, with the average person losing roughly 25 to 50 ounces of sweat per hour. Drinking at least 8 ounces of fluid every 15 minutes would cover you if you lose approximately 32 ounces of fluid per hour.
2. Eat a healthy plant-based diet naturally rich in potassium (bananas, potatoes, papayas and spinach are all high-potassium foods), and do not restrict sodium in the diet directly before a long exercise bout in the heat.
3. Make sure to warm up before exercising by performing a slow version of the same exercise that you will be doing during your exercise bout, and cool down by decreasing intensity until your heart rate returns to normal
4. Follow a regular aerobic exercise training program, gradually increasing in intensity and duration from week to week, which is the best way to train your muscles to resist fatigue.

Diet or Fitness to Moderate High LDL?

Q: I am in my early 30's and was told by my primary care physician that my LDL cholesterol level was a little too high, but not at risk. Should I focus more on my diet or my fitness level to moderate my LDL?

A: Great question, as this is a topic very dear to my own heart! Considering that cardiovascular disease (CVD), which includes heart disease and stroke, is far and away the leading cause of death and disability in American men and women (killing as many people each year as all forms of cancers, lung disease, diabetes and accidents combined), it would behoove all Americans, young and old, male and female, to live a heart-healthy lifestyle. This involves fine-tuning both your diet and your exercise habits, which together favorably impact your LDL, or “bad,” cholesterol level.

The first step in preventing CVD is to sit down with your personal physician and assess your risk factors. LDL cholesterol is the most established risk factor for CVD. You and your doctor will come up with your personal LDL goal, as your LDL goal really depends on your risk status: the higher your risk, the lower your goal. According to the American Heart Association, the “optimal” goal for LDL cholesterol—for the prevention of heart disease—is less than 100 mg/dL. An LDL of between 100 and 129 mg/dL is defined as “near or above optimal.”

If your LDL is too high, what should you do? Because lifestyle changes (diet and exercise) remain the foundation for cardiovascular disease prevention and cholesterol control, the answer to your excellent question is to focus on both diet and exercise to lower your LDL cholesterol level. In my book, Cholesterol DOWN, I provide a simple diet and exercise plan that includes nine “miracle foods” and 30 minutes of walking a day that can lower your LDL cholesterol by as much as 47% in just 4 weeks.