‘Mediterranean’ diet linked to lower risk of heart attacks, strokes in heart patients: But a ‘Western’ diet is not associated with an increased risk

A ‘Mediterranean’ diet, high in fruit, vegetables, fish and unrefined foods, is linked to a lower risk of heart attack and stroke in people who already have heart disease, according to a study of over 15,000 people in 39 countries around the world. The research also showed that eating greater amounts of healthy food was more important for these people than avoiding unhealthy foods — a ‘Western’ diet.

Source: ‘Mediterranean’ diet linked to lower risk of heart attacks, strokes in heart patients: But a ‘Western’ diet is not associated with an increased risk

Mediterranean 5/2 Eating Plan

The Five/Two Diet
Vegetable heartAs a method of weight loss and weight control, this easy solution of five/two pertains to a 7 day eating plan. Once you have reached your ideal weight, you transition to healthy baseline calorie intake every day. If you gain a pound, then you can transition back to the 5/2 plan. This is how it works:

• For 5 days a week, you eat a healthy diet based primarily on fruits, vegetables, a few nuts, a little olive oil, limiting pasta or rice to twice a week. Add limited whole grains to the mix, with low-fat meat, including salmon or other similar fish. Mirror your food selections with the Mediterranean diet like people who live along the southern Italian coast and Greek islands. Eating primarily fresh fruits, vegetables, and little saturated fat, they tend to live longer, in better health and with lower heart disease.

• For two days a week, eat very few calories, only 500-600. The two days must not be consecutive. Instead separate them such as Monday and Thursday.

Why not do the low calorie days together? Harsh calorie restriction can trigger what researchers call the starvation response. With starvation, the body revs up to store calories by lowering the metabolic rate and packing on calories when food becomes available. It is a natural process to maintain life.

Even though the two low calorie days are not true fasting, if they are consecutive such as Monday and Tuesday, your metabolic rate may be affected. Separating the days, combined with daily exercise such as walking is known to increase metabolic rate andkabob veg calorie burn. — And, with exercise, you are unlikely to stimulate a starvation response. In fact, with a marked reduction in calorie intake and consistent exercise, you will lose weight.

British physician Michael Mosley, described the 5/2 diet in his book FastDiet in 2012. In a follow up study done at the Aston University in the UK, they found intermittent fasting (very low calorie days) more effective than daily calorie restriction and calorie counting.

Favorable findings included:
• Reduced weight
• Reduced inflammation
• Reduced blood glucose
• Reduced lipids (cholesterol)
• Reduced blood pressure

True fasting (consuming no nutrition) has been shown to lower weight, prolong life, lower blood glucose and lower cholesterol levels. However, fasting also lowers metabolic rate, something you do not want, because your body becomes very efficient at storing excess calories and weight returns.

Eating two low calorie days per week is usually safe for Type 2 diabetics. Those taking medications and insulin must consult their medical provider for advice and to help manage medication dosages when reducing calorie intake. In the end, with weight loss, some Type 2 diabetics can reduce or stop some of their medications. Or, for those with borderline glucose elevations, weight loss and the drug Metformin, may help ward off the development of full-blown Type 2 diabetes. Without interventions, most people with borderline elevation of blood glucose will evolve to Type 2 diabetes within ten years.

Pay special attention to your daily intake:
• Choose fruits over sweets for desserts.
• Exercise portion control. Avoid second helpings. Wait 30 minutes and see if you are really still hungry.
• Do your best to prepare low calorie meals such as turkey breast instead of hot wings or steak.
• Forget potatoes, pasta, gravy, cheese sauce and fattening salad dressing.
• If you are preparing meals, serve light calorie recipes and fruit for dessert.
• Take time to exercise

Note: If you are, pregnant, breast feeding or a Type 1 diabetic, following a Mediterranean-type cuisine is healthy but do not follow the very low calorie day recommendations. However, this is a heart-healthy approach for those with high blood pressure and heart disease, even those who have had bypass and stent procedures.
Betty Kuffel, MD

Type II Diabetes Epidemic

Diabetes Increases Risk for Heart Disease

Obesity ConceptMillions of people have Type II diabetes and the number is growing with the obesity epidemic. At first, as blood sugars rise, Type II diabetes is a silent disease without recognized symptoms, but behind-the-scenes, excess sugar molecules in the blood are causing harm.

Diabetes occurs when inadequate insulin is available for sugar metabolism. Instead of being used by cells for energy, the sugar molecules increase in the blood and interfere with cell function. This leads to heart disease, high blood pressure, strokes, vision impairment and kidney damage.

Type II diabetes is a complex metabolic problem. Although the body produces enough insulin at first, it isn’t being used properly because at the cellular level, insulin resistance develops. This stimulating the pancreas to produce more and more insulin, until the cells become distressed and die off, leaving the body unable to maintain proper insulin production. The disease worsens.

Treatment for diabetes is variable. It can be very complex, requiring numerous medications, self testing and the addition of insulin injections. Some people do very well for years in a pre-diabetic state. If a fasting blood sugar is minimally elevated, just taking the oral medication metformin, may reduce progression. But if the sugar continues to rise, additional treatment must be started as soon as possible to normalize the sugar.

If someone you know is overweight, particularly if the weight is carried around the waistline, blood sugar levels should be monitored and treated if elevated. Losing weight will help, but weight loss is not easy.

Best results occur with reduced caloric intake and healthful food choices, combined Family exercisewith exercise. Even walking thirty minutes a day, helps lower blood sugar, burns calories and improves longevity.

Type I diabetes is different from Type II. Type I is usually seen in young often thin people, including infants and children. Cells in the pancreas that make insulin are destroyed and are unable to produce insulin, a hormone essential for sugar metabolism. Insulin cannot be taken orally. It must be injected or taken as a nasal spray.

obesityType II diabetes had been a disease of aging people until recent years when overweight children began developing this serious problem. Like adults, children are at risk for serious cardiovascular disease. Elevated blood glucose levels damage arteries throughout the body. Over time the vessels become so narrowed they cannot carry an adequate supply of oxygen-rich blood and nutrients to vital organs. As more children become obese, more of them develop diabetes and are at risk for early heart disease.

So, what should we do? First, understand that Type II diabetes is a serious health risk even when no symptoms are apparent. The American Diabetes Association recommends having a fasting blood sugar test performed at least annually. Blood is taken after having nothing to eat or drink for at least eight hours. A fasting blood sugar above 100 is abnormal.

Another blood test, the hemoglobin A1C, measures red blood cell glucose attachment. This test correlates directly with the blood glucose levels over preceding weeks/months. If the A1C is 8, the glucose average has been 183mg/dl. Until more information becomes available, specialists believe an A1C goal of <7% is valuable in reducing health risks.

Symptoms of High Blood Sugar:
Excess urination (Ex.-Getting up at night repeatedly.)
Excess water consumption (Ex.-Drinking water during the night.)
Increased appetite, blurred vision, low energy
Neuropathy (burning pain and numb feelings in hands and feet)

Additional information regarding diabetes, healthful eating and weight control can be found on the following websites:
www.realage.com, www.diabetes.orgDiabetes Health in your handsBetty Kuffel, MD

Valentine’s Day is free Heart book day


Our special free download event for Your Heart  has pushed it to #1 on the Top 100 Free in both the Internal Medicine and Cardiology categories! 

Thank you.

We’d love to have reviews from our readers posted to Amazon.



Greetings from Betty and Bev
February is National Heart Month!

Heart disease is the #1 cause of death, but

with the right knowledge and actions, it is preventable.

We’d like to share our heart health guide FREE as a Valentine gift for you, your friends and family members. Click on YOUR HEART and it will take you to the Amazon purchase page where you and your friends can download a kindle copy of YOUR HEART FREE.

2016 Promo Graphic - 2


If you are healthy and want to stay that way, or if you are overweight, have diabetes or heart disease, our book Your Heart, can help. It provides the science behind coronary artery disease with actions to improve health and longevity, including information on the 5/2 Mediterranean diet. This is a healthy way to maintain your weight over a lifetime. It’s easy and it works. Overweight children show signs of early heart disease. The book contains information on how to keep kids healthy, too.

Please share this link with everyone! Your Heart

Happy Valentines Day and Have a healthy 2016.

Betty and Bev

Heart Disease is Preventable


The simple answer: Coronary artery narrowing is a silent disease that develops over many years from untreated risk factors that are unknown or not addressed.

People don’t realize they have heart disease until something bad happens, such as a heart attack or sudden death. They don’t realize subtle symptoms such as mild shortness of breath, upset stomach and fatigue are signs of heart disease. Women tend to complain less and are more often not diagnosed when they do see a physician.

Narrowed coronary arteries restrict blood flow to the heart muscle and begin causing symptoms that resolve with rest. When arteries become blocked, the pain persists. A part of theArtery heart dies because the muscle is starved of blood and oxygen. Sweating, weakness, discomfort in the chest, jaw, neck, arm and sometimes the back are common with a heart attack. This is a medical emergency and 911 should be called for immediate medical care. If the artery can be opened with angioplasty and stents soon enough, heart damage is decreased. Fifty percent of people who have heart attacks die before reaching a hospital.

Coronary artery disease is preventable, but unhealthy lifestyles and food choices are difficult to change. We live in a fast food environment. The number of people smoking has decreased and some people are making healthier food choices through education, but heart disease is still the leading cause of death. Obesity has increased to epidemic proportions, even in the young, so we have a long way to go to become a healthier nation.

50% of US citizens have either high blood pressure, high cholesterol or smoke
2/3 of adults are overweight or obese
1/3 of children are overweight or obese
Overweight 5-year-olds show evidence of early heart disease

Take control of your health and reduce heart disease risks with healthy actions. See a physician to monitor health and measure glucose, thyroid, cholesterol, vitamin D, blood count and inflammatory markers such as C-reactive protein.
♥ Stop tobacco use
♥ Control high blood pressure
♥ Treat abnormal cholesterol levels with dietary modification and medication
♥ Obesity and Diabetes: normalize weight and glucose
♥ Exercise daily with your doctor’s recommendation
♥ Limit alcohol consumption
♥ Consider heredity factors and obtain early testing/treatment

You can counteract good genes by making bad life choices. You can offset bad genes by making healthy choices. The choice is yours to make.


Heart disease, osteoporosis and dementia increase with age.
New information supports prescribing estrogen to reduce these risks.

Few doctors will prescribe a hormone replacement following menopause because the Women’s Health Initiative (WHI) showed the risks of use far outweighed its benefits. According to the study, prescribing hormone replacements to block hot flashes put women at risk of breast cancer, uterine cancer, strokes and blood clots.

Hormone supplementation is complex. There are many pros and cons, but the WHI conclusion made it easy for doctors to just say no.

However, new research may reverse that practice. It might be time to once reconsider the use of hormone replacement for some woman.

Loss of ovarian hormone effects after menopause (or surgical ovarian removal) results in reduced bone density, leading to osteoporosis and broken bones. Many other symptoms such as skin wrinkling, hair changes and reduced libido are non-life threatening, but are irritating. In addition, serious health problems evolve over years and impact long term health.

Heart shapped brain♥ Heart diseasebrain skeleton



Heart disease is the #1 cause of death in women.
There was a time when we were told estrogen had no effect on cholesterol, but a recent study showed reduced estrogen resulted in decreased function and effectiveness of HDL. HDL is High Density Lipoprotein, the good cholesterol. We want this number to be high.

♥ In a Danish study, women who took estrogen after menopause had a significant reduction in heart attack, heart failure and mortality (with no increase in cancer, clots or stroke).
♥ A Japanese study on menopausal women reported similar favorable heart findings and, in addition, showed improved bone density.

Osteoporosis results in more than 1.5 million fractures each year.
Fifty percent of all women over the age of 50 will suffer an osteoporosis-related fracture. Estrogen aids in calcium metabolism and is a key component of bone mass. Loss of estrogen with menopause contributes to weak bones and fractures in aging women. Poor diet and lack of exercise during adolescence reduce bone strength in later years. Proper exercise, vitamin D and adequate calcium intake are beneficial for bone health.

Alzheimer’s disease is the 6th leading cause of death in the US – 2/3rds of these are women. At this time, Alzheimer’s is the only cause of death in the top ten that cannot be prevented or cured. The good news is, a recent preliminary study of the brain showed positive estrogen effects on the hippocampus (memory area) in women taking estrogen. Hormone replacement may reduce dementia in women. (See: Estrogen is back in the news. www.lipsticklogic.com)

As the population ages, dementia, osteoporosis and heart disease are becoming more prevalent. It is important to re-examine what can be done to reduce these debilitating illnesses. Estrogen replacement may once again be appropriate in some women.

Note: Why some women cannot take estrogen supplements.
There are 230,000 new cases of Breast Cancer each year and, annually, 40,000 women die from the disease.

There are many types of breast cancer. Some breast cancers result from genetic mutations, but 85% of breast cancers occur in women with no family history.

In some types of breast cancer, hormone replacement supports abnormal cell growth, helping the cancer cells grow and spread. These cancer cells have surface markers for estrogen and/or progesterone. This means hormone supplements should not be prescribed. A personal history of breast cancer or uterine/ovarian cancer also precludes the use of replacement therapy.

In the Women’s Health Initiative, the highest risk for breast cancer was associated with hormone replacement when both estrogen and progestin were prescribed. Women who have had a hysterectomy do not require progestin.

For additional information on similar topic see our other women’s health blog:www.lipsticklogic.com