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When it comes to exercise, every little bit helps

The common wisdom when it comes to exercise is that it must be sustained for at least 30 minutes to get any sort of value. Far too frequently in my practice I hear patients say, “I just don’t have the time to dedicate to an exercise routine.” But, as I’ve been saying for years, every little bit helps—and now there’s a major study that confirms this in the Journal of the American Heart Association.

Gretchen Reynolds in The New York Times wrote about how the 2008 federal exercise guidelines recommending 30 minutes of sustained activity five times a week to reduce the risk of disease or premature death didn’t support the advantages of multiple, smaller bursts of activity because they didn’t seem to improve endurance. However the new study shows that moving does have a direct effect on longevity. In other words, the more you move, the more you cut your mortality risk.

The bottom line is that ALL physical activity counts. So here are some ideas to get you moving to improve your cardiovascular health.

  • Dogs are a physician’s best friend. Nothing beats a canine companion to make sure you get several 10-minute walks a day.
  • Park on the other side of the lot. Sneak in a short walk by parking in the furthest spot from the store or a few blocks from your destination.
  • How big is that big box store? The next time you shop in one of those huge stores, walk the perimeter of the store to check out the aisles before you start shopping. Bonus points if you go up and down every aisle.
  • Walk it off. Just had a nice meal at a restaurant? Take a stroll around the block before you head home. It will also make the trip home far more comfortable.
  • Take the stairs. If you’re able, making it a habit of taking the stairs will not only sneak in more exercise, it will help with your endurance.

And for those of you who go for a long walk every day—keep it up. Every type of exercise counts.

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How to Cut the Salt for Your Heart and Your Health

I was recently on The Doctors to set the record straight about what too much salt does to our bodies. Studies show that high-salt diets are responsible for 57,000 deaths per year and I have patients who wouldn’t survive such a diet. Anyone who is sodium sensitive, has salt-reactive high blood pressure, diabetes or heart disease needs to limit their salt intake. The same goes for people with a family history of hypertension, which is found in many African-American families. Also, some people become more sodium sensitive as they age and there’s no way to know who these people are before they develop high blood pressure. The easiest preventive? Cut back on salt, especially salt in processed foods. Too much sodium can increase your risk of stroke, heart failure, osteoporosis, stomach cancer and kidney disease.

So how much salt is too much? The safest amount is 1,500 mg, especially if you are in an at-risk group. However, the current USDA guideline allows one teaspoon or 2,300 mg per day for a healthy adult. Although I’d like it to be lower, it’s an improvement over the 3,400 mg of sodium consumed by the average American every day.

Here’s how to get started cutting back on sodium:

  • Eat clean. Skip the processed and prepared foods (one 3-ounce serving of supermarket rotisserie chicken has 279 mg of sodium) and concentrate on getting more fruits, vegetables, whole grains, lean protein and healthy fats.
  • Make it yourself. Packaged food makers cut corners by adding salt and sugar. They’re cheap, addictive and allow manufacturers to substitute cheaper ingredients without being noticed. Learn to make your favorite foods yourself with quality ingredients. You’ll use less salt and greatly improve flavor.
  • Taste your food. Too many people reach for the salt shaker without even tasting their food. If you follow my advice and make it yourself with little or no salt, a slight sprinkling of sea or kosher salt on top will hit your taste buds in all the right places and still significantly reduce sodium.
  • Let your taste buds recalibrate. It will take awhile before you start to appreciate food with less salt. However, you can train your taste buds to appreciate food that’s not swimming in sodium.
  • Beware of fad foods. The latest food fad is ramen, but this can be loaded with sodium. Toss the flavoring packet and make your own broth at home with low-sodium chicken stock and lots of veggies.
  • Read the label. Before you buy anything, make sure you check the label. I’m deeply appreciative of the recently improved FDA labeling. You might be amazed at how loaded with sodium unexpected thing can be. Some culprits include salted caramel ice cream, breakfast cereals and breads.
  • Spice it up. Just because you’re skipping the salt doesn’t mean your food can’t be muy caliente. Just use fresh chilies or add a dash of cayenne or hot paprika. Canned chilies and bottled hot sauce is often loaded with sodium. Or add some heat with cumin, turmeric, coriander and nutmeg. And don’t forget the flavor boost from onions, shallots, fresh ginger and garlic.
  • Go for the green. There’s nothing like herbs to add real flavor to any dish. Supermarkets sell fresh herbs year round and they alos do great growing in containers. For extra flavor, whip together the Italian condiment gremolata—a chopped herb condiment made from parsley, lemon peel and garlic. You’ll never miss the salt.

Dr. Nieca’s Tip: You don’t have to sacrifice convenience by cutting out the salt. Roast a second fresh chicken on Sunday with the classic flavors of rosemary, garlic and lemon tucked under the skin. You’ll have flavorful chicken to use all week without a speck of added salt.

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How Old Are Your Arteries?

A few gray hairs here, a few wrinkles there around the eyes are treated as tell-tale signs of aging; worthy of time, effort, and expense to slow down the process, to the extent practicable.

A similar connection may be made to high blood pressure and vascular aging. Blood vessels stiffen as you get older and increase the resistance to blood being pumped out of your heart. This increased resistance results in high blood pressure.

In an interview with Consumer Reports for the June 2017  issue of Journal Hypertension, I discussed healthy vascular aging. The research showed that more than 30% of people in their 50’s had signs of vascular aging; only 1% over 70 had healthy vascular aging.

The benefits of paying attention to high blood pressure, as soon as it appears cannot be over-stated.  Those pesky gray hairs and crows’ feet lines can be left alone or camouflaged; healthy vascular aging requires your most serious attention.

Here is some good news you can use from the reported research: healthy aging is more likely for women who are leaner, non- diabetic or taking cholesterol medication.  Colorful fruits are winners! They are an important part of the Mediterranean style DASH diet together with exercise to  help lower blood pressure. A healthy lifestyle also helps to promote healthy vascular aging.

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Santa Barbara is Refreshing!

Last month I crossed the country to Santa Barbara, for a dream vacation, with my husband; a weeklong retreat from city life that pushed us to relax our minds while working the rest of the body.

We hiked in good walking shoes, we soaked ourselves in sunscreen—even on cloudy days. We carried plenty of water bottles—and remembered to stay hydrated all day. We walked along the beaches and hiked   rocky and steep trails. My hiking sticks offer an upper body work out, to boot.

It was exercise with a double benefit; fabulous fun that helps lower a multitude of health risks, including heart attack, stroke and high blood pressure. The big bonus was my husband Robert’s talented and clever photographic eye. We have beautiful memories and proof that I practice what I preach!

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How can I control my blood pressure?


Blood pressure control is generally achieved by a combination of exercise and a heart healthy diet. For most people, The DASH diet is among the most effective diets to keep blood pressure under control. Those veggies are also good for the waistline!  More generally, diet in combination with physical activity, weight loss, lowering alcohol and meditation generally contribute to productive control of blood pressure.

Blood pressure that measures 140 over 90 or higher requires a doctor’s attention and personal medical advice. Sometimes (even with a healthy lifestyle,  blood pressure medications may be advised by your doctor in conjunction with diet and exercise.