Franciscan Heart Center's Heart Health! booklet

Franciscan HealtH system • tHe soutH sound’s leader in Heart care

heartFranciscan Heart Center

Franciscan Health System • 2013

‘Must haves’ for your pantry

Doctors’ advice to use today

Recipes & Tips

Heart-Healthy Living FoR THe

wHoLe FamiLy!

Free

Life and Good Health are Precious Gifts.

It’s Time for a Heart to Heart.Make the most of your wellness exam by making a list before your appoint-ment. Things you want to cover include:

Prevention•What tests are

recommended for someone my age?

•What is the purpose of each?

•How often should they be repeated?

Symptoms and concerns• Pain. Type, location, frequency and duration.

•Health challenges.Bespecific.Ifyouhavetrouble sleeping, how often? Falling asleep, staying asleep, or both? Do you have other symptoms, like night sweats or daytime sleepiness? The more information you share, the more complete picture you provide your doctor.

Treatment recommendations•What are my options?

•Are there side effects?

•What are the consequences if I don’t follow through?

•Which option would you choose, and why?

Don’t have a family physician? We can help you find a provider to help keep you and your heart healthy! Call 1 (888) 825-3227 or visit www.FranciscanDoctors.org today.

“I appreciate it when my patients bring questions and topics for discus-sion. I want them to be engaged in our partnership for their health.”

Janis Fegley, DO, family medicine;

division chief of primary care

At Franciscan, we want to help you live wellto preserve yours. While heart disease is the leading cause of death in our country, it doesn’t have to be. Most heart problems can be prevented – some even reversed – through fairly simple changes in lifestyle. So we challenge you to take charge of your heart health. And we promise to walk with you every step of the way. Throughout the South Sound, Franciscan Heart Center is everywhereyoufindFranciscan.It’sourcaringfamily doctors attentive to your heart health, our community education programs to help you live your best life, and our exceptional team of cardiologists, heart and vascular surgeons and other dedicated specialists focused on one goal: getting you back to the life you love.

Here’s to your heart health! Franciscan Heart Center.

Get news and information about heart health events and more at:

www.facebook.com/FranciscanHealth

www.twitter.com/FHShealth

www.youtube.com (Search for Franciscan Health System)

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Don’t Worry; Take Action!We know a lot about what causes heart disease and the steps we can take to prevent it. Best of all, it’s never too late to protect your heart!

•Don’t smoke.

•Eatadietstingyinfatsandrichinfiber,fruitsand veggies.

•Eliminate hidden sugars (hint: they often end in “ose” - sucrose, glucose, fructose, maltrose and dextrose; corn syrups)

•Get moving – exercise at least 30 minutes a day, 5 days a week, every week.

Stay in CirculationArteries carry oxygen-rich blood to the organs. Veins carry blood back to the heart. While varicose veins may be unsightly, they can be easily corrected. It’s the arteries that can cause real problems. Clogged arteries outside the heart cause peripheral arterial disease (PAD), which often goes undetected. Abdominal aortic aneurysm (AAA), a bulging, weak area in the artery that supplies blood to the abdomen, pelvis and legs, is another silent threat.

See your doctor if you experience:

• Painful cramping, numbness or tingling in your legs, feet or buttocks

• Pain or tingling in your leg when you walk, which goes away when

you stop

• Poor wound healing or changes to the color

of the legs and feet

Women: Heart discrimination ahead. •Heart disease kills more women than men

each year; and kills more women than all types of cancer combined.

• Metabolic syndrome (abdominal fat, high blood pressure/blood sugar/

triglycerides) more negatively affects women’s hearts.

• A woman’s risk for coronary artery disease increases after menopause.

• Heart attack symptoms can be subtle or vague, so women are more likely to delay seeking help. Don’t wait! Call 9-1-1.

“The time to start worrying about your heart is...never! Worry is passive and stressful. Instead, take positive action steps to maintain and improve your heart health.”

William Bilnoski, MD, medical director,

cardiology

“Don’t attribute leg pain to aging or inactivity. It is a sign that your muscles aren’t getting enough oxygen. See your doctor! If you have plaque in your leg arteries, chances are plaque is in the arteries of your heart and brain, too.”

Todd Kihara, MD, medical director,

Franciscan Vascular Labs

Did you know? Medicare covers a one-time abdominal aortic aneurysm (AAA) screening ultrasound (provided

at all Franciscan hospitals) if you get an at-risk referral as a result

of your “Welcome to Medicare” physical exam. Ask your doctor about it.

Good Advice from Our Experts

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At Franciscan, we know the thought of surgery — especially heart surgery — is enough to make your heart skip a beat. Rest assured; Franciscan’s surgical outcomes are among the best in the nation. St. Joseph Medical Center was awarded a 3-star rating for 2011 for heart bypass surgery. Only 15 percent of cardiothoracic surgery practices in the country earn this distinction given by the Society of Thoracic Surgeons.

Life after a heart eventExperiencing a heart event is life-altering. Talk to your doctor about valuable follow-up care. You may feel nervous about doing what is required to strengthen your heart – and recover your quality of life. It’s important to know you’re not alone. We have the resources you need to get your health, and your confidence,backontrack!

Cardiac RehabilitationSpecially trained nurses and exercise physiologists provide your “exercise prescription” and monitor your progress. You can exercise safely, with less worry.

Heart Failure ClinicYou can successfully live with heart failure, as long as it is medically managed. Our Heart Failure clinic staff

works closely with you and your doctor to:

•Treatsymptoms(suchasfluidretentionand fatigue)

• Better manage medications

• Improve your quality of life — and keep you out of the hospital.

“Today’s minimally invasive techniques treat many heart problems, including valve repair and replacement. For our patients, this means less pain and faster recoveries.”

Craig Hampton, MD, FACS

cardiothoracic surgery

Facing Heart Surgery?

Sleep on it. Commit to

getting seven or more hours

of sleep per night.

5

Snooze to loseObesity is three times more common in people who get fewer than seven hours of sleep per night. Poor sleep is also associated with diabetes, high blood pressure, and heart disease.

Risk Factors

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Cardiovascular diseases: Are you at risk?Cardiovascular diseases involving the heart and blood vessel system include heart disease, stroke, high blood pressure, and angina (chest pain).

Risk factors you cannot control•Increasing age (male over 45; female over 55)

•Gender (more men have heart attacks earlier in life, but heart disease will kill more women)

•Family history

Risk factors you can control•Quit smoking

•Exercise regularly

•Limit alcohol

•Control your blood pressure

•Manage your cholesterol

•Ease stress

•Prevent or manage diabetes

You can cut your risk of heart attack and stroke in half by adopting healthy changes. Call your healthcare provider to discuss priorities and make a plan.

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piCK one ACtion FRoM tHe liSt and commit

to three changes you can make and sustain.

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Your risk: what to know & doCoronary Heart Disease

•Also known simply as heart disease, CHD is one of several cardiovascular diseases of the heart and blood vessel system. With symptoms that can be life threatening, CHD can lead to heart attack and heart failure. It is the leading cause of death for Americans.

Vascular Disease •Clogged arteries and hardening of the arteries

occur when blood vessels become damaged from high blood pressure, cholesterol, or other fatty buildup. The result—restricted blood flow—can cause tissue damage, stroke, or death.

Stroke •Often called a brain attack, stroke occurs when

a blood vessel in the brain bursts or is blocked, interrupting blood flow to the brain.

•Signs include numbness, confusion, trouble speaking, and severe headache.

High Blood Pressure•Also known as hypertension, it weakens and

damages the arteries, which can lead to heart disease and stroke.

•It’s called the “silent killer” because people often show no symptoms.

Cholesterol •LDL (think L for lousy) is bad cholesterol, raising

your risk of heart and vascular diseases, and stroke.

•HDL is good cholesterol (H for healthy). High levels can lower your risk of heart disease.

Diabetes •People with diabetes have a three times higher

risk of developing cardiovascular disease.

•The same good habits that prevent heart disease can help prevent diabetes.

Do! You can prevent or manage heart disease, stroke, high blood pressure, and diabetes by adopting these good-for-you habits:

•If you smoke, stop.

•Exercise 30 to 60 minutes most days.

•Adopt principles of the Mediterranean lifestyle as explained in this booklet.

•Maintain a healthy weight.

•Get regular checkups.

•Eat at home.

Cardiovascular Diseases: Know the Signs

9-1-1Heart Attack?Call 9-1-1 with any of these symptoms:

• Chest pain or upper body discomfort

• Shortness of breath

• Cold sweats, nausea, or light-headedness

• Racing heart beat

Stroke?Call 9-1-1 if you suspect someone is having a stroke, and can’t:

• Smile• Raise both arms• Repeat a simple

sentence

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USe tHe CHARt ABoVe to tRACK YoUR

nUMBeRS oVeR tiMe. Local health fairs or

hospitals are a good resource for health screenings.

Or contact your healthcare provider, who may

further customize your screening schedule based

on your personal and family medical history.

Higher risk

Lower risk

Apple or pear? Body shape matters People with apple-shaped bodies—larger waists with extra weight around the abdomen—are at a higher risk of developing diabetes, heart disease, and other complications of metabolic syndrome.

Those who have a narrow waist and carry more weight around the hips—pear-shaped—have a lower risk. Since we inherit our body shape, it’s one more reason to take control of the risk factors within our power to change.

Metabolic syndrome? Check yourselfSymptoms of metabolic syndrome increase your risk for heart disease, stroke, and diabetes. This risk is greater if you are overweight or inactive. And it’s highest in Hispanic, Native American, and African-American populations.

If you have two or more of these conditions, consult your healthcare provider:

•High blood pressure

•Elevated fasting blood sugars

•Extra weight, especially around the waist

•Abnormal blood lipid (cholesterol) levels

Healthy At Risk High RiskTotal Cholesterol Less than 200 201 – 239 240 and above

LDL (Lousy) Cholesterol Less than 100 101 – 159 160 and above

HDL (Healthy) Cholesterol 60 or higher 51 – 59 Women 50 or less

41 – 59 Men 40 or less

Triglycerides Less than 150 151 – 199 200 and above

Fasting Blood Sugar Less than 100 101 – 125 126 and above

CRP (measures inflammation) Less than 1.0 1.0 – 2.9 3.0 or higher

Blood Pressure

Systolic Less than 120 121 – 139 140 or higher

Diastolic Less than 80 81 – 89 90 or higher

Weight

Waist Circumference

Women Less than 35" 35" or greater

Men Less than 40" 40" or greater

Body Mass Index (BMI) 19 – 24 25 – 29 30 or higher

What’s your number?Date Date Date Date

Mediterranean: Not a diet, a lifestyleLive longer, and reduce your risk of heart disease, stroke, and diabetes by eating as our Mediterranean neighbors do:

• More fruits, veggies, beans, nuts, seeds, and grains• Olive oil as your main fat source• Small daily servings of non- or low-fat cheese and yogurt• Two to three servings of baked or broiled fish weekly• Lean red meat only once or twice a month

If lower blood pressure is your goal, consider the low-sodium DASH diet; see the National Heart, Lung and Blood Institute website.

1/2 fruits and nonstarchy vegetables• Apples• Berries• Broccoli• Brussels sprouts• Cabbage• Carrots•Cauliflower• Cucumber• Green beans

• Melon• Onions• Tomatoes• Dark leafy greens• Eggplants• Peaches• Pears• Plums• Zucchini

1/4 lean protein•Leanbeef,porkandfish• Dried beans, peas and

lentils• Chicken and turkey breasts• Tofu, tempeh• Eggs• Nuts•Low-fatmilk,yogurtand

cheese

1/4 whole grains or starchy vegetables•Barley(non-pearledisbest)•Brownrice,quinoaandoats• Dried beans, peas and lentils•Wholewheatpasta• Corn • Potatoes •Wintersquash

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need Help witH SeRVing SizeS?

Use a food scale or try these visual cues for a

single serving of:

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Food Labels: Front and Back

Buzz words decodedToday’s packaged foods entice us with marketing words that are often misleading. Here are some of the popular ones:

Know wHAt YoU’Re BUYing And eAting by reading food labels. Before buying a packaged

food item, answer the question, “Is the nutrition

in this good for me?”

The other side of the storyWhat’s really inside today’s packaged and processed foods—and beverages—is revealed on the Nutrition Facts label. This tell-all most often appears on the product’s back side. It is intended to help you make informed choices.

Verify what’s inside:Read the ingredients listed on the back of the package. The first thing listed is what weighs the most in the total weight of the food item. If you see the healthiest ingredients are toward the end of the list, they’re probably not a significant source of nutrition.

Don't forget to look forthe expiration date.

Start here Is this serving size reasonable?

Check calories

Limit these nutrients

Get enough of these nutrients

5% or less is low

20% or more is high

Aim dailyfor less than300 mg ofcholesterol

•Natural. The food product may still contain pesticides, genetically modified ingredients, high-fructose corn syrup, and be heavily processed.

•Healthy. While the food must meet specific guidelines for fat, cholesterol, sodium, and certain nutrients, it can still contain large amounts of sugar, preservatives, and artificial ingredients.

•Lightly sweetened. This term is not regulated by the FDA, so the product could contain any amount of sugar.

•Made with whole grains. Be sure “whole grain” or “whole-wheat flour” is among the first three or four ingredients listed on the package.

•Reduced sugar. The FDA controls this, and it means that the product contains 25% less sugar than the regular product.

•Sugar-free. The FDA states that the product cannot contain more than .5 grams of sugar or 1/8 teaspoon per serving.

Culprits: Fats, Sugar, Sodium

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witH poRtion SizeS eVeR inCReASing—

at convenience stores, restaurants, and in movie

theaters—we inadvertently consume more calories

than we need. Know common portion sizes. When

given a choice, order the smallest size.

Buyer beware!Packaged foods often contain large amounts of sodium from preservatives and additives, while packaged low-fat foods commonly get a flavor boost from sugar. Read the labels.

What lurks in your pantry? Fat free. Naturally sweetened. All natural. Don’t be fooled by misleading language on labels; look for the hidden or added sugar, salt, and fat. Consider these heart-healthy guidelines:

•Reduce your intake of solid fats (saturated and trans fats), replacing them with poly- and monounsaturated oils. Less than 35 percent of your total daily calories should come from fat.

•Watch the sugar: 4 grams equal 1 teaspoon. Most of us should have no more than 5 to 9 teaspoons per day.

•Your overall daily diet should contain no more than 2,300 mg of sodium. Sodium is the part of salt that is most pertinent to your health. African-Americans, adults 50+, and all ages with hypertension, diabetes, or chronic kidney disease should limit their daily sodium intake to 1,500 mg.

Not all teaspoons of salt are the same

•Most people will get more sodium than they require daily without adding any salt to their food.

Table 2,300mg sodium

Kosher 1,760mg sodium

Sea 1,570mg sodium

fine grain course grain flakey

Golden rules of food1. Build from breakfast. Break your nightly fast with a healthy

breakfast.

2. Eat the rainbow. Yellow peppers, red beets, purple cabbage.

3. Eat an apple a day. And keep going. Fruits and vegetables lower your risk of high blood pressure, heart disease, and stroke.

4. Turn over a new leaf. Make dark leafy greens, such as kale, spinach, and Swiss chard, a frequent vegetable choice.

5. Learn to love legumes. Good options are beans, lentils, peas, soybeans, and peanuts—all high in fiber, protein, iron and B vitamins.

6. Get hooked on fish. Meatless Monday, Tuna Tuesday, Sardine Saturday, Salmon Sunday. You get the idea: less meat and more fish with heart-protecting omega-3’s.

7. Correct your carbs. Pass on processed snacks, such as chips and crackers. Remember that healthy carbs are found in all plant foods and are essential fuel for your body and brain.

8. Keep grains whole. Three daily servings of whole or minimally processed grains, such as brown rice, quinoa, and bulgur, will reduce your risk of cardiovascular disease, diabetes, and obesity.

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SAVVY gRoCeRY SHoppeRS SAVe MoneY

by always going with a list (and never shopping

hungry). Commit to adding heart friendly foods to

your grocery list and checking labels when in doubt.

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•Purchase frozen fruits and vegetables in the off-season. Save fresh purchases for in-season, locally grown produce when they’re less expensive.

•Buy in bulk nuts, grains, pasta and other foods.

•Menu planning saves time and money. Work leftovers into your menus.

•Store brands are often cheaper than using coupons.

•Coupons may save money, but they often are for highly processed foods. Check labels.

•Stock up on canned goods when often-used items are on sale.

•Get your omega-3’s economically from canned salmon, sardines and herring.

•Serve lean protein as a side dish the size of a deck of cards, rather than the main event.

•Plan meals from your pantry or freezer once or twice a week.

• For snacks on-the-go, packing your own saves money.

How healthy is your kitchen?

Stock Toss 1. Oatmeal and whole-grain cereals with no more than 120 calories and at least 5 grams of fiber per serving

2. 100 percent whole-wheat bread, whole-grain crackers, brown rice

3. Canned low-sodium tomatoes and beans

4. Unsalted nuts, plant-based oils, packaged snacks with zero trans fats

5. Low-fat or nonfat dairy products

6. Whole-wheat pasta, bulgur, quinoa, barley

7. Healthier frozen dinners with whole grains, veggies

8. Peanut, almond, or cashew butters containing only nuts; low-sugar fruit spreads

9. Dried fruits, such as raisins, apricots, mangos

10. Milk, plain ice tea, coffee, water

1. Toaster pastries and cereals with more than 5 grams of sugar per serving

2. White—bread, crackers, rice

3. Canned goods with added sugar, salt and fats

4. Trans-fat-laden snacks (chips, buttery crackers); solid shortening

5. Full-fat dairy products

6. White pasta and boxed macaroni and cheese

7. High-fat and salty frozen dinners

8. Peanut butter and jams with added sugar

9. Gummy fruit snacks with artificial flavors; canned fruits with added sugar

10. Sugary drinks

Meal Planning Saves Time and Money

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ReAd tHe ReCipeS in tHiS BooKlet and find

2-4 that you’d like to incorporate into your menu

plan. Check the Kitchen Basics and the Fresh

Ingredients lists to plan what you’ll need at the

grocery store. By sticking to a list, you’ll save time

in the aisles and money at checkout, too.

Go ahead…try it, now!

Day Meal Notes

Sunday

Dinner Hearty Chicken Harvest Dinner 2 guests

Monday

Lunch

Dinner

Chicken leftoversCreamy Portobello Burgers w/Green Gusto Salad

pick up buns!

Tuesday

Lunch

Dinner

Portobello burgers w/ picklesFamily Night Fish Tacos

soccer practice

Wednesday

Lunch

Dinner

taco salad soup from freezer

working late

Sample Meal PlannerHere’s a common complaint: Eating healthy at home takes too much time.

Our answer: In just 15-20 minutes of planning every week or two, you’ll be organized for the next batch of meals. In many of our recipes, note how you can count on leftovers or purchase more of one food for another meal. There are many cook-ahead options, too. You can add or subtract ingredients to many of these recipes for dietary preferences.

Meal Planning Tips1. Incorporate just a few

new recipes each week, mixing our recipes with yours. Use what’s already in your freezer and pantry, too.

2. There’s nothing worse than leftovers going bad. So, there’s a space for lunch (M-F) as a reminder to pack leftovers in reusable containers for lunch the next day or for a fast dinner.

3. By doing this for 3-4 weeks, all you’ll have to do is rotate your menu plans on a monthly or seasonal basis. For more heart-healthy recipe ideas, go to wellfedheart.com

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1 In large saucepan, heat olive oil and sauté onion until translucent. Add mushrooms, celery and almonds. Cook 3-5 minutes.

2 Stir in barley, raisins and seasonings until barley is coated with other ingredients.

3 Add chicken broth and bring to a boil for 2 minutes, reduce to simmer for 55 minutes.

Make Mondays Meatless

1 tablespoon olive oil

1 large onion, minced

1 cup mushrooms, sliced

1 celery stalk, chopped

½ cup slivered almonds

1 cup barley or other whole grain

¼ cup raisins, golden or black

dash of salt1 tablespoon each

fresh rosemary and marjoram, minced or ½ teaspoon dried

3 cups chicken or vegetable broth, low-sodium

1 pound green beans, ends trimmed and sliced into 1-inch lengths

2 cups frozen peas2 scallions,

chopped1 orange or canned

mandarins pepper to taste

Dressing²/³ cup plain nonfat

yogurt2 tablespoons fresh

mint, chopped2 tablespoons

orange peel, finely grated

1 In a bowl, mix the orange peel with yogurt and fresh mint. Set aside.

1 Turn on broiler, set to high or 500°.

2 Heat olive oil in large sauté pan over medium heat.

3 Sauté chopped mushroom stems, onions, peppers and herbs until onions are translucent.

4 On a cookie sheet, broil mushrooms stem side down for 2-3 minutes. Turn over and broil stem side up for 3-4 minutes until liquid starts to accumulate in cap of mushroom.

1 tablespoon olive oil4 portobello mushrooms,

stems removed and chopped

1 large onion, halved and cut in ¼-inch strips

1 large yellow or red bell pepper, deseeded and cut into ¼-inch strips

1 teaspoon each of thyme and sage

4 ounces soft goat cheese, divided

Optional: lettuce and tomato, whole wheat buns

Creamy Portobello Burgers Serves 4

Sweet Barley Pilaf and Green Gusto SaladServes 6

5 Spread goat cheese in each cap and broil for 2 more minutes. Top with cooked vegetables and optional serving ideas as shown here.

Per serving: 157 calories, 8g protein, 11g carbohydrate, 10g fat, 5g sat fat, 4g mono fat, 13mg cholesterol, 3g fiber, 112mg sodium

Per serving with bun: 271 calories, 12g protein, 33g carbohydrate, 12g fat, 5g sat fat, 4g mono fat, 13mg cholesterol, 6g fiber, 318mg sodium


2 Boil green beans for 3 minutes. They should be a bit crunchy. Run under cold water to stop the cooking process, drain and put in a bowl.

3 Defrost peas under cool running water. Drain and add to beans with scallions and pepper to taste. Mix and refrigerate for 10 minutes.

4 Peel the remaining orange skin and fibers and cut into bite-size pieces.

5 Just before serving, add dressing to salad and toss. Plate and garnish with orange sections.


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1 Add first 8 ingredients in food processor and puree until well-mixed but still coarsely textured.

2 Add tomato juice and pulse once or twice to blend.

3 Warm finished gazpacho to serving temperature but DO NOT BOIL.

4 Heat olive oil in large skillet over medium heat until just starting to smoke. Sauté fish 2 minutes per side or until lightly browned. Ladle soup into bowls and gently place fish on top so it looks like it is floating.

Warm Gazpacho with Sizzling FishServes 6

1 Season fish with pepper.

2 Heat olive oil and sauté red pepper, onion, garlic and oregano. Place in a bowl.

3 Sauté fish until cooked through, then flake into small pieces.

4 Fold beans and olives into the fish and heat through. Add fish mixture to vegetables and sprinkle with lime juice.

5 To make a taco, place mixture in center of tortilla with condiments. Fold opposite sides in and roll.

Family Night Fish TacosServes 6

Love Your Omega-3’s

4 large tomatoes, quartered, deseeded and chopped (approx 3 cups)

1 large cucumber, peeled, deseeded and chopped

1 medium onion, chopped (approx 1 cup)

1 red bell pepper, chopped1 garlic clove, minced2 tablespoons chopped

fresh herbs such as basil, thyme, oregano or parsley

¼ teaspoon smoked paprika¼ teaspoon black pepper2 cups canned low-sodium

tomato juice2 tablespoons olive oil1½ pounds cod or other

thick, firm white fish, cut in 6 equal portions

Optional garnish: chopped scallions


Seasoned CookMake a double batch of gazpacho and freeze leftovers for another meal.


½ pound cod or other firm white fish

1 teaspoon black pepper1 tablespoon olive oil1 red bell pepper, sliced1 medium onion, sliced4 cloves garlic, minced1 tablespoon oregano1 15-ounce can black

beans, rinsed and drained

1 small can sliced black olives

1 tablespoon lime juice6 whole wheat or corn

12-inch tortillas, warmed in low oven

Seasoned CookTry condiments such as salsa, nonfat sour cream, shredded cabbage, diced tomatoes, sliced avocados and cilantro.

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1 Slice the greens or cut with scissors into thin ribbons. Toss together in salad bowl.

2 Add sunflower seeds, almonds and raisins to greens.

3 Put dressing ingredients in a small jar and shake until blended. Drizzle over greens, toss and serve.


6 cups greens, like kale, Swiss chard, cabbage, spinach

¼ cup toasted sunflower seeds

¼ cup slivered almonds

¼ cup golden raisins

Dressing1 tablespoon

canola oil½ tablespoon each

cider vinegar, honey, chopped mint

¼ teaspoon sesame oil

Asian Greens Ribbon Salad and Sweet Potato Shrimp CakesServes 4

¾ pound sweet potato, peeled and grated

½ pound small whole shrimp, peeled and diced

3 whole scallions, chopped

1 garlic clove, crushed

1 tablespoon fresh ginger, grated

½ teaspoon salt3 tablespoons

cornstarch3 egg whites2 tablespoons

canola oil

1 Mix first 6 ingredients in a bowl.

2 Whisk egg whites and cornstarch in a separate bowl until frothy, then add to sweet potatoes. Mix thoroughly.

Seasoned CookAssemble this dish the night before. Taste tomato sauce before using—if needed, add seasonings. Red pepper flakes are a spicy addition. Fiber content of whole wheat pasta can vary by manufacturer—check the labels.

Get Your Super Greens

12 ounces dry whole wheat pasta (fusilli or other)

3 cups tomato sauce with onions and garlic (no salt added)

2 cups sliced mushrooms

4 cups dark leafy greens like kale, spinach or Swiss chard

1½ cups shredded part-skim mozzarella cheese

Optional: 2 cups cooked, diced protein such as chicken or low-fat turkey sausage

Super Greens Pasta BakeServes 8

1 Cook pasta according to package directions, drain.

2 Preheat oven to 375°.

3 In a bowl, combine tomato sauce, mushrooms and kale with the pasta and mix. Add optional chicken or sausage if using. Add pepper to taste.

4 Pour into oven-proof casserole dish. Top with cheese and bake 20-30 minutes, until heated through and cheese is bubbly.


3 Form small patties of the mixture (about 2 tablespoons each) and place on a plate. Refrigerate 10 minutes.

4 Heat oil in a large nonstick skillet over medium-high heat. Transfer the patties to the skillet using a spatula. Cook 5 minutes per side. Drain on paper towel. Serve as shown or in lettuce leaf wraps.

Per serving: 340 calories, 20g protein, 46g carbohydrates, 8g fat, 1g sat fat, 5g mono fat, 113mg cholesterol, 3g fiber, 478mg sodium

Seasoned CookThis is a perfect make-ahead dinner. Consider doubling the recipe—it makes great leftovers.

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1 In a medium pot, bring broth and water to boil. Add lentils, garlic, black pepper and oregano. Reduce to simmer, cover and cook for 20 minutes. Drain any remaining liquid.

2 Meanwhile, in a steamer, cook vegetables until just tender.

3 Put lemon juice, oil and mustard in a small jar and shake until blended.

4 Put all ingredients, except cheese, in a large bowl and toss.

5 Sprinkle cheese on top.

Rainbow Lentil Medley Serves 4

Fortify With Fiber

2 cups broth, chicken or vegetable, low-sodium

1 cup water1 cup lentils, rinsed3-4 cloves garlic, minced¼ teaspoon each black

pepper and oregano6 cups mixed vegetables,

thinly sliced or diced, such as broccoli, squash, onion, red bell pepper, carrots

2 tablespoons fresh mint, finely chopped

2 ounces crumbled goat or blue cheese

Dressing¼ cup lemon juice2 tablespoons olive oil1 tablespoon Dijon mustard

375 calories, 22g protein, 47g carbohydrates, 13g fat, 4g sat fat, 6g mono fat, 11mg cholesterol, 19g fiber, 212mg sodium

Seasoned CookThis dish adapts to whatever vegetables are in season and whatever grains or beans you have in your pantry.


¾ pound chicken breasts, boneless, skinless

1 tablespoon olive oilOlive oil spray1 medium onion, thinly

sliced2 bell peppers, yellow or

red, sliced1 garlic clove, minced1 14-ounce can diced

tomatoes, low-sodium²/³ cup chicken stock,

low-sodium1 tablespoon each

oregano, basil1 cup canned cannellini

beans, rinsed and drained

1 Over medium heat, sauté the chicken in olive oil until golden brown. Remove from pan.

Hearty Chicken Harvest DinnerServes 4

2 Spray pan with olive oil, add onion, peppers, garlic and sauté until onions are translucent, 3-5 minutes.

3 Add tomatoes with juice and stir. Place the chicken over mixture, add stock and sprinkle with herbs.

4 Cover the pan and simmer for 30 minutes, stirring occasionally. To test when chicken is done, poke a knife in meat and juices should run clear.

5 Mash half of the beans, then add to pot and stir into liquid until sauce thickens. Add the rest of beans and simmer for 5 minutes more. Serve in bowls with green salad and crusty bread.

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No-Bake Berry Date DeluxeServes 8

No-Bake Entertaining

3 cups dates, pitted and roughly chopped

¼ cup rolled oats½ cup slivered almonds1 cup berries, such as

strawberries, raspberries or blueberries, mashed

1 cup fresh berries

1 Put almonds in food processor and pulse until finely chopped.

2 Add dates and oats and pulse until dates are finely chopped.

1 Place all ingredients in a salad bowl and mix thoroughly.

2 Make the dressing in a small glass jar and shake.

3 Pour dressing on salad, toss and serve.

Per serving: 249 calories, 9g protein, 32g carbohydrates, 10g fat, 1g sat fat, 6g mono fat, 0mg cholesterol, 8g fiber, 120mg sodium

1 cup mixed fresh herbs like basil, mint, cilantro, finely chopped

2 cups garbanzo beans (chickpeas), drained

2 cups cherry tomatoes, halved

6 black olives, pitted and sliced lengthwise

3 scallions, sliced

Optional: canned fish

Dressing2 tablespoons red wine

vinegar2 tablespoons olive oil½ teaspoon honey

Seasoned CookYou’ll love the brightness in flavors and versatility of this dish. It can stand alone, be served casually with canned fish or grilled lean protein.

Seasoned CookYou can make this dessert through Step 3 and refrigerate overnight to give the berries a chance to meld into the crust. To save money, use frozen fruit for the mash.

Herbaceous Garbanzo Bean and Tomato SaladServes 4

3 Press mixture into an 8-inch baking dish, preferably with removable sides. Top with mashed berries. Cover and set aside at least 30 minutes.

4 Before serving, top with fresh berries.


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Heart-Healthy Kitchen BasicsStarting with the ingredients below, add and subtract to create your own heart-healthy Kitchen Basics. Having a well-stocked kitchen makes shopping easier, because all you’ll need are a few fresh ingredients.

In the Pantry

Grains Barley* Brown rice Bulgur Rolled oats* Polenta Quinoa Whole wheat bread, pita

Whole wheat pasta (spiral noodles*, other shapes)

Whole wheat/rice crackers

________________ ________________ ________________

Beans/Peas (canned and dry)

Black* White (cannellini, navy)*

Garbanzo (chickpeas)*

Lentils (brown*, red, black)

Split peas ________________

________________ ________________

Nuts & Seeds (unsalted), Dried Fruit

Almonds, slivered* and whole

Flaxseeds Sunflower seeds*

Walnuts Golden raisins* (apricots, other)

________________ ________________ ________________

Canned Goods Broth, low-sodium

chicken*, vegetable*

Tomato juice, low-sodium*

Tomatoes, diced, low-sodium*

Tomato* or pasta sauce (no salt added)

Black olives* Fish (salmon, tuna, herring)

Salsa* ________________

________________ ________________

Vinegars Cider* Red wine* White wine Balsamic ______________

________________ ________________

Oils Olive oil* Olive oil spray* Canola oil* Sesame oil* ________________

________________ ________________

Seasonings Basil*, Bay leaf, Black pepper*, Cayenne, Chili powder, Cinnamon, Cumin, Curry powder, Dill, Marjoram*, Oregano*, Red pepper flakes, Rosemary*, Sage*

Salt* (kosher or sea), Smoked paprika*, Thyme*, Turmeric

________________ ________________ ________________

Other Staples Honey* Soy sauce, low-sodium

Hot pepper sauce

Ketchup Maple syrup Mustard: Dijon*, whole grain,

Baking soda Baking powder Cornstarch* Flour, whole wheat and all-purpose

Sugar (brown, white)

Vanilla ________________

________________ ________________

In the Fridge Eggs* Parmesan cheese

Milk, nonfat Yogurt, nonfat* Butter, unsalted Lemon and lime juices*

Lean protein ________________

________________ ________________

In the Freezer Edamame Green beans Mixed vegetables Peas* Berries* Homemade broth

Lean protein ________________

________________ ________________

Produce Basics

Onions* Garlic* Seasonal fruit Seasonal vegetables

________________ ________________ ________________

Fresh IngredientsRead each recipe and check to make sure you have the basic ingredients in stock. This list will tell you what fresh items you’ll need.

Creamy Portobello Burgers

4 ounces goat cheese 4 portobello mushrooms 1 yellow or red bell pepper (optional) lettuce, tomatoes, whole wheat buns

Barley Pilaf 1 stalk celery 1 cup mushrooms, sliced

Green Gusto Salad 1 pound green beans 1 orange (or canned mandarins) scallions yogurt, plain

Warm Gazpacho with Sizzling Fish

1 ½ pounds cod 1 cucumber 1 red bell pepper 4 tomatoes (optional) scallions

Family Night Fish Tacos ½ pound cod 1 avocado 1 bunch cilantro ½ cabbage 1 red bell pepper 1 tomato nonfat sour cream 6 12-inch whole wheat or corn tortillas

Asian Greens Ribbon Salad

6 cups dark leafy greens fresh mint scallions

Super Greens Pasta Bake

4 cups dark leafy greens 2 cups mushrooms, sliced 1 ½ cups shredded part-skim mozzarella cheese

(optional) 2 cups diced protein (chicken, turkey sausage)

Sweet Potato Shrimp Cakes

½ pound small whole shrimp (bay or Oregon)

¾ pound sweet potato scallions ginger

Rainbow Lentil Medley 6 cups mixed vegetables (broccoli, squash, red bell pepper, carrots)

2 ounces goat cheese mint

Hearty Chicken Harvest Dinner

¾ pound boneless, skinless chicken breasts

2 bell peppers, red or yellow

Herbaceous Garbanzo Bean and Tomato Salad

1 cup mixed fresh herbs (basil, mint, cilantro)

2 cups cherry tomatoes scallions (optional) flank steak, chicken

No-Bake Berry Date Deluxe

2 cups berries (strawberries, raspberries, blueberries)

3 cups pitted dates

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p. 22

p. 23

p. 25

p. 24

p. 25

p. 26

p. 27

p. 28

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*Item used in the recipes in this booklet

Family Health

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Play defense against diabetesChildren and teenagers are being diagnosed with Type 2 diabetes at increasing rates. Diagnosed at young ages, they’re at greater risk for developing heart disease. So feed them a healthy diet and keep them active.

Make healthy living child’s playHealthy habits should be a family affair and with good reason. Children learn what they live. These five approaches will help them live well:

Make snacks fun!Whether it’s after school or before soccer practice, growing bodies are hungry ones that call for quick healthy snack choices rather than empty calories. Get rid of the junk food and sugary drinks. Instead, fill the pantry and fridge at eye level with the fixings for these fun and kid-friendly alternatives:

HAVe A FAMilY Meeting

to map out everyone’s role

in healthy living. Discuss

menu planning and exercise

options. When everyone

plays a part, everybody wins.

•Frozen red and green grapes

• Sliced peaches •Kiwi cups

•Crisp apple wedges

•Veggie sticks

•Celery sticks with peanut butter

•Hard boiled eggs•A handful of nuts and dried fruit

•Frozen berries and yogurt

1. Play together. Find time for family games, swimming, or after-dinner walks. Children six and older need at least an hour a day of physical activity, and adults need at least 150 minutes per week.

2. Replace screen time with activity. Do your kids a favor: limit all screen time (TV, computer, video games) to less than two hours per day and none in the hour before bed. Keep video games active to get kids moving.

3. Follow their lead. Organized sports are a great way to stay fit, but they aren’t the only options. Let your child’s interests guide you—hike to collect leaves for an art project; head to a playground; or walk to the library.

4. Stamp out smoking. We know that the children of smokers are nearly twice as likely to become smokers themselves. Give yourself and your children a gift—quit now.

5. Drive by the drive-thru. Happy Meals aren’t healthy meals. If fast food is a must, forego the fries, and opt for milk rather than soda.

Physical Activity

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Be ACCoUntABle FoR YoUR exeRCiSe plAn.

Today start keeping a journal, so you’ll have

a permanent record of your progress and

your goals.

Strength training: It’s worth the weightA vital part of any fitness effort, strength training can reduce body fat, increase lean muscle, and burn calories more efficiently. Resistance moves build endurance, strength and balance, using your own body weight, free weights, stretchable bands, or weight machines. Gym memberships aren’t necessary. At home, canned goods can serve as free weights. Push-ups, abdominal crunches, and leg squats are great resistance exercises.

Fire up your metabolismHow fast your body burns calories depends on genetics, gender (men burn more calories than women), and age (it slows steadily after 40). But fear not, there are ways to jump start your metabolism, helping your body to burn calories faster.

Move it: so many reasons why Once you know the inside-and-out benefits of exercise—physical and mental gains!—you’ll lace up your tennies and get to it. Which of these will be your life changer?

•Boost immune system

•Maintain a healthy weight

• Improve mental health

•Sleep better

•Develop new brain cells

•Ease chronic back pain

•Increase flexibility and endurance

•Prevent osteoporosis

•Prevent cardiovascular disease

•Lower cholesterol

•Promote better blood pressure

•Reduce stroke risk

•Live longer

•Boost your cardio! Physical activity—especially high-intensity aerobic exercise—is one of the best ways to kindle your metabolism.

•Muscle up. The more muscle and less fat you have, the more calories you burn.

•Water, water everywhere. Getting dehydrated—even mildly—slows your metabolism. Drink water before eating and throughout the day. Beverages on ice help the body burn more calories.

•Eat! Eating fewer than 1,200 calories per day makes it more difficult for your body to burn calories. Having a small meal or snack every three to four hours actually burns more calories.

•Protein power. More calories are burned digesting protein than fat or carbs. Aim for lean meats, tofu, beans, eggs, and low-fat dairy products.

Not

hing

Esc

apes

the

Hea

rt.

Many seemingly unrelated conditions affect heart health, too. Here are just a few of them:

•Diabetes This disease ratchets up your risk for heart disease three-fold. If you have diabetes, manage it carefully with your doctor. If you’re pre-diabetic, lose excess weight and adopt a healthy lifestyle to reduce your risk.

•Obesity Excessive weight causes blood lipid levels to rise, which in turn raises triglycerides and “bad” LDL cholesterol, and lowers “good” HLD cholesterol; all of which speeds up plaque buildup in your arteries. Take heart: even losing as little as 10 pounds can help lower your blood pressure. Visit www.FranciscanWeightLoss.org.

•Obstructive Sleep Apnea (OSA) A condition in which people unknowingly stop breathing

several times a night, OSA is a riskfactorforatrialfibrillation,or arrhythmia. Treating OSA appears to reduce recurrence

of arrhythmia—and in turn helps prevent heart failure or stroke.

Visit www.FHShealth/sleep.

For more information about conditions that can affect your heart health, visit our award-winning health library at www.FHShealth.org/healthinfo.

For help finding a Franciscan primary care or specialty physician or professional provider, visit www.FranciscanDoctors.org or call our free physician referral service at 1 (888) 825-3227. Se habla español.

The Big Picture•Be a good role

model: Don't just talk the talk—walk the walk.

•Break a sweat: You don’t have to be an athlete, but get off the couch.

•Clean up your kitchen: Fill your pantry with foods that nourish.

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Making big changes can be daunting, but little ones don’t have to be. Consider doing one small thing per week to boost your heart health.

Small Changes, Big Gains

1. Get seven or more hours of sleep each night.

2. Keep up with regular health screenings.

3. Eat more fresh, unprocessed foods.

4. Learn how to read the Nutrition Facts on food and beverage products.

5. Shop with a food list; make sure heart-friendly foods are on it.

6. Involve all family members in menu planning and exercise.

7. Keep an exercise journal— with goals—so you can track your progress.

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Ready to quit?Freedom from Tobacco Support GroupSt. Joseph Medical Center, Tacoma, Dining Room 1 on Thursdays, 7 p.m.

Free, no registration required; just come! Call for more information: (253) 426-6746.

Want to lose weight? Franciscan Center for Weight Management• Weight Loss Surgery Full range

of surgical options, including gastric bypass and adjustable gastric bands, helping patients reduce and manage their weight for life and lower the risk of chronic health problems.

• Back On Track For those who have had bariatric surgery and gained weight. Goal setting, nutri- tional education and group activities help you get “Back on Track.”

Learn more about our ASMBS Bariatric Surgery Center of Excellence at St. Francis hospital: FranciscanWeightLoss.org

Free blood pressure checksMonitor your blood pressure between doctor visits at our Heart Check Center™ kiosks located at area shopping malls:• Commons Mall, Federal Way• Tacoma Mall, Tacoma• South Hill Mall, Puyallup

Support Groups• WomenHeart of Pierce County WomenHeart is run by heart

event survivors. The group is open to women with any type

of heart disease and supports their spiritual, emotional and educational needs. Visit www.womenheart.org or contact Tina Blackett at [email protected], (253) 426-4456.

• A.W.A.K.E. Support Group The “Alert Wakefulness and Keeping

Energetic” (A.W.A.K.E.) supports Continuous Positive Airway Pressure (CPAP) wearers and their families, and covers topics related to obstructive sleep apnea. For more information, call (253) 985-6951.

Our Franciscan Family Offers Yours All the Help You Need for a Heart-Healthy Life.

Know your health risk — three simple steps to save your life

1. Learn Your Health Risk Takeafree,confidential,onlinehealth risk assessment.

2. Listen to Your Health Risk If eligible, attend the free clinical screening where you’ll hear what steps you need to take to improve your health.

3. Live and Manage Health Risks Follow the clinical recommen-da tions and visit your doctor for a longer, healthier life!

HeartAwareHalf who die of heart attack had no warning — or did they?

StrokeAwareKnow and reduce your risk of the #1 disabling disease in America.

VascularAwareLeg pain? Maybe your muscles are oxygen hungry.

SleepAwareTired all the time? Find out why!

CancerAware - BreastOne in eight women will get it — what’s your risk?

CancerAware - LungLung cancer is not just for smokers. What’s your risk?

DiabetesAwareEarly detection can lower your risk of complications from diabetes.

BladderAwareAfraid to laugh, cough or sneeze? There is help!

Take our free, online health risk assessments at www.KnowMyHealthRisk.org.

Take nutrition up a notch!

• Franciscan Outpatient Nutrition Education Center Individual

nutrition counseling, body composition analysis and more. Call (253) 426-4926.

• Healthy Heart Nutrition Series Covers types of fat, label reading, recipe substitutions, strategies for dining out and more.

Call 1 (888) 825-3227.

Dealing with diabetes?Certifiededucatorshelpyoumanage diabetes and live well. Call (253) 426-6753 or visit www.FHShealth.org.

FREE Franciscan Health eNewsYou tailor topics to your health needs and interests. Subscribe today at www.FHShealth.org/eNews.

38 39

CARDIOLOGISTSFranciscan Heart & Vascular Associates

Tacoma (253) 627-1244 William Bilnoski, MD, FACC

Raed Fahmy, MD, FACC

Amrit Guptan, MD, FACC

Timothy Larson, MD, FACC

Theodore Lau, MD, FACC

Rosemary Peterson, MD, FACC

R. Antonio Secaira, MD

Patti Aramburu, ARNP

Ashley Kauzlaric, ARNP

Michelle Williams, ARNP

Auburn & Federal Way (253) 939-1230 Venkatesh Kandallu, MD

Robert Middleton, MD

Patrick Reagan MD, FACC Federal Way only

Daniel Wuthrich, MD

Ming Zhang, MD

Kevin Zhou, MD

Sandra Hughes, ARNP Federal Way only

Gig Harbor (253) 627-1244

William Bilnoski, MD, FACC

Raed Fahmy, MD, FACC

Timothy Larson, MD, FACC

Theodore Lau, MD, FACC

Lakewood (253) 627-1244 Timothy Larson, MD, FACC

Rosemary Peterson, MD, FACC

R. Antonio Secaira, MD

Enumclaw Medical Center (360) 802-5760 Jeffrey Rose, MD, FACC

VASCULAR SURGEONSFranciscan Vascular Associates

Tacoma (253) 382-8540 Lab service on site

Todd Kihara, MD

Ramandeep Sidhu, MD

Jennifer Barnett, ARNP

Pamela Charboneau, ARNP

Federal Way (253) 833-8032 Lab service on site

John Diaconou, MD

Omar Dorzi, MD

Lakewood (253) 985-6160 Omar Dorzi, MD

Gig Harbor (253) 530-2620 Lab service on site

Omar Dorzi, MD

Auburn (253) 833-8032 John Diaconou, MD

Enumclaw (253) 833-8032 Lab only

CARDIOTHORACIC SURGEONSFranciscan Cardiothoracic Surgery Associates

Tacoma (253)-272-7777 Nyen Chong, MD, FACS

Craig Hampton, MD, FACS

Susan Hecker, MD, MPH

G. Gilbert Johnston, MD, FACS

Baiya Krishnadasan, MD, FACS

John Luber, MD, FACS, FACC

Federal Way (253) 944-4186 Nyen Chong, MD, FACS

Gig Harbor (253) 530-2939 Nyen Chong, MD, FACS

OTHER FRANCISCAN HEART CENTER SERVICESCardiac Rehabilitation(253) 426-6768

Heart Failure Clinic(253) 627-1244

Heart Valve Clinic(253) 426-6700

Franciscan Heart Center. It’s Everywhere You Find Franciscan.

40 41

F r a n c i s c a n H e a r t c e n t e r

Franciscan Heart center services:

Cardiology

Heart, thoracic and vascular surgery

Minimally invasive surgery

Advanced imaging and diagnostics

Interventional catheterization

Heart failure clinic

Cardiac rehabilitation

Heart disease affects the whole family. For peace of mind, take our free online

evaluation today.

Franciscan Heart Center St. Joseph Medical Center 1717 S. J Street Tacoma, WA 98405

For advanced medicine and trusted care, cHoose Franciscan.

Seven minutes online with Franciscan HeartAware could save your life.Most people at risk for heart disease don’t know it. For

half of them, their first symptom will be a heart attack.

Heart disease can often be predicted – and prevented.

Take the Franciscan HeartAware online evaluation today.

If you are not at risk, you’ll have peace of mind. If you

are at risk, you can get a FREE heart health screening

appointment at Franciscan Heart Center.

take your Franciscan Heartaware evaluation at

www.HealthyHeartcheck.org today.

++

Franciscan Heart Center's Heart Health! booklet

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Transcript of Franciscan Heart Center's Heart Health! booklet