The Ten Dimensions of Wellness from an Aging Well Perspective (Podcast)

Have a listen to my interview with Dr. Andrea Wilkinson on the BrainShape Podcast, “Flourish or Fade with Angela Gentile.” Episode #121.

It was fun being a guest for the second time with Dr. Andrea. My book, Flourish or Fade: A guide to total well-being for women at midlife and beyond is available on Amazon. For more information on Dr. Andrea, please check out her website, https://www.brainshape.ca/ I hope you enjoy the interview!

Angela G. Gentile, MSW, RSW

Book News: Updates and a New Book

I have been working on my books and I have two updates and one new book to tell you about.

Now in hardcover: “Flourish or Fade”

My newest book, “Flourish or Fade: A guide to total well-being for women at midlife and beyond” (2021) is now available in hardcover! This is the first book that I have been able to make into a hardcover version. Amazon had approached me to see if I would be interested in trying out this new feature they were offering, so I took them up on it. Let me know if you decided to get a copy of it in hardcover. I would love to know what you think.

Paperback updated for 2021: “Caring for a Husband with Dementia”

I have updated the paperback version of “Caring for a Husband with Dementia” for 2021. I have taken out some links that no longer worked. Many of the links were from the “Alzheimer’s Reading Room” which has been removed off the internet. I have also added a reference to a book by Marie Marley and Daniel C. Potts which has a lot of the information that was in the links which have been removed. Their book is called, “Finding Joy in Alzheimer’s: New Hope for Caregivers” (2015).

Temporary cover: “Caring for Someone with Cognitive Decline”

I have completely revised, updated, and expanded my book on dementia caregiving to create a new book, “Caring for Someone with Cognitive Decline: Information, tips, and support for caregivers” (2021). It’s reasonably priced at $12.95 USD (eBook is $3.95 USD). This book was a project I had been wanting to do for a long time. I had been told the original book, “Caring for a Husband with Dementia” was suitable for all caregivers. After working with many people with dementia and their families, I felt it was time to complete this book project. The book is now available on Amazon, however, the cover is only temporary. I am currently in the process of seeking a new book cover design, so if you have any ideas, please let me know!

Angela G. Gentile, MSW, RSW

Cycling to Work for 30 Years

27 Apr 2021

My husband, Agapito, has been cycling to work for the past 30 years. He remembers back in 1991 when he made the decision to ride his bike to work. We were married in 1990, and that winter we had moved into our first house. He had started taking the bus to work, but he found he didn’t like the public transit system. So, he started riding his bike. He never looked back.

Spring 1992. No helmet!
30 Nov 2020

He rides in all kinds of weather. Winnipeg winters can be brutally cold.

26 Jan 2021

His face covering gets all frosty in the cold weather. The winters are hard on bikes and he figures he went through about 7-8 so far. He has always bought used bikes.

04 Dec 2014 – “Tip of the day: Lots of free, all-day parking all over the city, even downtown.” 
04 Sep 2015 – “Got a bit of rain on the commute home. Managed to keep all my valuables dry under the garbage bag.”

He rides rain or shine!

I wonder how long he will continue to ride his bike?

27 Dec 2021

Congratulations on 30 years of cycling, Agapito! I wish you many more years of riding your bike.

Angela G. Gentile

Flourish or Fade: A guide to total well-being for women at midlife and beyond – Book Now Available

Angela Gentile’s newest book is now available for purchase from Amazon.

A perfect Mother’s Day gift for Mom (Sunday, May 9, 2021).

>>>Buy the Paperback on Amazon ($16.99 USD) 

>>>Buy the ebook (Kindle) on Amazon ($5.99 USD)

Join us at the Zoom Book Launch during National Women’s Health Week,

on Tuesday May 11, 2021 at 8:00 pm CST.

A recording on YouTube will be available if you are unable to attend the live event.

WIN PRIZES!

TAKE CHARGE OF THE WAY YOU AGE

Flourish or Fade: A guide to total well-being for women at midlife and beyond provides you with the information and tools needed to improve life satisfaction. The Flower of Wellness Method will help you devise a plan to balance your body, mind, and soul. 

You will learn how to enhance your overall well-being by exploring the ten dimensions of wellness: 

Physical, Emotional, Brain, Social, Sexual, Spiritual, Environmental, Recreational, Financial, and Occupational.

This anti-ageist, realistic, and optimistic approach to life in the middle years and beyond will provide you with inspiration and tips that will have you feeling confident, happy, and satisfied with whatever may come your way. 

The Flower of Wellness Method is a fresh and contemporary approach to finding balance.

Do you want to flourish or fade in the later years? It’s your choice. 

Angela G. Gentile, M.S.W., R.S.W., is a registered clinical social worker/specialist in aging with more than 25 years of experience working with older adults and their families. She was born and raised in Ontario and now lives in Winnipeg, Manitoba.

www.AngelaGGentile.com

“Flourish or Fade” Book Launch Giveaways and Contest Details

Celebrate National Women’s Health Week with us! On May 11, 2021, at 8:00 pm CST, Angela G. Gentile will be hosting a Zoom book launch for her newest book, “Flourish or Fade.” Register on Eventbrite to attend. There are a number of awesome books, services, and products that have been donated by some amazing women to help make this book event special. Please see the list below and enter to win! (see Contest Details below).

Flourish or Fade

1. Angela G. Gentile: “Flourish or Fade: A guide to total well-being for women at midlife and beyond” (paperback, $21.00 CAD value). Now available!

BrainShape Accountability Calls

2. Dr. Andrea Wilkinson: BrainShape Accountability Calls ($300.00 CAD value)

“Free Phase II Accountability Calls with Dr. Andrea of BrainShape” ($300 CAD value)

Accountability Appointments take place via TWO 60-minute video calls. 

CALL 1: Discuss your concerns and struggles + build a plan to help you address them (e.g., sleeping difficulties, chronically stressed, low energy, lacking mental focus, etc.) Whatever the problem, let’s talk about it & build a plan you can implement right away. 

CALL 2: Accountability Appointment to check-in on the goals you set out in Call 1.

The winner of the BrainShape Services prize will book their INITIAL CALL by visiting www.BrainShape.ca/call and book a time in Dr. Andrea’s calendar. This is a free offering of the supportive elements provided inside the Brain Vitality Blueprint, and helps people take the first step towards improving their health and well-being. 

How I Made a Huge Mess of My Life

3. Billie Best: “How I Made a Huge Mess of My Life” (paperback, $12.99 USD value)

https://billiebest.com/

The World Came to Us

4. Molly Duncan Campbell: “The World Came to Us” (paperback, $12.99 USD value)

http://mollydcampbell.com/

The Playground of Possibilities Card Deck

5. Kay Ross: “The Playground of Possibilities” (card deck, $20.00 USD value)

This card deck is a self-help, personal-development tool with 52 questions for you to ask yourself. Every question starts with “What would be possible for me if I…?”, to prompt you to let go of your old, limiting thoughts, beliefs and stories about yourself and the world, choose more useful ones, take inspired action, and improvise more resourceful, joyful ways of being. Kay was born in Scotland, grew up in Australia, and has lived in Hong Kong for 27 years. She’s passionate about personal development and healing, and is also an improv performer. The deck costs $20 USD plus postage from Hong Kong (the full amount depends on the number of decks ordered and the destination).  

https://playgroundofpossibilities.com/card-deck/

Seize the Moment!

6. Camille Goscicki, of Vitalaging4women, “Seize the Moment! A Guide to Living in the Present” (ebook, $4.99 USD value)

Do you live with regrets from the past, and fear the unknowns of the future?

It’s time to let go of fears and regrets and live for today. Seize the Moment! is your mini-guide to grab the present moment and live for today. It includes three bonus worksheets that will help you become more mindful. (Everyday mindfulness tips, practicing mindfulness, and becoming present for peace of mind.) Note: eReader not included.

https://www.vitalaging4women.com

The Unexpected Journey of Caring

7. Donna Thomson: The Unexpected Journey of Caring (hardcover book, $39.00 CAD value).

“The Unexpected Journey of Caring: The Transformation From Loved One to Caregiver” by Donna Thomson and Zachary White, PhD with a foreword by Judy Woodruff (Rowman & Littlefield, 2019) Available at all online booksellers Hardcover – $39.00 CAD)

With a foreword by Judy Woodruff, The Unexpected Journey of Caring is a practical guide to finding personal meaning in the 21st century care experience.

Personal transformation is usually an experience we actively seek out—not one that hunts us down. Becoming a caregiver is one transformation that comes at us, requiring us to rethink everything we once knew. Everything changes—responsibilities, beliefs, hopes, expectations, and relationships. Caregiving is not just a role reserved for “saints”—eventually, everyone is drafted into the caregiver role. It’s not a role people medically train for; it’s a new type of relationship initiated by a loved one’s need for care. And it’s a role that cannot be quarantined to home because it infuses all aspects of our lives.

Caregivers today find themselves in need of a crash course in new and unfamiliar skills. They must not only care for a loved one, but also access hidden community resources, collaborate with medical professionals, craft new narratives consistent with the changing nature of their care role, coordinate care with family, seek information and peer support using a variety of digital platforms, and negotiate social support—all while attempting to manage conflicts between work, life, and relationship roles. The moments that mark us in the transition from loved one to caregiver matter because if we don’t make sense of how we are being transformed, we risk undervaluing our care experiences, denying our evolving beliefs, becoming trapped by other’s misunderstandings, and feeling underappreciated, burned out, and overwhelmed.

Informed by original caregiver research and proven advocacy strategies, this book speaks to caregiving as it unfolds, in all of its confusion, chaos, and messiness. Readers won’t find well-intentioned clichés or care stereotypes in this book. There are no promises to help caregivers return to a life they knew before caregiving. No, this book greets caregivers where they are in their journey—new or chronic—not where others expect (or want) them to be.

“Nobody grows up planning to be a caregiver, but many of us will become one and sometimes when we least expect it. Thomson and White bring powerful insights to help understand what it means to be a caregiver and how to truly support those of us who will travel this unexpected journey.” – Samir K. Sinha, director of geriatrics, Sinai Health System and University Health Network, Toronto; health policy research director, National Institute on Ageing

www.donnathomson.com 

Keeping it Together

8. Eleanor Silverberg: “Keeping it Together: How to Cope as a Family Caregiver without Losing Your Sanity” (paperback, $20.00 CAD value)

https://www.eleanorsilverberg.com/kit-book

I Could Be Wrong

9. Billie Best: I Could Be Wrong (paperback, $7.99 USD value)

https://billiebest.com/

Contest Details:

  • Contest open to adults aged 18+, worldwide. No purchase necessary.
  • Identify which prize(s) you would like to win. Submit the item name/number, your name and email address to Angela at caretoage@gmail.com. (Your name and email address will not be given out to anyone else, unless it is required in order for you to obtain your prize(s)).
  • One entry per person, per item.
  • Entries accepted from Wednesday April 21, 2021 at 5:00 pm CST until Saturday May 15, 2021 at 12:00 noon CST.
  • Winners will be drawn on or before Sunday May 16, 2021 at 12:00 noon CST.
  • Qualified winners will be notified by email and your mailing address will be required so we can ship you your prize.
  • Every attempt will be made to get your prize to you, however, in the unfortunate event there are restrictions in your country, you will be ineligible. In that case, another draw will be made to seek a suitable winner.

Good luck!

Angela G. Gentile, MSW, RSW

www.angelaggentile.com

Addicted to Anti-Anxiety or “Nerve” Pills — Benzodiazepine use disorder and what to do about it

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Image by Pete Linforth from Pixabay

Many people, especially women, develop feelings of anxiety and worry. Some call it “bad nerves.” This predisposition to feeling anxious can cause problems with everyday living, coping, and sleeping. I have assessed and interviewed many older people with a range of problems with anxiety. Feeling anxious is a completely normal reaction to stress or a situation where you may feel fearful. However, being in a continuous state of feeling afraid can cause problems both mentally and physically. Some say they feel like they are “trembling inside.”

Anti-anxiety medications (also known as “nerve pills”) are used by many people. These pills come from the family of “benzodiazepines.” Some of the commonly prescribed anxiolytics in Canada or the United States include (but not limited to):

  • Clonazepam (Rivotril)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)

A commonly prescribed non-benzodiazepine that acts like one is Zopiclone (eszopiclone in the USA). It is commonly used as a “sleeping pill.”

Generally, benzodiazepines end in “pam” or “lam.” Use of these medications can initially improve symptoms by offering a sedating effect, however, they can also be addictive. Side effects of these drugs include increasing the risk of cognitive impairment, confusion, delirium, falls, fractures, drowsiness, and motor vehical accidents. They are not recommended for use by older adults. In fact, older people are recommended to gradually reduce their dosage (a slow and steady decrease is recommended over a sudden discontinuance due to withdrawal symptoms). Always talk to a doctor about any changes to your medication. As the dose is gradually reduced and preferably stopped, it is important to identify and optimize alternatives to managing any underlying issues. These alternatives are preferably not other medicines.

Sometimes these medications are used on an “as needed” basis. For example, if you are afraid of flying, and you need to go on an airplane, you can take one of these medications (prescribed by your doctor) to use in specific situations. Or, if you have claustrophobia and you need to go for a scan such as an MRI, taking this medication may make it more bearable.

I have also seen where these medications are prescribed for help with sleep. People who have an anxiety disorder may be prescribed this classification of medications to see if it helps reduce anxiety or panic attacks. In older people, antidepressants are the preferred class of medications to help with anxiety.

Some other key tips to remember:

  • Avoid taking benzodiazepines with opioids or alcohol.
  • These medications are more often prescribed to women (Almost 1 in 5 Canadian women report to have used in the past year).
  • Almost 1 in 10 Canadians in Quebec have been reported to have an addiction to benzodiazepines.
  • If a benzodiazepine addiction is present, consider there may also be other substance use disorders or behaviours present (e.g, alcohol, opioids, marijuana, gambling).
  • If you are older, it’s best not to start taking benzodiazepines.
  • If the addiction is getting worse, an admission to a treatment facility may be necessary.

If you are finding yourself feeling “addicted” or “dependent” on these medications (or other substances or behaviours), you are “craving” these drugs, or you are needing to increase your dosage, you may want to see your doctor to discuss alternatives. Reducing the risk of harm is key.

For more details, The Canadian Coalition for Seniors Mental Health has published the Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults (2019) and is found online: https://ccsmh.ca/wp-content/uploads/2019/11/Benzodiazepine_Receptor_Agonist_Use_Disorder_ENG.pdf

Angela G. Gentile, MSW, RSW

Low-Risk Alcohol Usage Guidelines for Older Adults – Know your limits

depth of field photography of woman in pastel color sleeveless shirt and white sunhat

Photo by bruce mars on Pexels.com

Most adults enjoy drinking alcohol on occasion. Sometimes, though, this occasional drink turns into a daily habit. One drink turns into two or more. If a person is not mindful, this habit could turn into an addiction. Addiction is also known as dependency or substance use disorder.

People can become addicted to not only alcohol but drugs, including prescription drugs (such as benzodiazepines and opiates). For example, nicotine, the drug found in cigarettes, is very addictive. Addictive behaviour can also be problematic, as in gambling, sex, or online gaming.

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives. – American Psychiatric Association, retrieved 03 Dec 2019.

For a number of reasons, it is essential to keep in mind that as we age, it is recommended we reduce our consumption of alcohol. For adults aged 65 and older, it is important to be aware of the low-risk guidelines.

Canada’s Low-Risk Guidelines (DrinkSense for Seniors) which is provided by the “Canadian Centre on Substance Use and Addiction”, states that limits for adults (not older adults) who drink alcohol should be 10 drinks a week for women with no more than two per day, and 15 drinks a week for men with no more than three drinks a day on most days. There is no specific limit for older adults, but one of their “Safer Drinking Tips” includes the advice of “Always consider your age, body weight, and health problems that might suggest lower limits.”

standard-drink-picture_0

Standard Drink Portions:

      • Beer – 341 ml (12 oz.) of 5% alcohol content
      • Wine – 142 ml (5 oz.) of 12% alcohol content
      • Cider/Cooler – 341 m. (12 oz.) 5% alcohol content
      • Distilled alcohol/80 proof liquor (rye, gin, rum, vodka, etc.) – 43 ml (1.5 oz.) 40% alcohol content

Note: Not all wines are created equal. Some wines start at 5% alcohol content, some go as high as 18%!

I attended an “Aging and Addictions” course in November 2019 which was held by the Addictions Foundation of Manitoba, and they supported the drafted recommendations entitled “Prevention: Low-Risk Drinking Guidelines” for those 65 and older (noted below).

Low-Risk Drinking Limits (65+)

    • Women: No more than 1 standard drink per day, with no more than 5 drinks in total per week.
    • Men: No more than 1-2 standard drinks per day, with no more than 7 per week in total.
    • Non-drinking days are recommended every week.

Source: Canadian Coalition for Seniors’ Health. Canadian Guidelines for Older Adults. Prevention, Assessment, and Treatment of Alcohol Use Disorder, 2019.

These drafted guidelines are more in line with what I would recommend. I have seen what alcohol dependence can do to people and it is heartbreaking. And as noted in a previous post here on my website, to help preserve cognitive health, experts recommend no more than 2-4 drinks per week (see my Memory Rescue book review.)

For those who have a drinking problem, there is often stigma and shame attached. Many people can’t abstain or reduce their drinking behaviour on their own (harm reduction) and need help. If you or someone you know has a drinking problem, addiction or dependence, please contact the Addictions Helpline in your area.

> Addictions Helpline Canada 

> Addictions Helpline USA

AA 12-Step (https://www.aa.org/) or Smart Recovery (https://www.smartrecovery.org/) are peer support options to consider as well.

If you are considering getting on top of your drinking problem and need someone to talk to, please contact me and I can assist you in finding the help you need.

Angela G. Gentile, MSW, RSW

References:

https://www.psychiatry.org/patients-families/addiction/what-is-addiction

https://amho.ca/wp-content/uploads/Mon-300pm-IP1-3a-Older-Adults-with-Alcohol-Related-Problems-Best-Practice-Guidelines.pdf

https://www.canada.ca/en/health-canada/services/substance-use/get-help/get-help-problematic-substance-use.html

https://www.samhsa.gov/find-help/national-helpline

https://www.aa.org/

https://www.smartrecovery.org/

https://www.drinksenseab.ca/drinksense-tips/seniors/

https://ccsmh.ca/alcohol-guidelines/

“A Standard Drink” image source: https://studentaffairs.lehigh.edu/content/what-standard-drink

My Low-FODMAP Elimination Diet Experience to Treat Irritable Bowel Syndrome

 

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Pasta with garlic bread. Off-limits for people with GOS sensitivity

Normally I don’t like to share my personal stuff here on the World Wide Web, however, once in a while I come across something that I think, if I share this with the world, maybe, just maybe, it will help someone else. In this article, I want to share with you my very personal (and embarrassing) experience with irritable bowel syndrome (IBS), and a way to help diagnose and manage further episodes of diarrhea and stomach upset.

My “tummy troubles” started when I was in my early 20’s. I was in university and I remember having cramps and diarrhea that would seem to come out of nowhere. Sometimes it was worse when I felt stressed, but it usually took me by surprise. I usually had little warning and a short amount of time before I needed to relieve myself. It was embarrassing, and I remember once when I was working with Home Care, I had to use a client’s bathroom. Another time, I had to cancel a support group I was running because I was suddenly taken over by vomiting and diarrhea.

The doctor I saw at the time recommended I have a colonoscopy to determine if there was anything going on such as colitis. The results came back as “minor irritable bowel syndrome.” I am not sure how that was determined, but for me, it was more than minor. I had also been tested for celiac disease (gluten allergy), and that test came back negative.

Fast forward to 30 years later, plus a bout of chemoradiation for anal cancer, I was really desperate to figure out how to control this irritable bowel. My sphincter muscles are no longer as strong or healthy as they used to be (imagine your bum being put into a microwave oven and fried!) so my IBS symptoms are much more concerning. The control I had before is now at half the strength it used to be (I’ve never lost control, thank God!).  I asked my doctor once again for a referral to a specialist, this time to a gastroenterologist (GE).

I saw the GE in April 2019. He recommended I go on a low-FODMAP diet. He told me about a mobile app I could use on my phone. He then said he would schedule a flexible sigmoidoscopy and a biopsy for microscopic colitis. He also took a blood test to check for celiac disease.

When I went home, I looked up low FODMAP. I had heard of this before, but I was not totally sure what it was. I came across the Monash University in Australia and found out they have done a lot of work in the last 12 years on helping people manage their IBS. They had an app that cost around $10 CAD, and from the reviews I had read on it, it was something I felt I could really get some good use out of.  I purchased it and never regretted it. It is something I use regularly. I can look up things for my friends, too!

FODMAP (pronounced “fawd-map”) stands for a group of carbohydrates found in foods – Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. Many people (about 10-15%) find these types of ingredients hard to digest, therefore, causing an abdominal upset. These symptoms include abdominal pain, bloating, gas, nausea, diarrhea, constipation, and could include a combination of any or all of these. For me, it can get so severe, that I also vomit. This may be too much information for some of you, but unfortunately at times, when I am having a bad “attack,” my body expels my stomach and bowel contents at the same time. I have it “coming out of both ends.” It is very quick and short-lived. I feel better soon after these attacks. So, I get it pretty bad sometimes.

The low-FODMAP process includes eliminating all foods that have the FODMAP irritants until all symptoms noted above are gone. The foods fall into different categories: Fructose, Lactose (many people are lactose intolerant), Mannitol, Sorbitol, GOS, and Fructan. This process can take two to six weeks. For me, it only took a couple of weeks. My family was very supportive and I avoided eating out. Once symptoms are under control, then you start reintroducing each of the foods to see if it triggers a response. There are “safe serving sizes” for each food that are very helpful.

For me, it turns out I am sensitive to GOS –- Galacto-oligosaccharides. These are found in foods such as nuts, beans, legumes, wheat, and grains. I found out quickly that I can only handle 8-10 pistachios or almonds at a time and I need to wait a few hours between having these foods again, in fear of “stacking” and causing an attack.

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All those years I thought I was eating healthy (12-grain bread, almonds, cashews, pistachios, legumes, etc.) turned out to be one of the worst things I could be doing for my body. Thirty years of suffering, not understanding why I was having so much trouble. One time I remember calling a restaurant to say I was sure I had food poisoning. Looking back now, it was probably just an IBS attack.

By June of 2019 (two months later) I was feeling I had a handle on my diet. I had also seen a dietician for nutrition counselling, and I had a Nutrigenomix DNA test to help me personalize my dietary approach. I had also started intermittent fasting and tried out the ketogenic diet for a bit.

Overall, the low FODMAP diet and Monash University FODMAP Diet app changed my life, for the better. Every once in a while I have an upset, and I go to the app or I find out what the ingredients were in a meal I ate. I am still learning as I go, and unfortunately, durum wheat semolina pasta with a side order of brioche garlic bread is the equivalence of dynamite for me. Enzyme therapy is another option that I could consider to help manage my GOS sensitivity. I am looking into this.

I am hopeful that research will continue and the lives of people with IBS with improve. Although it is not a cure-all, considering doing a low-FODMAP diet to help improve and manage your “tummy troubles” is highly recommended. Working with your healthcare professionals and specialists is also important.

Angela G. Gentile, MSW, RSW

Social Worker/Author

For more info: www.AngelaGGentile.com

How to Prevent Heart Disease — The Number One Cause of Death Worldwide

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Image by Bruno Glätsch from Pixabay

Heart disease is the number one killer, worldwide. Prevention is key. Although these ten points were written for healthcare professionals,  there are a few points that we can incorporate into our own lives. In the first point, we are to be encouraged to aim for a healthy lifestyle throughout life. It’s never too early or too late to start living a heart-healthy lifestyle.

It is also important to note points four and five — the heart-healthy diet and exercise recommendations. Making healthy choices 80% of the time is what we are aiming for. Knowledge is power.

 

Top 10 Take-Home Messages for the Primary Prevention of Cardiovascular Disease

American Heart Association, 2019

1.  The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life.

2.  A team-based care approach is an effective strategy for the prevention of cardiovascular disease. Clinicians should evaluate the social determinants of health that affect individuals to inform treatment decisions.

3.  Adults who are 40 to 75 years of age and are being evaluated for cardiovascular disease prevention should undergo 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimation and have a clinician–patient risk discussion before starting on pharmacological therapy, such as antihypertensive therapy, a statin, or aspirin. In addition, assessing for other risk-enhancing factors can help guide decisions about preventive interventions in select individuals, as can coronary artery calcium scanning.

4.  All adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, processed meats, refined carbohydrates, and sweetened beverages. For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.

5.  Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.

6.  For adults with type 2 diabetes mellitus, lifestyle changes, such as improving dietary habits and achieving exercise recommendations, are crucial. If medication is indicated, metformin is first-line therapy, followed by consideration of a sodium-glucose cotransporter 2 inhibitor or a glucagon-like peptide-1 receptor agonist.

7.  All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.

8.  Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.

9.  Statin therapy is first-line treatment for primary prevention of ASCVD in patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), those with diabetes mellitus, who are 40 to 75 years of age, and those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion.

10.  Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.

Arnett et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000678

Age well, my friend.

Angela G. Gentile, MSW, RSW

Intermittent Fasting Information Session

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Please join me (Angela G. Gentile) at Village Chiropractic in Winnipeg (482 River Avenue) on Friday, April 26, 2019; 6:00 pm – 7:30 pm. I will be presenting an education session on “Intermittent Fasting for Health & Weight Management.” I’ve been practicing an IF lifestyle since December 26, 2018 and I haven’t looked back. I am excited to share what I have learned and I am looking forward to answering any questions you may have.

Please register soon – it’s FREE and spots are limited!

 

Angela G. Gentile, MSW, RSW