South Beach Heart Enh Cd.Indd

THE SOUTH BEACH HEART PROGRAM •ILLUSTRATIONS• •QUESTIONAIRES• •MEAL PLANS• •EXERCISES• Arthur Agatston, MD Author of the #1 New York Times Bestseller The South Beach Diet SSouthouth BBeacheach HHearteart eenhnh ccd.inddd.indd 1 111/8/061/8/06 112:17:572:17:57 PPMM Notice This audiobook is intended as a reference volume only, not as a medical manual. The information given here is designed to help you make informed decisions about your health. It is not intended as a substitute for any treatment that may have been prescribed by your doctor. If you suspect that you have a medical problem, we urge you to seek competent medical help. The information in this audiobook is meant to supplement, not replace, proper exercise training. All forms of exercise pose some inherent risks. The editors and publisher advise listeners to take full responsibility for their safety and know their limits. Before practicing the THE CORONARY ARTERIES exercises in this audiobook, be sure that your equipment is well-maintained, and do not take risks beyond your level of experience, aptitude, training, and fitness. The exercise and dietary programs in this audiobook are not intended as a substitute for any exercise routine or dietary regimen that may have been prescribed by your doctor. As with all exercise and dietary programs, you should get your doctor’s approval before beginning. Mention of specific companies, organizations, or authorities in this audiobook does not imply endorsement by the author or publisher, nor does mention of specific companies, aorta organizations, or authorities imply that they endorse this audiobook, its author, or the publisher. pulmonary artery pulmonary artery © 2007 by Arthur Agatston, MD Photographs © 2007 by Rodale Inc. The South Beach Diet® is a Registered Trademark of the SBD Trademark Limited Partnership. left main coronary artery (LM) All rights reserved. No part of this publication may be reproduced or transmitted left circumflex coronary in any form or by any means, electronic or mechanical, including photocopying, artery (LCx) recording, or any other information storage and retrieval system, without the written permission of the publisher. right coronary artery (RCA) Illustrations by Lisa Clark Photographs by Mitch Mandel/Rodale Images left anterior descending Book design by Carol Angstadt artery (LAD) The higher up a blood clot forms when it blocks a coronary artery, the greater the area of heart muscle affected. If the clot occurs in the left main coronary artery, then all of the heart muscle supplied by the left circumflex and left anterior descending arteries will die, causing a deadly heart attack. THE SOUTH BEACH HEART PROGRAM THE SOUTH BEACH HEART PROGRAM SSouthouth BBeacheach HHearteart eenhnh ccd.inddd.indd 22-3-3 111/8/061/8/06 110:56:120:56:12 AAMM HEALER’S VIEW OF lumen lumen CORONARY ARTERY DISEASE endothelium 1 endothelium A soft plaque plaque 2 B artery begins to remodel soft plaque progression PROGRESSION TO PLAQUE 3 C RUPTURE AND HEALING REGRESSION PLUMBER’S VIEW OF platelets CORONARY ARTERY soft plaque soft plaque DISEASE plaque progression rupture 4A 4B D The plumber’s view (above) is the formerly held concept of how a heart attack happens. blood blood clot clot soft plaque Plaque was thought to gradually build up within an artery, slowly closing it, the way sludge closes a drainpipe. (A) Healthy coronary artery injured vessel wall with a normal-sized lumen, where blood flows 5A freely. (B) First signs of plaque narrowing the E 5B lumen. (C–D) Gradual growth of plaque fur- ther narrowing the lumen. (E) Artery narrowed to 70%. Chest pain with exertion (angina) scar tissue thought to result. Note: As the plaque grows, blood clot calcification the over-all size of the artery remains (hard plaque) unchanged. 6A scar tissue 6B (F) Lumen nearly filled with plaque. Bloodflow F stagnates, a blood clot forms and obstructs flow, and a heart attack results. The belief was that the greater the blockage, the more immi- normal-sized lumen. (2–3) Gradual buildup of likely. (4A) Soft plaque ruptures the endothelium. (6A) After a plaque ruptures, healing of the nent a heart attack. The logical plumber’s soft plaque. Unlike in the plumber’s view, the Blood platelets are attracted to the injured site injury to the artery wall begins. Scar tissue approach was to open the artery with angio- plaque grows outward and the artery becomes and begin to form a blood clot. (5A) The clot forms and then calcification, or hard plaque, plasty or to bypass it when partially blocked larger; this is called remodeling. Because the extends into the lumen. If it blocks the lumen, occurs. Healed hard plaque typically does not and before it closed. The plumber’s view has size of the lumen is preserved, a large amount then blood can’t get to the heart muscle and cause a heart attack. Hard plaque can be turned out to be all wrong! of plaque can build up without compromising the muscle dies. This is a heart attack. Admin- seen on a noninvasive heart scan. The healer’s view (opposite) reflects what bloodflow; therefore neither chest pain nor an istered in time, clot-busting drugs or angio- With aggressive prevention, regression of we now know about how coronary artery dis- abnormal stress test result. Without aggressive plasty can abort the heart attack. Most plaque soft plaque occurs. Plaque rupture and a heart ease occurs. (1) Healthy coronary artery with a prevention, progression to plaque rupture is ruptures do not cause a heart attack, however. attack are avoided. (4B–6B) Regression and THE SOUTH BEACH HEART PROGRAM THE SOUTH BEACH HEART PROGRAM SSouthouth BBeacheach HHearteart eenhnh ccd.inddd.indd 44-5-5 111/8/061/8/06 110:56:130:56:13 AAMM coronary artery HEALTHY ENDOTHELIUM QUESTIONAIRES plaque Just For Men DAMAGED ENDOTHELIUM Just For Women plaque Top: The endothelium is the inner endothelium is damaged by car- cell lining of an artery. Center: A diac risk factors, such as hyper- healthy endothelium acts as an tension, obesity, diabetes (or effective barrier to the penetra- prediabetes), or smoking, it is tion of bad LDL cholesterol par- made more porous to LDL, and ticles. Bottom: When the there is a greater buildup of cho- THE SOUTH BEACH HEART PROGRAM SSouthouth BBeacheach HHearteart eenhnh ccd.inddd.indd 66-7-7 111/8/061/8/06 110:56:140:56:14 AAMM Just for Men 10. Do you have a family history of early heart disease? (Do you have a brother or father who was diagnosed with heart disease Are You at Risk for Heart Disease? before the age of 55 or a sister or mother who was diagnosed with heart disease before the age of 65?) 1. Have you ever been diagnosed with cardiovascular disease, □ Yes □ No □ Don’t Know including a heart attack, angina, or stroke, or have you undergone angioplasty or bypass surgery? 11. Are your triglycerides greater than 150 mg/dL? □ Yes □ No □ Yes □ No □ Don’t Know 2. Are you 40 years of age or older? 12. Is your fasting blood glucose greater than 100 mg/dL? □ Yes □ No □ Yes □ No □ Don’t Know 3. Do you smoke or do you have extensive exposure to secondhand 13. Do you have a homocysteine level of more than 12 µmol/L? smoke? □ Yes □ No □ Don’t Know □ □ Yes No 14. Do you have a C-reactive protein (CRP) level of more than 4. Have you been diagnosed with diabetes, prediabetes, or 3 mg/L? metabolic syndrome? □ Yes □ No □ Don’t Know □ □ Yes No 15. On average, do you spend less than 2 hours a week exercising at 5. Are you taking medication to treat high blood pressure or is your least moderately (for example, brisk walking, golf, active blood pressure greater than 140/90? gardening)? □ Yes □ No □ Don’t Know □ Yes □ No 6. Do you have a waist circumference of more than 40 inches? 16. Do you eat fish at least twice a week? (If you don’t know, use a tape measure to find out.) □ Yes □ No □ □ Yes No 17. Do you eat fresh fruits and vegetables and whole grains on a 7. Do you have a high Calcium Score? daily basis? □ Yes □ No □ Don’t Know □ Yes □ No 8. Do you have an HDL, or “good,” cholesterol level of less than 18. Do you make a conscious effort to avoid trans fatty acids in your 40 mg/dL? diet? □ Yes □ No □ Don’t Know □ Yes □ No 9. Do you have an LDL, or “bad,” cholesterol level of more than 130 mg/dL? □ Yes □ No □ Don’t Know THE SOUTH BEACH HEART PROGRAM THE SOUTH BEACH HEART PROGRAM SSouthouth BBeacheach HHearteart eenhnh ccd.inddd.indd 88-9-9 111/8/061/8/06 110:56:150:56:15 AAMM Just for Women 10. Do you have a family history of early heart disease? (Do you have a brother or father who was diagnosed with heart disease Are You at Risk for Heart Disease? before the age of 55 or a sister or mother who was diagnosed with heart disease before the age of 65?) 1. Have you ever been diagnosed with cardiovascular disease, □ Yes □ No □ Don’t Know including a heart attack, angina, or stroke, or have you undergone angioplasty or bypass surgery? 11. Are your triglycerides greater than 150 mg/dL? □ Yes □ No □ Yes □ No □ Don’t Know 2. Are you 55 years of age or older or are you postmenopausal? 12. Is your fasting blood glucose greater than 100 mg/dL? □ Yes □ No □ Yes □ No □ Don’t Know 3. Do you smoke or do you have extensive exposure to secondhand 13.

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