1.

cups fat-free milk

1.

cup strawberries, hulled and quartered

2.

kiwis, peeled and quartered (about cup)

2.

tablespoon fresh mint, chopped, plus two sprigs for garnish

1.

tablespoon granulated sugar or sugar subst.i.tute

1.

cup crushed ice

In a blender or food processor, combine the milk, strawberries, kiwis, chopped mint, sugar or sugar subst.i.tute, and ice and blend until smooth. Garnish with fresh mint sprigs.

PER SERVING.

155 calories, 8 g protein, 32 g carbohydrate, 0 g fat, 0 mg cholesterol, 81 mg sodium, 4 g fiber; plus 75 IU vitamin D (19% DV), 270 mg calcium (27% DV), 113 mg vitamin C (188% DV) TROPICAL MANGO-CITRUS SMOOTHIE.

Here's another fabulous smoothie recipe you can enjoy anytime, for health or just for pleasure.

Makes 2 servings, 2 cups each

1.

cups fat-free milk

1.

medium mango, peeled and chopped (about 1 cup)

1.

medium orange, zest, peeled and chopped (about cup), plus 1 sliced orange for garnish

1.

lime, zest and juiced

1.

teaspoon minced fresh ginger

1.

cup crushed ice

1. Zest the orange (can use vegetable peeler), and set aside the zest. Peel the orange, and chop.

2. Zest the lime, and set aside the zest. Juice the lime.

3. In a blender or food processor, combine the milk, mango, chopped orange, lime juice, lime and orange zest, ginger, and ice and blend until smooth.

PER SERVING.

171 calories, 8 g protein, 30 g carbohydrate, 0 g fat, 0 mg cholesterol, 80 mg sodium, 4 g fiber; plus 75 IU vitamin D (19% DV), 277 mg calcium (28% DV), 73 mg vitamin C (122% DV)

PART FOUR.

LIVING LONG AND STRONG.

CHAPTER 7.

CARDIOVASCULAR DISEASE.

One spring day, Wendy noticed the world's longest conga line of ants traveling across her driveway, heading into her garage. From there, the ants disappeared into an almost imperceptible crack near an interior wall. She called an exterminator, expecting to get a bill for a hundred dollars or so for spraying around the garage. Instead, she ended up with an estimate of $12,000. As with heart disease, what looked to be a small isolated problem from the outside turned out to be a sign of a much bigger problem developing out of sight.

You see, seven years earlier, Wendy and her husband decided to do a little home remodeling, including an upstairs bathroom. It turns out that there was a tiny hole in the floor of their newly installed shower-a hole that dripped water onto the beams holding up the second floor. At first, that small amount of water had no noticeable effect but over the years it added up to a couple billion billion drops. The subflooring and wood studs had rotted-ambrosia to carpenter ants, which knew a good thing when they found it and made a nest. So, in addition to the cost of fumigating the whole house, the shower stall had to be removed, tile pried up, subfloor and studs ripped out and replaced, new tile installed, et cetera, et cetera. Many thousands of dollars worth of "et cetera." drops. The subflooring and wood studs had rotted-ambrosia to carpenter ants, which knew a good thing when they found it and made a nest. So, in addition to the cost of fumigating the whole house, the shower stall had to be removed, tile pried up, subfloor and studs ripped out and replaced, new tile installed, et cetera, et cetera. Many thousands of dollars worth of "et cetera."

Cardiovascular disease is a lot like Wendy's house. Many people ignore their doctors' warnings about high cholesterol or blood pressure numbers because they feel perfectly healthy. But those numbers are just the ants on your body's metaphoric driveway, the thing that clues you in to what's going on inside inside. By the time you get diagnosed with high cholesterol or high blood pressure or high triglycerides, you may already have significant structural damage.

I often tell my clients to take nutritional changes at a pace that feels comfortable to them. That's not good enough when it comes to cardiovascular disease. The consequences of doing too little are severe-heart attack, stroke, pain, debility, death. Sadly, not everyone gets a second chance. So don't wait until after your next vacation, or your daughter's wedding, or that anniversary dinner to start. My advice is to start immediately and go for broke! Change your diet, change your habits, change your lifestyle. I'll show you the how in this chapter. No matter what your risk factors, there are things you can start doing now.

WHAT AFFECTS.

CARDIOVASCULAR DISEASE?.

Oxygen enters the blood stream through the lungs. The blood goes through the heart, which pumps it throughout the body to carry oxygen and nutrients to every cell, from the hair follicles on your head to your toes. Because blood has to travel to such remote areas, blood vessels have to come in various sizes, from the thick arteries and veins that branch off from the heart, to the tiny capillaries that feed the tiniest, most distant parts of your body. Cardiovascular disease, also commonly called heart disease heart disease, can affect any part of this vast network, from the heart (cardio-) through all the blood vessels (-vascular).

Healthy blood vessels are flexible and strong, capable of containing the pulsing pressure of rushing blood, heartbeat after heartbeat, year after year, for a lifetime. We'd like to think that they are durable, too, but the reality is that vessels are relatively fragile. Think about Monarch b.u.t.terflies. They migrate hundreds of miles in a single season-some more than 1,500 miles-on wings that are so fragile that they can be destroyed with a single touch. That's what blood vessels are like: tough but delicate, st.u.r.dy but vulnerable. If anything goes wrong and blood can't get to all parts of the body, cells won't receive the nutrition and oxygen they-and you-need to survive. If blood can't get to the heart, the result is a heart attack. If blood can't get to all to portions of the brain, the result is a stroke. In other words, the blood must keep flowing.

HIGH BLOOD PRESSURE (HYPERTENSION).

As the heart contracts to pump blood through the arteries, the force of that rushing blood against the vessel walls is called systolic blood pressure systolic blood pressure. As the heart relaxes between beats, the blood presses less forcefully against the vessel walls, as reflected by diastolic blood pressure diastolic blood pressure. When you go to the doctor, your blood pressure is given in two numbers: systolic pressure over diastolic pressure, measured in millimeters of mercury (mmHg).

Physicians recommend that you maintain blood pressure at or below 120/80 mmHg, but high blood pressure (HBP) is medically defined as any reading higher than 140/90 mmHg. Readings of 121 to 130 systolic or 81 to 89 diastolic are considered prehypertension, a warning that blood pressure may soon rise into the danger zone. The higher your blood pressure, the greater your risk of disease, including heart attack, stroke, kidney failure, and other blood vessel disorders. Even prehypertension causes physiologic changes that can be thought of as preatherosclerosis preatherosclerosis. That's because when blood pressure is higher than normal, it pummels the delicate lining of blood vessels. Left untreated, HBP can cause structural damage and inflammation. In addition, HBP can trigger a condition called atherosclerosis atherosclerosis-the formation of plaque, a fatty substance that builds up on the inside of the vessels, making them narrower and less flexible, and choking the blood supply to every part of the body. Mind you, these narrow vessels must still carry the same amount of blood as they did when they were healthy, which only adds to the pressure the vessel walls must bear. So high blood pressure is a risk factor for even higher blood pressure. That's why blood pressure problems never really go away-once you have damage from HBP, you'll have to fight to control it forever.

FAQSI have high cholesterol, and I've heard that red yeast rice works the same as some of the statin drugs. I'll do anything to avoid taking medication. Does red yeast rice work? Is it safe?

Red yeast rice does work to lower cholesterol, but only because it contains naturally occurring chemicals that are identical to medicinal statins. They work the same, and they have the same risks and side effects-including possible liver toxicity and muscle pain or weakness. The difference is that prescription medications are standardized, regulated, and produced in a sterile environment. The amount of active ingredient in each dose of red yeast rice can vary from package to package, or even from capsule to capsule in the same package. Worse, red yeast rice may contain contaminants, some of which may cause serious illness. This is one of those cases when natural natural doesn't mean better. If you want the benefits of red yeast rice, talk with your doctor about whether you should start taking a statin medication. doesn't mean better. If you want the benefits of red yeast rice, talk with your doctor about whether you should start taking a statin medication.

If you've been diagnosed with HBP, your doctor has probably already told you the basics. You can control blood pressure by getting to and maintaining a healthy weight, reducing your bad cholesterol (LDL) if it's high, limiting the salt in your diet, exercising, and adding calcium, vitamin D, magnesium, and pota.s.sium to your diet (discussed below).

HIGH LDL CHOLESTEROL, LOW HDL CHOLESTEROL.

Cholesterol is a natural fat-like substance found in all animal tissue-humans included-because it is part of all cell membranes. Cholesterol is also part of the myelin sheath that surrounds and protects nerves, and it is used to make vitamin D, bile, and some hormones. Our bodies make all the cholesterol we need for health, but we also get cholesterol from eating meat, poultry, and fish. (Incidentally, cholesterol is never never found in plant-based foods, so "cholesterol-free!" labels on products like peanut b.u.t.ter are really just stating the obvious.) found in plant-based foods, so "cholesterol-free!" labels on products like peanut b.u.t.ter are really just stating the obvious.) Cholesterol comes in two main varieties: low-density lipoprotein (LDL) cholesterol (commonly called bad cholesterol bad cholesterol-remember L for lousy lousy), and high-density lipoprotein (HDL) cholesterol (good cholesterol-remember H for hero hero). LDL cholesterol is one of the components of vessel-clogging plaque. Over time, plaque can incorporate calcium and other substances that make the plaque hard and brittle. If the plaque deposits grow large enough, they can block a blood vessel. In addition, the brittle plaque can break off, travel through the blood stream, and form a clot anywhere in the body.

The higher your LDL cholesterol, the greater your risk of developing life-threatening plaque. So, you want your low low-density low low. According to the National Inst.i.tutes of Health (NIH), the optimal level of LDL cholesterol is below 100 mg/dL. High LDL cholesterol is defined as 160 mg/dL and higher-but certainly anything above 130 is worth treating.