Coronary Calcium Scans Predict Mortality:

by John A. Rumberger, PhD, MD, FACC, FSCCT

The coronary calcium scan or HeartScan has been available since the early 1990’s and is the main subject of the documentary ‘The Widowmaker’ [Netflix] regarding the controversy of finding early heart disease through non-contrast CT and the very profitable treating of advanced heart disease using stents and other devices.
Heart disease remains the single largest cause of death in the US, killing 40% more people than all cancers combined – but unlike screening tests supported by the American Cancer Society such as mammography or colonoscopy – screening for heart disease has not been adopted by the American Heart Association or the American College of Cardiology.

The coronary artery [Agatston] ‘score’ [CAC] is a measure of the volume of the calcified coronary artery plaque which was demonstrated 20 years ago to be a reliable surrogate to the coronary atherosclerotic plaque burden. The supposition has been that the higher the score, the higher the risk – this has essentially been demonstrated in studies with 3 to 5 year follow-up and the question remains if the CAC score retains its predictive power out beyond a decade.
A recently published study [Ann Intern Med, July 7, 2015, vol. 163:1, pp 14-21] in nearly 10,000 asymptomatic individuals who had a non-contrast CT HeartScan in Nashville, TN between 1996 and 1999 looked at a 15+ year follow up on all-cause mortality.

The results of the initial CAC score distributions and subsequent overall all-cause mortality are shown in the table below:
Unadjusted All-Cause Mortality vs. CAC Score
CAC Score CAC Category All-Cause Mortality/year [based on 15 year follow-up]
0 No visible plaque 3% [~0.2% per year]
1-10 Very Mild 6% [~0.4% per year]
11-100 Mild 9% [~0.6% per year]
101-400 Moderate 14% [~0.93% per year]
401-1000 Extensive 21% [~1.5% per year]
>1000 Severe 28% [~1.87% per year]

Although conventional risk factors such as age, high blood pressure, high cholesterol, and family history were also important, age and CAC score remained the top predictors in this 15+ year follow up. For those at the top of the CAC chart, the authors indicated that mortality “is quite high and can approach 30%, 40%, and even 50% over the 15 years.”

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Mediterranean Diet and Age-Related Cognitive Decline

John A. Rumberger, PhD, MD, FACC, FSCCT

It is believed that ‘oxidative’ stress and atherosclerosis contribute partly to age related loss of cognitive ability. Studies using the so called “Mediterranean Diet” – an antioxidant rich diet of low carbohydrates, plentiful fruits, vegetables, nuts, olive oil, and lean sources of protein – may be the most beneficial in lowering the risk for heart and vascular disease.

A new study done from Barcelona, Spain enrolled individuals at high cardiovascular risk with randomized assignment to a Mediterranean diet supplemented with mixed nuts [30 g/day] or a standard low fat [American Heart Association] diet.
Follow up cognitive tests showed the participants allocated to a Mediterranean diet plus olive oil and nuts at 4.1 years did much better than those assigned the low fat diet.

Dr. Rumberger comments: the newest data suggest that the ‘low fat’ hypothesis, advocated primarily by the American Heart Association for the past 40 years, and based on research done in the 50’s and 60’s is misleading and that the issues of ‘fat’ in the diet have limited effect on the future development of heart disease. During these years with ‘low fat diets’ we have seen significant increases in obesity and adult onset diabetes due to problems with carbohydrates and high fructose corn syrup. The original Mediterranean Diet continues to be the one of choice for prevention of heart disease [and cancers] and apparently according to the above, continued cognitive health as we age.

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Coconut Ginger Braised Chard

This recipe is a great way to incorporate chard into your cooking! The chard is lightly braised in a broth of coconut milk, fresh ginger and a hint of red pepper flakes.

• 1 large bunch green chard
• 1 tablespoon olive oil
• ½ medium sweet onion, thinly sliced
• 2 cloves garlic, thinly sliced
• 1 tablespoon grated fresh ginger
• ¼ cup vegetable broth
• ¼ cup coconut milk
• ½ teaspoon kosher salt
• ¼ teaspoon black pepper
• Pinch of red pepper flakes

Slice chard into 1-inch strips. Heat olive oil in a large sauté pan over medium-high heat. Sauté the onions for about 3 minutes or until they begin to brown. Add the garlic and sauté 1 minute. Add the chard and remaining ingredients to the pan. Cover and cook over low heat for 8 to 10 minutes. Serve immediately. Serves 4.

Nutrition Information
Serving size: ½ cup
Calories: 89; Total fat: 7g; Saturated fat: 7g; Cholesterol: 0mg; Sodium: 543mg; Carbohydrate: 7g; Fiber: 2g; Sugars: 2g; Protein: 3g;


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Adding Chard To Your Diet Can Be Easy And Beneficial!

By: Erin Walter, RD

These colorful leafy greens are a great way to add variety into the diet. Chard is unique because the stalks come in many colors from reds to yellows and even white and are sometimes referred to as “rainbow chard”. Chard also comes in different forms including baby and mature which offers versatility to this nutrient dense vegetable. The baby chard has a softer stalk and milder taste which is great eaten raw in salads and as sandwich toppers while the mature chard is best for cooking to tone down the some of the bitterness and soften the stalks.

Chard is packed with many nutrients including vitamins A, C, and K, potassium, iron and calcium just to name a few. It also contains powerful antioxidants and phytonutrients including carotenoids and betalains. Health benefits of these nutrients include anti-inflammatory and anti-oxidant properties that may help to stave off chronic inflammatory diseases.

Cooking with chard is easy and adds delicious flavors and textures to your meals. Chard can be sautéed or braised as side dish or added to soups and stews, and even rice or pasta dishes. It’s typically available all year round though its peak season is in the summer months of June through August. Next time you are shopping at your grocery store or even your local farmers market, try to pick some up to add a variety of colors, textures and flavor to your dishes!


Hornick B. Chard a vegetable valedictorian in the class of leafy greens. Food and Nutrition Magazine. July/August 2015. 32-33.

Swiss Chard.

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How to Deal with Muscle Soreness

Whether we are just starting out or pushed too hard at the gym, we have all had days where we are hurting and sore from our workouts. Surely the last thing you are thinking about is working out again, yet many times it’s just what you need!

After strenuous exercise, the muscle tries to repair itself and causes inflammation within the body. Adding light movement (think walking, swimming or light bike riding) will help to bring circulation to those muscles and increase blood flow, almost acting like an internal massage for your muscles.

Another way to help? Foam rolling. This will also increase blood flow to the area and flush in new “fresh” blood and oxygen to the affected area. This type of therapy can be painful, but if done on the onset of soreness, you may find you have a shorter recovery period.

Next time your feel your workout from the day before, don’t relax on the couch! Get moving, stretch and give yourself a massage with a foam roller or rolling stick!

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Pinto, Black, and Red Bean Salad with Grilled Corn and Avocado

With Memorial Day quickly approaching, try this side to kick off the summer. This side is a good source of: fiber, folate, thiamin, phosphorus, vitamin C, magnesium, B vitamins, vitamin E, and monounsaturated fats. Enjoy and have a safe Memorial Day!

• 1 cup halved heirloom grape or cherry tomatoes
• 1 teaspoon salt, divided
• 3 ears shucked corn
• 1 medium white onion, cut into 1/4-inch-thick slices
• 1 jalapeño pepper
• 1 tablespoon olive oil
• Cooking spray
• 1/3 cup chopped fresh cilantro
• 1/3 cup fresh lime juice
• 1 (15-ounce) can no-salt-added pinto beans, rinsed and drained
• 1 (15-ounce) can no-salt-added black beans, rinsed and drained
• 1 (15-ounce) can no-salt-added kidney beans, rinsed and drained
• 2 diced peeled avocados

1. Preheat the grill to medium-high heat.
2. Place the tomatoes in a large bowl, and sprinkle with 1/2 teaspoon salt. Let stand 10 minutes.
3. Brush corn, onion, and jalapeño evenly with oil. Place vegetables on grill rack coated with cooking spray. Grill corn for 12 minutes or until lightly charred, turning after 6 minutes. Grill onion slices and jalapeño 8 minutes or until lightly charred, turning after 4 minutes. Let vegetables stand 5 minutes. Cut kernels from cobs. Coarsely chop onion. Finely chop jalapeño; discard stem. Add corn, onion, and jalapeño to tomato mixture; toss well. Add remaining 1/2 teaspoon salt, cilantro, and next 4 ingredients (through kidney beans) to corn mixture; toss well. Top with avocado.
Nutritional information: Calories 141, Fat 6.4 gm, Saturated fat: 0.9 gm, Monounsaturaed fat: 4.2 gm, Polyunsaturated fat: 0.9 gm, Protein: 5 gm, Carbohydrate: 18.2 gm, Fiber 6.8 gm, Cholesterol: 0 mg, Iron: 1.2 mg, Sodium: 211 mg, Calcium: 38 mg


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Healthy ways to make amazing fries for your family!

Who doesn’t love French fries? They seem to be the ultimate comfort food but they don’t have to be a guilty pleasure any more. It is easy to make healthier fries at home that are full of vitamins. Try to stay clear of your local drive-through window and try to whip up a batch of one of the nutritious fries below that everyone in the family will enjoy.

1. Try Daikon Fries: Daikons are a mild-flavored winter radish that are from Southeast or East Asia but are grown in North America. They are low in calories and rich in vitamin C. When daikons are roasted they are delicious. Try peeling the daikon and chop into pieces that are similar to French fries. Toss them with olive oil and a pinch of salt, roast at 350 F for 30 minutes or until they are tender and slightly browned. Serve with a dipping sauce such as thyme, lemon juice, mustard, olive oil, and black pepper.

2. Try Carrot Fries: Yes carrot fries! Try slicing carrots into wedges similar to French fries then simply toss with olive oil, pinch of salt and pepper and bake until crisp. Carrots are a vitamin-rich root vegetable and one medium sized carrot contains 204 percent of your daily recommended value of vitamin A. They are delicious and guilt free!

3. Try Jicama Fries: Jicama is a root vegetable and resembles a potato or turnip with a mild flavor. It is native to South America and Mexico and is a good source of fiber and an excellent source of vitamin C. Try to very thinly slice the jicama, toss with olive oil, sprinkle a pinch of salt, onion powder, garlic powder and paprika to taste, and bake.

4. Try Yucca Fries: Yucca, another root vegetable, is rich in manganese and vitamin C. For yucca fries, bring a large pot of water to a boil, add yucca and cook until tender, then drain. Once cool enough to handle cut into ¼ to ½ inch thick fries. Place in a large bowl and toss with olive oil, chile powder, ground coriander and salt and pepper. Bake for approximately 20 minutes.

5. Try Zucchini Fries: Yes zucchini fries! Zucchini is high in vitamin C, riboflavin, and vitamin B6. Slice zucchini into wedges, then simply toss with olive oil, pinch of salt and pepper and bake until desired crispness.

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