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A cautionary tale? Clinton's bypass should scare us straight

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The news that former president Bill Clinton, 58, had arteries so clogged that he needed heart bypass surgery may be a wake-up call for aging Americans with a checkered nutritional past.

Clinton's love of fast food is legendary. His close call is putting heart-healthy diets on people's radar screens, says Alice H. Lichtenstein, chair of the nutrition committee for the American Heart Association.

A good diet and regular exercise are two of the best protections against heart disease, which kills nearly 1.5 million people a year. Americans should make changes now, says cardiologist Richard Milani of the Ochsner Clinic Foundation in New Orleans. ''It's never a lost cause. It's never too late to change.''

The American Heart Association has suggestions for a heart-healthy diet and lifestyle. For more information:

The goal: Maintain a healthy body weight.

The reality: About 66% of Americans are overweight or obese, the government says.

How to do it: Studies indicate that losing 5% to 10% of weight can reduce the risk factors for heart disease and stroke. To lose a single pound, you have to burn 3,500 calories more than you consume. Both calorie restriction and increased physical activity are important.

But ''losing weight is not synonymous with a heart-healthy diet,'' Milani says. ''If I gave you bread and water for two months, you would lose weight, but you may not be heart-healthier.''

Cardiologist Arthur Agatston, author of the best-selling The South Beach Diet, says, ''If you are eating whole foods, fruits and vegetables, you can eat plenty and not be obese.''

The goal: Consume a variety of fruits and vegetables, especially those that are dark green, deep orange or yellow. Choose five or more servings per day.

The reality: Americans eat an average of 3.6 servings of fruits and vegetables a day. Only 20% of Americans eat five or more servings a day, says a study by NPD Group.

How to do it: ''There's an abundance of fresh fruits and vegetables available year round now, and the quality of frozen vegetables is outstanding,'' Lichtenstein says. ''Put vegetables in your spaghetti sauce, sprinkle frozen peas on your salad. They'll thaw quickly. Have vegetables readily available for putting on a sandwich and keep fruit in a bowl on the table.'' To get enough fiber, consume whole fruits and vegetables rather than juices. They also fill you up better, she says.

The goal: When choosing grains, look for whole grains.

The reality: Most Americans consume less than one serving of whole-grain foods a day, the government says.

How to do it: Consider using more whole-wheat products, oats, brown rice, barley, bulgur, wheat berries, Lichtenstein says. ''Wheat berries are wonderful but take a long time to cook. You can boil or cook them like rice. They are really chewy and have a lot of neat texture and flavor. All you need to do is find one or two recipes for whole grains, and it won't be so intimidating to cook these foods.''

The goal: Engage in regular physical activity. The government recommends at least 30 minutes of moderate-intensity activity such as brisk walking most days of the week. Some experts say 60 minutes a day is a better goal for weight control.

The reality: About 47% of adults say they meet the government's recommendation, according to the Centers for Disease Control and Prevention.

How to do it: Walk, run, bike, dance, play, swim, but do something you enjoy regularly, experts say. You can be more active by taking several 10-minute walks during the day, pacing while using the phone or forming a walking group in your neighborhood. Or you can wear a pedometer and walk at least 10,000 steps a day, which is roughly 5 miles.

The goal: Limit intake of saturated (animal) fat to less than 10% of calories a day. Minimize intake of trans fatty acids (hydrogenated fat) found in processed foods.

The reality: Americans are getting about 11% of their calories from saturated fat, according to government data.

How to do it: Immediately switch from full-fat to low-fat and non-fat dairy products, Lichtenstein says. Switch to leaner cuts of meat, decrease portion sizes, beware of fatty processed meats, trim fat from all meat and remove skin from chicken or turkey before eating, she says.

Substitute beans for meat. They are a great source of fiber and are usually prepared without saturated fat, she says. Substitute liquid vegetable oils such as canola oil, soybean oil and olive oil for saturated fat and hydrogenated fat.

The goal: Consume at least two servings of fish (3 to 6 ounces per serving) a week.

The reality: The average American eats fish at home about 30 times a year; that number drops to 20 times when tuna is excluded, the NPD Group says.

How to do it: ''I buy a large quantity of flounder, salmon and tilapia,'' Lichtenstein says. ''I break it down into quantities I would cook for my family in an evening meal and then freeze it. In the morning, I put it in the refrigerator, and then quickly cook it at night.''

Some of the AHA's other recommendations:

* Limit the intake of salt to less than 6 grams a day.

* Keep cholesterol intake to less than 300 milligrams a day.

* Limit alcohol consumption. No more than one drink per day for women and two drinks per day for men.

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© Copyright 2004 USA TODAY, a division of Gannett Co. Inc.


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