Go-Red-For Women Campaign: American Hearat Association Feb 5-12

Tomorrow is National Wear Red Day. Thousands of Americans will be wearing red to draw attention to this startling fact: Over 430,000 women are silenced each year by cardiovascular disease – and most of these deaths are preventable.

Kardea encourages you to wear something red tomorrow to honor those women – and that you’ll help fund the research and programs that can save them. Today, the American Heart Associataion is launching a Go Red & Give campaign. One week, one goal: $100,000 to keep our sisters, mothers, daughters and wives safe.

Donate directly to the American Heart Association to support education, outreach and research programs to help save women’s lives.

Your donation could help keep someone you love safe from the #1 killer disease in the U.S.

Kardea Nutrition Teams with The Cooking Cardiologist®

Kardea Nutrition™ is pleased to announce that it has teamed with Dr Richard Collins, a Mayo Clinic trained cardiologist, also known as The Cooking Cardiologist®, to advance an integrated nutritional approach promoting cardiovascular health and wellness.

“What you eat and how much you eat can significantly alter cardiovascular health,” say Dr. Collins, ”Certain nutrients can be very helpful. Others can be quiet harmful. The power of nutrition lies with the overall eating patterns and preferences.”

The National Institutes of Health and the American Heart Association have long asserted that dietary choices are the foundation of cardiovascular disease prevent and health promotion. The NIH recognizes that lifestyle choices, emphasizing nutrition “compares well with many of the cholesterol-lowering drugs.[i]” For some, food choices allow individuals to maintain healthy cholesterol, blood pressure and blood sugar levels without the use of medications. For others, food choices reduce the medications required to achieve healthy levels.

In addition to serving on Kardea’s Board of Advisors, Dr. Collins will join Kardea’s founder, Robert Leighton, in co-authoring The Kardea Gourmet: Great Science, Fantastic Foods and Cardiovascular Health. This book will provide readers with a clear understanding of how inflammation and cholesterol, blood pressure and blood sugar levels interact to affect cardiovascular health. It then will review the impact of specific nutrients and overall diet. Gourmet chefs from noted restaurants around the country also will be providing the meal plans that deliver the right nutritional balance and heart healthy nutrients including Omega-3s, fibers, plant sterols and antioxidants.

Sections of the book, including recipes, are posted on kardeagourmet.com . Updates are being added on a weekly basis. Kardea is seeking input from interested readers.

Founded in 2007, Kardea Nutrition™ LLC was launched to empower people to manage their cholesterol, naturally and nutritiously. Kardea Nutrition™ has since extended its scope to enable the power of nutrition to advance overall cardiovascular health. It products are currently available at many retailers throughout the United States including Whole Foods , Nordstrom, drugstore.com and Hy-Vee. Products can also be purchased directly from Kardea’s online store.


[1] Your Guide to Lowering Cholesterol with Therapeutic Lifestyle Changes (TLC), U.S. Department of Health and Human Service, National Institutes of Health, National Heart, Lung, and Blood Institute, December 2005. www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf

Spirits for the Heart

I often prefer a stiff drink over a glass of wine. At the end of a long week, I may seek a very dry martini or a good scotch to ease the accumulated stresses. For me, these spirits cut the edge. Neither beer nor wine provides the same remedy. One, maybe two, is all. Generally, not more than 2 times per week.

The prevailing wisdom, however, has been that wine is the healthier alternative. Wine may well be an important element in the Mediterranean diet, a way of eating associated with longer life, reduced risk of cardiovascular and cancer mortality and reduced risk of dementia and declines in cognitive function as we age. Wine contains micronutrients that are beneficial.

A study released by researchers at the Harvard Medical School and the Harvard School of Public Health found that liquors and beer deliver some of the same health benefits as wine (1). The study focused on the relationship between moderate alcohol intake and a reduction in inflammation.

Normally, inflammation is part of a healthy immune response that heals injury and fight infection But chronic inflammation is very different. Cancer, diabetes, depression, heart disease, stroke, Alzheimer's—these seemingly diverse diseases--are increasingly thought to have inflammation as a common denominator.

And the concerns around cholesterol and cardiovascular health also center on inflammation. LDL cholesterol, the type of cholesterol that can clog your arteries, is most seriously an issue when the arteries are inflamed.

A marker for inflammation is the compound C-reactive protein (CRP) that can be measured through blood tests. Assessing CRP levels is currently recommended for those at increased risk of heart disease. High levels of CRP are associated with future heart attacks and strokes.

Prior to the Harvard study, much research did indicate that moderate levels of alcohol consumption led to reductions in CRP levels. Most studies examining this relationship focused on a single type of alcoholic beverage. As a result, it remained uncertain whether the impact differed by the type of alcoholic beverage consumed.

The Harvard study compared CRP levels and alcohol consumption of 11,815 women. Some were beer drinkers. Others drank wine. And others drank liquors. Still others enjoyed some each. Overall, the association between alcohol and CRP levels were found to be related to alcohol consumption rather than the type of alcohol consumed.

Needless to say, the power of alcohol consumption was found to be less than the power of good eating habits, lower weight and physical activity. The results, however, are consistent with the general recommendation. Alcohol, in moderation, may well be a useful component in a healthy lifestyle. Cheers!

American Heart Association Recommendations: At this point, the AHA does not recommend drinking alcohol, but if you drink, AHA emphasizes moderation. Moderation means not more than one to two drinks per day for men and one drink per day for women. Too much can increase weight, triglycerides and blood pressure. Excessive drinking can lead to other serious heart problems.

(1) Levitan, B, Emily, "Association Between Consumption of Beer, Wine, and Liquor and Plasma Concentration of High-Sensitivity C-Reactive Protein in Women Aged 39 to 89 Year" The American Journal of Cardiology Volume 96, Issue 1, July 1, 2005, pp 83-88.

Wilted Spinach from Kardea Nutrition

1 Pound Fresh Spinach
2 Medium Cloves Garlic, chopped.
1.5 Tablespoon Kardea Extra Virgin Olive Oil with Added Plant Sterols

Wash the spinach carefully. Often, spinach comes with bits of dirt that are really unpleasant when grinding between your teeth. To clean, fill a pot with water and drop leaves in. The heavier dirt particle will fall to the bottom while the leaves float. Leaving the water in the pot, remove the spinach, place in a colander, rinse and drain.

Heat a larger frying pan on a medium-low to medium heat. Add 1.5 tablespoons of olive oil. When oil is hot, add garlic and then quickly add the spinach to the pan. Cover tightly. After the spinach has wilted, stir to assure that oil and garlic lightly coat all the leaves.

Cardiovascular Health Improvements in US May Be Slowing-Possibly Reversing

The number of American adults considered 'low risk' for heart disease has fallen below 10 percent, according to a new study, which places the spotlight on the growing need to address the risk via nutrition.

Published in the American Heart Association journal Circulation, the paper reveals that the progress in heart health that had been made during the 1970s and 1980s has now been reversed. According to the authors, only 7.5 percent of Americans between the ages of 25 and 74 were in the low risk category in 1999-2004. The figure for adults rated low risk was 10.5 percent in 1988-94.

The study, Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States Adults, created a low-risk index based on the following five factors:
• Not currently smoking• Total cholesterol below 200 (mg/dL) and not using cholesterol-lowering drugs• Blood pressure (systolic/diastolic) below 120/80 millimeters of mercury (mmHg) without using blood pressure-lowering medication• Body mass index (BMI) less than 25 kg/m2• Never diagnosed with diabetes.

Nutrition: Quantity & Quality

Adults at low risk of heart disease are those unlikely to develop cardiovascular disease or the associated risk factors. The researchers said that from a preventive health point of view, it was disappointing that less than 10 percent of Americans are meeting all the low-risk factors.
"Our analysis suggests that achieving low risk status for most US adults remains a distant and challenging goal. Unfortunately, the limited strides that were made towards this goal during the 1970s and 1980s were eroded by the increases in excess weight, diabetes and hypertension during more recent decades," said lead author Earl Ford of the US Public Health Services at the Centers for Disease Control and Prevention (CDC) in Atlanta, Ga.

The report found that while fewer adults are smoking, an increasing proportion are developing high blood pressure or diabetes or becoming overweight or obese.

While excessive weight continues to be a rising challenge, the quality of nutrition continues to play an important role in heart health promotion and disease prevention. Diets incorporating the right types of fibers, fats and other nutrients such as plant sterol and potassium can actively work to reduce blood levels of cholesterol, hypertension or the onsight of Type II diabetes. Yet, there remains tremendous confusion over nutrients and diets whose benefits are supported by strong science.

Source: Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States AdultsCirculation. 2009 Published online before print September 14, 2009doi: 10.1161/CIRCULATIONAHA.108.835728Authors: Earl S. Ford MD, MPH, Chaoyang Li MD, PhD, Guixiang Zhao MD, PhD, William S. Pearson PhD, and Simon Capewell MD

Walnut Basil Pesto -- Lighter, Healthier

We grow a variety of herbs ---oregano, parsley, rosemary and basil-- in the Kardea garden. The oregano and rosemary retain wonderful flavors when they are dried, but the parsley and basil lose their zest. Pesto offers a great way to enjoy these herbs. The pesto also freezes well and can be enjoyed throughout the winter.

We have refined a standard pesto recipe to improve its heart healthy qualities. Sauteed walnuts replace the parmesan cheese, reducing both the sodium and saturated fat levels. The walnuts are a good source of L-arginine and ALA omega-3 fatty acids. Both these nutrients have been found to improve arterial function and blood flow. Moreover, the walnuts help maintain the great pesto consistence.

Both the basil and the parsley are a good source of anti-oxidants, particularly beta-carotene. Fatty acid ratio is a healthy 4:2:1 of monounsaturated: polyunsaturated: saturated.

Use over your favorite pasta or on sandwiches. A small dollop also can be used when serving a hearty soup.

Ingredients
4 Cups Fresh Basil Leaves, loosely packed
1 Cup Fresh Parsley, loosely packed
1 Cup Walnut
2/3 Cup Extra Virgin Olive Oil
4 Large Cloves Garlic, Chopped

Heat a pan over low heat. When hot, add 1/3 cups of olive oil, 3 cloves of chopped garlic and all the walnuts. Sautee 3-4 minute or until garlic is soft but not browned. Set aside and let cool.

In a food processor, add the second 1/3 cup of olive oil, the basil, the parsley and 1 clove of the fresh, chopped garlic. Blend with the sautéed walnuts.

Makes about 2 cups pesto. To freeze, place about .5 cup (enough for about a pound of pasta) in a small container. Cover with a thin coat of olive oil and freeze.

Admittedly, when serving with pasta, a bit of parmesan cheese brightens the dish, but keep it to a sprinkle. You will find that this pesto dish is far lighter than some of the more traditional pesto recipes.

Roasted Tuna with Rosemary

Carving a roast at the table kicks off a great social meal. For heart health and cholesterol management, we have replaced the beef or pork tenderloin with tuna–a 3-4 pound filet.
You may be able to find this filet at your local grocery, but it is more likely that you will need to go to a fish store or upscale food market. Be prepared. They likely will ask what you are planning on making with this large chunk of fish.

Like any good roast, this tuna not only anchors a festive meal, but it also makes great sandwiches the next day.

3-4 Lbs Tuna (skinned whole filet, not steaks)
½ Fennel Bulb, chopped (optional)
2 Cloves Garlic, chopped (optional)
1 Teaspoon Kosher or Sea Salt (optional)

Marinade
½ Cup Olive Oil
1 Juice of a Medium Lemon
½ Cup White Wine preferably one that is not too dry.
2 Teaspoons Rosemary

Combine ingredients for the marinade and pour over tuna. Let stand in covered bowl outside the refrigerator for about 1 hour.

If you decide to use the fennel, prepare while the tuna is marinating. Beyond its lovely flavor, the fennel serves as a moist bed on which the tuna sits while roasting.

Heat a pan on medium heat and then add about 1/4 cup of the marinated, chopped garlic and fennel. Cover and cook until the fennel is tender, stirring occassionally (about 15 minutes). Remove from heat.

Preheat oven to 350 degrees.

Heat a large, heavy pan and coat hot pan with olive oil. Brown the tuna on all sides. If you opted to use the fennel, remove the tuna and place the sauted fennel on bottom of pan. Place the tuna on this bed of fennel . Pour the remaining marinade over the tuna and sprinkle salt. Cover and place in preheated oven. Roast for about 20-25 minutes. Remove from oven. Let this rest for about 5-10 minutes. Bring to the table. You are now ready to slice this tuna into meaty slices, serving medium-rare to medium slices. Spoon over gravy from pan.

Serves 6-8

Nutritional Profile Per 6 ounce Serving:Total Calories: 270Total Fat: Fatty Acid Profile: 7g mono, 2.5g poly, 2.5g saturated, 0g trans; Protein: 34g ; Cholesterol: 55mg; Carbohydrates: 1g; Total Fiber: 0g Soluble Fiber: 0g; Plant Sterols: 250mg (.25g) if using Kardea sterol-fortified olive oil; Omega-3s: 1.7g (Bluefin) Magnesium 20% Recommended Daily Intake (RDI)

Serve with a barley pilaf to enhance cholesterol-lowering benefits.

And if you have leftover, serve cold on a crusty roll with a slice of tomato, a few diced capers, a drizzel of olive oil & bit of dijon mustard.

Mediterranean Diet Works As A Whole System

Researchers continue to find an association between the Mediterranean diet and increased longevity.

"Overall diet is more important than individual components, with emphasis on moderate—but not excessive—wine consumption, particularly during meals, preference for olive oil as the main added lipid, low consumption of meat, and high consumption of vegetables, fruits, and legumes," author Dr Dimitrios Trichopoulos (Harvard School of Public Health, Boston, MA).

The researchers examined data from healthy individuals in Greece who participated in the European Prospective Investigation into Cancer and Nutrition (EPIC) trial.
The researchers looked at data from the Greek segment of EPIC, from over 23 000 healthy men and women aged 20 to 86 at enrollment. As is typical in the Greek population, many individuals were overweight or obese and many men were smokers. Most were moderately active.

This work confirms that it is not one single component of the Mediterranean diet that is driving reduced risk of mortality. "In order to promote longevity, people have to do several things at the same time. They just can't focus on one food—just eat blueberries or take a folic-acid pill. It's a whole lifestyle, whole diet approach for health promotion," say Dr. Teresa Fung of the Harvard School of Public Health.

Kardea Nutrition Links Dietitians & Natural Foods Retailers with Natural Cholesterol Management Speakers’ Bureau

Lifestyle changes emphasizing therapeutic nutrition offer significant opportunities to positively affect a range of interconnected health issues --- including cholesterol management, metabolic syndrome, diabetes and hypertension. Generally, where these multiple issues occur, the importance of cholesterol management is amplified.

The challenge: consumers are often confused or misinformed in regard to the best ways to use nutrition to naturally improve cholesterol levels. Numerous studies, including those reviewed by the Food & Drug Administration, the American Heart Association and the National Institutes of Health, have shown that a 20-30% reduction in LDL cholesterol levels is readily achievable with nutritional therapy.

As part of an initiative to enhance consumer understanding, Kardea Nutrition is developing a program to link food retailers, particularly natural foods retailers, with registered dietitians.

Among the components of this Kardea initiative is the creation of a Natural Cholesterol Management Speakers’ Bureau. As part of this program, dietitians with proven expertise in cholesterol management will be providing in-store classes that address the integrated roles of fiber, plant sterols, niacin, omega-3s, and monounsaturated fats.

Nutritional health professional and natural foods retailers interested in participating in this program should contact Kardea Nutrition directly at customerservice@kardeanutrition.com.

Carbohydrates & Cholesterol: Recommendations from the National Cholesterol Education Program

NCEP Evidence Statement: When carbohydrate is substituted for saturated fatty acids, LDL cholesterol levels fall (Strength of Evidence: A2, B2). However, very high intakes of carbohydrates (greater than 60 percent of total calories) are accompanied by a reduction in HDL cholesterol and a rise in triglyceride (B1, C1). The latter responses are sometimes reduced when carbohydrate is consumed with viscous fiber (C2); however, it has not been demonstrated convincingly that viscous fiber can fully negate the triglyceride-raising or HDL-lowering actions of very high intakes of carbohydrates.

NCEP Recommendations: Carbohydrate intakes should be limited to 60 percent of total calories. Lower intakes (e.g. 50% of calories) should be considered for persons with the metabolic syndrome who have elevated triglyceride or low HDL cholesterol. Regardless of intakes, most of the carbohydrate intake should come from grain products, especially whole grains, vegetables, fruits, and fat-free or low-fat dairy products.

Macronutrient NCEP Dietary Recommendations

Carbohydrate: 50-60% of Total Calories* **

Protein: 15% of Total Calories

Total Fat: 25-35% of Total Calories*

Monunsaturated Fat: Up to 20% of Total Calories

Polyunsaturated Fat: Up to 10% of Total Calories

Saturated Fat: Less than 7% of Total Calories

Dietary Cholesterol: Less than 200mg/day.

*Allows an increase of total fat to 35% of total calories and reduction in carbohydrate to 50% for persons with the metabolic syndrome. Any increase in fat intake should be in the form of either polyunsaturated or monounsaturated fat.
**Carbohydrate should derive perdominantly from foods rich in complex carbohydrates including grains--especially whole grains---fruits, and vegetables.

Plant Sterols: Recommendations from the National Cholesterol Education Program

NCEP Evidence Statement: Daily intakes of 2-3 grams per day of plant stanol/sterol esters will reduce cholesterol by 6-15 percent Strength of Evidence (A2, B1)

NCEP Recommendation: Plant stanol/sterol esters (2g/day) are a therapeutic option to enhance LDL cholesterol lowering.

Lowering Cholesterol: A Piece of the Heart Health Puzzle

The relationship between LDL cholesterol and cardiovascular diseases has been well-documented and summarized by the NIH's National Cholesterol Education Program.

Epidemiologic studies (i.e. research that associates the lifestyles of different populations or groups to a disease), laboratory studies (i.e. research into the effects of certain nutrients or medication on cells outside the body) and clinical studies (research on the effects of certain nutrients or medications on a living person) all show that cholesterol is a critical factor in the development of atherosclerosis.

Atherosclerosis occurs when plaque builds up on the walls of your arteries. This plaque leads to a narrowing and ultimate closing of an artery. Plaque also can break free of the arterial wall. It then can lodge further down your artery, causing a blockage that can lead to a stroke, heart attack, or a blood clot in your arms, legs or other parts of your body.

National Cholesterol Education Program Summary of Research

• Studies across different populations reveal that those with higher cholesterol levels have more arterial plaque and heart disease than those with lower levels. People who migrate from regions where average serum cholesterol in the general population is low to areas with high cholesterol levels show increases in their cholesterol levels as they acculturate. These higher levels in turn are accompanied by higher levels of heart disease.
• Atherosclerosis often can be identified in adolescence or early adulthood. The cholesterol level in young adulthood predicts development of heart disease later in life. In three prospective studies with long-term follow-up, detection of elevated serum cholesterol in early adulthood predicted an increased incidence of heart disease in middle-age.
• The power of elevated LDL to cause heart disease has been shown most clearly in persons with genetic forms of very high cholesterol. In these persons, advanced coronary atherosclerosis and premature heart disease occur commonly even in the complete absence of other risk factors. These disorders provide stronge evidence that LDL is a powerful cause.
• Since LDL-cholesterol levels of less than 100 mg/dL throughout life are associated with a very low risk for heart disease in populations, they can be called optimal. Even when LDL-cholesterol concentrations are near optimal (100–129 mg/dL), plaque formation occurs; hence, such levels must also be called above optimal. At levels that are borderline high (130–159 mg/dL), plaque formation proceeds at a significant rate, whereas at levels that are high (160–189 mg/dL) and very high (above 189 mg/dL) it accelerates further.
• A large number of clinical trials on cholesterol-lowering therapy have been carried out over the past four decades. The initial encouraging findings of earlier trials have recently been reinforced by the robust findings of a large number of studies.
  

The Research in Context: Only A Piece of the Puzzle

Lowering LDL cholesterol is not a guarantee of cardiovascular health. Many people on cholesterol-lowering medications still suffer heart attacks, strokes and other cardiovascular challenges. Similarly, LDL cholesterol levels above the "optimal" levels should not necessarily require an individual to proceed to a lifetime of cholesterol-lowering medications. Each of us should discuss this carefully with our medical providers.

In these conversations, however, you should recognize that cholesterol-lowering is only one piece of the puzzle. Some things to consider:

• Once built-up in your arteries, plaque is difficult to remove. Cholesterol-lowering therapies may only serve to reduce further development, but not fully remedy arterial health.
• The medical community also is investigating the role that different types of LDLs might play in the development of both plaque itself and the ability for plaque to remain “stable” and not break free from the arterial wall. This may be a factor even if LDL levels are low.
• Low levels (below 40mg/dl) of HDL cholesterol have been shown to be a risk factor for heart diseases and high levels (above 60mg/dl) have been associated with reducing the risk of heart disease and plaque development.

Beyond cholesterol management, cardiovascular health flows from different hereditary, environmental and lifestyle factors. It is a complex equation.

The important point: cholesterol management should be thought of as a lifetime approach, starting in your teens, to maintain cardiovascular health. Like weight-management and physical fitness, cholesterol management and its nutritional tools can promote long term health.

The Cholesterol "Pill" & Health Policy

Over the past few days, the media has meted out criticisms of Big Pharma and their cholesterol medications. Certainly, some of it is well deserved. Some, however, confuses the issues and does not consider some fundamental issues related to health policy.

A Bit of Background

Statins and other cholesterol medications represent a critical piece of Pharma's profits. Worldwide, cholesterol meds represent the single largest class of drugs sold--exceeding $25 billion per year.

Why so much?

These medications do work to reduce LDL (bad) cholesterol, and the relationship between LDL cholesterol, heart disease and stroke has been well study and confirmed.

Then there is the magnitude of the issue. Combined, cardiovascular diseases are the primary causes of death and morbidity in the United States.

But, these medication do not "heal". Stop taking these medications, and your LDL cholesterol will rise--all other things being equal. Users of cholesterol medications thus may find themselves on these drugs for decades.

Overall, couple the huge population at risk of cardiovascular disease with the length of time that these medications are potential used, and a huge market is created.

An Oversold Solution?

Cholesterol medications have been oversold and hyped in their ability to remedy heart issues.

Managing cholesterol can improve the cardiovascular system, but it is not and cannot be a guarantee of heart health. Cholesterol also can be managed by means other than medications--nutrition, weight control and exercise. Nutritional approaches that combine nutrients that actively and positively influence blood lipids ---Omega-3 & monounsaturated fatty acids in lieu of saturated fats, plant sterols, soluble fiber, niacin---can achieve results equivalent to many of medications, particularly for the borderline line high cholesterol types like me. This view is widely endorsed in the medical community including the American Heart Association and the American College of Cardiologists.

Certainly, this does not mean that these drugs are without value. For many, the lifestyle and nutritional approaches are not adequate. Medications is required, and for those at high short term risk, they may be essential. Yet, theses meds should complement the therapeutic lifestyles. The approaches should be integrated and the medications should not be the first line of therapeuty.

Moreover, these medications are most effective in affecting only a component of cholesterol---lowering LDL cholesterol. There are other aspects of blood lipids that are important for heart health---the level of HDLs, the ratio of total cholesterol to HDLs, the size of the LDL particle--to name just a few.

Even in regard to LDL cholesterol, a single medication may not achieve heart risk adjusted targets (to calculate your risk-adjusted ldl targets, go to http://www.kardeanutrition.com/cholesterol/ldl_calculator.aspx ). The pharmaceutical solution is to identify other drugs to be taken with the existing medications.

No doubt, new drugs are coming to market or are in development that work with existing medications to favorably affect blood lipid levels. So, you can look forward to taking more medications! Today, we find ourselves with many people taking many drugs, and overall, we are only dimly aware of their interactions and long term afffects on health.

Drivers of a Healthcare Imbalance

From a health policy perspective, we need to give careful thought to what is going.

One issue is that we allow Big Pharma to spend hundreds of millions dollars per year promoting these medications. At whose expense? Well for one, the consumer advertising campaigns dwarf the public health education campaigns that advance nutritional and lifestyle alternatives. We all would be well served if the consumer received more balance input.

A few policy alternatives could be considered. We could require the pharmaceutical companies to contribute an equivalent amount of advertising money to lifestyle and nutrition public health education. This would not be unlike the tobacco companies funding of smoking cessation programs. Alternatively, we could require those media outlets that air these promotion to donate airtime to publilc health education.

Consumer behavior and incentives also are at issue. The advertising ---this unnecessary hype- works in large part because many consumers want to believe that a single pill will eliminate the risk of heart disease--regardless of what they eat, how much they weigh or how much exercise they get. Intellectually, not many of us would ever concede that we believe in the power of the single pill. Practically, the single pill gives us comfort when we fail to live heart healthy lifestyles.

At least for the well-insured consumer, it also may be cheaper, both in terms of time and money, to pursue the pharmaceutical approach than to embrace the alternatives.

Presidential candidates from both parties are discussing fundamental changes in our health care system. Special interest, including Big Pharma, can be expected to mold this system to their benefit. As citizen, we will be best served by making sure that real public health is advanced. Make your voice heard in this debate!