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Chronic venous insufficiency: What to know

Venous insufficiency occurs when the valves in a person's veins do not work properly. This means that the veins are less able to transport blood back to the heart.

Venous insufficiency is fairly common. According to the Society for Vascular Surgery, it affects up to 40 percent of people in the United States.

It is also usually chronic. This condition causes leg and foot swelling, varicose veins, and aching legs.

In this article, we cover the causes and risk factors for venous insufficiency, as well as how to diagnose and treat it.

What is venous insufficiency? Woman holding her leg due to venous insufficiency
Symptoms of venous insufficiency can include dull aching and swelling in the legs and blood clots.

The heart pumps oxygen-rich blood through the arteries to the rest of the body, while the veins bring deoxygenated blood back to the heart.

When a person has venous insufficiency, their veins have trouble moving deoxygenated blood from the arms and legs back to the heart. Faulty valves inside the veins usually cause venous insufficiency.

Veins have valves made up of two flaps, which prevent the backward flow of blood. These are called bicuspid valves. If the veins are damaged or become dilated, the valves may fail to close properly.

When the valves do not work properly, blood will flow back into the veins instead of forward to the heart. This causes blood to pool in the veins, often in the legs and feet.

This results in many of the symptoms associated with venous insufficiency, such as skin discoloration, swelling, and pain.

Symptoms Some of the symptoms of venous insufficiency include: heaviness, throbbing, or dull aching in the legs swelling of the legs and ankles cramping or itching in the legs patches of darker, brownish skin thicker or harder skin on the legs or ankles open sores blood clots varicose veins Thank you for supporting Medical News Today Causes and risk factors varicose veins on the leg
Varicose veins can cause venous insufficiency. The following factors are more likely to cause venous insufficiency: having a family history of the condition having blood clots having varicose veins being pregnant having obesity smoking having phlebitis, or swelling of superficial veins sitting or standing for long periods of time Treatments The best treatment for chronic venous insufficiency will vary from person to person. Doctors must consider several factors before deciding on the best treatment course. Some of these factors include the cause and symptoms of venous insufficiency and the age and health status of the person. Treatments for chronic venous insufficiency include the following: Medications Healthcare provides may prescribe medications that improve blood flow through the vessels. Some medications that can help treat venous insufficiency include: diuretics, which are medications that remove excess fluid from the body pentoxifylline, which reduces inflammation and improves blood flow blood thinners, or anticoagulants, which prevent blood clots Home remedies People can reduce the symptoms of venous insufficiency at home using the following methods: Wearing compression stockings. These are special elastic stockings that apply pressure to the lower leg and foot. Compression stockings help reduce swelling and improve blood flow. Elevating the legs above the heart. This helps pull blood from the legs toward the heart Practicing good skin hygiene. People with venous insufficiency can develop skin problem, such as dermatitis, cellulitis, or atrophie blanche (white atrophy). People with venous insufficiency can take care of their skin using the following methods: keeping it moisturized so that it does not become dry or flaky exfoliating regularly to remove dead skin cells applying topical ointments as their healthcare provider instructs Nonsurgical procedures The following nonsurgical methods can help treat venous insufficiency: Ablation In some cases, doctors will recommend destroying damaged veins in a process called ablation. They destroy the veins by applying either heat or chemicals. Sclerotherapy In sclerotherapy, a doctor will inject a liquid or foam solution into the damaged vein. The vein reacts to the solution and swells shut. Then, the body absorbs the vein and redirects blood to other healthy veins. Phlebectomy A phlebectomy is a minimally invasive procedure in which a medical professional removes varicose veins through small punctures in the skin. Laser therapy Laser therapy is a relatively new procedure in which a doctor uses lasers to close damaged veins. Surgical procedures People with serious cases of venous insufficiency may require surgery. Some surgical procedures that treat venous insufficiency include: repairing damaged veins or valves stripping or removing damaged veins implanting a small mesh tube, called a stent, to widen the vein ligation, in which a doctor ties off veins through a small incision in the skin Types of venous insufficiency Chronic venous insufficiency falls into three different categories depending on the severity of the symptoms. Stage 1. Swelling and changes in skin pigmentation characterize this stage. Stage 2. Swelling, changes in skin pigmentation, and dermatitis characterize this stage. Stage 3. Swelling, changes in skin pigmentation, varicose veins, and ulcers characterize this stage. Venous insufficiency can cause chronic venous hypertension, a condition characterized by high blood pressure in the veins of the legs. Blood clots or other blockages in the veins can also lead to this condition. If left untreated, chronic venous hypertension can cause abnormalities in the capillaries within the leg tissues, resulting in ulceration, swelling, and hyperpigmentation. This is a condition in which patches of skin become darker than usual. Thank you for supporting Medical News Today Diagnosis mri scanning procedure
A doctor may request an MRI scan to diagnose venous insufficiency. A physical examination is the first step toward diagnosing venous insufficiency. A doctor will also review a person's medical history and current health status before making a diagnosis. Diagnostic procedures that help determine whether or not a person has venous insufficiency include: Venogram. This examination uses X-ray technology to examine how blood flows through the veins. It requires injecting contrast material into a vein. Healthcare providers uses venograms to locate blood clots and evaluate varicose veins. Duplex ultrasound. This noninvasive test examines the speed and direction of blood flow through the veins and arteries. Additional medical tests for venous insufficiency can include: Prevention Many of the risk factors associated with venous insufficiency are related to a person's lifestyle. People can reduce their risk of developing venous insufficiency by making small lifestyle adjustments, such as: getting regular exercise avoiding wearing high heels avoiding standing or sitting for long periods of time maintaining a healthy body weight Summary Venous insufficiency is common condition in which the blood does not flow smoothly through the veins and back to the heart. This is due to faulty valves in the veins. Venous insufficiency is a common condition. It is not life-threatening, but it is usually chronic. Symptoms of venous insufficiency include varicose veins, swelling, and heavy, aching legs. Left untreated, venous insufficiency can lead to other health conditions, such as dermatitis, venous ulceration, and chronic venous hypertension. Treatment of venous insufficiency varies depending on the severity of the symptoms, the individual's medical history and current health status, and the cause of the condition. Treatments for venous insufficiency focus on managing symptoms and preventing further complications. Those who have had venous insufficiency require ongoing care even after successful treatment, as the condition often reappears.
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What to know about high blood pressure during pregnancy

A woman can develop high blood pressure, or hypertension, at any point during pregnancy.

High blood pressure is affecting more and more pregnant women. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women who developed high blood pressure in the United States almost doubled between 1993 and 2014.

High blood pressure affects an estimated 6–8 percent of pregnancies in women aged 20–44 in the U.S.

If left untreated, high blood pressure can lead to serious health complications for the mother, her infant, or both. In most cases, however, hypertension is preventable and treatable.

In this article, we will discuss the different types of high blood pressure that a woman can develop during pregnancy, the risk factors and complications of high blood pressure, and how to prevent and treat high blood pressure during pregnancy.

Types of hypertension in pregnancy Pregnant woman having her blood pressure taken
A woman may experience chronic hypertension, gestational hypertension, or preeclampsia during pregnancy.

According to the CDC, blood pressure measurements that are greater than or equal to 140/90 millimeters of mercury indicate high blood pressure.

Women can experience one of three types of high blood pressure during pregnancy: chronic hypertension, gestational hypertension, or preeclampsia.

A person may have chronic hypertension before pregnancy, whereas gestational hypertension only occurs during pregnancy.

However, gestational hypertension may sometimes persist after the pregnancy to become chronic hypertension.

Chronic hypertension

Women who have chronic hypertension either had high blood pressure before becoming pregnant or developed it within the first half, or 20 weeks, of their pregnancy.

It is possible for a woman to develop a subtype called chronic hypertension with superimposed preeclampsia.

Women with this condition have high blood pressure and can possibly develop an abnormal amount of protein in their urine, or proteinuria. The presence of protein in the urine can indicate problems with the kidneys. Women may also have changes in liver function.

Gestational hypertension

Gestational hypertension only occurs during pregnancy and without the presence of protein in the urine or changes in liver function. Women usually develop this condition in the second half, or after the first 20 weeks, of their pregnancy.

This form of high blood pressure is typically temporary and tends to go away after childbirth. However, it can increase a woman's risk of developing high blood pressure later in life.

In some cases, the blood pressure will remain elevated after the pregnancy, resulting in chronic hypertension.


Preeclampsia is a high blood pressure condition that women can develop during pregnancy or after giving birth. It is a serious condition that can have severe consequences. It usually occurs in the third trimester. It rarely occurs after delivery, but it is possible.

Doctors often diagnose preeclampsia after taking blood pressure measurements and testing blood and urine samples. Women who develop a mild form of preeclampsia may not experience any symptoms.

If symptoms of preeclampsia do develop, they can include:

high blood pressure proteinuria excessive swelling of the face and hands weight gain due to fluid retention headaches dizziness irritability shortness of breath abdominal pain nausea vomiting blurred vision sensitivity to light

Preeclampsia with seizures, or eclampsia, is a different condition. It can be fatal.

Complications of hypertension for the mother If hypertension is severe or uncontrolled, it can cause complications for the mother and baby. High blood pressure during pregnancy puts women at an increased risk of more serious health conditions later in life. One 2013 study revealed that gestational hypertension was associated with a higher risk of ischemic heart disease, myocardial infarction (heart attack), heart failure, and ischemic stroke. Poorly controlled high blood pressure puts a woman at risk of developing preeclampsia and gestational diabetes. One complication of hypertension is HELLP syndrome. This is a rare life-threatening liver and blood disorder. Doctors consider it to be a severe variant of preeclampsia. HELLP stands for: Hemolysis, or the breaking down of red blood cells Elevated Liver enzymes, which is a sign of liver damage Low Platelet count; platelets are a material that forms blood clots Other complications associated with high blood pressure during pregnancy include: stroke placental abruption, a serious medical condition in which the placenta separates from the wall of the uterus too early preterm delivery, or giving birth before the due date, which healthcare providers may advise if the placenta is not providing a enough nutrients and oxygen to the baby or if the mother's life is in danger Thank you for supporting Medical News Today Risks of hypertension for the baby High blood pressure can increase the risk of poor birth outcomes, such as preterm delivery, smaller-than-average size, and infant death. High blood pressure affects the mother's blood vessels. This can decrease the flow of nutrients through the placenta to the baby, resulting in a low birth weight. Hypertension-related preterm delivery can result in health complications for the baby. These may include difficulty breathing if the lungs are not fully developed, for example. Signs and symptoms Pregnant woman at the doctors
A pregnant woman should attend regular prenatal checkups. The American Heart Association (AHA) call high blood pressure the "silent killer" because most people who have it do not develop symptoms. This means that a person may have high blood pressure without knowing it. Monitoring blood pressure is an essential part of prenatal care. It is important to remember that women can develop high blood pressure before, during, and after their pregnancy. It is important that women attend regular prenatal checkups to ensure that their blood pressure and other vital signs are within normal ranges and receive treatment if not. Also, blood pressure fluctuates in response to small changes in a person's life, such as stress, diet, exercise, and the quality of their sleep. This is why it is so important that people check their blood pressure regularly. Risk factors for hypertension Risk factors for gestational hypertension and preeclampsia include: a history of preeclampsia preexisting hypertension pregestational diabetes having twins or triplets preexisting kidney disease some autoimmune diseases The following are risk factors for a person to develop hypertension: having a family history of high blood pressure being overweight race age having high cholesterol stress smoking cigarettes drinking alcohol not exercising often becoming pregnant at an older age having had high blood pressure during a previous pregnancy Thank you for supporting Medical News Today Treatment Women with chronic hypertension should continue taking antihypertensive medication during their pregnancy. However, some common antihypertensive medications are not suitable for pregnant women to take, so healthcare providers may recommend a different medication. If gestational hypertension is severe or a woman develops preeclampsia or eclampsia, a doctor may prescribe medications to lower her blood pressure and help the baby mature if the pregnancy is not full-term. Women may be hospitalized for monitoring. Healthcare providers may recommend anticonvulsive medications, such as magnesium sulfate, to prevent seizures in people with eclampsia or preeclampsia. In some cases, a doctor may advise delivery of the baby for treatment. The timing of delivery depends on how severe the mother's condition has become, as well as how far along the pregnancy is. Women who are pregnant should speak with their healthcare provider about ways to control their blood pressure. Prevention Pregnant woman performing yoga
Doctors recommend regular exercise to prevent high blood pressure. Making simple lifestyle changes, such as getting more exercise and eating a more balanced diet, can help prevent high blood pressure. It is important to note that some risk factors, such as family history, race, and past pregnancy history, are not within a person's control. For this reason, not all cases of hypertension in pregnancy are preventable. Some ways to lower the risk of high blood pressure during pregnancy include: limiting salt intake staying hydrated eating a balanced diet that is rich in plant-based foods and low in processed foods getting regular exercise getting regular prenatal checkups avoiding smoking cigarettes and drinking alcohol Medical professionals tend to recommend that people have regular blood pressure screening, especially when they have risk factors, so that they can begin to treat it early. Summary High blood pressure, or hypertension, during pregnancy can be life-threatening to a woman in some cases. If left untreated, high blood pressure can cause harm to both the mother and her infant. It does not always lead to serious health complication, and sometimes, it will go away following childbirth. Hypertension during pregnancy is typically preventable and treatable. A doctor must closely monitor hypertension in pregnancy to prevent potentially life-threatening health complications. It is important that women attend regular prenatal evaluations and report any abnormal symptoms to ensure their own health and that of their infant.
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Statins: Risk of side effects is low, say experts

For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.
pills and stethoscope against a pink and blue background
New research suggests that the benefits of statins outweigh the risks.

The American Heart Association (AHA) statement applies to those who — according to current guidelines — are at risk of heart attack and ischemic strokes, which are strokes arising from blood clots.

Statins are drugs that reduce low-density lipoprotein (LDL) cholesterol by blocking an enzyme in the liver.

Around a quarter of adults over the age of 40 years old in the United States use statins to reduce their risk of heart attack, ischemic stroke, and other conditions that can develop when plaque builds up in arteries.

However, up to 1 in 10 of individuals taking statins stop using them because they assume that the drug is responsible for symptoms that they experience, although that may not be the case.

"Stopping a statin," says Dr. Mark Creager, who is director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, and former president of the AHA, "can significantly increase the risk of a heart attack or stroke caused by a blocked artery."

The journal Arteriosclerosis, Thrombosis, and Vascular Biology carries a full report on the research that went into the statement.

Within guidelines, 'benefits outweigh risks'

The statement's authors say that trials have proved that statins have had a major effect on reducing heart attacks, strokes, other cardiovascular diseases, and associated deaths.

Further to this, they reviewed a large number of studies and clinical trials that have evaluated the safety and potential adverse effects of statins.

"Over 30 years of clinical investigation," the authors write, "have shown that statins exhibit few serious adverse effects."

They point out that, apart from a few exceptions, it is possible to reverse the adverse effects of statin use. This should be compared, they argue, with the fact that heart attacks and stroke damage the heart or brain permanently, and they can kill.

They list the exceptions as "hemorrhagic stroke and the possible exception of newly diagnosed diabetes mellitus and some cases of autoimmune necrotizing myositis."

"Thus," they conclude, "in the patient population in whom statins are recommended by current guidelines, the benefit of reducing cardiovascular risk with statin therapy far outweighs any safety concerns."

According to the AHA, the current guidelines recommend the use of statins for the following groups:

Those who have experienced heart attack, stroke, transient ischemic attacks, or who have a history of cardiovascular conditions such as angina and peripheral artery disease. Adults aged 40–75 years old whose LDL cholesterol is in the 70–189 milligrams per deciliter (mg/dl) range and whose risk of having a heart attack or stroke in the next 10 years is 7.5 percent or above. Adults aged 40–75 years of age who have diabetes and whose LDL cholesterol is in the range 70–89 mg/dl. Anyone aged 21 years and older with a very high LDL cholesterol level of 190 mg/dl and above.
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'Muscle aches and pains'

People using statins who report side effects most often mention "muscle aches and pains."

However, the research that the statement's authors reviewed reveals that fewer than 1 percent of people who use statins "develop muscle symptoms that are likely caused by statin drugs."

Uncertainty about the causes of any aches and pains, coupled with the fact that they are taking statins, may prompt people to make a link where none exists.

The AHA say that if individuals stop taking their statins for this reason, they may be doing more harm than good by raising their risk of a cardiovascular event.

They urge healthcare providers to "pay close attention to their patients' concerns and help them assess likely causes." They could, for instance, check for blood markers of muscle damage. If they are normal, this could reassure their patients.

Another option is to check vitamin D levels, as insufficiency amounts can also cause muscle aches and pains.

Risk of diabetes and hemorrhagic stroke

There is a slight chance that statins might raise the risk of diabetes, especially in those at higher risk. These include individuals with obesity or whose lifestyle is largely sedentary.

The statement suggests that the absolute risk of being diagnosed with diabetes as a result of using statins is around 0.2 percent per year.

For those who already have diabetes, there could be a slight increase in the amount of glucose in the blood, as their HbA1c measure may reflect.

However, the increase is very small and should not prevent the use of statins, note the AHA.

The research that the statement reviewed did not find that statins increase the risk of a first hemorrhagic stroke, which is a type of stroke that occurs when a blood vessel ruptures.

People with a history of hemorrhagic stroke, on the other hand, may have a slightly higher risk of a further one if they use statins. However, this risk is very small and the overall benefits of statin use in reducing strokes and "other vascular events" outweighs it.

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Risk of other side effects

The statement's authors also looked at evidence that statin use might increase the risk of other conditions. These included damage to peripheral nerves, other neurological effects, damage to the liver, cataracts, and ruptures to a tendon.

They found, however, "little evidence" to support the idea that using statins raised the risk of these conditions.

In rare instances, there could be a side effect called rhabdomyolysis, which is a type of muscle injury that can lead to acute kidney failure. A sign of this can be passing dark urine, so if this happens people should stop taking their statins and see their doctor, say the AHA.

From the reviewed evidence, the statement suggests that rhabdomyolysis is a side effect in less than 0.1 percent of people taking statins.

"In most cases, you should not stop taking your statin medication if you think you are having side effects from the drug — instead, talk to your healthcare provider about your concerns."

Dr. Mark Creager

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What are the best foods to eat for energy?

All food provides the body with energy, but this energy can vary greatly. Some foods, such as sugars and refined carbs, give the body a quick jolt of energy. However, more often, the body needs more sustainable energy from ingredients such as fruits, grains, and legumes.

The list we give here focuses on foods and drinks that provide more stable energy throughout the day.

Drinks The following drinks can help boost energy: 1. Water Energy boosting foods water
Drinking water throughout the day boosts energy levels.

Water is the most crucial energizing ingredient on this list. Water is vital for every cell in the body to work correctly.

While most people think of dehydration as an extreme scenario, the body may become partially dehydrated if a person goes all morning without water.

Maintaining energy can be as simple as carrying a water bottle around and sipping it throughout the day to stay properly hydrated.

2. Coffee

Coffee is a recognizable energy booster. The caffeine in coffee makes the body and mind feel alert and may make people more productive.

Coffee also contains antioxidants called polyphenols, which may reduce oxidative stress in the cells and help the body function better.

Coffee is a stimulant, however, so people should consume it in moderation. Too much coffee may lead to energy loss as the body withdraws from the caffeine.

3. Green tea

Green tea still contains small amounts of caffeine, but it also has compounds that may help reduce oxidative stress and inflammation in the body. The result may be a smoother transition than coffee to a more awake and energetic state.

4. Yerba maté

Yerba maté is a drink native to South America. Drinking the herb as a tea provides the body with similar stimulating effects as tea or coffee.

Yerba maté contains many active nutrients, antioxidants, and amino acids. People who drink yerba maté say it provides a much smoother form of energy by comparison to the jolt of energy from coffee.

As a study in the journal Nutrients notes, yerba maté may also improve mood and help people feel full, even after exercise, which may be helpful for those looking to lose weight while maintaining their energy levels.

Fruits The following fruits may help boost energy: 5. Bananas Bananas may be the best quick snack for sustained energy. While bananas are a good natural source of sugar, they are also rich in fibers that help slow the digestion of that sugar. Bananas contain helpful nutrients that make the body feel full of energy. A study in the journal PLoS One notes that eating a banana before a long bicycle ride helps performance and endurance just as much as a carbohydrate drink. While most people are not cycling each day, bananas may still provide energy. 6. Avocados Avocados are a well-rounded fruit in terms of health values and nutrients. As a study in Critical Reviews in Food Science and Nutrition notes, they contain nutrients, protein, and fiber that may help sustain energy levels throughout the day. They also contain good fats that may increase energy levels, and make fat-soluble nutrients more available in the body. 7. Goji Berries Goji berries are small, reddish berries containing many nutrients and important anti-aging and antioxidant properties, as a review in Drug Design, Development and Therapy notes. The specific antioxidants have many possible benefits, including giving the body more energy. Dried goji berries make a great addition to a trail mix, and many people add a few to a water bottle to drink throughout the day. 8. Apples Apples may be another simple snack to give the body lasting energy. Along with fiber and nutrients, a study in the journal Horticulture Research notes that apples are high in antioxidants called flavonoids, which may help fight against oxidative stress and inflammation in the body. 9. Strawberries As a study in the Journal of Agricultural and Food Chemistry notes, strawberries are a good source of minerals, vitamin C, and folates. They also contain phenols, which are essential antioxidants that may help the body create energy at the cellular level. People can add strawberries to many dishes, and a handful may also be an easy snack to add to a diet. 10. Oranges Most people enjoy oranges for their taste, which comes from the antioxidant vitamin C. Vitamin C may help reduce oxidative stress in the body and prevent fatigue. A study in the journal Antioxidants notes that young adult male students who have higher levels of vitamin C may also have better mood and may be less likely to experience confusion, anger, or depression. 11. Dark berries Berries, including blueberries, raspberries, and blackberries, may be a good energy boosting food when the body is craving something sweet. Dark berries tend to be higher in natural antioxidants than lighter-colored ones, which may reduce inflammation and fatigue in the body. They also tend to have less sugar than sweeter fruits, while still satisfying a craving for a sweet taste. Thank you for supporting Medical News Today Animal products The following animal products may help boost energy: 12. Fatty fish Energy boosting foods salmon
Salmon contains omega-3 fatty acids, which may improve brain function and reduce fatigue. Fish, in general, is an excellent and light source of protein and B vitamins that may give the body sustained energy throughout the day. Fatty cold-water fish, such as salmon, sardines, and tuna, tend to be higher in omega-3 fatty acids. As a study in the journal Nutrients notes, omega-3 fatty acids may improve brain function and reduce inflammation in the body, which may be a cause of fatigue in some people. 13. Beef liver Beef liver may be one of the best meat sources for vitamin B-12, which keeps the body feeling full of energy. While many cuts of meat contain vitamin B-12, the difference is that beef liver has a large amount. According to the United States Department of Agriculture (USDA), a 3-ounce cut of beef flank steak contains about 1.5 micrograms (mcg) of vitamin B-12. The same cut of beef liver contains 60 mcg of vitamin B-12, according to the USDA. 14. Yogurt Yogurt may also be a source of energy. As the USDA show, natural yogurt is rich in protein, fats, and simple carbohydrates, which provide energy to the body. Yogurt is also very easy to eat on the go, which makes it a great alternative to vending machine food. 15. Eggs Eggs provide the body with plenty of protein and nutrients for sustainable energy. As the USDA note, one large hard-boiled egg contains about 6 grams (g) of protein and 5 g of fat, as well as vitamins and minerals to help keep the body energized and feeling full for longer than other snacks. Vegetables The following vegetables are good options for energy: 16. Yams and sweet potatoes Yams and sweet potatoes are beneficial sources of carbohydrates, which provide energy. Yet sweet potatoes are also high in fiber, which may help slow the body's absorption of these carbohydrates. This may make them a good option for sustained energy throughout the day. 17. Beets As a study in the journal Food Science and Biotechnology notes, beets may provide the body with a great source of antioxidants and nutrients that help improve blood flow and energy. People can consume beets as dried beetroot chips, cooked beets or as a bottle of beetroot juice. 18. Dark leafy greens Dark, leafy greens such as kale, spinach, and collard greens are nutrient dense and contain filling proteins, as well as nutrients and antioxidants. Greens may be difficult to digest raw for some people, so breaking them down by cooking them with a bit of vinegar or lemon juice may help. 19. Dark chocolate Dark chocolate may be an easy way to increase energy. Rich, dark chocolate usually has much less sugar than milk chocolate. Less sugar means less immediate energy, but more cocoa content means more of the benefits of cocoa, including helpful antioxidants such as flavonoids. A study in the journal Archives of the Turkish Society of Cardiology notes that dark chocolate may benefit the cardiovascular system by helping more blood pump around the body. This blood carries fresh oxygen, which may also make a person feel more awake and alert. Grains The following grains may help with energy: 20. Oatmeal A bowl of whole-grain oatmeal may be a great way to provide the body with energy. Oats are rich in fiber, and they may enable the body to feel fuller for longer than other breakfast choices. As a study in The Journal of Nutrition notes, whole-grain oats are also a source of essential minerals, vitamins, and phenolic compounds, all of which may help energize the body. 21. Popcorn Popcorn is rich in carbohydrates. However, it also contains fiber to help slow the digestion. Popcorn may make a person feel full for longer than other carbohydrates. As a study in Nutrition Journal notes, people who ate popcorn rather than potato chips felt fuller from the snack. This may be helpful for dieters, as popcorn usually contains fewer calories than potato chips. 22. Quinoa Quinoa is a seed, but most people treat it as a grain. Quinoa is high in protein, carbohydrates, and fiber. The combination of amino acids and slow-release carbohydrates may make for sustainable energy rather than a short burst of glucose from other grains. 23. Brown rice One of the benefits of brown rice may be that it retains much of the fiber from the husk. The husk is not there in white rice, which may cause the body to absorb the carbohydrate content quickly. This may lead to a spike and then a crash in energy levels. By having the husk, brown rice may help slow the digestion of these carbohydrates, therefore, releasing energy more slowly. Thank you for supporting Medical News Today Beans and legumes The following beans and legumes may help with energy: 24. Soybeans Whether roasted soybeans or young edamame beans in the pod, soybeans contain protein with a wide variety of amino acids, as well as magnesium and potassium, according to the USDA. 25. Lentils Energy boosting foods lentils
Lentils are an excellent source of protein and fiber. Lentils are a relatively cheap form of protein and fiber, which may make them a great option for people on a budget. The USDA note that 1 cup of lentils contains about 18 g of protein, 40 g of carbs, 15 g of fiber, and less than 4 g of sugar. The fiber may help to manage the digestion of the carbs, keeping the body full and providing a source of sustained energy. 26. Nuts Many nuts contain a blend of protein, fats, and some carbohydrates to provide energy throughout the day. Nuts are typically also rich sources of vitamins and minerals such as magnesium, calcium, or phosphorous. Nuts are usually high in essential fatty acids. As a study in the Journal of Parenteral and Enteral Nutrition notes, these fatty acids may help reduce inflammation, which may also reduce fatigue. Nuts are high in calories, as well, so people should be careful not to eat too many 27. Peanut butter Peanut butter is typically rich in protein, fats, and fiber, and may help a person feel full for longer after eating it. This may cut the need for constant snacking, which may also leave a person feeling drained as their body has to digest continuously. 28. Seeds Many seeds, such as pumpkin seeds, chia seeds, and flax seeds, are rich sources of fatty acids and fiber, which may translate to more energy. Seeds are also easy to carry and make a great addition to a quick trail mix. Foods to avoid While most foods provide energy, the ones above focus on sustained energy. Foods to try to avoid may include: fast foods or fried foods added sugars packaged snacks and candy bars baked sweets such as cakes and cupcakes Takeaway While this list is not exhaustive, the idea behind finding energy boosting foods is to consume a varied, balanced diet. Vitamins, fiber, fats, and proteins are all essential for energy, but it is crucial to find a balance between them. People should try to choose a varied diet containing many different, nutritious foods that give the body sustained energy.
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Excess belly fat common in those with high heart risk

Excess waist fat is common in many people with a high risk of heart disease and stroke, according to a recent European study.
middle aged man doing squats
New research finds that two-thirds of people at high risk of developing cardiovascular disease have excess belly fat.

The study, called EUROASPIRE V, is a survey of cardiovascular disease prevention and diabetes. It forms part of a European Society of Cardiology research program.

The findings featured recently at the World Congress of Cardiology & Cardiovascular Health in Dubai in the United Arab Emirates.

They revealed that nearly two-thirds of individuals at high risk of cardiovascular disease had excess abdominal fat.

The results also showed that:

Only 47 percent of those taking drugs to reduce high blood pressure were achieving a target of under 140/90 millimeters of mercury, or under 140/85 for those who reported having diabetes. Among individuals using lipid-lowering medication, only 43 percent had reached the low-density lipoprotein (LDL) cholesterol target of under 2.5 millimoles per liter. Many who were not in receipt of treatment for high blood pressure and high LDL cholesterol had those conditions. Only 65 percent of individuals receiving treatment for type 2 diabetes had attained the target blood sugar of under 7.0 percent glycated hemoglobin (HbA1c).

"The survey," says Kornelia Kotseva, chair of the EUROASPIRE Steering Committee and a professor at Imperial College London in the United Kingdom, "shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids, and diabetes."

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Individuals with high heart risk

The recent study focuses on "apparently healthy individuals in primary care at high risk of developing cardiovascular disease, including those with diabetes."

Altogether, 78 primary care practices from 16, mainly European, countries took part in the research, which took place during 2017–2018.

They recruited individuals who were under 80 years of age and had no history of coronary artery disease or other conditions arising from atherosclerosis.

However, assessments had shown that they were at high risk of developing cardiovascular disease due to one or more of the following: high blood pressure, high cholesterol, or diabetes.

The researchers used medical records to identify those eligible for the study and invited them for an interview and clinical exam.

The interviewers asked questions about diet, exercise, smoking, and other lifestyle factors.

The analysis included a total of 2,759 people. Of these:

64 percent had central obesity, which is a measure of excess abdominal fat. 37 percent were in the overweight category for body mass index (25.0–29.9 kilograms per square meter). 18 percent were current smokers. 36 percent were achieving the typical guideline physical activity level of at least 30 minutes on 5 days of the week.

The researchers defined central obesity as having a waist size of at least 88 centimeters (34.7 inches) for women and at least 102 centimeters (40.2 inches) for men.

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'GPs need to be more proactive'

Prof. Kotseva urges primary care practitioners to be proactive about looking for cardiovascular risk factors.

They need to probe beyond the risk factors that they are already aware of and "always investigate smoking, obesity, unhealthy diet, physical inactivity, blood pressure, cholesterol, and diabetes," she argues.

Individuals often don't realize that they should be receiving treatment. They may visit their doctor for diabetes care and not know that they also have high blood pressure.

"In our study, many participants with high blood pressure and cholesterol were not being treated," notes Prof. Kotseva.

She suggests that the findings highlight a need for more investment and policy that focuses on prevention.

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The recent news follows that of earlier research that featured at the European Society of Cardiology Congress in April 2018 in Ljubljana, Slovenia.

In that study, researchers from the Mayo Clinic in Rochester, MN concluded that excess belly fat is "bad for the heart," even in individuals whose BMI is in the normal range.

They advised doctors not to assume that having normal BMI means that there is no heart-related issue in an otherwise healthy individual.

A BMI in the normal range does not necessarily indicate normal fat distribution. It is important to measure central obesity as well, to get a better picture of heart risk.

"These data make it clear that more efforts must be made to improve cardiovascular prevention in people at high risk of cardiovascular disease."

Prof: Kornelia Kotseva

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