Height and Weight Chart

Head circumference

Head circumference is a measurement of the circumference of the child's head at its largest area (above the eyebrows and ears and around the back of the head). During routine check-ups, the distance is measured and compared to previous measurements. Normal ranges are based on sex and age.

Height/weight chart

A chart may be used to measure and compare a child's growth to a standard range. The parameters to be measured and charted are height, weight, and head circumference.

Information

A growth chart is used to measure and compare a child's growth with what is considered normal for that child's age and gender. The nationally accepted growth charts are based on measurement data collected by the National Center for Health Statistics. The parameters measured include height, weight, and head circumference.

Height and weight measurements are used to document a child's height or length (in inches or centimeters), weight (in ounces and pounds, or grams and kilograms), based on his age in weeks, months, and years. For children under 3 years, height is measured while they are lying down. For children over 3, height is measured while standing. Height and weight measurements are recorded and graphed until the child is 17.

Head circumference is a measurement of the size of the head taken by wrapping a tape measure above the eyebrows and around to the back of head.

Measurements are compared to the standard (normal) range for children of the same gender and age. Results are read as percentiles of average. For example, a child with a height at the 75th percentile means that only about 25% of children the same age and gender are taller and about 75% of children are shorter.

Growth charts are important in that they may provide an early warning that the child has a medical problem. For instance, during the first 18 months of life and particularly during early infancy, abnormal growth of the head can alert the doctor to a problem.

Growth that is too rapid may indicate the presence of hydrocephalus (water around the brain), a brain tumor, or other conditions that cause macrocephaly (abnormally large head). Growth that is too slow may indicate problems in brain development, early fusion of sutures (the bones of the skull), or other problems.

Insufficient gain in weight, height or a combination may indicate failure-to-thrive, chronic illness, neglect, or other problems.

Abnormal growth as seen on the growth charts is only an indicator of a potential problem. Your doctor will determine if it represents an actual medical problem or simply needs to be followed carefully. Because of individual variations in genetics and hormones, growth charts are not an accurate predictor of a child's future, full-grown height.

Diabetes Diet

Diabetes Food Pyramid

The Diabetes Food Pyramid divides food into six groups, which vary in size to show relative amounts of servings for each group.

This pyramid differs from the Food Guide Pyramid released by the USDA. In the Diabetes Food Pyramid, the groups are based on protein content and carbohydrates instead of their food classification.

Definition

Specific diabetic dietary guidelines have been developed by the American Diabetes Association and the American Dietetic Association to improve the management of diabetes.

Key principles are to:

• Achieve weight control through reducing calories
• Reduce intake of dietary fat (specifically saturated fat)
• Individualize guidelines for carbohydrates based on the type of diabetes you have and the control of your blood sugar levels.

Function

There are 2 primary types of diabetes. The nutritional goals for each are different.

With type 1 diabetes, studies show that total carbohydrate has the most effect on the amount of insulin needed and the maintenance of blood sugar control. There is a delicate balance of carbohydrate intake, insulin, and physical activity that is necessary for the best blood levels of a sugar called glucose. If these components are not in balance, there can be wide fluctuations -- from too-high to too-low -- in blood glucose levels. For those with type 1 diabetes on a fixed dose of insulin, the carbohydrate content of meals and snacks should be consistent from day to day.

For children with type 1 diabetes, weight and growth patterns are a useful way to determine if the child's intake is adequate. Try not to withhold food or give food when a child is not hungry. Insulin dosing and scheduling should be based on a child's usual eating and exercise habits.

With type 2 diabetes, the main focus is on weight control, because 80% - 90% of people with this disease are overweight. A meal plan, with reduced calories, even distribution of carbohydrates, and replacement of some carbohydrate with healthier monounsaturated fats helps improve blood glucose levels.

Examples of foods high in monounsaturated fat include peanut or almond butter, almonds, walnuts, and other nuts. These can be substituted for carbohydrates, but portions should be small because these foods are high in calories.

In many cases, moderate weight loss and increased physical activity can control type 2 diabetes. Some people will need to take oral medications or insulin in addition to lifestyle changes.

Children with type 2 diabetes present special challenges. Meal plans should be recalculated often to account for the child's change in calorie requirements due to growth. Three smaller meals and 3 snacks are often required to meet calorie needs.

Changes in eating habits and increased physical activity help reduce insulin resistance and improve blood sugar control. When at parties or during holidays, your child may still eat sugar-containing foods, but have fewer carbohydrates on that day. For example, if birthday cake, Halloween candy, or other sweets are eaten, the usual daily amount of potatoes, pasta, or rice should be eliminated. This substitution helps keep calories and carbohydrates in better balance.

For children with either type of diabetes, special occasions (like birthdays or Halloween) require additional planning because of the extra sweets.

Recommendations

Reduce the amount of dietary fat. The current American Diabetes association guidelines advise that less than 7 - 10% of calories should come from saturated fat. These are the fats that raise LDL ("bad") cholesterol. Dietary cholesterol should be less than 200 - 300 mg per day. Additionally, intake of trans-unsaturated fats should be minimized. These are better known as partially hydrogenated oils. Reducing fat intake may help contribute to modest weight loss.

Keep protein intake in the range of 15 - 20% of total calories. Choices low in fat are recommended such as nonfat dairy products, legumes, skinless poultry, fish and lean meats. To keep the cholesterol content in range, approximately 6 ounces of protein per day is recommended. A portion of poultry, fish, or lean meat is about the size of 2 decks of cards.

Carbohydrate choices should come from whole grains breads or cereals, pasta, brown rice, beans, fruits and vegetables. Increasing dietary fiber is a general guideline for the entire population rather than specifically for people with diabetes. Portions and type of carbohydrate affect calories and is reflected by weight and blood glucose control. Learning to read labels for total carbohydrate rather than sugar provides the best information for blood sugar control.

Limit sources of high-calorie and low-nutritional-value foods, including those with a high content of sugars. Sugar-containing foods should be substituted for other carbohydrate sources (such as potatoes) instead of just adding them on to the meal.

A registered dietitian can help you best decide how to balance your diet with carbohydrates, protein and fat.

Diabetes

Endocrine glands

Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the pace of chemical activity in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

Diabetic retinopathy

Diabetes causes an excessive amount of glucose to remain in the blood stream which may cause damage to the blood vessels. Within the eye the damaged vessels may leak blood and fluid into the surrounding tissues and cause vision problems.

Islets of Langerhans

Islets of Langerhans contain beta cells and are located within the pancreas. Beta cells produce insulin which is needed to metabolize glucose within the body.

Blood test

To monitor the amount of glucose within the blood a person with diabetes should test their blood regularly. The procedure is quite simple and can often be done at home.

Pancreas

The pancreas is located behind the liver and is where the hormone insulin is produced. Insulin is used by the body to store and utilize glucose.

Insulin pump

Various styles of insulin pumps may be utilized by people with diabetes to inject insulin into the body in a controlled, more convenient and discreet manner.

Glucose test

A person with diabetes constantly manages their blood's sugar (glucose) levels. After a blood sample is taken and tested, it is determined whether the glucose levels are low or high. If glucose levels are too low carbohydrates are ingested. If glucose in the blood is too high, the appropriate amount of insulin is administered into the body such as through an insulin pump.

Insulin pump

The catheter at the end of the insulin pump is inserted through a needle into the abdominal fat of a person with diabetes. Dosage instructions are entered into the pump's small computer and the appropriate amount of insulin is then injected into the body in a calculated, controlled manner.

Type I diabetes

In response to high levels of glucose in the blood, the insulin-producing cells in the pancreas secrete the hormone insulin. Type I diabetes occurs when these cells are destroyed by the body’s own immune system.

Diabetic blood circulation in foot

People with diabetes are at risk for blood vessel injury, which may be severe enough to cause tissue damage in the legs and feet.

Food and insulin release

Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.

Insulin production and diabetes

Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar.

Monitor blood glucose - series: Part 1

Set up the meter according to the specific directions that come with your meter. Get the supplies ready, including a new test strip and disposable lancet. Place the lancet into the lancing device.

Definition

Diabetes is a life-long disease marked by high levels of sugar in the blood.

Causes, incidence, and risk factors

Diabetes can be caused by too little insulin (a hormone produced by the pancreas to control blood sugar), resistance to insulin, or both.

To understand diabetes, it is important to first understand the normal process of food metabolism. Several things happen when food is digested:

• A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body.
• An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel.

People with diabetes have high blood sugar. This is because their pancreas does not make enough insulin or their muscle, fat, and liver cells do not respond to insulin normally, or both.

There are three major types of diabetes:

• Type 1 diabetes is usually diagnosed in childhood. The body makes little or no insulin, and daily injections of insulin are needed to sustain life.
• Type 2 diabetes is far more common than type 1 and makes up most of all cases of diabetes. It usually occurs in adulthood. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to the insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.
• Gestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes.

Diabetes affects more than 20 million Americans. About 54 million Americans have prediabetes. There are many risk factors for diabetes, including:

• A parent, brother, or sister with diabetes
• Obesity
• Age greater than 45 years
• Some ethnic groups (particularly African Americans, Native Americans, Asians, Pacific Islanders, and Hispanic Americans)
• Gestational diabetes or delivering a baby weighing more than 9 pounds
• High blood pressure
• High blood levels of triglycerides (a type of fat molecule)
• High blood cholesterol level
• Not getting enough exercise

The American Diabetes Association recommends that all adults over age 45 be screened for diabetes at least every 3 years. A person at high risk should be screened more often.

Symptoms

High blood levels of glucose can cause several problems, including frequent urination, excessive thirst, hunger, fatigue, weight loss, and blurry vision. However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all.

Symptoms of type 1 diabetes:

• Increased thirst
• Increased urination
• Weight loss in spite of increased appetite
• Fatigue
• Nausea
• Vomiting

Patients with type 1 diabetes usually develop symptoms over a short period of time, and the condition is often diagnosed in an emergency setting.

Symptoms of type 2 diabetes:

• Increased thirst
• Increased urination
• Increased appetite
• Fatigue
• Blurred vision
• Slow-healing infections
• Impotence in men

Signs and tests

A urine analysis may be used to look for glucose and ketones from the breakdown of fat. However, a urine test alone does not diagnose diabetes. The following blood glucose tests are used to diagnose diabetes:

• Fasting blood glucose level -- diabetes is diagnosed if higher than 126 mg/dL on two occasions. Levels between 100 and 126 mg/dl are referred to as impaired fasting glucose or pre-diabetes. These levels are considered to be risk factors for type 2 diabetes and its complications.
• Random (non-fasting) blood glucose level -- diabetes is suspected if higher than 200 mg/dL and accompanied by the classic symptoms of increased thirst, urination, and fatigue. (This test must be confirmed with a fasting blood glucose test.)
• Oral glucose tolerance test -- diabetes is diagnosed if glucose level is higher than 200 mg/dL after 2 hours (This test is used more for type 2 diabetes.)

You should also ask your doctor how often to you need your hemoglobin A1c (HbA1c) level checked. The HbA1c is a measure of average blood glucose during the previous 2 to 3 months. It is a very helpful way to determine how well treatment is working.

Ketone testing is another test that is used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle, and they are harmful at high levels. The ketone test is done using a urine sample. High levels of blood ketones may result in a serious condition called ketoacidosis. Ketone testing is usually done at the following times:

• When the blood sugar is higher than 240 mg/dL
• During acute illness (for example, pneumonia, heart attack, or stroke)
• When nausea or vomiting occur
• During pregnancy

Treatment

There is no cure for diabetes. Treatment involves medicines, diet, and exercise to control blood sugar and prevent symptoms and complications.

LEARN THESE SKILLS

Basic diabetes management skills will help prevent the need for emergency care. These skills include:

• How to recognize and treat low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia)
• What to eat and when
• How to take insulin or oral medication
• How to test and record blood glucose
• How to test urine for ketones (type 1 diabetes only)
• How to adjust insulin or food intake when changing exercise and eating habits
• How to handle sick days
• Where to buy diabetes supplies and how to store them

After you learn the basics of diabetes care, learn how the disease can cause long-term health problems and the best ways to prevent these problems. People with diabetes need to review and update their knowledge, because new research and improved ways to treat diabetes are constantly being developed.

SELF-TESTING

If you have diabetes, your doctor may tell you to regularly check your blood sugar levels at home. There are a number of devices available, and they use only a drop of blood. Self-monitoring tells you how well diet, medication, and exercise are working together to control your diabetes and can help your doctor prevent complications.

The American Diabetes Association recommends that premeal blood sugar levels fall in the range of 80 to 120 mg/dL and bedtime blood levels fall in the range of 100 to 140 mg/dL. Your doctor may adjust this depending on your circumstances.

WHAT TO EAT

You should work closely with your health care provider to learn how much fat, protein, and carbohydrates you need in your diet. A registered dietician can be very helpful in planning dietary needs.

People with type 1 diabetes should eat at about the same times each day and try to be consistent with the types of food they choose. This helps to prevent blood sugars from becoming extremely high or low.

Persons with type 2 diabetes should follow a well-balanced and low-fat diet.

HOW TO TAKE MEDICATION

Medications to treat diabetes include insulin and glucose-lowering pills called oral hypoglycemic drugs.

Persons with type 1 diabetes cannot make their own insulin, so daily insulin injections are needed. Insulin does not come in pill form. Injections that are generally needed one to four times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day. Other people may use a new type of inhaled insulin.

Insulin preparations differ in how quickly they start to work and how long they remain active. Sometimes different types of insulin are mixed together in a single injection. The types of insulin to use, the doses needed, and the number of daily injections are chosen by a health care professional trained to provide diabetes care.

People who need insulin are taught to give themselves injections by their health care providers or diabetes educators.

Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and medicines taken by mouth. There are several types of medicines used to lower blood glucose in type 2 diabetes. They fall into one of three groups:

1. Medications called oral sulfonylureas that increase insulin production by the pancreas.
2. Medications called thiazolidinediones that help increase the cell's sensitivity (responsiveness) to insulin.
3. Medications that delay absorption of glucose from the gut. These include acarbose and miglitol.

There are some injectable medicines used to lower blood sugar. They include exenatide and pramlintide.

Most persons with type 2 diabetes will need more than one medication for good blood sugar control within 3 years of starting their first medication. Different groups of medications may be combined or used with insulin.

Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity, because when their ideal weight is reached, their own insulin and a careful diet can control their blood glucose levels.

It is unknown if hypoglycemic medicines taken by mouth are safe for use in pregnancy. Women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breastfeeding.

Gestational diabetes is treated with insulin and changes in diet.

EXERCISE

Regular exercise is especially important for people with diabetes. It helps with blood sugar control, weight loss, and high blood pressure. People with diabetes who exercise are less likely to experience a heart attack or stroke than diabetics who do not exercise regularly. You should be evaluated by your physician before starting an exercise program.

Here are some exercise considerations:

• Choose an enjoyable physical activity that is appropriate for your current fitness level.
• Exercise every day, and at the same time of day, if possible.
• Monitor blood glucose levels before and after exercise.
• Carry food that contains a fast-acting carbohydrate in case you become hypoglycemic during or after exercise.
• Carry a diabetes identification card and a mobile phone or change for a payphone in case of emergency.
• Drink extra fluids that do not contain sugar before, during, and after exercise.

Changes in exercise intensity or duration may need changes in diet or medication dose to keep blood sugar levels from going too high or low.

FOOT CARE

People with diabetes are prone to foot problems because of the likelihood of damage to blood vessels and nerves and a decreased ability to fight infection. Problems with blood flow and damage to nerves may cause an injury to the foot to go unnoticed until infection develops. Death of skin and other tissue can occur.

If left untreated, the affected foot may need to be amputated. Diabetes is the most common condition leading to amputations.

To prevent injury to the feet, people with diabetes should adopt a daily routine of checking and caring for the feet as follows:

• Check your feet every day, and report sores or changes and signs of infection.
• Wash your feet every day with lukewarm water and mild soap, and dry them thoroughly.
• Soften dry skin with lotion or petroleum jelly.
• Protect feet with comfortable, well-fitting shoes.
• Exercise daily to promote good circulation.
• See a podiatrist for foot problems or to have corns or calluses removed.
• Remove shoes and socks during a visit to your health care provider and remind him or her to examine your feet.
• Stop smoking, which hinders blood flow to the feet.

Expectations (prognosis)

With good blood glucose and blood pressure control, many of the complications of diabetes can be prevented.

Studies have shown that strict control of blood sugar and blood pressure levels in persons with diabetes helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke.

Complications

Emergency complications include diabetic hyperglycemic hyperosmolar coma.

Long-term complications include:

• Diabetic retinopathy
• Diabetic nephropathy
• Diabetic neuropathy
• Peripheral vascular disease
• Hyperlipidemia, hypertension, atherosclerosis, and coronary artery disease

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if symptoms of ketoacidosis occur:

• Increased thirst and urination
• Nausea
• Deep and rapid breathing
• Abdominal pain
• Sweet-smelling breath
• Loss of consciousness

Go to the emergency room or call the local emergency number if symptoms of extremely low blood sugar (hypoglycemic coma or severe insulin reaction) occur:

• Weakness
• Drowsiness
• Headache
• Confusion
• Dizziness
• Double vision
• Lack of coordination
• Convulsions or unconsciousness

Prevention

Maintaining an ideal body weight and an active lifestyle may prevent the onset of type 2 diabetes. Currently there is no way to prevent type 1 diabetes.

Aging Changes in The Heart and Blood Vessels

Taking your carotid pulse

The carotid arteries take oxygenated blood from the heart to the brain. The pulse from the carotids may be felt on either side of the front of the neck just below the angle of the jaw. This rhythmic "beat" is caused by varying volumes of blood being pushed out of the heart toward the extremities.

Circulation of blood through the heart

The heart is a large muscular organ which constantly pushes oxygen-rich blood to the brain and extremities and transports oxygen-poor blood from the brain and extremities to the lungs to gain oxygen. Blood comes into the right atrium from the body, moves into the right ventricle and is pushed into the pulmonary arteries in the lungs. After picking up oxygen, the blood travels back to the heart through the pulmonary veins into the left atrium, to the left ventricle and out to the body's tissues through the aorta.

Radial pulse

Arteries carry oxygenated blood away from the heart to the tissues of the body; veins carry blood depleted of oxygen from the same tissues back to the heart. The arteries are the vessels with the "pulse", a rhythmic pushing of the blood in the heart followed by a refilling of the heart chamber. To determine heart rate, one feels the beats at a pulse point like the inside of the wrist for 10 seconds, and multiplies this numbers by six. This is the per-minute total.

Normal heart anatomy (cut section)

The normal heart viewed so that major valves can be seen.

Effects of age on blood pressure

Blood vessels become less elastic with age. The "average" blood pressure increases from 120/70 to 150/90 and may persist slightly high even if treated. The blood vessels respond more slowly to a change in body position.

Information

Some changes in the heart and blood vessels normally occur with age, but many others are modifiable factors that, if not treated, can lead to heart disease.

BACKGROUND

The heart has two sides. The right side pumps blood to the lungs to receive oxygen and get rid of carbon dioxide. The left side pumps oxygen-rich blood to the body.

Blood flows out of the heart through arteries, which branch out and get smaller and smaller as they go into the tissues. In the tissues, they become tiny capillaries.

Capillaries are where the blood gives up oxygen and nutrients to the tissues, and receives carbon dioxide and wastes back from the tissues. Then, the vessels begin to collect together into larger and larger veins, which return blood to the heart.

Aging causes changes in the heart and in the blood vessels. Heart and blood vessel diseases are some of the most common disorders in the elderly.

AGING CHANGES

Heart

• Normal changes in the heart include deposits of the "aging pigment," lipofuscin. The heart muscle cells degenerate slightly. The valves inside the heart, which control the direction of blood flow, thicken and become stiffer. A heart murmur caused by valve stiffness is fairly common in the elderly.
• The heart has a natural pacemaker system that controls heartbeat. Some of the pathways of this system may develop fibrous tissue and fat deposits. The natural pacemaker (the SA node) loses some of its cells. These changes may result in a slightly slower heart rate.
• Heart changes cause the ECG of a normal, healthy aged person to be slightly different than the ECG of a healthy younger adult. Abnormal rhythms (arrhythmias) such as atrial fibrillation are common in older people, which may be caused by heart disease.
• A slight increase in the size of the heart, especially the left ventricle, is not uncommon. The heart wall thickens, so the amount of blood that the chamber can hold may actually decrease despite the increased overall heart size. The heart may fill more slowly.

Blood vessels

• The main artery from the heart (aorta) becomes thicker, stiffer, and less flexible. This is probably related to changes in the connective tissue of the blood vessel wall. This makes the blood pressure higher and makes the heart work harder, which may lead to hypertrophy (thickening of the heart muscle). The other arteries also thicken and stiffen. In general, most elderly people experience a moderate increase in blood pressure.
• Receptors, called baroreceptors, monitor the blood pressure and make changes to help maintain a fairly constant blood pressure when a person changes positions or activities. The baroreceptors become less sensitive with aging. This may explain the relatively common finding of orthostatic hypotension, a condition in which the blood pressure falls when a person goes from lying or sitting to standing, resulting in dizziness.
• The wall of the capillaries thickens slightly. This may cause a slightly slower rate of exchange of nutrients and wastes.

Blood

• The blood itself changes slightly with age. Aging causes a normal reduction in total body water. As part of this, there is less fluid in the bloodstream, so blood volume decreases.
• The number of red blood cells (and correspondingly, the hemoglobin and hematocrit levels) are reduced. This contributes to fatigue. Most of the white blood cells stay at the same levels, although certain white blood cells important to immunity (lymphocytes) decrease in number and ability to fight off bacteria. This reduces the ability to resist infection.

EFFECT OF CHANGES

Under normal circumstances, the heart continues to adequately supply all parts of the body. However, an aging heart may be slightly less able to tolerate increased workloads, because changes reduce this extra pumping ability (reserve heart function).

Some of the things that can increase heart workload include illness, infections, emotional stress, injuries, extreme physical exertion, and certain medications.

COMMON PROBLEMS

• Heart and blood vessel diseases are fairly common in older people. Common disorders include high blood pressure and orthostatic hypotension.
• Arteriosclerosis (hardening of the arteries) is very common. Fatty plaque deposits inside the blood vessels cause it to narrow and can totally block blood vessels.
• Coronary artery disease is fairly common.
• Angina (chest pain caused by temporarily reduced blood flow to the heart muscle), shortness of breath with exertion and heart attack can result from coronary artery disease.
• Abnormal heart rhythms (arrhythmias) of various types can occur.
• Heart failure is also very common in the elderly. In people older than 75, heart failure occurs 10 times more often than in younger adults.
• Valve diseases are fairly common. Aortic stenosis, or narrowing of the aortic valve, is the most common valve disease in the elderly.
• Anemia may occur, possibly related to malnutrition, chronic infections, blood loss from the gastrointestinal tract, or as a complication of other diseases or medications.
• Transient ischemic attacks (TIA) or strokes can occur if blood flow to the brain is disrupted.

Other problems with the heart and blood vessels include the following:

• Peripheral vascular disease, resulting in claudication (intermittent pain in the legs with walking)
• Varicose veins
• Blood clots
  • Thrombophlebitis
  • Deep vein thrombosis

PREVENTION

You can help your circulatory system (heart and blood vessels). Heart disease risk factors that you have some control over include high blood pressure, cholesterol levels, diabetes, obesity, and smoking.

• Eat a heart-healthy diet with reduced amounts of saturated fat and cholesterol, and control your weight. Follow your health care provider's recommendations for treatment of high blood pressure, high cholesterol or diabetes. Minimize or stop smoking.
• Moderate exercise is one of the best things you can do to keep your heart, and the rest of your body, healthy. Consult with your health care provider before beginning a new exercise program. Exercise moderately and within your capabilities, but do it regularly.
• People who exercise usually have less body fat and smoke less than people who do not exercise. They also tend to have fewer blood pressure problems and less heart disease.
• Exercise may help prevent obesity and helps people with diabetes control their blood sugar.
• Exercise may help you maintain your maximum abilities as much as possible and reduces stress.