Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
Facilitator Script
Hello everyone. Welcome and thank you for coming! My name is [name], and I’m with
[organization].
Next Steps to Better Nutrition is an educational program developed jointly by the National
Council on Aging and the Walmart Foundation.
The Walmart Foundation meets the needs of the underserved by directing charitable giving
to programs that support hunger relief and nutrition, education, environmental
sustainability, and women’s economic empowerment.
The National Council on Aging, or NCOA, is a nonprofit service and advocacy organization
whose mission is to improve the lives of millions of older adults. NCOA works with thousands
of organizations across the country to help seniors find jobs and benefits, improve their
health, live independently, and remain active in their communities.
This week, we are going to talk about preventing heart disease. We want to share with you
suggestions of small steps you can take to improve your heart health by increasing your
knowledge about heart disease and nutrition and participating in activities to keep your
heart healthy.
NOTE to Facilitator: There are additional reading materials for background that are provided
for these modules courtesy of American Heart Association—“Eat This, Not That: Healthy Food
Options” and “Don’t Fall Prey to Portion Distortion”—to provide additional context and
material to show your participants.
Slide 2
Heart disease, also called coronary heart disease, is a simple term used to describe several
problems related to the buildup of plaque in the walls of arteries, also known as
atherosclerosis. Plaque causes the arteries to narrow, making it harder for blood to flow and
creating a risk for a heart attack or stroke.
• A heart attack is when your heart can’t get enough blood because a blood vessel in
or near your heart becomes blocked. During a heart attack, you may have chest pain
with nausea, indigestion, extreme weakness and sweating, or you may experience
other symptoms. If you think you may be having a heart attack, call 911. If you are a
female, your symptoms may include shortness of breath, nausea/vomiting, and back
or jaw pain. (http://www.heart.org/HEARTORG/Conditions/911-Warnings-Signs-of-aHeart-Attack_UCM_305346_SubHomePage.jsp)
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Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
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A stroke is when the blood supply to the brain is blocked. It is the fourth leading
cause of death and a leading cause of disability in the U.S. The initials F-A-S-T are an
easy way to remember the sudden signs of stroke. When you spot the signs, you’ll
know that you need to call 9-1-1 for help right away.
o F stands for “face drooping” – Does one side of the face droop or is it numb?
Ask the person to smile. Is the person’s smile uneven?
o A stands for “arm weakness” – Is one arm weak or numb? Ask the person to
raise both arms. Does one arm drift downward?
o S stands for “speech difficulty” – Is speech slurred? Is the person unable to
speak or hard to understand? Ask the person to repeat a simple sentence,
like “the sky is blue.” Is the sentence repeated correctly?
o T stands for “time to call 9-1-1” – If someone shows any of these symptoms,
even if the symptoms go away, call 9-1-1 and get the person to the hospital
immediately. Check the time so you’ll know when the first symptoms
appeared.
Beyond F.A.S.T. – Other symptoms you should know:
o Sudden numbness or weakness of the leg, arm, or face.
o Sudden confusion or trouble understanding.
o Sudden trouble seeing in one or both eyes.
o Sudden trouble walking, dizziness, loss of balance or coordination.
o Sudden severe headache with no known cause.
Ask participants: Who can tell me what the “F” in “F-A-S-T stands for? What about the “A”?
The “S”? The “T”?
Answer: F = face drooping, A = arm weakness, S = speech difficulty, T = time to call 9-1-1
Slide 3
Heart valve problems involve the doors between your heart’s chambers. If they don’t close or
open properly, blood can leak through or leak backward.
Many people with valve disease are unaware of any symptoms or may not have any
symptoms of heart valve problems.
Some physical signs of heart valve disease can include:
• Chest pain or palpitations (rapid rhythms or skips).
• Shortness of breath, difficulty catching your breath, fatigue, weakness, or inability to
maintain regular activity level.
• Lightheadedness or loss of consciousness.
• Swollen ankles, feet, or abdomen.
Symptoms do not necessarily determine the seriousness of a person’s valve problems.
Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
It’s important to know that some patients do not experience any symptoms, yet they can still
have a valve problem that needs treatment.
Some people suddenly experience very noticeable symptoms. Valve disease symptoms can
also develop very quickly if the condition is severe.
For some people, the disease progresses very slowly, and the heart is able to compensate
over time so that the symptoms are barely noticeable.
However, the risk and damage may still be significant, so education and awareness about
the possible causes for a gradual onset of symptoms is important for patients who may be at
risk.
The “Valve Disease Symptom Tracker” handout #1, can help you track your symptoms over
time. A change in symptoms is important to discuss with your physician.
A valve problem can be severe with no symptoms. A valve problem can also be insignificant
in terms of leakage, but problematic because of the uncomfortable symptoms. It is
important to tell your health care provider any time you notice new or irregular symptoms
that may relate to your condition.
Ask participants:
Note to AHA If possible – add triangle from the symptom tracker and also use as handout
Slide 4
There are other types of heart problems, including heart failure, abnormal heart rhythms,
heart valve problems, and peripheral arterial disease or PAD.
• Heart failure is when the heart is not pumping as well as it should. Symptoms may
include shortness of breath, leg, ankle or foot swelling, tiredness or fatigue,
persistent cough, or other symptoms.
• Abnormal heart rhythms is when the heart beats too fast, too slowly, or in an irregular
way. The result can be an insufficient amount of blood being pumped to meet the
body’s needs. Some abnormal heart rhythms require medical treatment to avoid
other complications, such as heart attack or stroke.
• Peripheral arterial disease, or PAD, can happen when the openings in your blood
vessels narrow and your legs, feet, and other extremities don’t get enough blood. You
may feel leg pain when you walk or exercise. Some people feel numbness or tingling
in their feet or legs or have sores that heal slowly.
Slide 5
Risk factors for heart disease fall under two categories. The first category includes factors
you cannot control such as:
• Age – Your risk for heart disease increases as you age.
Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
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Gender – Women’s risk of heart disease increases in the years after menopause.
Family history – a family history of early heart disease also places you at greater risk.
Slide 6
The second category includes factors you can control, such as:
• Blood pressure
• Cholesterol
• Prediabetes & diabetes
• Smoking
• Overweight
• Lack of physical activity
• Unhealthy diet
Ask participants: Are there any changes you could make to your daily routine that could
reduce your risk?
Slide 7
It’s important to know your blood pressure numbers. What do the two numbers stand for?
The higher number, called systolic pressure, is when your heart beats, pumping blood. The
lower number, called diastolic pressure, is when your heart is at rest between beats. You
have high blood pressure if the top number, bottom number, or both are too high. High blood
pressure often has no symptoms, and some people with high blood pressure don’t know
they have it. Your health care provider should check your blood pressure regularly.
Why is knowing your blood pressure numbers so important?
• High blood pressure is one of the major risk factors for heart disease.
• It is the leading risk factor of women’s death in the U.S. and the second leading risk
factor for death for men.
• One-third of American adults have high blood pressure, and 90 percent of American
adults are expected to develop high blood pressure over their lifetimes.
• More than 40 percent of non-Hispanic black adults have high blood pressure. Not
only is high blood pressure more prevalent among African Americans, it also develops
earlier in their life.
High blood pressure raises your risk for strokes, heart attacks, heart failure, kidney damage,
eye disease, and premature death.
Ask participants: How often should you get your blood pressure checked?
Answer: If your blood pressure is normal, you should get it checked at least once every 2
years. If your blood pressure is higher, your doctor may want to check it more often.
(Taken from the AHA website: http://www.heart.org/HEARTORG/Conditions/Heart-HealthScreenings_UCM_428687_Article.jsp)
Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
Slide 8
Two main ways to lower blood pressure: adopting healthy lifestyle habits and taking
medication, if needed.
Some lifestyle changes you can make:
• Achieve a heathy weight
• Eat a heart-healthy diet, like the DASH diet
• Quit smoking
• Use less salt
• Reduce Stress
• Exercise regularly
• Limit how much alcohol you drink
Slide 9
The foods you eat can help by lowering your risk for heart disease and stroke, while
improving your overall health. Research shows a heart-healthy diet is rich in fruits,
vegetables, fish including salmon, albacore tuna, mackerel, herring or trout. Whole-grains,
low-fat dairy products, beans and lean meats such as skinless poultry, can reduce your risk
of stroke.
Slide 10
Sodium is a mineral that is essential for life.
It’s regulated in the body by your kidneys, and it helps control your body’s fluid balance. It
also helps send nerve impulses and affects muscle function.
When there is extra sodium in your bloodstream, it pulls water into your blood vessels,
increasing the total volume of blood inside. With more blood flowing through, blood pressure
increases. It’s like turning up the water supply to a garden hose – the pressure in the hose
increases as more water is blasted through it. Over time, high blood pressure may
overstretch or injure the blood vessel walls and speed the build-up of gunky plaque that can
block blood flow. The added pressure also tires out the heart by forcing it to work harder to
pump blood through the body.
Even if you don’t have high blood pressure, eating less sodium can reduce the rise in blood
pressure that occurs with age, and reduce your risk of heart attack, heart failure, stroke,
kidney disease, osteoporosis, stomach cancer, and even headaches. The extra water in your
body can also lead to bloating and weight gain. No wonder the American Heart Association
wants you to change your relationship with salt! Take a look at the American Heart
Association’s handout “Effects of Excessive sodium on your Health and Appearance”.
For all of you parents and grandparents, children are not immune from too much sodium.
Next Steps to Better Nutrition
Part 4: Keeping Your Heart Healthy
Ask participants: What ingredients can you use to replace some or all of the salt when
cooking?
Answer:
• Spices and herbs
• Vinegars, such as balsamic vinegar
• Citrus juices, such as lemon juice or lime juice.
(Taken from AHA website: http://sodiumbreakup.heart.org/test-your-knowledge/)
Slide 11
The right fluids are just as important as the right foods when it comes to healthy eating.
Don’t let yourself get dehydrated. And don’t count on your thirst to tell you when you’re
thirsty. As we age, our body doesn’t tell us soon enough that we’re thirsty.
Water is an important nutrient too! Drink fluids consistently throughout the day (on a
schedule) to maintain adequate hydration.
Teas, coffee, and water are your best choices. Keep fluids with sugar and salt at a minimum,
unless your physician has suggested otherwise.
Adequate fluid intake is essential to maintenance of blood pressure, cognitive function, skin
health, normal bowel function, prevention of urinary tract infections, and normal bladder
control.
Slide 12
Tips
Slide 13
Thank you for joining us today! I hope you discovered something new that you’d like to try to
eat healthier.
If you have any questions, please feel free to contact: add contact info.
In addition, this location does hold physical activity classes. Here are just a few programs
available for you to consider joining.
Please join us next month at DATE/TIME for Part 5 of Next Steps to Better Nutrition.