# Presentation: 353456

## Slide 1

**Notes:**
Honoring the Gift of Heart Health: Visuals

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Heart, Lung, and Blood Institute
NIH Publication No. 03-5220
November 2003

## Slide 3

**Notes:**
Visual 1-1

Say:
The heart is a hollow, muscular, cone-shaped organ, about the size of a fist.  (Hold up your fist for the group members to see).

Point out each part of the heart as you say:
— The heart has two upper chambers and two lower chambers.
— The upper chambers (right atrium and left atrium) receive blood.
— The lower chambers (right ventricle and left ventricle) pump blood.

## Slide 4

**Notes:**
Visual 1-2

Say:
— The heart is located in the middle of the chest. 
— The heart is part of the circulatory system.
— The circulatory system is made of all the vessels that carry the blood throughout the body.
— Vessels are long, hollow tubes of tissue, much like drinking straws.
— Vessels carry blood to and from the heart.

## Slide 5

**Notes:**
Visual 1-3

Point to each picture and say:
Blood (with little oxygen) enters the right top chamber of the heart.
Blood then flows down to the right lower chamber so it can be pumped out to the lungs.  In the lungs, waste is taken from the blood (carbon dioxide).  The blood then gathers more oxygen.
The blood, rich with oxygen, returns to the heart and enters the upper left chamber.
The blood flows down to the lower left chamber and is pumped to all of the body organs and tissues.

## Slide 6

**Notes:**
Visual 1-4

Say:
—  Heart disease is a serious problem for American Indians and Alaska Natives (AI/AN).
—  It is the number one cause of death for AI/AN.
—  One out of four AI/AN dies from heart disease.

**Notes:**
Visual 1-5

Say: Your chances of getting diabetes increases if:
— You are overweight, especially if you have extra weight around the waist.
— You are physically inactive.
— You have a family member with diabetes.
— You had diabetes during pregnancy (gestational diabetes), or gave birth to at least one baby 
    weighing more than 9 pounds.
— Your blood pressure is 140/90 or higher, or you have been told that you have high blood 
    pressure. 
— Your cholesterol levels are not normal. Your HDL cholesterol ("good" cholesterol) is 35 
    or lower, or your triglyceride level is 250 or higher. 

## Slide 8

**Notes:**
Visual 2-1

Say:
— The heart is an organ that pumps blood throughout the body.
— Blood carries oxygen and nutrients through the arteries to every part of the body.
— Coronary arteries carry the oxygen-rich blood to the heart muscle.
— Normally, the coronary arteries supply all of the blood that our heart needs to do its work, even when we are very active and the 
    demands on our heart are great. 

## Slide 9

**Notes:**
Visual 2-2

Say:
— A heart attack occurs when the blood supply going to a portion of the heart through one of the coronary arteries is blocked.  Here is
    how this happens:  
       — Heart disease, which can lead to a heart attack, develops over time as fatty deposits build up on the inside of the coronary 
   arteries, narrowing them so that not enough blood gets through to meet the needs of the heart.
— When the coronary artery becomes nearly or completely blocked, usually by a clot, blood flow is closed off and a heart attack 
    begins.
— If the blockage continues, part of the heart muscle will start to die.

## Slide 10

**Notes:**
Visual 2-3

Say:  
— There is also angioplasty, a procedure in which a balloon is inserted into the artery and inflated to open the artery and restore blood
     flow.
— Sometimes with angioplasty, doctors will insert a stent.  A stent is a wire mesh tube that is used to prop open the artery that has 
    been cleared, using angioplasty.
— The stent stays in the artery permanently and holds it open to improve blood flow to the heart muscle.
— The sooner these and other treatments are given, the more heart muscle can be saved.

## Slide 11

**Notes:**
Visual 3-1

Ask:
How do you think physical activity can help you?

Say:
Physical activity can:
— Strengthen your heart and lungs
— Help you feel better about yourself
— Lower your stress
— Help you sleep better
— Gives you more energy

## Slide 12

**Notes:**
Visual 3-2

Say:
Physical activity can:
 Help lower your blood pressure
— Help lower your blood cholesterol
— Help lower your chance for heart disease, diabetes, and cancer.

## Slide 13

**Notes:**
Visual 3-3

Say:
Physical activity may help you:
— Lose excess weight
— Control your appetite 
— Control anxiety and depression
— Deal better with stress

## Slide 14

**Notes:**
Visual 3-4

Say:
You may want to start with activities like these:
— Walking
— Picking berries
— Fishing
— Gardening

Other activities include:
— Raking leaves
— Vacuuming
— Gardening
— Traditional dancing
— Climbing stairs

## Slide 15

**Notes:**
Visual 3-5

Say:
After a while you will be able to do even more.  Activities you might enjoy include:
— Playing soccer, basketball, or baseball
— Running or jogging
— Chopping wood
— Playing traditional games
— Doing aerobics or floor exercises
— Herding cattle
— Skiing

Other activities include:
— Swimming
— Bicycling
— Hiking
— Canoeing
— Jumping rope
— Rollerblading
— Skating
— Hunting

## Slide 16

**Notes:**
Visual 3-6

Say:
If you can't set aside 30 minutes at one time to be active, you can break your activity into shorter periods of 10 minutes or more.  Just make sure it adds up to at least 30 minutes each day.  Here is an example:
— Use your stationary bike for 10 minutes before you go to work
— Take a 10-minute walk with your kids after work 
— Do aerobic exercises for 10 more minutes later in the day 

## Slide 17

**Notes:**
Visual 4-1

Say:
—  Blood pressure is the force of the blood against the walls of your arteries.
—  Blood pressure is needed to move the blood through your body. 

## Slide 18

**Notes:**
Visual 4-2

Say:
—  Your blood pressure reading has two parts.  Both numbers are important.
—  The first number (120) is the pressure of the blood when the heart beats.
—  The second number (80) is the pressure when the heart rests.
—  It is written like this: 120/80 mmHg. 

## Slide 19

**Notes:**
Visual 4-3

Say:
High blood pressure can lead to a stroke (brain attack), heart attack, kidney problems, and blindness. 

## Slide 20

**Notes:**
Visual 4-4

Say:
—  The best way to find out if you have high blood pressure is to have it checked at least once a year.
—  Check it more often if you have high blood pressure. 

## Slide 21

**Notes:**
Visual 4-5

Say:
—  Let's talk about where sodium is found in foods.
—  Most of the sodium that we eat comes from packaged foods.  Examples are regular canned soups and vegetables, frozen dinners, 
     salty chips, and cured meats like hot dogs.
—  Some sodium comes from salt added during cooking or at the table.
—  The rest is found naturally in many foods.

- *Percent Daily Values are based on a 2,000
-  calorie diet. Your Daily Values may be higher
-  or lower depending on your caloric need.

**Notes:**
Visual 4-6

Say:
—  The food label found on packaged foods is one of the best tools we have for choosing foods for a healthy diet.
—  In this session, we will talk about what you can find on the food label.  We will also learn how to use the food label to choose foods
     that are lower in sodium. 

Point to visual and say: 
— The Percent DV for sodium for frozen carrots is circled on the food label. 

## Slide 23

**Notes:**
Visual 5-1

Say:
—  Cholesterol travels through the bloodstream in different types of packages called lipoproteins (fat plus protein).
—  Low density lipoprotein or LDL carry the cholesterol to your blood vessels, clogging them like rust in a pipe.
—  Cholesterol also travels in the blood in high-density lipoproteins, or HDL.  HDL helps to remove the cholesterol from the body.

Let's look at it this way:
—  The LDL car (lousy, bad cholesterol) throws fat and cholesterol onto the street (like your blood vessels).
—  The HDL person (healthy, good cholesterol) cleans up fat and cholesterol deposited by the LDL and gets rid of it.  (Your liver gets rid
     of it from your body.) 

## Slide 24

**Notes:**
Visual 5-2

Ask:
How do you find out if you have high blood cholesterol?

Answer:
A person's cholesterol is measured with a blood test that can be done best at a doctor's office, but also at a cholesterol screening site. 

## Slide 25

**Notes:**
Visual 5-3

Say:
Here is what the total cholesterol numbers mean:

Less than 200 (Desirable):
Good for you!  Keep up the good work!

200-239 (Borderline High):
Depending on your other risk factors, you may be at a higher risk for heart disease.  Talk to your doctor about your overall risk for heart disease. 

240 or more (High):
You are at a higher risk for clogged arteries and a heart attack.  See your doctor to determine your risk for heart disease. 

## Slide 26

**Notes:**
Visual 5-4

Say:
 Blood flows freely to all cells of the body when arteries are healthy.
 When your LDL cholesterol (lousy, bad) is too high, cholesterol may become trapped in the walls of the arteries causing them to  
    harden.

   The opening of the arteries can become narrowed and clogged. 

## Slide 27

**Notes:**
Visual 5-5

Say:
Here are foods that are higher in saturated fat:
— Whole milk
— Products made from whole milk (regular cheese and sour cream)
— Butter
— Lard and shortening
— Fatty cuts of meat such as chuck, regular ground beef, ribs, bacon, and sausage
— Canned meats such as pork and mini sausages. 
— Chicken and turkey with skin
— Tortilla, fry bread, and other bread made with lard, butter, or shortening. 
— Oils such as coconut, palm and palm kernel oil. 
— Ice cream sundae with whipped cream and toppings
— Doughnuts, and pastries

## Slide 28

**Notes:**
Visual 5-6

Say:
Here are some foods that are lower in saturated fat:
— Fat free and lowfat milk, cheese, and yogurt
— Tub margarine
— Vegetable oil
— Lean meat such as loin, round, and extra lean ground beef. (Alaska:  Caribou, moose, deer, ptarmigan, salmon, halibut, and seal
    meat)
— Chicken and turkey without the skin
— Fish
— Beans
— Rice
— Tortillas and bread  (Alaska:  pilot bread and bread)
— Fruits like apples, oranges, peaches, berries, and melon
— Vegetables like corn, potatoes, squash, cabbage, and carrots  (Alaska:  wild seaweed, willow leaves, beach asparagus, wild 
    rhubarb [sourdock], and wild celery)

## Slide 29

**Notes:**
Visual 5-7

Say:
—  Foods high in cholesterol can also raise your blood cholesterol and increase your risk of heart disease.
—  Dietary cholesterol is found in food that comes from animals.
—  Foods that are highest in cholesterol are:
egg yolk
organ meats like liver, kidneys, tongue, tripe, heart

## Slide 30

**Notes:**
Visual 5-8

Say:
—  Foods that come from plants do not contain cholesterol.
—  Foods that do not contain cholesterol include:
vegetables like tomato, green pepper, lettuce, corn, and beans
fruits like banana, apple, orange, berries, and melon
rice 
grains like corn tortillas 
cereals like oatmeal 

**Notes:**
Visual 5-9

Say:     
— Soluble fiber is in foods such as oats, fruits, vegetables, and cooked dry beans and peas.  

— This gives you one more reason to eat a variety of fruits and vegetables. 

— Fruits and vegetables that are a good source of soluble fiber are citrus fruits (oranges and grapefruit), pears, apples, peaches 
   bananas, brussels sprouts, broccoli and carrots.  

— For great sources of soluble fiber try to include a variety of cooked dry beans.

- *Percent Daily Values are based on a 2,000
-  calorie diet. Your Daily Values may be higher
-  or lower depending on your caloric need.

**Notes:**
Visual 5-10

Say:
For heart health, choose foods with a lower Percent Daily Value for saturated fat and cholesterol.

(Point out where to find  saturated fat, trans fat, and cholesterol on the food label.)

(Show the group where the Percent Daily Value is found on the food label.) 

## Slide 33

**Notes:**
Visual 6-1

Say:
Will weighs 170 pounds.  He is 5 feet and 6 inches tall (1.68 meters).  His wife, Sally, weighs 120 pounds.  She is 5 feet (1.52 meters) tall.  Let's look at the weight chart to find out if Will and Sally are within the healthy weight range.

Answer: 
Will’s BMI is 27, so he is overweight.  Sally’s BMI is 23; she is at a healthy weight.

## Slide 34

**Notes:**
Visual 6-2

Say:
A waist measurement of more than 35 inches for women and more than 40 inches for men is high. A high measurement may increase your risk for heart disease. 

## Slide 35

**Notes:**
Visual 6-3

Say:
Like Sally in scene three, if you:
— Eat smaller portions,
— Eat a variety of lower fat, lower calorie foods, and
— Increase your physical activity level, you can lose weight in a healthy way. 

## Slide 36

**Notes:**
Visual 6-4

Say:
Losing weight has become a money making business.  You hear about miracle diets that claim to help you lose weight fast and easy.  These products make one thing lighter—and that's your pocketbook.  Be careful about diets and exercise products that use personal testimonies in their ads. 

## Slide 37

**Notes:**
Visual 6-5

Say:
A key to choosing a healthy diet and losing weight is to know what to eat and how much.  Let's look at how many servings of each food group are suggested.

(The Alaska Native Food Guide Pyramid is on the next slide.  Please choose the Food Guide Pyramid that is most appropriate for your community.) 

## Insert Alaska Native Food Guide Pyramid

**Notes:**
Visual 6-5

Say:
A key to choosing a healthy diet and losing weight is to know what to eat and how much. Let's look at how many servings of each food group are suggested.

(The American Indian Food Guide Pyramid is on the previous slide.  Please choose the Food Guide Pyramid that is most appropriate for your community.) 

- *Percent Daily Values are based on a 2,000  calorie diet. Your  Daily
-  Values may be higher  or lower depending on your caloric need.

**Notes:**
Visual 6-6

Point out where the group members can find the amount of calories in one serving on the food label. 

**Notes:**
Visual 7-1 (American Indian)

Say:  
The American Indian Food Guide Pyramid is a helpful tool.  It shows both the types and amounts of foods we can choose for better heart health.

**Notes:**
Visual 7-1 (Alaska Native)

Say:  
The Alaska Native Food Guide Pyramid is a helpful tool.  It shows both the types and amounts of foods we can choose for better heart health.

## Slide 42

**Notes:**
Visual 8-1

Say:
People often find that they are too tired to fix the kinds of meals they would like their families to eat.  We need to learn some shortcuts. 

## Slide 43

**Notes:**
Visual 8-2

Show Visual 8-2 while you review "Cook in Advance" from the handout "Tips for Busy Families." 

## Slide 44

**Notes:**
Visual 8-3

Say:
Fast foods can be higher in fat, sodium, and calories, but you can choose lower fat, lower sodium, and lower calorie foods from the menu.

(Keep this visual on display while you review the handout, "Tips for Eating Out the Heart Healthy Way.") 

## Slide 45

**Notes:**
Visual 9-1

Say:  
Today we are going to talk about what can happen when you smoke.  We are also going to talk about ways to stop smoking or support a friend or family member who wants to quit. 

(Keep the Visual on display while you review the handout, "How Smoking Can Harm You.“)

## Slide 46

**Notes:**
Visual 9-2

Ask:  Do you think pregnant women should smoke? 

Answer:  Pregnant women should not smoke because it will affect their baby’s health and well-being. They also should stay away from others who smoke because of the harm that secondhand smoke causes. 

(Keep the Visual on display while you review the handout, "How Smoking Harms Infants and Children.“) 

## Slide 47

**Notes:**
Visual 9-3

Ask:  Why do you think many people begin smoking as teenagers? 

Review this visual to show the reasons for teenage smoking.  Also, add these reasons if they are not said.

— AI/AN youth start smoking at much younger ages than other youth and the source of tobacco is from family and friends.
— Teens want to be like their friends.
— Young people smoke to try to look older. 
— They want to be like celebrities who smoke in movies or on television.          
— Some teens are influenced by advertisements that make smoking look “cool” or sophisticated.
— Some teens may want to be like parents or other family members who smoke.
— Some teens will smoke just to do something their parents don’t want them to do.
— Young people downplay the harm smoking can do or think they will not be harmed.
— Teens may like the jackets, hats, and other prizes tobacco companies offer. 

## Slide 48

**Notes:**
Visual 10-1

Say:
Everyone gave much time and effort to attend the sessions.  I hope you will use the information to help improve your and your family's heart health.