The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.

The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.

Chapter One

Week 1

What's Your Risk?

A healthy heart and a strong, lean body go together. If you gain weight over the years or become less fit, you increase your risk for a heart attack, stroke, and other heart-health problems. Heart disease is the number one killer in North America -- for both men and women. Your risk soars if you are obese, diabetic, or have high bloodpressure or high cholesterol. Your doctor may already have warned you that you have one or more risk factors for a heart attack or stroke. My 8-Week Plan will show youhow to reduce your risk and increase your chances to live a long, healthful life. But first you need to understand your heart-health status andknow what questions to ask your doctor. Call and ask your doctor toorder the following tests (or ask for copies of the results, if you have hadthese tests done recently):

If your health insurance doesn't cover some or all of these tests, Ithink it is worthwhile to cover the cost yourself. Many labs provide theservice directly to consumers, but they recommend that you check withyour doctor to help you interpret the results.

WHILE YOU'RE TALKING TO YOUR DOCTOR, GET CLEARANCE TO START AN EXERCISE PROGRAM OR TO PICK UPTHE PACE OF YOUR CURRENT PROGRAM. When you get yourtest results, enter them in the Before and After Progress Worksheet onpage 250. I'll explain more about what these tests mean in Week 2.

Measure Yourself

If you are overweight, you probably know it already, and your doctor has probably warned you about the dangers. Before you start my 8-Week Plan, use these three simple measures to see whether you should be concerned about excess weight. You will use this information along with your blood test results to map out a personal heart-health plan.

• Your Body Mass Index (BMI)
  
  
• Your Waist/Hip Ratio -- to determine whether you're an "apple" or a "pear"
  
  
• The "Inch of Pinch" test

Muscle weighs more than fat, and some people have larger, heavierbones than others. You can be heavy and perfectly healthy if a large percentage of your weight is in bone and muscle. However, if a high percentage of your weight is fat, you are at increased risk for diabetes, heartdisease, stroke, some types of cancer, and other health problems.

What's Your BMI?

The BMI (Body Mass Index) is a standard calculation used by doctors and nutritionists to determine if your weight is appropriate for your height. To use the chart:

• Locate your height in the left column.
  
  
• Follow the row across until you find the weight closest to your weight.
  
  
• The number at the top of that column is your BMI.

If your BMI is 30 or higher, your risk of death from any cause is increased by 50 to 150 percent. If you are overweight, resolve right nowto lose the extra pounds, which will help to reduce your risk of heartattack, stroke, diabetes, and many ther health problems. The 8-Week Plan will get you off to a good start.

Record your result on your Before and After Progress Worksheet in the Worksheet section. A healthy weight is an index of 19 to 25, moderately overweight is an index of 26 to 29, and severely overweight is an index higher than 30. Don't use this index if you are pregnant or nursing. If you are a serious athlete, have large muscles, or large bones, see the"Inch of Pinch" test below.

Are You An "Apple" or a "Pear"?

Some people store fat primarily in the belly area and are called appleshaped, while those who store fat primarily on their hips are called pearshaped. Storing fat primarily in your belly area rather than on your hipsincreases your chances of suffering heart attacks and diabetes. When youtake in more calories than your body needs, your liver turns them into fat. Fat cells stored around your belly are different from those stored on your hips. The blood that flows from belly fat goes directly to your liver, whereas the blood that flows from your hips goes into your general circulation. The livers of people who store fat in their belly area are blockedfrom removing insulin by the extra fat and therefore don't removeinsulin from the bloodstream as effectively as the livers of people whostore fat on their hips. So "apples" tend to have higher levels of bloodinsulin and sugar. You need insulin to drive energy-giving sugar fromyour bloodstream into your cells. But insulin also lowers blood levels ofHDL, the good cholesterol, which prevents heart attacks, and raises bloodlevels of harmful triglycerides, which cause heart attacks. I'll explainmore about the risks of belly fat in Week 3.

Your Waist/Hip Ratio is calculated by dividing your waist size by yourhip size. Use a measuring tape to measure your hips at the widest part of your buttocks. Then measure your waist where it is smallest, usually justabove the belly button. Then divide your waist measurement by your hipmeasurement. Record the result on your Before and After Progress Worksheet. Women should have a ratio of 0.8 or lower; men should have aratio no higher than 1.0. If your ratio is higher than these ideals, you arean "apple" with excess fat stored around your abdomen.

---

Excerpted from The Healthy Heart Miracle: Your Roadmap to Lifelong Health by Gabe Mirkin, Diana Mirkin
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.