Editor’s Note: February is American Heart Month. Each Thursday throughout the month, the Clinton Herald has been publishing feature stories about those who have survived cardiac events as well as ways that readers can improve their own cardiovascular health. This is the fourth and final story in our 2019 series.

CLINTON — A lowered cholesterol level. Weight loss. Increased energy. Elimination of pre-diabetic symptoms.

All were experienced by Sister Kathleen Holland as a result of changing her lifestyle through the Complete Health Improvement Program, one of MercyOne and the community's tools to combat a list of chronic conditions that includes heart disease.

The goals of CHIP, a lifestyle medicine education program that focuses on whole-person health, is to help participants make long-lasting lifestyle changes by addressing the causes of chronic disease and to teach them to use lifestyle as their best medicine, with the idea that some chronic diseases are reversible, while others are preventable.

Holland is a graduate of the 18-topic course that walks participants through lifestyle-enhancing sessions that help them learn to make healthy choices in all facets of life. Everything from food choices, heart health and cancer prevention to relieving stress and practicing forgiveness are covered in the sessions, which have been offered since October 2015 and have educated almost 80 people.

Overall, those graduates as a group have noted a 10 percent reduction in their total cholesterol count, a 12 percent reduction in their LDL cholesterol numbers, triglycerides dropping 10 percent and glucose counts that also are down 10 percent. Some have been able to reduce the dose of medication they are taking, under the guidance of their own physician, while others have been fortunate enough to no longer need blood pressure or blood sugar medications due to their new, healthier lifestyle, said Andrea Barnett, MercyOne's community health and wellness coordinator.

Barnett also serves on several community task forces to help improve the health of Clinton County residents. It's a looming task, according to state data that annually ranks Iowa's 99 counties based on health factors.

In 2018's county health rankings, Clinton County ranked 81st of the 99 counties in the state, bettering its position by moving up two spaces from the previous year's rankings. What those rankings and Mercy's own community assessments point to, Barnett said, is a need for residents to focus on losing weight to combat obesity, increasing their physical activity to 150 minutes per week, enhancing their nutrition, improving their mental health and dealing with substance abuse issues.

The 2018 rankings also show that heart disease is the second leading cause of death under the age of 75 in Clinton County, coming in behind malignant tumors at No. 1 and significantly ahead of unintentional injuries at No. 3. Chronic lower respiratory disease and diabetes mellitus round out the top five causes of death for people under 75 in Clinton County.

To combat those diseases, Clinton, through community groups aimed at improving health and wellness, has ramped up healthy living efforts. They include the 5-2-1-0 campaign and Let’s Live Healthy Clinton.

Let's Live Healthy Clinton focuses on three areas – Move More, Eat Well, Feel Better. The initiative is working toward changes in concessions at schools, identifying walking locations and increased education for everyone from middle school students through older adults. The 5-2-1-0 is a reminder for people to eat five fruits and vegetables a day, cut screen time to no more than two hours per day, participate in one hour of moderate to vigorous activity per day and to have zero sugary drinks per day, instead drinking water or fat/free, skim or 1 percent milk.

That's also where CHIP comes in. Surprisingly, according to Barnett, a person has 70 percent control over their health risks. The other 30 percent is equally influenced by genes, the environment and access to food, water and health care. Helping people get to their healthiest life, she said, comes down to eating a whole-food diet and exercise, combined with managing stress, and letting go of worry and those "hot rock" issues that plague on a daily basis.

CHIP sessions are held throughout the year, with the latest class starting earlier this month. Participants are given a cookbook, a workbook and a textbook along with online programming to guide them through the sessions so they can study on their own and then gather for the sessions, where they learn and also gain support from other class members. They are assessed at the start of the program and then again at the end to see how their body is responding to a new way of living.

In Holland's case, the benefits included not only a reduction in her blood sugar and weight, but an overall gratefulness for a healthy life.

"The CHIP program was the start of a lifestyle change for me," she said. "The information received throughout the classes, as well as the support of peers and encouragement of the instructors, helped me to take responsibility for my daily food choices and exercise."

That is exactly where Barnett wants residents to end up, and it all comes down to one simple question.

"What are you doing to make changes," she asked.

To learn more about CHIP, call Barnett at (563) 244-5801.

Diet and lifestyle recommendations

– Use up at least as many calories as you take in. Start by knowing how many calories you should be eating and drinking to maintain your weight. Nutrition and calorie information on food labels is typically based on a 2,000-calorie-per day diet. You may need fewer or more calories depending on several factors including age, gender and level of physical activity.

– Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equal combination of both) each week. Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. If it’s hard to schedule regular exercise sessions, look for ways to build short bursts of activity into your daily routine, like parking farther away and taking the stairs instead of the elevator. Ideally, your activity should be spread throughout the week.

– Eat a variety of nutritious foods from all the food groups. You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have minerals, protein, whole grains and other nutrients but are lower in calories. They may help you control your weight, cholesterol and blood pressure.

– Eat an overall healthy dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes and non-tropical vegetable oils. Limit saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages. If you choose to eat red meat, compare labels and select the leanest cuts available.

One of the diets that fits this pattern is the DASH (Dietary Approaches to Stop Hypertension) eating plan. Most healthy eating patterns can be adapted based on calorie requirements and personal and cultural food preferences.

– Eat less of nutrient-poor foods. The right number of calories to eat each day is based on your age and physical activity level and whether you're trying to gain, lose or maintain your weight. You could use your daily allotment of calories on a few high-calorie foods and beverages, but you probably wouldn’t get the nutrients your body needs to be healthy. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. Read Nutrition Facts labels carefully — the Nutrition Facts panel tells you the amount of healthy and unhealthy nutrients in a food or beverage.

– As you make daily food choices, base your eating pattern on these recommendations: Eat a variety of fresh, frozen and canned vegetables and fruits without high-calorie sauces or added salt and sugars. Replace high-calorie foods with fruits and vegetables. Choose fiber-rich whole grains for most grain servings. Choose poultry and fish without skin and prepare them in healthy ways without added saturated and trans fat. If you choose to eat meat, look for the leanest cuts available and prepare them in healthy and delicious ways. Eat a variety of fish at least twice a week, especially fish containing omega-3 fatty acids (for example, salmon, trout and herring). Select fat-free (skim) and low-fat (1%) dairy products. Avoid foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet. Limit saturated fat and trans fat and replace them with the better fats, monounsaturated and polyunsaturated. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.

Cut back on beverages and foods with added sugars. Choose foods with less sodium and prepare foods with little or no salt. To lower blood pressure, aim to eat no more than 2,300 milligrams of sodium per day. Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further. If you can’t meet these goals right now, even reducing sodium intake by 1,000 mg per day can benefit blood pressure.

– If you drink alcohol, drink in moderation. That means no more than one drink per day if you’re a woman and no more than two drinks per day if you’re a man.

– Live tobacco free. Don’t smoke, vape or use tobacco or nicotine products, and avoid secondhand smoke or vapor.

Source: American Heart Association