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Did you know that 80 percent of all strokes are preventable? Learn which foods should be eaten in moderation to reduce your family's risk of stroke. Stroke is the fifth leading cause of death in the nation and a major cause for disability, killing 130,000 people each year. But did you know that 80 percent of all strokes are preventable, according to the American Stroke Association? Several stroke risk factors -- high blood pressure, smoking, diabetes, physical activity level, obesity, high cholesterol and heart and artery disease -- can be controlled, treated and improved, right down to the foods we choose to consume each day. Diets high in sodium can increase blood pressure, putting you at greater risk for stroke. A high-calorie diet can lead to obesity -- another risk factor. And foods high in saturated fats, trans fat and cholesterol will raise your blood cholesterol levels causing blood clots, which -- you guessed it -- can lead to a stroke. The “not-so-fab” five foods listed below play a large role in damaging your body and causing vascular disease, stroke and heart disease and should be avoided on a regular basis. However: Moderation is the key to life, in my opinion. Sure, everyone is going to have a soda here and there or a steak off the grill, but keep it off the main menu.  1. Packaged and Fried Food Have you noticed foods like hot dog buns and bottled salad dressings rarely go bad? Ever asked yourself why? This is due to the use of hydrogenated oils, which are trans fats. Hydrogenated oils stay solid at room temperature and do not require refrigeration. Convenient? Yes. Healthy? No. Unfortunately, many frozen foods and meals also fall into this category, except for frozen fruits and veggies. So here’s the lowdown on trans fats: They’re considered by many experts as the worst type of fat you can consume, raising your LDL (“bad”) cholesterol and lowering your HDL (“good”) cholesterol. While some meat and dairy products contain small amounts of naturally occurring trans fat, most dietary sources are formed through an industrial process adding hydrogen to vegetable oil, causing the oil to solidify at room temperature.  The FDA is in the process of restricting or possibly banning trans-fats from food in the U.S. A study published in JAMA Cardiology compared data from counties with and without trans-fat restrictions and the findings were substantial: There was a 6 percent decline in hospitalizations for heart attack and stroke in counties with trans-fat restrictions.  Bottom line: Ideally no processed food should pass your lips, but realistically, aim for less than 2 grams of trans fat per day. Skip the store-bought treats at the office and fries at lunch. Also avoid crackers, regardless of what you are dipping them in. Choose to eat fruits to satisfy your sweet cravings and veggies and hummus to satisfy the savory.  2. Lunch meat Processed meats, including bacon, smoked meats and hot dogs, are all on the DNE (Do Not Eat) list, unless you want to play with fire. Processed meats are a no-go if you want to keep your arteries clear of plaque buildup. So what is the alternative to your salami sandwich?  Try a healthy alternative like a tuna sandwich with avocado (a great alternative to mayo) or a veggie sandwich. 3. Diet soft drinks First of all, when a drink is sweeter than a candy bar but it contains zero sugar and zero calories, buyer beware. Many consumers think because a soda is labeled “diet” it’s a better choice, but studies have linked diet soft drink consumption with an increased risk of stroke and vascular disease. In a nine-year study of more than 2,500 people, those who drank diet soda daily were 48 percent more likely to have a heart attack or stroke or die from those events, compared with those who rarely or never drank soda. What else are you supposed to drink? If you must drink soda, break the everyday habit and drink it on special occasions; otherwise water rules. And if you don’t like water, try flavoring your water with fruit slices. 4. Good-old red meat So is there ANY good meat out there you ask? The answer is yes, but it’s not red. In the journal Stroke, an article showed women who consumed large servings of red meat regularly had a 42 percent higher incidence of stroke. Red meat is high in saturated fat, which clogs arteries with plaque. The alternative to red meat is a heart-healthy protein like poultry or fish, or even non-animal products like beans, nuts and tofu.  5. Canned foods Steer clear of factory processed soups, beans and sauces. Canned items all have incredible amounts of sodium or MSG or baking soda/powder to maintain their freshness and shelf life. One study showed if you consume more than 4,000 mg of salt per day, you more than double the risk of stroke compared to diets with less than 2,000 mg. Another tip: When possible, plan and make meals from scratch. Making the wrong meal or snack choices is one of the biggest contributing risk factors for stroke and heart disease. Most people know what good food choices are, but they don’t realize the serious impact the bad choices have on overall health. Learn what is most beneficial to your body to consume. It will be a life changer – literally.

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Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.

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Craving a snack with crunch, sweet flavor and a powerful nutritious punch? These healthy, homemade variants of this make-it-and-take-it super snack are sure to satisfy your sweet tooth and your healthy lifestyle. Who says healthy snacks and bland taste go together? We say you can have it all — nutritious and delicious snack foods that taste great and satisfy — and trail mix fits the bill. Your homemade batch can be as healthy as you like. The nuts provide fiber, protein and a whole lot of crunchy goodness; dried fruit and touches of chocolate infuse the mix with just the right amount of sweetness. We’ve compiled some simple-to-make and hard-to-resist recipes so you can easily pick up a few items from the grocery store’s bulk bins, or your kitchen cupboard, and put together a snack for your kiddos lunches or the office. Better yet, grab your mix and head out for a stroll or hike, or take along on your next road trip or adventure in Nevada’s rugged, desert locales.

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Renown’s team of nurses and respiratory therapists discuss what you need to know before undergoing surgery, including fasting guidelines and how to improve recovery. There are several things to know before you undergo surgery, including steps to prepare at home in advance of your procedure.   Fasting Guidelines: No solid foods eight hours prior to surgery You may have clear liquids three hours before your surgery. Clear liquids include water, apple juice and lemon or lime-flavored soda water (not cola). In addition, do not chew or smoke tobacco (regular or e-cigarettes) after midnight the night before your surgery, unless instructed by your doctor or anesthesiologist.

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At 85, James Domingos is still enjoying life as a cowboy, thanks to a transcatheter aortic valve replacement. Always rolling with the punches when it comes to life, 85-year-old James Domingos faced his health issues with the same grit. For many years, he roped cattle for friends and rounded up horses for the Bureau of Land Management. In recent years, a pacemaker controlled the rhythm of his heart, but didn’t slow him down. “We used to be able to take walks for 15 minutes in one direction and take the dog,” says Domingos’ wife, Joy. “Then it got to be less and less.” Tests at Renown Health revealed a heart valve was nearly closed. His heart doctor, Jake Ichino, MD, FACC, FSCAI, suggested a transcatheter aortic valve replacement, known as TAVR, which repairs a heart valve without removing the damaged valve. The procedure is recommended for patients who are at high risk for open heart surgery.

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As the Healthy Nevada Project expands to 50,000 study participants, researchers are sharing the health insights gleaned from the pilot phase of the project.   Air pollution is a major health factor affecting northern Nevadans, according to data gathered by researchers in the pilot phase of the Healthy Nevada Project, one of the largest population health studies in the country. Today, the project — which began 18 months ago as a partnership between Renown Health and the Desert Research Institute — is expanding to add 40,000 additional participants bringing total enrollment to 50,000 Nevadans. “We are thrilled to share the first insights from our 10,000-person pilot phase and discuss how we will begin using those results to improve patient care,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown Institute for Health Innovation, a collaboration between Renown and DRI. Healthy Nevada Project Pilot Phase — and What Happens Next The pilot phase of the Healthy Nevada Project proved Nevadans are excited to know more about themselves and want to contribute to research that could improve health outcomes for the entire state. The pilot phase enrolled 10,000 participants in less than 48 hours and DNA sample collection from each participant was completed in just 69 working days. Based on pilot phase data, researchers have seen increased use of regional healthcare services correlated with fluctuations in air quality and so-called “bad air events” such as wildfires and atmospheric inversions. In phase two, Renown IHI will evaluate possible links between genetics and increased susceptibility to respiratory ailments. Study researchers also announced care providers and scientists will begin working on a number of clinical programs and scientific studies focused specifically on Washoe County’s high age-adjusted death rates for heart disease, cancer and chronic lower respiratory disease. Collectively, these conditions among local residents stand at 33 percent above the national rate. In the coming months, Renown IHI will begin providing advanced calcium score screenings to pilot phase participants at higher risk for cardiovascular disease. This will allow researchers to examine the link between genetics and calcium buildup in the heart. Researchers are also evaluating future studies focused on age-related macular degeneration and breast cancer risks in northern Nevada.   Pilot Phase Insights Fifty percent of pilot study participants responded to a comprehensive, socioeconomic survey, which revealed: High rates of lower respiratory disease in northern Nevada and co-morbidities such as diabetes and hypertension suggest air pollution in northern Nevada is a confounding and significant factor in health. Study participants had parents who died from cancer and heart disease at a higher rate than the age-adjusted national average. Study participants exercised less than recommended by the American Heart Association and expressed interest in receiving help with behavior modification using diet/nutrition and weight loss tools. In phase two, if study participants choose to complete a follow-up survey, they will have the chance to pick an additional health and wellness app specific to their individual genetic results. Learn More To see if you are eligible to participate in the study, to sign up for study updates and for full details on the Healthy Nevada Project, please visit HealthyNV.org.

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If you’re having surgery on your shoulder, why does it matter what’s in your stomach? We asked Dr. Matthew Hoberg to explain more about pre-surgery directives, including fasting. If you have an upcoming surgery, your care team likely gave you instructions to fast before your procedure. But why? We asked Matthew Hoberg, M.D., medical director of Renown Surgical Services, to explain why it’s important to forgo food and drinks before surgery. Why are patients instructed to fast before surgery? Regardless of surgery type or site, we want the stomach to be empty before having anesthesia, because anesthesia can reduce your body’s ability to protect and prevent food or acids from the stomach from entering the lungs. Normally, your body is able to prevent this, but anesthesia medicines make it harder for your body to do so. When food or liquids from the stomach get into the lungs, doctors call it “aspiration.” This is rare, but can be dangerous if it does happen. Solid foods and liquids leave the stomach at different rates too. Solid food takes longer to empty from the stomach than liquids, so the time to stop eating solids (eight hours) is longer than that for clear liquids (two hours). The body has energy reserves to produce needed nutrients and fuel during fasting. Recently, studies have shown it is important to stay hydrated and have some carbohydrates in clear liquids up to two hours before surgery, so clear liquids are allowed until two hours before surgery. There are also special rules for babies and young children who need surgery. For example, you may give breast milk up to four hours before surgery. If your baby drinks formula, you should stop six hours before surgery, and all solid foods you should stop eight hours before. Your child’s doctor or nurse will give you exact instructions. What if you show up for surgery and have broken the no-eating rule? Will surgery be re-scheduled? If patients have not followed the fasting guidelines, surgery will be postponed or rescheduled due to the possible increased risk associated with not having an empty stomach. The exception would be emergency surgery that cannot be delayed in which case special precautions are taken to help prevent anything from getting into the lungs. What other pre-operative rules should be followed to the letter? All instructions given to patients before their surgery or procedure should be followed. There are specific medical reasons behind all the instructions and they are designed for safety — to minimize risks, lower complications like infections and enhance the recovery process to help patients get back to normal as quickly as possible. Also, many patients ask if they should continue taking medications before surgery. The answer is: It depends. Your doctor or nurse will tell you which medicines you should take and when. Some medicines need to be stopped before surgery. But for others, it’s important you keep taking them as usual. You may also get new medicines to take before surgery. You may be asked to take some medications before surgery as part of advanced pain management protocols. If you need to take medicine right before your surgery, you can take it with a sip of water.

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To be on the move is a scary concept when you’re recovering from surgery. But did you know getting up and at ’em could be the key to a quicker recovery, post-surgery? Here’s some expert insight from Renown Surgical Services. The team at  has some news for you: Rest and movement are important to prevent serious complications. Here are some tips about how to get mobile after your procedure — and why it’s fundamentally important. Tip 1: Start Simple While you’re in bed, move your legs and feet up and down. Be sure to ask the nurses to help you get out of bed and into the chair for all your meals, or walk to the bathroom when needed. If you feel up to it, take a walk in the hallways with the nursing staff. Tip 2: The Sooner, the Better This may be surprising, but too much rest is not necessarily a good thing. The old saying “You use it, or you lose it” rings very true to maintaining the strength needed to get yourself out of bed. Beginning the mobility process early in your hospital stay will not only help you maintain strength and function, it may also help you get home sooner. Though it may seem counter intuitive, lying in bed all day can delay your healing time and cause serious complications to arise, including pneumonia, deep vein thrombosis or blood clots, pressure ulcers and sometimes constipation. Tip 3: Mobilize Your Support System Getting out of bed, sitting in a chair for meals and walking around your room or hospital unit can help reduce your risk of complications. The nursing staff will help you out of bed the same day of your surgery if it’s cleared by your doctor. Tip 4: Safety First The nursing staff is here to keep you safe, so make sure you call them for assistance getting out of bed. Even if you think you can do it yourself, use your call light to notify the nursing staff you are ready to get up and move. In addition, new medications can sometimes impair our judgment, balance and safety, so it’s always better to have help even though you may not need it. This is also why you may have a “bed alarm” on, to remind you to call for help and keep you safe while you are recovering. Tip 5: Move, But Manage Your Pain Many people find that getting up and moving actually helps their pain, rather than making it much worse. Taking the right amount of medication at the right times will minimize your pain and help you to get moving. Your care team will work with you on how much pain medication is right to manage any postoperative pain, with the goal for you to be comfortable enough to be able to move and gradually increase your activity each day. Tip 6: Maintain that Momentum at Home Mobility doesn’t end once you’re discharged from the hospital. It’s key to keep moving to maintain health and function. When you first arrive home, it’s crucial to take frequent movement breaks throughout the day. Increase activity as it becomes more comfortable, and be sure to ease back into an active daily routine. If you have concerns about your mobility once home, be sure to discuss this with your doctor at your follow-up appointment. Renown Surgical Services | 775-982-3993 Ask your doctor if you have any questions about your medical condition or the specific surgical procedure planned, or contact the team at Renown Surgical Services. Learn More

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Read about Jordan Stiteler, a local mom who says the Healthy Nevada Project provided insights into her family’s genetic makeup — and the likely cause of her dad and great grandfather’s deaths. Now she is changing her life due to her new diagnosis of familial hypercholesterolemia, which will allow her to take steps toward preventing the same fate. Jordan Stiteler’s dad died suddenly of a stroke nearly ten years ago — at only 45 years old. His grandfather died at age 40. Now through the Healthy Nevada Project’s no-cost genetic testing, she is closer to understanding why that may have happened. And she can take proactive steps to prevent the unhealthy symptoms that often lead to a stroke and heart problems. After getting her Geno 2.0 by National Geographic ancestry report, Stiteler got a call from Renown Institute for Heart & Vascular Health Cardiologist and Renown IHI Director of Research, Dr. Christopher Rowan. “They told me that I have FH, which is familial hypercholesterolemia,” she said. “I have genetically very high cholesterol because I have a non-functioning gene that doesn’t get rid of my cholesterol like a normal body would.” Familial Hypercholesterolemia: Simple Life Changes Dr. Rowan told Stiteler it is curable with medication and a change in lifestyle. Stiteler has embraced healthy lifestyle changes by exercising more and eating healthier. “It is so important. Being a mom, I think you have so much more to live for. Having this information has changed my life.” Stiteler feels confident FH affected her Dad. “It is helping my family realize that we need to get tested,” she said. “There were big milestones that my Dad missed. He didn’t get to see either of us get married or have our children. That was huge.” She has become passionate about sharing the need to join the Healthy Nevada Project as her way of helping to prevent other families from possibly going through what she and her family did with the early loss of her Dad. In addition to FH results, the Healthy Nevada Project is returning clinical results on BRCA 1/2 (hereditary breast and ovarian cancer) and Lynch syndrome (colorectal and endometrial cancer) to consenting study participants. To sign up for the Healthy Nevada Project, go to HealthyNV.org. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

Read More About The Healthy Nevada Project Changed My Life: A Local Mom's Story

The Healthy Nevada Project – a first-of-its-kind population health study combining genetic, clinical, social and environmental data – has reached another landmark milestone. The study is notifying study participants at risk for familial hypercholesterolemia, BRCA and Lynch syndrome. “I took part in the Healthy Nevada Project to find out my ancestry. I didn’t even realize the test could give me so much information,” says 29-year-old Jordan Stiteler, who was recently diagnosed with familial hypercholesterolemia (also known as FH) through the Healthy Nevada Project. “After my dad passed away suddenly at age 45, I learned I had high cholesterol but I didn’t know it was genetic and I didn’t get an FH diagnosis until last week,” Jordan explains. “I immediately changed my diet, started walking more and doing more cardio. I also set up an appointment with my primary care physician for the first time in a while. I’ve talked with my family and even strangers about testing since my diagnosis. I hope my story will inspire others to test and can save someone’s family from going through the same loss I did.” Healthy Nevada Project Notifying Patients of Familial Hypercholesterolemia Risks Jordan is among the first Healthy Nevada Project participants to receive clinical results from the genetic study led by Renown Institute for Health Innovation (Renown IHI) – a collaboration between Renown and the Desert Research Institute Foundation. This groundbreaking population health study is now reaching out to study participants like Jordan, who asked to be notified of health risks. If study volunteers choose, the project will also provide guidance on treatment and additional testing for family members who may also be at risk. The project is starting with the return of FH risks which is a genetic tie to high cholesterol. Just a few months ago, a paper in the Journal of the American College of Cardiology recommended genetic testing become the standard of care for patients with a definite or probable FH diagnosis. Jordan says she plans to have her young son tested as well. “This is the future of health; not just reacting to sick people, but a coordinated effort between innovative technologies, data-driven researchers, and responsive practitioners to deliver personalized interventions to identify, prevent and treat disease,” says Anthony Slonim, M.D., Dr.PH., FACHE, president and CEO of Renown Health and president of Renown IHI. “As care providers, we often don’t see patients until they’re already sick and that’s a difficult problem. By embracing personal genomics, we can accelerate the ability of researchers to access data and apply those learnings back to our health system sooner.” In the Months Ahead: Notification of BRCA1/2 & Lynch Syndrome Risks The Healthy Nevada Project will start notifying study volunteers at risk for other CDC Tier 1 conditions including hereditary breast and ovarian cancer syndrome (BRCA 1/2 genes) and Lynch syndrome in the months ahead. These conditions are the key focus for the Healthy Nevada Project. The reason: Because early detection and treatment will save lives, and these conditions are some of the most common. “This research allows us to look into cancer, cardiac, respiratory illness and beyond to identify underlying causes, assess real risks and eventually initiate appropriate preventive actions much earlier. Human subject research is often intangible to participants – we are treated as subjects. The Healthy Nevada Project is creating actionable information for our participants while engaging in leading-edge research on health determinants,” said Joseph Grzymski, Ph.D., associate research professor at DRI, principal investigator of the Healthy Nevada Project and chief scientific officer for Renown Health. Landmark Population Health Study Continues to Expand Since launching two years ago, the Healthy Nevada Project has quickly evolved and expanded. The pilot project enrolled 10,000 participants in just 48 hours in September 2016. In March 2018, phase two of project expanded to an additional 40,000 participants with genetic testing partner, Helix. Helix’s genomic sequencing provides participants and researchers greater depth and quality of DNA data. With this, they can gain further insights to improve health. During a recent media roundtable announcing the return of clinical results, the Healthy Nevada Project also announced plans to complete testing of 40,000 people by the end of 2018. This will bring the project’s total enrollment to 50,000 people – approximately 10 percent of northern Nevada’s population. The Healthy Nevada Project hopes to reach more than 250,000 people in its next phase. The ultimate goal is to offer genetic testing to every Nevadan interested in learning more about their genetics and health. Join the Healthy Nevada Project Recruitment for phase two is still open. In addition to opting in to receive clinical results, participants receive National Geographic’s Geno 2.0 ancestry app at no cost. They also have the chance to pick an additional app for health and wellness after completing a follow-up survey. Learn More or Sign Up

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Friday, April 12 is National Grilled Cheese Sandwich Day! So Let us help you create a healthier melt-in-your-mouth version to this popular cheesy sandwich. Ah, the grilled cheese. It’s the quintessential comfort food that not only pairs easily with a cup of soup, but it’s easy to whip together with just a few ingredients. There are many reasons to celebrate the gooey cheesiness of this toasted sandwich, but at nearly 700 calories, it’s definitely an occasional treat. But with just a few ingredient swaps — think light mayonnaise or toasting the bread in a toaster instead of slathering it in butter — you can remake your grilled cheese into a mouth-watering and nutritious meal. We’ve compiled a couple of easy substitutions, and some of our favorite healthy twists, so you can try a new variation of an old favorite. Be Choosy with Your Cheese It’s the star of your sandwich, but do you need to always grab the yellow slices? Try to opt for stronger flavors, like blue cheese or extra-sharp cheddar, to help you retain flavor while using less cheese on your sandwich. Better Bread Goes A Long Way Plain old white bread might be your toast of choice, but by choosing a whole wheat or multi-grain bread for your sandwich you’re not only adding in new crunch and flavor, you can also increase your fiber and nutrient intake. Hold the Butter Your mom, and maybe even your grandmother, probably spread a layer of butter on your grilled cheese throughout your childhood. But know this: It isn’t necessary. While butter helps crisp the crust, it doesn’t add too much in the way of flavor. Instead, brush the bread with olive oil, or try using a thin layer of reduced-fat mayonnaise or a creamy spread. Or skip grilling altogether by toasting your bread and then baking your sandwich open faced in the oven for a few minutes at 350 degrees. Healthier Options Looking for a new twist? Here are three incredibly tasty (and healthier) versions of the traditional grilled cheese sammy. 1. Baby Swiss And Tomato Grilled Cheese 2. Green Grilled Cheese 3. Spinach, Pesto & Havarti Grilled Cheese

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Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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