Discomforting

The events of recent weeks have Paula Deen swinging on a pendulum like a tin duck in a shooting gallery. The slings and arrows are not entirely undeserved; she waited three years with a diagnosis of diabetes to make the announcement of her condition; and even then it was only after securing a potentially lucrative drug endorsement deal.

In the interim she continued to promote her southern style of cooking. It is a style defined by generous portions, liberal use of fats like butter and sweet treats made with ingredients like refined sugars.

There are also questionable recommendations like those found in Paula's Lunch-Box Set cookbook aimed at kids; like offering cheesecake as a regular breakfast option.

Perhaps now she should consider offering up slices of humble pie, instead.

The natural reaction is to swing the pendulum entirely to the other extreme; to condemn the previously populist message. But that approach misses the big picture: What can we learn from Paula Deen? Specifically, what can we learn about diabetes and its complications, including heart disease? With all the rigmarole, what can we highlight that brings a positive awareness out of this event?

We can begin focusing on some of the heart disease issues that specifically affect older women in the U.S., like Paula, who are over 50 years of age.

Women less than 55 years old have a 1 in 19 risk of heart disease. In women over 55 years of age, 1 in 6 will have heart disease.

Women with heart disease fare worse than their male counterparts, especially in areas like undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Some of that may be due to inherent differences between the sexes, features of which we simply do not yet understand. The other reasons which are immediately addressable are under and less intensive treatment.

An important component in rectifying this situation is that women understand the enormity and severity of the problem.

Heart disease kills more women in the U.S. each than men. Misdiagnosis, although infrequent, often leads to poor outcomes.

It is important for both women and their health care providers to be aware of the gender influence on disease presentation.

Women are more likely to present with atypical symptoms of coronary artery disease. These symptoms may be shortness of breath, abdominal discomfort, weakness and general feelings of malaise and illness. It is a presentation that can lead to a misdiagnosis like gastrointestinal disease or panic attacks.

An awareness of risk factors and family history is very important information in assessing risk in a non-biased fashion.

There are also steps women can take to reduce their own risk and improve their outcomes. Women are often the primary caregivers within family units. As such, they often put their own needs last. It is important if there are symptoms or signs of possible heart disease, that these get evaluated promptly — especially if there is a strong family history.

The effects of stress on the heart, particularly in women, are well documented. Takatsubo, broken heart or apical ballooning syndrome is a well-documented condition which mimics a blocked coronary artery ("the widow maker") in every way, even in potential fatality. It is not, however, caused by a blocked artery. It is induced by extreme stress or trauma. If not fatal, full recovery is the usual prognosis.

Activities that can reduce stress in women are particularly beneficial. Meditation, yoga and other activities that reduce both external and internal stressors are great examples.

Exercise is another great example. In depressed women, exercise has been shown to be as beneficial as single drug therapy.

A diet of moderation with fresh, wholesome ingredients as we prescribe in our Grassroots Gourmet approach can lead to cardiovascular health and gustatory pleasure.

The pursuit of pleasurable activities, like crafting and consuming a delicious meal can reduce stress as well.

When it comes to prevention, an ounce of prevention is worth a pound of bypass grafts or stents.

Let us not look at where Paula has finished and heave stones, let us rather look where we have followed and correct our own course.