Dr. Sara B. Seidelmann, PhD, MD

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

At the most basic level, nutrition counseling can be simply a talk with a family physician. Doctors receive training in nutrition as part of their education, and they are generally qualified to make recommendations about diet for their patients. Some doctors take a professional interest in nutrition and become experts by taking extra classes or studying nutrition in their practice. In general, however, complex nutrition guidance will be referred to a nutrition specialist, generally a dietitian.

Registered dietitians are nutrition experts that have passed specific higher education, accreditation, and internship requirements. They may work in hospitals, nursing facilities, or private practices to provide nutrition therapy and advise patients about their health and diet. Like dietitians, nutritionists also work to counsel patients about food and health. Some nutritionists have degrees in nutrition or food science, but the title 'nutritionist' is not protected by law. In the United States, anyone is allowed to call themselves a nutritionist, regardless of their education level.

Nutrition counseling can be useful for anyone who is looking to get to a healthy weight, manage a chronic illness through diet, or simply lead a healthier lifestyle. Some examples of issues that benefit from nutrition counseling include:

• Obesity
• Eating disorders
• High cholesterol
• High blood pressure
• Food allergies
• Kidney disease
• Digestive disorders, such as irritable bowel syndrome
• Cancer
• Pregnancy or lactation
• Participation in competitive sports

During a nutrition counseling appointment, the provider -- doctor, nutritionist, or dietitian -- typically will look over a the patient's medical history and talk to them about their current diet, their goals, what kinds of food they like, and any problems that they are currently struggling with in their health or diet. Then the specialist will help the patient set food goals and create a customized plan to help them meet their nutritional needs. Nutrition specialists may also offer classes, workshops, cooking demonstrations, and more. Their role is not to lecture the patient about what one should be eating, but to offer education and resources to make eating healthy foods easier.