Momordica Charantia or Bitter Melon, Bitter squash or Bitter gourd is a vine of the tropical and subtropical family Cucurbitacae.  These are widely grown in Asia, Africa, and the Carribbean for its edible, extremely bitter tasting fruit. There are several varieties that differ in the shape and bitterness of the fruit.  Bitter melon most likely originated on the Indian subcontinent, and was introduced into China in the 14th century.   

Bitter Melon has  been utilized in several studies within the last two decades, on various medical conditions and diseases. Over 100 studies using modern techniques have authenticated its use in diabetes and its complications (nephropathy, cataract, insulin resistance), as antibacterial as well as an antiviral agent (including HIV infection), anti carcinogenic and as an anti-parasitic.  

In an animal model, bitter melon extract has been shown to lower blood glucose by suppressing its synthesis in the liver, on the one hand through depression of the key gluconeogenic (glucose formation from a non carbohydrate source i.e. proteins or fats) enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase and on the other by enhancing glucose oxidation by the shunt pathway through activation of its principal enzyme G6PDH.  
More recently bitter melon was found to have the potential for increasing insulin sensitivity in patients with type 2 diabetes compared to those with type 1 disease. 

Bitter melon displays cytotoxic (cell killing) activity.  In one study a ribosome inhibiting protein (RIP) MCP30 has been shown to inhibit histone deacetylase-1 (HDAC-1) activity and induce apoptosis (programmed cell death) in prostate cancer cells.  

Bitter melon is consumed as a food, however, consumption of the seeds, extracts, and large quantities of juice can cause adverse effects.  Bitter melon may interact with certain drugs including chemotherapy agents such as vinblastine and paclitaxel. It also has additive blood sugar lowering effects when combined with insulin or oral hypoglycemic agents.  Before using bitter melon you should speak with a medical professional.  

As promised, here is the last portion of heart healthy living.  I have included some heart healthy dinner and dessert ideas as well as some exercise tips.  Healthy dinners should be limited in saturated fat and rich in foods containing antioxidants and fiber such as brightly colored fruits and vegetables, whole grains, beans and nut products.  Dinner may also include lean meats and fish to help keep you full while keeping the size of your portions in mind.  

As the old adage says eat breakfast like a king, lunch like a prince and dinner like a pauper.   A study performed at the University of Tel Aviv in July of 2013 showed how changing the timing of meals by switching between a high calorie breakfast and a high calorie dinner, but keeping the total daily calories the same, would impact health and weight loss in women.  During a 3 month study, 50 overweight women were selected randomly to a 1,400-calorie diet that consisted of breakfast 700 calories, lunch 500 calories, and dinner 200 calories or the same calories and same food choices but with the breakfast and dinner meals switched.  Both of the groups lost weight, but the women who consumed the large breakfast lost an average of 19 pounds and twice as many inches around their waists compared to approximately 8 pounds in the large dinner group.   Large breakfast eaters also had significantly lower levels of insulin, glucose, and fat in their blood, which may help lower risk of diabetes and heart disease.  

 Our body's circadian rhythms may influence hormone release and other functions such as our metabolism.  Another tip is to avoid eating after dinner which is usually due to boredom.  Try going for a short walk instead.  This will help prevent late night munching and burn some excess calories.  Also, ensure your diet is well-balanced during the day.
Foods that contain fiber such as fruit, vegetables, and whole grains keep you satisfied and full between meals.  

Salmon Panzanella via Eatingwell.com

Makes: 4 servings, 2 cups salad & 3 ounces salmon each
Total Time: 30 minutes

INGREDIENTS
     8 Kalamata olives, pitted and chopped
     3 tablespoons red-wine vinegar
     1 tablespoon capers, rinsed and chopped
     1/4 teaspoon freshly ground pepper, divided
     3 tablespoons extra-virgin olive oil
     2 thick slices day-old whole-grain bread (or gluten free bread if needed), cut into 1-inch cubes 
     2 large tomatoes, cut into 1-inch pieces
     1 medium cucumber, peeled (if desired), seeded and cut into 1-inch pieces
     1/4 cup thinly sliced red onion
     1/4 cup thinly sliced fresh basil
     1 pound center-cut salmon, skinned (see Tip) and cut into 4 portions
     1/2 teaspoon kosher salt

PREPARATION

1. Preheat grill to high.
2. Whisk olives, vinegar, capers and 1/8 teaspoon pepper in a large bowl. Slowly whisk in oil until combined. Add bread, tomatoes, cucumber, onion and basil.
3. Oil the grill rack (see Tip). Season both sides of salmon with salt and the remaining 1/8 teaspoon pepper. Grill the salmon until cooked through, 4 to 5 minutes per side.
4. Divide the salad among 4 plates and top each with a piece of salmon.

TIPS & NOTES

• Tips: If using fresh bread, you can grill the bread slices along with the salmon and then cut them into cubes. Alternatively, cut bread into cubes, place on a baking sheet and bake at 300°F until dry.
• How to skin a salmon fillet: Place salmon fillet on a clean cutting board, skin-side down. Starting at the tail end, slip the blade of a long knife between the fish flesh and the skin, holding down firmly with your other hand. Gently push the blade along at a 30° angle, separating the fillet from the skin without cutting through either.
• To oil the grill rack, oil a folded paper towel, hold it with tongs and rub it over the rack. (Do not use cooking spray on a hot grill.) When grilling delicate foods like tofu and fish, it is helpful to spray the food with cooking spray before placing it on the grill.

NUTRITION Per Serving: 362 calories; 21 g fat (3 g sat, 12 g mono); 72 mg cholesterol; 15 g carbohydrates; 0 g added sugars; 29 g protein; 5 g fiber; 386 mg sodium; 1002 mg potassium.
Selenium (67% daily value), Vitamin C (30% dv), Potassium (29% dv), Vitamin A (20% dv), Magnesium (18% dv), Excellent source of omega-3s


Grilled Chicken with Tomato Salsa adapted from Organic Kitchen

Makes: 4 Servings

Ingredients
For the Chicken:
4 boneless, skinless organic chicken breast fillets, about 6 oz each
2 tablespoons fresh lemon juice
2 tablespoons olive oil
2 teaspoons ground cumin
2 teaspoons dried oregano
1 tablespoon coarse black pepper


For the Salsa:
1 green chile
1 pound plum tomatoes, seeded and chopped (you can buy organic canned or jarred variety)
3 scallions, chopped
1 tablespoon fresh chopped parsley
2 tablespoons chopped fresh cilantro
2 tablespoons fresh lemon juice
2 tablespoons olive oil

Preparation: 
1. To help thin the chicken breasts it helps to pound them with a meat mallet between two sheets of plastic wrap until thin.
2. In a dish, combine the lemon juice, olive oil, cumin, oregano, and pepper.  Add the chicken and turn to coat.  Cover and let marinate for at least 2 hours, or i recommend in the refrigerator overnight.
3.  To make salsa, char the chile skin either over a gas flame or under the broiler.  Let cool for 5 minutes.  Using care rub off charred skin, make sure to wash hands afterwards or use gloves.  To give the flavor less spice remove the seeds, for more spice leave seeds. Charring the flesh allows the natural sweetness to be released and the heat is moderated.  The hottest part of the chile is the white membrane that connects the seeds to the flesh.  
4.  Chop the chile very finely and place in a bowl.  Add the seeded and chopped tomatoes, the chopped scallions, chopped fresh parsley and cilantro, lemon juice and olive oil and mix well.  Set aside until ready to serve.  
5.  Remove the chicken from the marinade.  Heat a ridged grill pan.  If you do not have a ridged grill pan on hand you may use a George Foreman grill etc.   Add the chicken fillets and cook on side until browned, for about 3 minutes.  Turn over and cook for a further 4 minutes.  Serve with the chile salsa.  Enjoy!


Dr.SuzHeals Easy Homestyle Heart Healthy Chile

Makes: 4 Servings Vegetarian and 8 Servings if add the ground turkey

Ingredients
        2 1/2 lbs organic ground turkey (optional)
        2 tablespoons sunflower oil
        1 tablespoon ground cumin
        1/2 teaspoon ground cinnamon (adds a special flavor!)
        1 large onion, chopped
        2 garlic cloves, chopped finely
        1 1/4 cups organic chicken stock or vegetable stock
        2 1/2 lbs diced plum tomatoes, may use canned or jarred organic tomatoes 
        2 boxes or cans of either organic red kidney beans or black beans 
        1/4 cup chili powder
        1 medium red bell pepper, medium diced
        1 1/2 teaspoons kosher salt
        1/4 cup jalapenos or green chiles, seeds removed if desire less spicey, coarsely chopped

Preparation:

   1.  Heat the oil in a large frying pan over medium heat until simmering.  Add the onions and bell pepper, season             with 1/2 teaspoon of salt, and cook, stirring occasionally until softened.  
   2.  Add the garlic, chili powder, cinnamon and cumin, stir to coat the vegetables, and cook until fragrant.  Add the         ground turkey (if desired) and measured salt 1 teaspoon and cook as you break the meat into small pieces with         a wooden spoon until the meat is no longer pink, about 7 minutes. 
   3.  In a large pot add the tomatoes and cook on medium heat until simmering, about 4 minutes.
   4.  Add the beans to the pot with the simmering tomatoes while stirring.  
   5.  Add the mixture with the vegetables and ground turkey (optional) to the simmering tomatoe and beans.  To            this add the jalapenos or green chiles. Stir thoroughly.  
   6.  Let simmer on low to medium heat for about 40 minutes.   


Warm Chocolate Pudding adapted from eatingwell.com

Makes: 6 servings
Total Time: 20 minutes

INGREDIENTS
1 large free range organic egg
2 1/4 cups nonfat or low-fat milk, almond milk, hemp milk, divided 
2/3 cup unrefined sugar, divided
1/8 teaspoon salt
2/3 cup unsweetened cocoa powder
4 tablespoons tapioca (cornstarch substitute 2tbsp tapioca = 1 tbsp cornstarch) 
1 teaspoon vanilla extract

Preparation:

1. Lightly beat egg with a fork in a medium bowl.
2. Combine 1 1/2 cups milk, 1/3 cup sugar and salt in a medium saucepan; bring to a simmer over medium heat, stirring occasionally.
3. Meanwhile, whisk the remaining 1/3 cup sugar, cocoa and tapioca in a medium bowl. Whisk in the remaining 3/4 cup milk until blended. Whisk the simmering milk mixture into the cocoa mixture. Pour the mixture back into the pan and bring to a simmer over medium heat, whisking constantly, until thickened and glossy, about 3 minutes. Remove from heat.
4. Whisk about 1 cup of the hot cocoa mixture into the beaten egg. Return the egg mixture to the pan and cook over medium-low heat, whisking constantly, until steaming and thickened, about 2 minutes. (Do not boil.) Whisk in vanilla. Serve warm.

Make Ahead Tip: Pour the pudding into a bowl and place a piece of plastic wrap directly on the surface. Refrigerate for up to 3 days; serve cold.

NUTRITION Per serving: 164 calories; 2 g fat (1 g sat, 1 g mono); 37 mg cholesterol; 34 g carbohydrates; 6 g protein; 3 g fiber; 110 mg sodium; 311 mg potassium.


Exercising to Stay Heart Healthy

Before beginning an exercise program you should definitely speak with your primary care provider and or cardiologist.   Total body low or non impact exercises and sports are one of the best for people with heart disease. Your heart needs to work harder to fuel all the muscle groups involved.  By doing this your heart will grow stronger over time.  Some examples are; swimming, rowing, elliptical machines with arms and cross country skiing.  

Yoga is great because it helps to lower blood pressure and decreases stress.  Yoga helps to promote a healthy mind and body.  You do not need to attend a class to receive the benefits, here is a website that provides exercises and information on getting started with yoga http://www.yogajournal.com/category/beginners/

Keeping active all day helps people burn more calories and stay healthier.  People who are active the entire day (cleaning, gardening, running errands) usually are healthier than those that will exercises for 30 to 60 minutes and then sit at their desk or computer.  If you work at a desk job standing up every 30-40 minutes and doing a few stretches or taking a walk around the office will help.  You can also wear a pedometer to measure how active you are.  Take the stairs instead of the elevator as much as possible.  Get a walking buddy during lunch and walk a few laps before sitting down to eat.  There is nothing preventing you from staying active except yourself.  Everyone has a busy day but you can find time if you plan ahead.  Stay healthy! 

Eating a healthy lunch can be difficult if you are unprepared.   An unhealthy lunch that contains high amounts of sodium, sugar and saturated fats may leave you bloated, tired and unfocused.  Also, skipping lunch altogether, may lead to overeating later in the day or evening causing weight gain, increased blood pressure and cholesterol.  
<--See Pic   :)

My first tip is when food shopping, make sure to pick up items that you can use for lunch.  You should prepare ahead of time to ensure that you bring your lunch with you to work or school or even have it readily available if you stay at home.  

Here are a few lunch staples to pick up the next time you are at the grocery store.

Bread for sandwiches:   
Most of us probably don't have the time to make our own bread at home.   I like to get bread that has plenty of whole grains, high fiber to keep you full longer and is heart healthy i.e. low sodium, whole grains.  This is VERY important so pay close attention.  I have found that many people think because packaging says WHOLE WHEAT and the bread has a brown color that it means it contains whole grains and is high in fiber.  That is not the case!  You MUST read the ingredients.  If the first ingredient says "wheat flour" or "enriched bleach flour" etc means white flour and not whole-wheat flour was used.  Also, do not be mislead by words like 7 grain or 12 grain.  Companies use these key words to fool you.  
Ezekial Bread, from food for life company, is a great example of a heart healthy bread option.   7 Sprouted Grains, brown rice bread (Gluten Free) and Ezekial 4:9 sprouted whole grain bread are just a few options. 

Between the bread: 

Organic Turkey and Chicken: There are a few companies that sell pre-sliced organic turkey and chicken.  Applegate farms is sold in several grocery stores around the country.  Their commitment to natural and organic ingredients as well as eliminating GMO's (Genetically Modified Organisms) is fantastic.  Another quick and healthy idea is to buy a pre roasted organic chicken or turkey.  Whole Foods Market stores and some local healthy grocery stores are starting to sell these.  You can pull the meat off the bone for organic pulled chicken sandwiches or add the meat to salads.     
Nut Butters:  Organic Peanut Butter and Almond Butter are a great protein alternative for lunches, especially for kids.  Of course you want to use the proper serving and stick to the unsalted and unsweetened versions.  In addition to protein nuts contain Vitamin E and monounsaturated fats that help to regulate cholesterol by lowering the bad LDL cholesterol while maintaining  the good HDL cholesterol.   According to a review in the British Journal of Nutrtion, people who eat nuts four times a week may lower their risk of dying of coronary heart disease by 37 percent, compared with people who seldom or never eat nuts.    A healthy serving size is about 1tbsp of peanut or almond butter.  Some examples of organic peanut and almond butters are Whole Foods 365, MaraNatha and Arrowhead Mills
Peanut or Almond Butter can also be used to make smoothies, baking or just as a snack with apples or celery.

Some other lunch ideas are hummus with carrots, veggie burgers, smoothies and salads.  Below are a few quick and healthy lunch recipes.  Enjoy!  

Chicken and Bean Salad-Serves 4 
1/4 tsp salt
3 tbsp organic extra virgin olive oil
6 tbsp organic orange juice
1/4 cup white-wine vinegar or red-wine vinegar
1 tbsp organic Dijon Mustard
1/2 cup organic red onion (optional to taste)
15 oz black, white beans or other (I prefer boxed organic beans but canned if easier)
2 1/2 cups pulled, sliced or diced organic cooked/roasted chicken breast--you may use the pre cooked/roasted organic chicken as discussed in above post
About 2 small diced zucchini and/or summer squash
1 cup coarsely chopped fresh basil
Freshly ground pepper to taste (optional)
2 cups torn organic spinach, kale, escarole or other to taste

Directions

1. To prepare vinaigrette:  Whisk in 3 tablespoons oil with the 1/4 tsp salt.  Add 6 tablespoons orange juice, vinegar, and mustard; whisk until well blended. Taste and whisk in up to 4 tablespoons more juice to mellow the flavor if needed.  Set aside at room temperature.
2. To prepare salad: Combine beans, chicken, zucchini (and/or summer squash), in a large bowl until well blended. Add chopped basil and 3/4 cup vinaigrette; toss until combined. Taste and season with pepper, if desired.
3. Toss the remaining vinaigrette with escarole, spinach, kale or other leafy greans in a medium bowl. Serve the salad on the greens, garnished with fresh basil leaves.
   

Hearty and Heart Healthy Peanut Butter and Jelly Lunch Smoothie -Serves 2

1 cup ice cubes
1 cup fresh or frozen organic strawberries 
1 cup fresh or frozen organic blueberries
1 small organic banana
2 tbsp organic creamy peanut butter
2 tbsp organic milled flax
1 cup water, almond or hemp milk

Instructions

1. Combine all ingredients in a blender in the order listed.
2. Blend until smooth.

Sweet Potatoe and Black Bean Burger-Recipe Adapted from the Cafe Flora Cookbook   Makes 8 Burgers

Note: This recipe takes some additional time and effort since you must make the burgers yourself.  I would recommend finding some time at the beginning or end of your day or even on the weekend.  You can store in the fridge or freezer for easy lunches or dinners during the week!

Ingredients:

1½ pounds organic or local sweet potatoes (smaller potatoes cook faster)
⅓ cup millet
1 cup old fashioned organic oats (use certified gluten-free oats if you are avoiding gluten)
1 can or box (15 ounces) organic black beans, rinsed and drained (or 2 cups cooked black beans)
½ small red onion, diced
½ cup lightly packed fresh cilantro leaves, chopped
2 teaspoons cumin powder
1 teaspoon chili powder
1 teaspoon chipotle powder or smoked hot paprika
½ teaspoon cayenne powder (optional, to taste)
½ teaspoon salt
High quality organic vegetable oil for cooking burgers (or coconut oil, if you don't mind the coconut taste, olive oil may burn)
8 organic whole wheat flour hamburger buns (optional)

your favorite burger fixings (avocado or guacamole, tomato or pico de gallo, lettuce, sprouts, ketchup, hot sauce, mustard, pickles, cheese)

INSTRUCTIONS

1. Roast the sweet potatoes: Preheat the oven to 400 degrees Fahrenheit. Slice the sweet potatoes down the center lengthwise. Place the sweet potatoes cut side down on a rimmed baking sheet. Roast until they yield to a gentle squeeze, 30 to 40 minutes or longer. Once the sweet potatoes are cool enough to handle, remove the skin (it should pull off easily) and roughly chop the insides. Set aside to cool completely.
2. Cook the millet: In a small saucepan, bring 1 cup of water to boil. Stir in the millet, reduce heat to low and simmer, covered, until tender (about 25 minutes). Drain off any remaining liquid and set aside to cool.
3. Grind the oats: Use a food processor or blender to grind the oats until the flakes are broken up, but not as fine as flour.
4. Mix the burgers: In a large mixing bowl or the bowl of your electric mixer, combine the cooled sweet potatoes and millet, black beans, onion, cilantro, cumin, chili powder, chipotle or paprika, cayenne (optional, add to taste for spicier burgers) and salt. Use a potato masher, big mixing spoon or the paddle attachment of your mixer to mix really well. It's ok if the black beans get smashed in the process.
5. Mix in the oats: Sprinkle the ground oats over the mixture and mix well with a big spoon until the mixture holds together when you shape a portion into a patty. If possible, cover and refrigerate the mixture for best results (the patties will hold together better during cooking if they are chilled first).
6. Shape the burgers: Use a measuring cup to measure out ½ cup of the mixture. Gently shape it into a patty about 3½ inches in diameter. Use your hands to gently flatten the burgers and smooth out any jagged edges. Repeat the process for each patty; you should end up with 8. If you would like to toast your hamburger buns, preheat the oven to 350 degrees now.
7. Pan fry the burgers: Heat 1 tablespoon oil in a large cast iron or non-stick skillet over medium heat. When it's hot, place several burgers in the pan, leaving enough room to flip them. Cook each patty until browned and heated through, about 3 to 4 minutes per side. Add 1 tablespoon oil to the skillet for each pan of burgers you fry.
8. Toast the buns (optional): Place the buns on a baking sheet, cut sides up, and bake until lightly toasted, about 2 to 3 minutes.

Tips:
I'm not sure these patties will hold together properly on a grill; panfrying is probably the best but you could also bake them in the oven and if at work possibly the microwave for 20-30 sec.  
Also, patties should freeze well for later use

Heart healthy snacks should give you energy to help you stay focused throughout your day and provide essential nutrients to help prevent heart disease.  I have included a list of some foods to keep on hand at home followed by some recipes and tips that include these items.  Take a look and enjoy!  Stay healthy.  Go Organic!  Buy Fair Trade!


Organic raw almonds, pumpkin seeds, walnuts, sunflower seeds
Organic Fair Trade Caffeine Free Green Teas (i.e. arbor teas company)
Raw organic honey
Cinnamon
organic fruits and veggies (apples, carrots, kale, spinach, blueberries, kiwi, zucchini, acorn squash, sweet potatoes, red peppers, asparagus, oranges, tomatoes, cantaloupe, watermelon)
Ground organic flaxseed
Organic lowfat yogurt
Organic Sunflower oil
Certain organic dried fruits; pomegranate seeds, goji berries, mulberries, etc.    you can find dried fruits online @
http://www.therawfoodworld.com/driedfruits-p100222


The above foods contain several nutrients to help fight heart disease such as Phytoestrogens, Phytosterols, carotenoids and polyphenols.  

Studies have shown that foods with phytoestrogens (i.e. flaxseeds), help to lower the risk of stroke, cardiac arrhythmias and blood clots as well as lower LDL, triglycerides and blood pressure.  
Phytosterols are plant sterols that contain a chemical make up similar to cholesterol  and have shown to reduce blood cholesterol. All nuts and seeds, including wheat germ, have phytosterols.
Carotenoids are heart-protective antioxidants in many colorful fruits and veggies. Alpha-carotene, beta-carotene, lutein, and lycopene (in watermelon and tomatoes) are carotenoids.
Polyphenols are another set of antioxidants.  They help to protect blood vessels, lower blood pressure, reduce LDL "bad" cholesterol. Flavonoid polyphenols include catechins, flavonones, flavonols, isoflavones, reservatrol, and anthocyanins.  Non-Flavonoid polyphenols include ellagic acid (found in all types of berries).

B complex viitamins (B-12, B-6, B-3), Vitamins C and E, Magnesium, potassium and calcium

B-12 (Folate) and B-6: prevent blood clots and hardening of arteries or atherosclerosis
B-3 (Niacin): Increases "good" cholesterol HDL
C and E: antioxidants protect cells from damage of free radicals
Magnesium, potassium and calcium: lowers blood pressure
Fiber: lowers cholesterol 


Quick and Heart Healthy Snacks:

1 minute Apples and Cinnamon: 2-3 servings 

2 of your favorite apples
1stp cinnamon
1 medium to large zip lock bag

1. Take 2 apples cut into 8 sections each (16 pieces)
2. Place in a Ziplock bag 
3. Add 1 tsp ground cinnamon
4. Close the bag tightly and shake thoroughly 
Enjoy!

Tasty Kale Chips: 8 cups 

1 bunch of organic kale
1 tbsp organic sunflower oil
1/4 tsp salt
1 tsp Organic Smoked Paprika 

1. Remove the center ribs and stems from 1 bunch kale; tear the leaves into 3-to-4-inch pieces. 
2. Toss with 1 tablespoon sunflower oil, 1 tsp smoked paprika and 1/4 teaspoon salt. 
3. Spread on 2 baking sheets coated with thin layer sunflower oil. 
4. Bake at 350 degrees F until browned around the edges and crisp, 12 to 15 minutes.

Per serving (2 cups): Calories 60; Fat 4 g (Saturated 1 g); Cholesterol 0 mg; Sodium 170 mg; Carbohydrate 6 g; Fiber 2 g; Protein 2 g

Nut and Seed Mix with Goji Berries: approx 7 servings

1 cup raw organic almonds
1 cup organic walnuts
1/4 cup organic shredded coconut
1/2 cup organic dried goji berries 
1/2 cup organic pitted dried dates, chopped
1/2 cup organic hulled pumpkin seeds
1/2 cup organic sunflower seeds
1 cup organic dried mulberries (optional)
Handful of organic flax seeds

1. Combine all the above ingredients in large bowl
2. Store in airtight container 
Bring with you for a daily healthy snack

Dr.SuzHeals Yummy Sweet Green Smoothie (approx 4 servings)

2 medium organic bananas 
2 organic apples
1 cup organic coconut yogurt or other lowfat yogurt 
1/3 cup organic ground flaxseed
1/2 bunch organic kale
1/2 bunch organic spinach
3 organic kiwi
64oz Filtered water
1 cup frozen organic or fresh organic blueberries

1. Slice bananas, apples and kiwi, remove stems from kale and spinach and cut
2. Add all cut fruit, blueberries, yogurt, flaxseed and water to blender
3. Blend on medium speed for 3 minutes 
Serve!

Sources: http://www.webmd.com/food-recipes/features/25-top-heart-healthy-foods

Being a Podiatrist, I have had many friends and acquaintances over the past couple of days ask me about wearing high heels during pregnancy.  Kate Middleton has been traveling around New York City with Prince William sporting high heels while about five months pregnant.    

Women want to remain fashionable and pretty during pregnancy.  Many women before pregnancy have become accustomed to wearing 3-5 inch or even 6 inch heels while at work or when going out.  These women already feel well balanced, strong and comfortable in high heels.  Note: I consider high heels any height above 2 inches. 

Hormones released during pregnancy into the bloodstream, such as progesterone, cause ligaments to loosen in the lower back and abdomen to allow room for your baby to grow.  These hormones also cause ligaments in your ankles and feet to loosen.   Feet widen and ankle strength may diminish making wearing high heels risky and no longer comfortable.  

Loose ankle ligaments can also cause instability.  The instability of your ankles added to balance issues that occur because of redistribution of body weight, may lead to injuries that could harm you and your fetus.   Wearing high heels during pregnancy adds to this risk.  

 Common sense and a few tips can help prevent injuries to mom and baby:

1.  Choose heels with a low to moderate height, below 2 inches
2.  Shoes with heels that have a wider base.  Heels that contain a wider base provide more stability and help to prevent trips, falls and ankle sprains.
3.  If you are going to wear low to moderate heels, do so for a short amount of time.  After going out for a meeting or dinner, etc change back into a comfortable supportive shoe.

As you move further along in your pregnancy especially after 24 weeks, it is a good idea to stop wearing heels altogether.  Even wearing low heels can cause injury to you or your fetus.  Be safe and always put health over fashion!