Heart Healthy Eating to Improve Cholesterol J E N N Y A C C E T T U R A, R D

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1 Heart Healthy Eating to Improve Cholesterol S T. M I C H A E L S H O S P I T A L J E N N Y A C C E T T U R A, R D

2 Overview Types of cholesterol Effects of high cholesterol on health Steps for heart healthy eating Healthy weight Exercise Healthy fats Fibre Sugars and sweets Cholesterol lowering foods Heart healthy eating FAQs

3 Types of Cholesterol Cholesterol Marker Impact Factors LDL (lousy cholesterol) HDL (healthy cholesterol) Increases risk of coronary artery disease Picks up bad cholesterol to bring to liver to remove Overweight, smoking, lack of exercise, bad fats, low fiber Overweight, smoking, lack of exercise Triglycerides Increases risk of coronary artery disease Overweight, smoking, alcohol, sugar

4 What is Coronary Artery Disease? 1. Normal blood flow 2. Plaque causing abnormal blood flow 3. Clot forms after plaque bursts blocking blood flow completely

5 Step 1: Maintain a Healthy Weight

6 What is a healthy weight? Weight is assessed using BMI (kg/m²): Healthy BMI: Overweight BMI: Obese BMI: >30

7 Weight Loss Healthy weight loss: 1-2 pounds per week Weight loss strategies: Record what you eat (write it down, app using mynetdiary or myfitness pal) Plan your meals in advance Reduce portions Reduce calories from liquids There is no single weight loss strategy that works for everyone!

8 Weight Loss Shame Guilt Indulgence Will power Thoughtfullness Organized Planning Skill power

9 Step 2: Regular Physical Activity

10 Benefits of Physical Activity Lowers LDL and increases HDL Weight Maintenance Improved sleep and stress relief

11 How to Increase Your Physical Activity 1. Choose an activity that you enjoy 2. Pick a time 3. Pick a place 4. Aim for at least minutes per day 5. Combine both cardio and resistance activities

12 Step 3: Include Healthy Fats

13 Unsaturated Fat Types of Fat Saturated Fat Trans fat Good for our heart, lowers LDL and triglycerides Some are bad for our heart, increases LDL Bad for our heart, increases LDL and decreases HDL Fish, vegetables oils, nuts, avocado Meat, butter, coconut oil, dairy Hard stick margarine, fried foods

14 Omega-3 Unsaturated Fats Health benefits: Reduces risk of heart disease May help prevent Alzheimer s and dementia Where do we find them? Fish (especially salmon, mackerel, rainbow trout, sardines, herring and char) 2x/week Canola or soybean oil Ground flaxseed/flaxseed oil Walnuts Tofu Omega-3 fortified eggs and milk

15 Choosing a Cooking Oil Monounsaturated Fat (Good Fat) Saturated Fat (Bad Fat)

16 Step 4: Eat More Fibre

17 Benefits of Fibre Lowers LDL (10g of fibre may lower LDL by 5%) Blood sugar control Bowel regularity and feeling of fullness

18 How to Include More Fibre Breakfast Old fashioned or steel cut oats Cereal with >4g fibre/serving High fibre oat muffins Whole grain bread Lunch & Dinner Whole grain bread, rice and pasta Whole grains council website to choose starches Legumes (beans, lentils, chickpeas) or barley 2-3x/week Snacks Fruits and vegetables Ground flaxseed and/or chia seeds added to yogurt Nuts or seeds

19 Step 5: Eat Less Sugar

20 Sugar Sources Added sugar vs. naturally occurring sugar Limit added sugars to a maximum of 6-12tsp per day (based on 2000kcal diet) Common sources to avoid: Sugar (white, brown, honey, icing, syrups) Fruit juice Regular pop Candy Baked/fried desserts Chocolate, cookies, donuts, muffin, cake Sauces/condiments (ketchup, BBQ sauce)

21 Glycemic Index (GI) A way of ranking carbohydrates based on how quickly they raise blood sugar levels Low GI foods raise blood sugar levels slowly High GI foods raise blood sugar levels quickly Choose lower GI foods more often May improve blood cholesterol and blood sugar levels

22 Food Group Low GI Medium GI High GI Breads Cereal Grains Spelt bread Sourdough bread Whole grain tortilla All bran cereals Oat bran Steel cut oats Barley Bulgar Pasta Quinoa Parboiled rice Chapati Pita bread Pumpernickel bread Roti Rye bread Whole grain whole wheat bread Cream of wheat Instant oats Quick oats Basmati rice Brown rice Cornmeal Rice noodles White rice White bread or naan Corn flakes Rice Krispies Special K Jasmine rice Sticky rice Instant white rice

23 Food Group Low GI Medium GI High GI Other starches Peas Sweet potato Winter squash Beets Corn Parsnip Red or white potatoes (cooled) Carrots Instant potatoes Red or white potatoes (hot) Rice cakes Soda crackers Fruits Apple Banana (unripe) Berries Cantaloupe Grapefruit Honeydew melon Mango Orange Peach/Pear/Plum Pomegranate Prunes Banana (ripe) Cherries Cranberries Figs Grapes Kiwi Lychee Pineapple Raisins Banana (brown, overripe) Watermelon

24 Added vs. Naturally Occurring Sugar Naturally occurring sugar Added sugar

25 Artificial Sweeteners Is it safe to replace sugar with artificial sweeteners? Yes, artificial sweeteners are safe to use in moderation Extensively tested and found to be safe When used to replace high calorie sugar foods, can assist with weight loss Lack of research on long term side effects and/or benefits

26 Step 6: Include Cholesterol Lowering Foods

27 Nuts All nuts are a good source of unsaturated fats Walnuts especially are high in omega-3 fats Goal 1 handful of nuts per day (1/4 cup)

28 Pulses Black beans, kidney beans, chickpeas and lentils Excellent source of soluble fibre Goal ½ cup daily

29 Beta-glucans Specific type of beneficial fibre found in oats and barley Goal 1/2 cup, 3-4 times per week

30 Soy Products Includes soy milk, tofu, roasted soy nuts Reduces LDL cholesterol Goal 2-3 servings per week

31 Heart Healthy Eating FAQ

32 Butter What does the media say? Natural is best. Margarine is not a good alternative because it is close to plastic What does the research say? Recent research still shows that eating butter increases LDL (lousy) cholesterol Larger increase than cheese

33 Butter Good or Bad? Cigarettes are made from all natural ingredients natural is not always best! Margarine is one molecule away from the same compound as plastic (you can make the same comparison between water and hydrogen peroxide) Bottom line: For those with existing high cholesterol, it is still best to limit butter consumption Choose margarine or unsaturated oils for cooking most often Use small amounts to cook eggs or spread thinly if needed

34 Coconut Oil What does the media say? Can withstand higher cooking temperatures What does the research say? 92% saturated fat Most of the claims are based on populations in peru Traditional diets contained coconut flesh or cream Other aspects of diet not comparable to Western diets Cannot attribute benefits to coconut alone

35 Coconut Oil Good or Bad? Should not be relied on as sole source of added fat Caution for those with existing high cholesterol due to potential for further increase in LDL Use a variety of unsaturated oils instead

36 Eggs Previously recommended to limit egg intake due to concerns about cholesterol in egg yolks Recent evidence dietary cholesterol intake has minimal impact on blood cholesterol Blood cholesterol controlled mostly by the liver How many can you eat? 1 per day (7 per week)

37 Black Bean Sweet Potato Wrap Ingredients: 1 can black beans 1 small yellow onion ½ red pepper ½ green pepper Cumin and chili powder to taste 1-2 sweet potatoes 2 tsp of canola oil Whole wheat tortillas Cheddar cheese Directions: 1.Rinse canned beans. 2.Wash and dice onion and peppers. 3.Sautee onion with oil until translucent. Add in peppers and beans. 4.Add spices as per taste (cumin and chili powder). 5.Rinse and place sweet potatoes on a foil sheet. 6.Bake at 425 F for minutes or until soft. 7.Spread sweet potato on tortilla. Place bean mixture on top and sprinkle cheese on top.

38 Oat Muffins Ingredients: 1 cup plain Greek yogurt 2 ripe bananas, mashed ½ cup frozen or fresh blueberries 2 eggs 1 ½ cups rolled oats ¼ cup wheat germ ¼ cup ground flaxseed ¼ cup of brown sugar or substitute 1 ½ tsp baking powder ½ tsp baking soda ½ tsp cinnamon Directions: Preheat oven to 400F. Combine ingredients in a bowl. Spoon into lined muffin pan. Bake for minutes.

39 Additional Questions? T H A N K Y O U!