EATING FOR A HEALTHY HEART A patient information leaflet on a cardio-protective diet

Transcription

1 Leicestershire Nutrition and Dietetic Service EATING FOR A HEALTHY HEART A patient information leaflet on a cardio-protective diet A diet that includes foods that specifically help to keep your heart healthy is known as a cardioprotective diet and is explained in this leaflet. There are many factors that can influence your risk of heart disease. What you eat and drink can have a direct effect on some of these factors, including your body weight, blood pressure and blood lipids (these are fats found in the blood and include cholesterol and triglycerides). Are you a healthy weight? Body Mass Index (BMI) is used to work out how healthy your weight is for your height. The ideal BMI that is linked with the lowest risk of disease in adults is between 18.5 and 25. As your BMI increases above 25 so does your risk of some diseases, including heart disease. Work out what your BMI is from the chart below: Height (m) (kg) st (st / lbs) st st st st st st st st st st st st st st st st st st st st st st st st st st st st st 12 4' 9 1/2 4' 11 5' 1/2 5' 2 5' 4 5' 5 1/2 5' 7 5' 8 1/2 5' 10 5' 11 1/2 6' 1 6' 3 6' 4 1/2 6' 6 Height (ft/in) Page 1 of 6

2 Are you a healthy shape? Carrying more weight around your middle is known to be linked to an increased risk of heart disease. One way to find out your risk is to measure your waist circumference halfway between your bottom rib and your hipbone and see how you compare with the measurements below: Waist measurement for: At risk of health problems High Risk of health problems Men Women Greater than 94cm (37 inches) Greater than 80cm (32 inches) Greater than 102cm (40 inches) Greater than 88cm (35 inches) What is a Cardio-Protective Diet? A Mediterranean-style diet has been found to help reduce the risk of heart disease and reduce the risk of a second heart attack if you have already had one. A Mediterranean-style diet is based on fruit, vegetables, pulses, wholegrain foods and fish, with butter replaced with products based on plant oils. In particular aim to eat: 5 or more portions of fruit and vegetables a day (see page 3) A diet low in saturated (animal) fat (see page 3) Oily fish at least twice a week (see page 4) In addition to the above, it is important to take a diet in line with the eatwell plate (see below), which shows the proportions of each of the five food groups we should eat throughout the day: Reproduced with kind permission of the Food Standards Agency Page 2 of 6

3 Ideas for how to eat 5 or more portions of fruit and vegetables a day Fruit and vegetables are an important part of a cardio-protective diet as they are low in fat and energy, high in fibre and contain a range of protective vitamins. A variety of different fruit and vegetables are recommended to get as many of the benefits as possible, although green leafy vegetables such as spinach and broccoli are particularly good. What is a portion? 1 medium size apple, pear, banana, orange, peach, nectarine 2 medium size plums, satsumas, apricots Small bunch / handful of grapes, berries, cherries 1 small box (matchbox size) dried raisins, 1-2 tablespoons of dried fruit 1 slice of melon, pineapple, ½ grapefruit 2-3 tablespoons of tinned fruit small bowl of salad 2-3 heaped tablespoons of vegetables (raw, cooked, frozen or canned) 1 small glass of unsweetened fruit juice (limit to one a day) How to achieve 5 a day drink a glass of fruit juice with breakfast add chopped fruit to cereal or yoghurt add salad to sandwiches try stewed, fresh or tinned fruit as a dessert add extra vegetables to sauces and casseroles serve vegetables and salad with main meals try stir-fried, steamed or mashed vegetables How to eat a diet low in saturated fat Saturated fat is found mainly in meat and dairy products but also in pastries, confectionery and other ready-made foods. To reduce your intake choose foods that are low in fat and contain polyunsaturated or monounsaturated fats instead. Go for lower fat alternatives: Semi-skimmed, 1% or skimmed milk instead of full cream milk, or unsweetened alternatives such as soya or almond drinks Low fat, light, diet, natural or Greek yogurts instead of full fat yogurt Reduced fat cheeses e.g. edam, cottage cheese, fromage frais, low fat cheese spreads or reduced/half fat hard cheese, instead of full fat hard cheeses Low fat or reduced fat spreads (containing less than 40g total fat per 100g) instead of full fat spreads or butter, as well as reduced fat mayonnaise and salad cream Choose lean cuts of meat and trim off all visible fat Grill, bake, braise, dry roast or stew foods without adding fat rather than frying or roasting Choose fish and poultry without skin more often than red meat Use moist sandwich and jacket potato fillings to avoid adding butter or spreads Watch how often you have cakes, biscuits, confectionary and pastries If using spreads or oils then choose ones based on sunflower, corn, rapeseed or olive oil instead of butter, lard, ghee (remember to still watch the quantity as are high in calories) Check labels for the traffic light system for saturated fat: Green Amber Red = contains less than 1.5g per 100g = contains 1.5-5g per 100g = contains more than 5g per 100g Page 3 of 6

4 Oily fish Current recommendations are that adults should aim to eat 2 portions of oily fish a week. If you are pregnant then there is specific advice about eating fish (contact your Midwife or Dietitian for further advice). Oily fish are fish that are naturally high in omega 3 fats (sometimes also referred to as EPA and DHA) that are particularly good for the heart. Some examples of oily fish are given below (those highest in omega 3 are listed first). If you would like more detailed information about the omega 3 content of fish, please ask your Dietitian. Mackerel Kippers Pilchards Tuna Trout Salmon Sardines Herring A serving of oily fish is roughly 100g (4oz). Many of the oily fish can be bought fresh, smoked or tinned. The tinned variety may be available in brine (salt water), oil, water or a sauce be sure to drain those in brine well and, if you are watching your weight, drain those in oil. Although fresh tuna is a good source of omega 3 fats, canned tuna fish contains only very small amounts. For snacks and meals containing oily fish try: Salmon, mackerel or tuna as fillings for sandwiches, tortilla wraps or pittas Pilchards, sardines or mackerel in a tomato sauce as a filling for baked potatoes Sardines or mackerel as a topping on toast and crackers Baked or grilled salmon, tuna, mackerel or trout served with a salad or vegetables and potatoes Flaked salmon, tuna or mackerel added to stir-fries, pasta, fish pie or pizza Making or buying fish cakes with salmon or tuna Kippers for breakfast or lunch If you do not like the taste of these fish, or you are vegetarian, then it is possible to get omega 3 fats from other sources including: rapeseed (canola), walnut and soya oils soya beans, tofu walnuts, pecans, almonds ground flax seed (or linseeds) and flax oil eggs enriched with omega 3 It is not known if these sources give the same benefit as omega 3 from fish oils. If you are thinking about taking a fish oil supplement it is advisable to discuss this first with a Dietitian. Page 4 of 6

5 What about Fibre? Choosing foods that contain a type of fibre called soluble fibre can also help to protect your heart by reducing blood cholesterol levels. Good sources of soluble fibre include fruit, vegetables, pulses (peas, beans, lentils) and oats. To increase your intake of pulses try adding to stews, rice or salad dishes.... Products containing plant stanols/sterols? Plant stanols and sterol esters are found naturally in some vegetable oils, grains and nuts. Some products (e.g. Benecol or Flora Proactiv drinks, yogurts and spreads) have these substances added. If taken regularly and in the amount suggested they may help to lower cholesterol by up to 10%.... Foods that are naturally high in cholesterol? Some foods, such as egg yolks and certain types of offal and shellfish, contain some dietary cholesterol (a type of fat). It is known that the saturated fat content of most people s diet has a bigger impact on blood cholesterol than eating these types of foods. If you are eating a varied and balanced diet in line with the eatwell plate then these foods can be included.... Salt? As a nation we consume more salt than is recommended, most of which comes from processed and ready made foods, and this can increase blood pressure. The majority of people are advised to consume less than 6g salt (equal to 2.4g sodium), that s about a teaspoon per day. To keep your intake low limit foods that are high in salt (e.g. processed foods, ham, bacon, foods tinned in brine) and avoid adding salt to your cooking and at the table.... Alcohol? High intakes of alcohol can increase blood pressure, weight and blood lipids (triglycerides). If you drink alcohol then keep your weekly intake within safe limits no more than 21 units per week for men, and 14 units per week for women. Avoid binge drinking which is consuming more than 3 alcoholic drinks in less than 2 hours. 1 unit is approximately ½ pint beer or lager, a small glass of sherry, or single pub measure of spirits (home measures count as double). A small glass of most wines (125ml) is about 1½ units.... Soya? Eating 25g or more of soya protein a day as part of diet low in saturated fat can help reduce blood cholesterol levels. A number of soya products including drinks, desserts, beans and tofu are available in supermarkets and are a good way to increase variety to your diet. As a guide an average serving of a soya rich product (e.g. a 1/3 pint of soya drink or a soya pudding) contains about 6g soya protein. Page 5 of 6

6 ... Activity? Together with eating the right foods, staying active is one of the best things you can do to keep your heart healthy. Regular activity, for a total of at least 30 minutes a day on 5 to 7 days of the week is recommended. To gain the most benefit this activity should be for at least 10 minutes at a time and of a moderate intensity (i.e. enough to raise your heart rate and make you feel a little warm, without getting completely out of breath). Brisk walking, cycling, swimming and dancing are all ideal. If you are unsure how much activity it is safe for you to do speak to your G.P. first. How are you doing? Now that you have read this leaflet think about your own diet and how you compare with the recommendations for looking after your heart. Fats Fruit & veg Fish Fibre Alcohol Salt Activity Am I taking the right amount? Am I choosing the right types? What changes could I make? Dietitian (name and contact number). If you would like more information on looking after your heart you may wish to contact: The British Heart Foundation 14 Fitzhardinge Street, London, W1H 6DH Heart Information Line: Developed and produced by Leicestershire Nutrition and Dietetic Services Reviewed June 2014 Crown Copyright Leicestershire Partnership NHS Trust and University Hospitals of Leicester NHS Trust Access our website on Page 6 of 6