HEART-HEALTHY LIVING

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2 HEART-HEALTHY LIVING Even small steps toward a more healthful lifestyle can make a big difference in keeping your heart healthy. Knowledge, nutrition and activity can help you improve your heart health. Along with your healthcare provider s guidance, set goals to take better care of your heart. Here are some tips for living a heart-healthy lifestyle: Get more active. Try to exercise for about 30 minutes, most days of the week. This can lower your blood pressure, raise your good cholesterol level and lower your bad cholesterol level. It also makes it easier to manage your weight, gives you more energy, helps you cope with stress and helps you sleep better. Check with your healthcare provider before you start any physical activity program. Aim for a healthy weight. If you are overweight, weight loss can help lower your blood pressure and decrease the burden on your heart and joints. Eat a healthy diet. Choose more heart-healthy fats, such as olive and canola oils. Eat more fiber to help lower your cholesterol. Bake, boil or broil, rather than fry foods. Choose lean cuts of meat and trim any visible fat. Include fish and poultry in your diet at least a few times a week. Limit high-calorie and high-fat desserts. Please note: Product selection may vary between Costco Wholesale locations

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4 FILL YOUR CART WITH HEART- HEALTHY OPTIONS AT COSTCO Read the Nutrition Facts on the food label. Serving Size Calories Saturated and Trans Fats Fiber Sugar Keep track of how many grams of carbs you are eating. Keep snacks to calories, and meals to calories. Select foods with zero grams of trans fats and as few grams of saturated fat as possible. Choose foods with at least three grams of fiber, and eat a total of grams of fiber a day. Select foods with as little added sugar as possible. Try to eat foods with 10 grams of sugar or less per serving. And remember, proteins make you feel full and satisfied and they have little or no carbohydrates.

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6 DIVIDE YOUR CART & MAKE HEALTHIER FOOD CHOICES Apply MyPlate principles to your cart. Imagine a line that divides your cart into sections for vegetables, fruits, whole grains lean proteins, and low-fat dairy products. As you fill your cart, choose foods that fall into each category.

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8 Costco has a large selection of fruits and vegetables, so buy enough for all of your meals and snacks. When you eat, fill half of your plate with fruit or vegetables. Eating fruits and vegetables makes you feel full for very few calories. The antioxidants in fruits and vegetables help to cool inflammation and reduce body fat.

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10 Experts recommend eating 5-9 servings of fruits and vegetables each day. This is what one serving of fruit and vegetables really means. Food Raw Vegetables or Salad Greens Cooked Vegetables Raw Fruit Fruit Juice 1 Serving Equals: 1 cup ½ cup 1 medium-sized fruit or ½ cup ½ cup

11 Key Points: Fresh produce in season tastes better and costs less Fresh is best, but frozen or canned is a great substitute when fresh is not available Look for low-sodium canned products Look for frozen products without sauce or seasoning

12 HEART-HEALTHY SUPPLEMENTS AT COSTCO Discuss any of these options with your healthcare provider before adding them to your heart-health regimen. Multivitamin and mineral supplements. A daily multivitamin and mineral supplement can help you get the right amount of vitamins and minerals each day, if you can t get them through your diet. Co-Q10 supplements. These are sometimes recommended for people who are taking statin medications for their heart-health. Niacin. This may help some people maintain cholesterol levels that are already within a normal range. If you take cholesterol-lowering drugs, you should not take niacin unless it is recommended by your healthcare provider, as it may cause flushing or hot flashes. Fish oil capsules. Supportive, but not conclusive, research shows that the omega-3 fatty acids found in fish oil capsules may reduce your risk of heart disease.

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14 CHOOSE LEAN PROTEINS AT COSTCO Whether you eat red meat, pork, poultry, fish or seafood, choose lean proteins for weight loss and weight maintenance. Protein helps you: Build (and keep) lean muscle tissue Increase the number of calories you burn every day Boost your metabolism Promote weight loss Fight off hunger

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16 HEALTHY PROTEIN SNACKS AT COSTCO To control carbs and boost protein, add these heart-healthy snacks to your shopping cart: Hard boiled eggs Greek-style plain yogurt stir in some chia seeds or ground flax seeds Cottage cheese String cheese Sliced turkey breast rolled around cooked or raw green beans

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18 BUDGET-FRIENDLY FISH PRODUCTS AT COSTCO Tuna in pouches or cans makes an easy, portable lunch. Canned salmon is rich in omega 3 fatty acids, calcium, Vitamin D and magnesium. Omega-3s help reduce stress hormones and reduce belly fat.

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20 POULTRY CHOICES Ground poultry (turkey or chicken) is a perfect substitute for ground beef in your recipes. Purchase lean ground poultry made from the white meat breast portion. If not labeled lean, ground turkey can have fat and skin added, which increases the fat content.

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22 MEAT FACTS Meat is a good source of high-quality protein. Red meats (beef, lamb, pork) contain iron, vitamin B12 and zinc. Lean cuts of meat are best. The leanest cuts of meat include: round, sirloin, tenderloin, and chuck. Trim visible fat from meat before cooking. Processed meats, such as bacon, hot dogs, bologna and other cold cuts, contain more sodium and fat than fresh meats. Processed meats also contain preservatives, such as nitrites. So, eat less processed meat and look for fresh options when available.

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24 SHOPPING FOR MILK For most people, low-fat milk, such as 1% or non-fat skim, is the best choice. Children under the age of 2 should drink whole milk. If you are lactose intolerant try a lactose-free milk or dairy-free milk option, such as soy or almond milk.

25 YOGURT Yogurt can be eaten as a healthy part of breakfast, snacks, or even dessert. Yogurt is a great source of calcium, probiotics and protein. Be sure to choose yogurts low in sugar Many types of yogurt, such as the fruit at the bottom or packaged with add-ins like chocolate candies, can contain a lot of added sugar. Add your own flavors to plain yogurt for the healthiest choice Add a tablespoon or two of protein-rich granola, chia seeds, or berries for a naturally crunchy and sweet flavor. Plain Greek yogurt has only 110 calories per serving, and only a fraction of the carbohydrates and sugar in other types of yogurt. Greek yogurt has more than twice the amount of protein of regular yogurt. Try adding cut fresh fruit or a tablespoon of nuts, seeds or granola to plain yogurt for added protein, fiber and flavor.

26 CHEESE Do you avoid cheese because of the fat and calories? Light cheeses are lower calorie and have less fat. Cream cheese may be lower in calories or fat than other cheeses, but it also has very little protein. Serving size is what matters. You can also save money and pre-package your own 100 calorie cheese packs. Cheese can be a great source of calcium, protein and Vitamin D, and can be eaten alone or as a flavorful addition to soups, salads, or other recipes. Get the right kind of cheese for your healthy lifestyle, and eat the right size portions. Dairy in your diet help you burn more calories and keeps you feeling full for longer. Eating dairy can help you flatten your belly faster than just cutting calories alone.

27 BUTTER The type of butter product you buy could mean the difference of calories a week, based on using just one tablespoon a day. Natural is best, but margarine products provide buttery flavor and texture with fewer calories and less fat.

28 SHOPPING FOR EGGS AT COSTCO Eggs have around 60 calories and 6 grams of protein for a large egg, and are packed full of vitamins and minerals. Eggs can be used for delicious and healthy breakfast omelets, in baking, or boiled for a portable, protein-rich snack. Fresh is best, but egg substitutes can be used to provide a quick, lower calorie, and lower fat replacement for fresh eggs.

29 SHOPPING FOR BREAD AT COSTCO Make sure the first ingredient is whole wheat flour. Wheat flour, unbleached, multigrain, enriched, or stone-ground wheat flours are sneaky ways of saying refined white flour, which you want to avoid. Check for high fiber content. Most refined, white flour-based breads will contain almost no fiber, while true whole grain bread will contain at least 3 grams of fiber per slice. Calories matter. Diet or light breads have about 45 calories per slice, while most others have about 100 calories per slice.

30 WHOLE GRAINS AT COSTCO Promote belly fat loss by helping to control your appetite. Whole grain foods get digested slower than refined versions so they keep you feeling full for longer.

31 OATMEAL Oats are a great source of soluble fiber, vitamins & minerals. Oat products all contain similar nutrition, but differ in texture and cooking time. Instant oats are finely chopped and just need hot water to prepare. Rolled oats take 5 minutes to cook. Steel-cut oats have the least amount of processing and require a longer cooking time.

32 CEREALS AT COSTCO Choose cereals with a fiber content of 4 grams or more: Fiber helps reduce cholesterol levels and keeps blood glucose levels steady. One serving of All Bran has about 51% of the daily recommended serving of fiber, with about 13 g of fiber per 1/3 cup serving. All-Bran gets most of its fiber from wheat bran. Mini-Wheats, or shredded wheat, provides 20 % of the daily recommended serving of fiber, with 6 g of fiber per 24 mini biscuits. Mini-Wheats gets its fiber from 100% whole wheat.

33 BEVERAGES AT COSTCO Plain water is best Milk and 100% juice are most nutritious. Too much juice adds extra calories and sugar. Caffeine: coffee and tea in moderation are OK. Flavored seltzer or sparkling water with lemon or lime is a refreshing and naturally low fat and low calorie option. Vitamin water is fortified with vitamins and other nutrients, but may still be adding calories to your diet. Check the labels carefully. Diet soda and sugar free drink mixes offer calorie-free options that are made with artificial sweeteners.

34 HEALTHY UNSATURATED FATS AT COSTCO Replace unhealthy saturated fats with healthy unsaturated fats such as: Avocado Nuts Peanut or Almond Butters Flax or Chia Seeds Fatty Fish (salmon, herring, mackerel) Plant-based oils (olive, sunflower, peanut)

35 NUTS & SEEDS Looking for a great snack? Include a small amount of nuts every day. Dry roasted or unsalted types are best. Nuts contain healthy mono-unsaturated fats, vitamins and minerals. Mono-unsaturated fats fight inflammation and help decrease belly fat. Watch your portions. One ounce, or two tablespoons, of nuts contains about 180 to 200 calories. Walnuts, Chia Seeds and Flax seeds are a good source of Omega-3 fatty acids.

36 BEANS & LENTILS Add more beans or lentils to your daily meals. Beans and lentils contain no cholesterol and are naturally low in fat. Can be eaten alone, or in soups, salads, as part of tacos or wraps, or as a base for dips. High in protein, fiber, vitamins and minerals.

37 BETTER BAKING Exchange ingredients to reduce calories and increase nutrition in your cakes, cookies and muffin recipes. Use unsweetened applesauce 1:1 for oil. Use dark chocolate chips or cacao nips instead of milk chocolate. Increase fiber by using flaxseed egg substitute 1:1 for eggs (1 tbsp. ground flaxseed with 3 tbsp. water, set for 5 mins). Use whole wheat flour or almond flour instead of white, refined flour. Use a healthy unsaturated fat like mashed avocado instead of butter. Mix 1 tbsp. chia seeds with 1 cup milk or nondairy milk substitute, refrigerate overnight, and you ll have a delicious, creamy homemade pudding snack rich in fiber and protein.

38 Cholesterol is a waxy, fat-like substance. The body makes most of its cholesterol, but some also comes from animal-based foods we eat, such as dairy, eggs, butter, meat, bacon and full-fat ice cream. Avoid these high-fat products and eat foods high in soluble fiber, such as whole grain cereals, fruits and legumes, which help prevent the body from absorbing cholesterol. Cholesterol raises your risk for heart and blood vessel disease. There are two kinds of cholesterol in your blood: good and bad. Bad (LDL) cholesterol sticks to the inside of your blood vessels and narrows them. Good cholesterol (HDL) helps your body get rid of some of the bad cholesterol and protects you from heart and blood vessel disease. Triglycerides are another type of fat in your body that are used for energy. High triglycerides raise your risk for heart attacks and strokes. CHOLESTEROL Cholesterol Targets Total cholesterol Less than 200 mg/dl LDL HDL Triglycerides Less than 100 mg/dl 60 mg/dl or higher Less than 150 mg/dl

39 HIGH BLOOD PRESSURE High blood pressure usually has no symptoms. Some people with high blood pressure don t know they have it. Your healthcare provider should check your blood pressure at each office visit. High blood pressure raises your risk for strokes, heart attacks, heart failure, kidney damage, eye disease and pre-mature death. There are two main ways to lower blood pressure: adopting healthy lifestyle habits and taking medication, if needed. Here are some lifestyle changes you can make: Achieve a healthy weight Eat a heart-healthy diet If you smoke, quit Eat less salt Reduce stress Exercise regularly Limit how much alcohol you drink Blood Pressure Readings Normal High Prehypertension 120/80 or lower 140/90 or higher Top number: ; Bottom number: 80-80

40 HEART-HEALTHY PRODUCTS AT COSTCO Home blood pressure monitors. Taking your blood pressure at home can help guide your healthcare provider about making changes in your blood pressure or heart medicines, if necessary. Costco offers several arm and wrist models for home blood pressure monitoring. Automatic blood pressure monitors are easy to use; just wrap the cuff around your arm or wrist, press a button and your blood pressure appears on the screen. Aspirin. People who are at high risk for a heart attack or have already had a heart attack may find it helpful to take a daily, low dose of aspirin. Ask your healthcare provider if it is right for you. Fitness monitors. Costco sells a variety of heart rate monitors and activity monitors, or you can simply check your pulse to measure your heart rate. When you feel your pulse, count the number of beats in 15 seconds. Multiply this number by 4 to calculate your beats per minute. Pillboxes. A pillbox can help you organize your medicines and keep you from forgetting to take your daily doses.