Let s Get Heart Smart! Heart Healthy Eating Healthy Eating Tip of the Month April 2013
Introduction Our hearts do amazing things for us! For example, did you know that the heart beats an average of 100,000 times per day? Or that the heart will circulate 5.6 liters of blood throughout the body three times in one minute? This month, learn how to take care of that hard working heart by making heart smart food choices. Heart Health Terminology Cholesterol: A waxy substance that helps provide structure to the walls of our cells. It is also used by our body to make hormones, bile acids, vitamin D, and other substances. HDL (High Density Lipoprotein): The Good Cholesterol, It carries cholesterol back to the liver so it can be eliminated from the body. LDL (Low Density Lipoprotein): The Bad Cholesterol, that can build up in your arteries. This results in narrowing of the arteries reducing blood flow in your body, called atherosclerosis. Arteries that become blocked can cause heart attacks or raise blood pressure, which can lead to heart damage. Triglycerides: A common form of fat in your body. A high level of this combined with a low HDL or high LDL cholesterol level can speed up the process of atherosclerosis.
What Are The Recommended Cholesterol Levels? Total cholesterol HDL LDL Triglycerides Less than 200mg/dl Over 55mg/dl for women Over 45mg/dl for men Less than 100mg/dl Less than 100mg/dl My doctor told me my cholesterol is too high, what can I do? Limit Saturated Fat Saturated fat raises LDL cholesterol more than anything else in your diet! Foods that are high in saturated fat include: o Fatty cuts of meat o Bacon/sausage o Whole milk o Cream o Butter o Some vegetable oils: coconut and palm kernel oil
Limit Trans Fat Trans fat can increase your LDL cholesterol, this type of fat is found in foods made with hydrogenated oils like hard margarines and shortenings Foods high in trans fat include: o Baked products like cookies, donuts, and cakes o Hard margarines o Fried foods made with hydrogenated oil Eat More Soluble Fiber Soluble fiber helps stimulate the uptake of cholesterol from our blood vessels Foods with this include: o Beans o Whole-grain cereals and breads o Fruit o Vegetables
How much soluble fiber is in my food? 1/2 cup of cooked oatmeal has 1gram 1/2 cup of black beans has 2 grams 1 medium pear has 2 grams 1 medium orange has 2 grams 1/2 cup of Brussels sprouts has 3 grams Goals to Help You Reduce Your Cholesterol Less than 7% of your daily calories should be from saturated fat. o To give you an idea how many grams that is see the table below: If you consume: Eat no more than: 1,500 calories a day 10 grams saturated fat 2,000 calories a day 13 grams saturated fat Aim for 10-25 grams of soluble fiber per day. Even an increase of 5-10 grams per day can reduce your LDL level by 5%.
Fats That Promote Heart Health While the media often proclaims that a low fat diet is best, there are actually several types of fat that reduce cardiovascular disease risk. Monounsaturated Fats: These can reduce your LDL cholesterol Sources include: o Canola, olive, and peanut oils o Avocados o Nuts These fats are typically liquid at room temperature The majority of the fats you eat should come from this type of fat. Polyunsaturated Fats: Omega-3 Fatty Acids Slow the rate of plaque deposits in blood vessels Decrease blood pressure Lower triglycerides Reduce inflammation and blood clotting Sources include: o Salmon o Tuna o Lake trout o Walnuts o Flaxseed
Polyunsaturated Fats: Omega-6 Fatty Acids These can help reduce LDL cholesterol and lower blood pressure as well. Sources: o Nuts o Seeds o Vegetable oils such as sunflower, safflower, corn, and soybean oils You Can Easily Add Healthy Fat To Your Diet! Add walnuts or almonds to cereal Add avocado to sandwiches or salads Use olive oil in dressings or to sauté vegetables, seafood, or meat
What Does a Heart Healthy Diet Look Like? Well-balanced eating involves choosing foods from all of the food groups! Food Group Daily Servings Serving Sizes Grains (whole grains are best!) 6-8 1 slice of bread 1 oz dry cereal ½ cup cooked rice, pasta, or cereal Vegetables 4-5 1 cup raw leafy vegetables ½ cup cut-up raw or cooked ½ cup vegetable juice Fruits 4-5 1 medium fruit ¼ cup dried fruit ½ cup fresh, frozen, or canned Dairy Fat-free or low-fat milk and milk products Lean meats, poultry, and fish Nuts, Seeds, Legumes (beans or peas) 2-3 1 cup milk or yogurt 1 ½ oz cheese 6 or less 1 oz cooked meats, poultry, or fish 1 egg 4-5 per week 1/3 cup or 1 ½ oz nuts 2 Tbsp peanut butter 2 Tbsp of ½ oz seeds ½ cup cooked legumes Fats and Oils 2-3 1 tsp soft margarine 1 tsp vegetable oil 2 Tbsp salad dressing Sweets and Added Sugars 5 or less per week 1 Tbsp sugar 1 Tbsp jelly or jam ½ cup sorbet 1 cup lemonade Source: Your Guide To Lowering Your Blood Pressure With Dash, published by the National Heart, Lung, and Blood Institute.
How Effective Is Heart Healthy Eating? Soluble fiber and Cholesterol This study measured the changes in total and LDL cholesterol in men and women with high levels of cholesterol after being given 6 grams of oat beta-glucan (a soluble fiber) for a total of 6 weeks. Researchers found that oat beta-glucan significantly reduced total cholesterol and LDL cholesterol levels. Bottom Line: Oat beta-glucan lowers LDL and total cholesterol levels in people with high cardiovascular risk. Source: Queenan KM, Stewart ML, Smith KN, et al. Concentrated oat beta-glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial. Nutrition Journal. 2007; 6: 1-8. Omega-3 Fatty Acids and Cardiovascular Risk This study investigated the effects of consuming omega-3 fatty acids on the course of atherosclerosis. Participants were those who had more than 20% narrowing of at least one blood vessel and an angioplasty or coronary bypass in the previous 6 months. They either were given a daily fish oil supplement or a placebo. Researchers found that in those who consumed approximately 1.5g of omega-3 fatty acids per day, they had decreased progression (and some improvement) of atherosclerosis. Bottom Line: Consumption of omega-3 fatty acids modestly slows the development of coronary atherosclerosis. Source: Von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis: A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999; 130: 554-562.
Saturated Fat and LDL Cholesterol This study examined the effects of lowering saturated fat consumption on the amount of LDL cholesterol receptors. Scientists compared the average American diet with two other diets lower in saturated fat. Blood samples of participants were analyzed during weeks 6 and 8 of the study. Researchers found that by reducing saturated fat, LDL receptor abundance increased and observed a linear, inverse relationship between the change in LDL cholesterol levels and the change in LDL receptor abundance. Bottom Line: Reductions in saturated fat increase the number of LDL cholesterol receptors, which is associated with reductions in total and LDL cholesterol levels. Source: Mustad VA, Etnertpm TD, Cooper AD, et al. Reducing saturated fat intake is associated with increased levels of LDL receptors on mononuclear cells in healthy men and women. Journal of Lipid Research. 1997; 38: 459-468.
How to Interpret the Claims on Food Labels Source: Your Guide To Lowering Your Blood Pressure with Dash, published by the National Heart, Lung, and Blood Institute
Other Label Reading Tips Look for the following on the food label: Serving Size: All of the information on the label about calories and nutrients is for one serving. Calories: Choose foods that help you get the nutrients you need without going over your daily calorie goal. (Too many calories lead to weight gain.) Total fat, saturated fat, and trans-fat: Choose foods with less than 5 grams of total fat per serving. Try to pick foods with heart-healthy fats instead (monounsaturated and polyunsaturated fats).
Choose foods with less than 3 grams of saturated fat and trans-fat. Read the ingredients! If a food contains partially hydrogenated oil, then it contains trans-fat. Sodium: Look for foods low in sodium by finding ones with 300 mg or less per serving. Total Carbohydrate and Sugars: If you have high triglycerides, chose foods with less than 30 grams of total carbohydrate and less than 15 grams of sugar per serving. Dietary Fiber: Look for foods with at least 5 grams of fiber per serving. Source: Academy of Nutrition and Dietetics (formerly the American Dietetic Association). Nutrition Care Manual Current News Eggs Regain Reputation Egg yolks are high in cholesterol, but new evidence is suggesting that eggs are not as bad as we thought. Eight prospective studies were analyzed and found no evidence that eating up to one egg a day increased the risk of heart disease or stroke.
However, for the few diabetic participants included in the studies, high egg consumption was associated with an increased risk of heart disease and hemorrhagic stroke. Source: The New York Times http://well.blogs.nytimes.com/2013/01/28/eggs-regainreputation/ Why Health Officials Want You to Eat More Potassium The latest sodium recommendation from the World Health Organization (WHO) is that a person should consume no more than 2,000 milligrams of sodium per day. However, now the WHO is recommending that we also get 3,510 milligrams of potassium per day. By increasing potassium consumption this may decrease the risk for high blood pressure, which may lower a person s risk for heart disease and stroke. Foods high in potassium include beans and peas which have up to 1,200 milligrams of potassium per cup. Vegetables such as spinach, cabbage, and parsley, or fruits like bananas, papayas, and dates are also potassium-rich. Source:http://www.npr.org/blogs/thesalt/2013/01/31/170767 216/bring-on-the-beans-health-officials-want-you-to-eatmore-potassium
Heart Healthy Recipes Teriyaki Salmon with Zucchini Ingredients: Low-sodium teriyaki sauce 2 (6 ounce) salmon fillets Sesame seeds 2 Small zucchini, thinly sliced 4 scallions, chopped Canola oil Preparation: 1. Combine 5 tablespoons of low-sodium teriyaki sauce and salmon in a zip-lock plastic bag. Seal and marinate 20 minutes. 2. Toast sesame seeds in a large non-stick skillet over medium heat and set aside. 3. Drain fish, discarding marinade. Add fish to skillet and cook 5 minutes. Turn and cook another 5 minutes over medium-low heat. 4. Remove from skillet, and keep warm. 5. Add zucchini, scallions, and 2 teaspoons of oil. Sauté 4 minutes, or until lightly browned. 6. Stir in 2 tablespoons low-sodium teriyaki sauce. 7. Sprinkle with sesame seeds and serve with salmon. Source: www.health.com/health/recipes
Quick and Easy Salad Dressings Instructions for all recipes add all ingredients to a small bowl and whisk well. Refrigerate leftovers. Tangy Asian 2 teaspoons lemon juice 2 teaspoons honey 2 tablespoons vinegar (white or cider) 4 tablespoons oil (extra virgin olive, vegetable or canola oil) 1 teaspoon freshly grated ginger root 1 tablespoon low-sodium soy sauce Creamy Caesar 1/4 cup fat-free buttermilk 2 tablespoons fat-free mayonnaise 1/2 teaspoon Dijon mustard 1/2 teaspoon minced garlic from the jar 1/4 teaspoon anchovy paste (by the sardines in the grocery store) 1/4 teaspoon black pepper 1/4 teaspoon salt Red Wine Vinaigrette 1/3 cup red wine vinegar 1/2 cup extra virgin olive oil 1 tablespoon Dijon mustard 1/8 teaspoon salt 1/8 1/4 teaspoon black pepper Creamy Ginger 1/2 cup fat-free Greek yogurt 1 teaspoon freshly grated ginger root 1 teaspoon minced garlic from the jar (or 2 cloves minced) 1 tablespoon reduced sodium soy sauce 1 tablespoon extra-virgin olive oil [optional, add some zip by adding 1-2 teaspoons of lemon juice] Source: http://www.heart.org/heartorg/
Healthy Eating Tip of the Month Promotion! Enter to win a cookbook featuring 200 quick and easy heart healthy recipes! W ith busy schedules it can be hard to find the time to prepare nutritious meals, but with the American Heart Association Quick and Easy Cookbook, 2 nd edition you can spend minimal time in the kitchen and still make delicious, healthy meals! Many of these recipes can be made in 30 minutes from start to finish! This cookbook also provides practical strategies on how you can: Create a weekly meal plan to fit your lifestyle Make healthier food choices Spend less time in the grocery store Organize your kitchen and use cooking techniques to make meals fast, without extra fuss. How Do I Enter? Stop by the Healthy Eating Tip of the Month display in the University Hospital Cafeteria located near the cash registers during the month of April and enter your name into the prize drawing. The winner s name will be drawn in May.
Helpful Websites www.eatright.org The website for the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) http://www.heart.org/heartorg/ The American Heart Association website. http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc. pdf For more information about lowering your cholesterol from the National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/public/heart/index.htm The National Heart, Lung, and Blood Institute website. http://www.mayoclinic.com/health/heart-healthyrecipes/re00098 A variety of healthy recipe ideas from the Mayo Clinic. http://www.sparkpeople.com/ A free tool that can help you reach personalized healthy lifestyle goals. You can not only track your meals and activity, but also find lots of healthy recipes for any cuisine.
PATIENT FOOD AND NUTRTITION SERVICES Nutrition Counseling Center UH Room #2A237 (second floor) 1500 E. Medical Center Drive Ann Arbor, MI 48109 P: 734-936-7527 Created by: Ashley Woodward, Dietetic Intern