SMALL CHANGES MAKE A BIG DIFFERENCE. Lifestyle changes for your heart

SMALL CHANGES MAKE A BIG DIFFERENCE Lifestyle changes fr yur heart

Heart disease is the leading cause f death fr Americans. The gd news is that there are a lt f things yu can d t lwer yur risk. This brchure includes infrmatin n hw t lwer yur risk f heart disease with diet and ther lifestyle changes.

Risk Factrs fr Heart Disease The fllwing risk factrs increase yur chances f develping heart disease. Yur risk fr heart disease is higher if yu have tw r mre factrs. Risk factrs yu can change (check ff yur risk factrs): High chlesterl - Ttal chlesterl mre than 200 mg/dl - Lw-density lipprtein (LDL, r bad chlesterl) mre than 100 mg/dl High-density lipprtein (HDL, r gd chlesterl) less than 40 mg/dl Triglycerides greater than r equal t 150 mg/dl Cigarette smking High bld pressure Diabetes Lack f exercise Obesity Unhealthy diet (high in trans fat, saturated fat, and prcessed carbhydrates, such as white flur, white rice, r sugar) Risk factrs yu cannt change: Family histry f early heart disease (female family member befre 65 years ld; male family member befre 55) Age (male ver 45; female ver 55) Being male 1

What Can Yu D t Lwer Yur Risk? Yu can make a difference! The mst effective way t lwer yur risk f heart disease is by making psitive lifestyle changes. This brchure gives yu imprtant guidelines t fllw t imprve yur eating habits. In additin t changing yur diet, ther lifestyle changes can als lwer yur risk and will help manage ther risk factrs, such as high chlesterl, high bld pressure, and diabetes. If yu are a smker, quit. Learn abut ur Wellness Caching by Phne prgrams fr supprt (see bxed text belw). Aim fr at least 30 minutes f exercise, such as brisk walking, 5 days a week. See page 10 fr mre infrmatin. Learn abut ur Wellness Caching by Phne prgrams t help yu get started (see bxed text belw). If yu are a smker, quitting the habit is the mst imprtant step yu can take tward decreasing yur risk fr heart attack and strke. Call 1-866-862-4295 t learn abut ur Wellness Caching by Phne prgrams and see if an appintment with a cach is right fr yu. A wellness cach can give yu strategies and resurces t help yu quit tbacc, eat healthy, get active, reduce stress, r manage yur weight. Available t Kaiser Permanente members Mnday thrugh Friday, 6 a.m. t 7 p.m. (PT). Infrmatin abut the caching services yu receive will be included in yur electrnic health recrd and accessible by yur Kaiser Permanente care team. 2

Dietary Changes t Lwer Yur Chlesterl and Yur Risk f Heart Disease Just a few small changes in yur eating habits can help lwer yur risk f heart disease and lwer yur chlesterl. Fcusing n the prblem areas in yur diet and then making small but realistic changes may help yu avid taking medicatins. The changes listed n the next page nt nly lwer yur chlesterl but als make yur heartbeat mre stable, make platelets less sticky, lwer levels f inflammatin in yur bdy, and make the plaque (blckage) in yur arteries mre stable all f which lwer yur risk f a heart attack. Isn t it wrth a try? 3

The mst imprtant changes yu can make are: Eat mre plant-based fds. Eating a plant-based diet is linked with lwer rates f heart disease. Aim fr 5 r mre servings f vegetables and 2 t 3 servings f fruit a day. Eat mre beans, lentils, and whle grains. Decrease yur saturated fat intake by limiting fatty meats and 2 percent r whle-fat dairy. Avid trans fat (partially hydrgenated il). D nt eat fds with partially hydrgenated il n their list f ingredients. See the shpping sectin n page 8 fr mre infrmatin n reading labels. Use small amunts f extra virgin live il and canla il instead f ther fats and ils. Limit red meat (beef, prk, and lamb) t 2 times per mnth. Chse chicken, turkey, beans, lentils, and tfu instead. Eat fatty fish such as salmn, trut, tuna, herring, and mackerel at least 2 times per week. 4

Getting Started STEP 1: Turn t the TARGET FOODS CHART in the back f the brchure. Yur main gals are listed under WHERE TO START. STEP 2: As yu read thrugh the fds listed under INSTEAD OF THIS, circle the fds that yu eat regularly. These will be the nes yu ll want t wrk n first. STEP 3: Next, take a lk thrugh the suggestins under the TRY THIS clumn, as well as the suggestins fr shpping and eating ut n pages 8 and 9. They will give yu sme ideas t try befre making yur plan. STEP 4: Nw yu are ready t cmplete yur plan n the TARGET FOODS CHART. Under the clumn CHANGES I AM WILLING TO MAKE, write dwn changes yu will make. Hw will yur breakfast, lunch, dinner, r snacks be different? Hw abut eating ut? Remember that yu have chices when changing yur eating habits. Yu can chse t: Find a substitute. Change hw ften yu eat a fd. Change hw much yu eat. 5

It may be helpful t put yur TARGET FOODS CHART in a cnvenient place t remind yurself f the changes yu will make. Be patient but persistent. Fr example, it may take 1 t 3 mnths t see yur bld chlesterl level drp. Hw much it drps will depend n hw high in saturated and trans fat yur diet is nw, hw many changes yu make, and hw yur bdy respnds t yur new diet. Remember that these dietary changes can help t lwer yur risk f heart disease even if yur bld chlesterl levels stay the same! 6

Suggestins fr Chsing Healthier Fds TRANS FAT: A NOTE OF CAUTION The Nutritin Facts sectin n a label can say a fd has 0 grams f trans fat, but it actually may have mre. Labeling laws allw fd cmpanies t say a fd item is trans-fat-free if it has less than ½ gram f trans fat per serving. S, yu culd eat several servings f an item labeled trans-fat-free and get enugh trans fat t increase yur risk f heart disease. As little as 2 t 7 grams a day can increase yur risk. Hw much shuld yu be eating? Zer grams f trans fat a day. SODIUM If yu have high bld pressure, reducing sdium has been shwn t lwer bld pressure after nly a few weeks. Even if yu d nt have high bld pressure, decreasing the amunt f sdium yu have each day can decrease yur risk f a heart attack r strke. The average American has 3,500 t 5,000 mg f sdium a day, with a surprising 80 percent cming frm restaurant fd, fast fd, and prcessed fds nt the salt shaker. Yur gal is n mre than 2,400 mg f sdium per day. What can yu d t reduce the amunt f sdium yu cnsume? Eat ut less ften. Aim fr 1 day a week. Ck at hme. Make extra and eat it fr lunch the next day. Eat fewer prcessed, packaged, and canned fds. Lk at the Nutritin Facts sectin n the labels f fds yu eat ften t see hw much sdium yu are getting. 7

Eat mre fresh fds, such as vegetables, fruits, whle grains, beans, peas, lentils, fish, chicken, and meats prepared withut salt. Cut the amunt f salt yu add while cking in half until yu are nt adding much, if any. Use herbs, spices, lemn juice, vinegar, balsamic vinegar, garlic, nins, wine, dry mustard, r Mrs. Dash instead. Cut the amunt f salt yu add at the table in half until yu are nt using any at all. Yur taste buds will get used t the lwer amunt f sdium in just 3 t 4 weeks. SHOPPING Read labels. Use the Nutritin Facts t cmpare similar prducts. Check the serving size, sdium, and amunt and type f fat. Avid fds that have these fats in the ingredients list: partially hydrgenated il (trans fat), ccnut il, palm kernel il, vegetable shrtening, and lard. Buy fresh fds when pssible. Prcessed fds (packaged, canned, bxed) have mre unhealthy fat, sdium, and sugar. Try nt t shp when yu are hungry. Shp frm a list. Use the TARGET FOODS CHART t make healthy chices. 8

EATING OUT Chse restaurants with varied menus s yu have a lt f ptins. Ask hw fds are prepared and request substitutins if needed. Order briled, baked, r pached fds r fds cked in canla r live il. Trim all fat frm meats and remve skin frm pultry befre eating. Avid fried fds. Order butter, gravy, sauces, and salad dressings (such as blue cheese and Thusand Island) n the side and avid r limit the amunt yu use. At the salad bar, chse fresh vegetables, fruit, and cked beans. Take nly small amunts f fds with maynnaise (such as cleslaw, pasta salad, and ptat salad). Chse live r canla il based salad dressings in small amunts instead. Skip the cheese, fatty meats, and crutns. Think small. Split a main dish r ask fr a dggy bag at the beginning f the meal. Order fresh fruit fr dessert. It s ften available, even if it s nt n the menu. Order a la carte. If yu rder a cmplete meal, yu are paying fr fd yu may nt want r need. 9

Exercise Increasing yur physical activity is ne f the mst imprtant things yu can d fr yurself. Exercising has many benefits: Decreases yur risk f heart disease Decreases bld pressure by 5 t 10 mm f mercury May decrease the risk f sme cancers, such as cln and breast Helps prevent diabetes Decreases the risk f Alzheimer s disease and dementia Decreases depressin as much as medicatin Increases yur energy Helps cntrl weight Imprves sleep Wrk up t at least 30 minutes f aerbic activity n 5 r mre days f the week. Yu can als d tw 15-minute r three 10-minute sessins in a day. Fr the first 5 minutes f yur exercise rutine, start ut slwly t give yur muscles a chance t warm up. End with a 5- t 10-minute cldwn by gradually slwing yur pace. Examples f aerbic activity: Brisk walking Dancing Jgging Basketball Swimming Tennis Hiking Rllerblading r rller skating Biking 10

Aim fr a mderate level f intensity. Yu are exercising at the right intensity if it is hard enugh t make yu breathe deeply and sweat a little, but easy enugh t carry n a cnversatin. If yu are nt currently exercising, start at a lw level and wrk up t mre strenuus exercise. If yu have an nging health cnditin, talk t yur physician befre starting an exercise prgram. A Jb Well Dne Cngratulatins! Yu ve dne a great jb f identifying sme imprtant changes yu can make in yur eating and ther lifestyle habits that will lwer yur risk f heart disease. Remember t put yur TARGET FOODS CHART in a cnvenient place t remind yurself f the changes yu will make. If yu want mre help r have questins, cntact yur lcal Kaiser Permanente Health Educatin Department fr class infrmatin r t speak with a registered dietitian. Yu can als find infrmatin nline at kp.rg/heart. Yu re already n yur way t a healthier life! 11

TARGET FOODS CHART STEP 1 STEP 2 STEP 3 STEP 4 Where t Instead Try this Changes I am start f this willing t make Eat mre plantbased whle fds. Fruits and Vegetables Canned vegetables and fruits Fruits and Vegetables Eat at least 5 servings f fresh vegetables and 2 3 fresh fruits a day. One serving is ½ cup cked r 1 cup raw. Example: Bring fruit t wrk fr a snack r keep fresh fruit at yur desk. Whle Grains, Legumes, Whle Grains, Legumes, Nuts, Example: Try adding Nuts, and Seeds and Seeds walnuts t yur cereal r White bread, bagels, Brwn rice, quina, bulgur, dughnuts, pastries, whle-grain breads and cereals, salad. muffins, crissants, biscuits Nut butters with added il and sugar, larger amunts f nuts and whle-wheat pasta Dried beans, peas, lentils, and sy prducts Old-fashined nut butters (limit t 2 tablespns per day) seeds r nut butters Nuts and seeds such as walnuts Prcessed fds (canned, and flaxseeds as a garnish (limit packaged, bxed) t 2 tablespns per day) Eat less red meat Meat, Pultry, and Pultry, Seafd, and Other Example: Try ne (beef, prk, lamb) Seafd Prtein Surces meatless, cheeseless (nly tw times a Fatty cuts f meat such (4 6 unces a day) meal, such as sup r as sausage, bacn, ht Eat at least 2 servings f fatty mnth). chili, nce a week. dgs, lunch meats, fried fish such as salmn a week Eat fish, chicken, beans, and tfu chicken, fried fish Beef, prk, r lamb Chicken r turkey withut the skin, shellfish, tuna in water, instead. Organ meats (liver, lw-sdium 97% fat-free lunch heart, kidney, sweet- meats breads, brains) Tfu, cked beans and peas, such as kidney, pint, garbanz, black beans, split peas, and lentils Chse healthy Fats and Oils Fats and Oils fats and ils. Butter, stick margarine, (3 7 teaspns a day) shrtening, lard, salt Limit saturated prk, bacn grease, fat. ccnut il, palm il, Nnstick cking spray Avid trans partially hydrgenated Avcads, lives ils (partially Blue cheese, ranch, r hydrgenated) Thusand Island salad fats. dressing, maynnaise Olive r canla il, trans-fat-free margarine, liquid margarine Fat-free r lw-fat maynnaise, a small amunt f regular maynnaise, fat-free r lw-fat salad dressing, vinaigrette, live Limit added Cream cheese, sur r canla il-based dressing, sugar. cream, half and half Cffee creamers (liquid r pwder) flavred vinegars, lemn juice, lime juice, salsa Reduced-fat r fat-free cream cheese r sur cream Fat-free cffee creamers r 1% milk Example: Try mustard instead f maynnaise n sandwiches. Dairy Prducts Dairy Prducts Examples: Use fat-free Whle r 2% milk r Fat-free r 1% lw-fat milk r milk n cereal. ygurt ygurt, r sy milk Use ne whle egg Whle-milk cheeses Reduced-fat r fat-free cheese and tw egg whites fr (cheddar, Swiss, jack, (including cttage cheese r scrambled eggs. American) rictta) Whle eggs Egg whites r egg substitute (limit egg ylks t 4 a week) Snack Fds Ptat, crn, r trtilla chips; cheese puffs; ppcrn; crackers; granla Desserts Cakes, pies, ckies Ice cream, milkshakes, smthies Snack Fds Fresh fruit and vegetables; whle-grain pretzels; airppped r light ppcrn; fat-free r lw-fat whle-grain crackers; a handful f nuts Desserts Fresh fruit Pureed frzen fruit; fat-free, lw-fat, r light frzen ygurt; fat-free, lw-sugar ice cream; srbet; sherbert; sugar-free Ppsicles Example: Switch t carrts with hummus instead f chips and dip.

Other lifestyle changes yu are willing t make t lwer yur risk: I WILL... Quit smking. Exercise (such as brisk walking) at least 30 minutes a day, 5 days a week. Take a health educatin class t help manage my diabetes, high chlesterl, high bld pressure, r lse weight. Call 1-866-862-4295 t learn abut Wellness Caching by Phne fr supprt. (Available t Kaiser Permanente members nly.)