'Eat Smart' - Nutrition for a Healthy Heart

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Definitions - Fats & Cholesterol Found in Blood LDL HDL 'low density lipoprotein' also known as 'bad cholesterol' major cholesterol-carrying molecule in blood delivers cholesterol to the arterial walls levels increase with diets high in saturated fat and trans fats goal: level < 2.0 mmol/l or 50% decrease from baseline blood work 'high density lipoprotein' also known as 'good cholesterol' picks up cholesterol from arterial wall and delivers it to the liver for excretion may pick up oxidized portions of LDL particles levels increase with exercise monounsaturated fats (in foods like olive oil and avocados) may increase HDL goal: level > 1.0 mmol/l for men, level > 1.3 mmol/l for women TRIGLYCERIDES likely contribute to blocked arteries levels increase with obesity, diabetes and diets high in alcohol, sugar and processed foods. goal: level < 1.7 mmol/l (< 1.5 mmol/l for diabetes) Adapted from da Silva, L. 1995. Dietary fat and antioxidant vitamins & their potential influence on ASHD Beneficial Fats Research shows some fats are not only beneficial they are essential for good health. Foods high in omega-3 fats and monounsaturated fats are associated with reduced cholesterol levels and a decreased risk of heart disease. Although the fats listed below are beneficial they must still be eaten in small quantities - or weight gain will result! These fats should replace harmful fats in your diet. 12

FAT & CHOLESTEROL Both the AMOUNT and the TYPE of fat you eat matters when keeping your cholesterol under good control. Not all fats are created equal. Refer to the table on the back to decide which ones you should limit. All fats are energy (calorie) dense. Large amounts of ANY fat can lead to weight gain. Try following the steps below to optimize your own cholesterol levels. FOODS STEPS BEST CHOICES STEP 1 Choose lower fat milk products Skim or 1% milk 1% M.F. yoghurt 20% M.F. cheese 1% cottage cheese Low fat sour cream STEP 2 Choose lower fat meat & alternatives STEP 3 Include sources of Omega 3 fats Fish & Shellfish Dried beans Soy products Skinless poultry Lean meats -Trim visible fat - Least amount of marbling Eggs (limit yolks to 3/week) Limit portion sizes to 3-4 oz Salmon, mackerel, herring or trout 2-3 x week or 1 tsp flax oil (not heated) or 1 Tbsp ground flax per day Fish or flax supplements STEP 4 Limit the amount of fat you add to food to 3-6 servings per day (1-2 servings per meal) One Serving = 1 tsp margarine, butter or oil 1 tsp regular mayonnaise 1 Tbsp light mayonnaise 1 Tbsp vinaigrette creamy salad dressing 2 olives ¼ small avocado Bake, broil, poach, steam, roast & barbeque more often. 13

Unhealthy Fats to Limit or Avoid (less than 20 grams per day): Type of Fat Sources Saturated Fat -LIMIT- Usually solid at room All animal fats High fat dairy products Butter, lard Cocoa butter, Chocolate Palm/palm kernel oil Coconut oil Many processed & store bought baked goods Effect on Blood Cholesterol Level LDL Trans Fatty Acids -AVOID- Made when liquid oils are turned into solid fats Found on labels as: Vegetable Oil Shortening Hydrogenated Oil Trans Fatty Acids All margarines (unless labeled as 100% non-hydrogenated) Many processed & store bought foods such as crackers and cookies Fries and other deep-fried foods LDL HDL Triglycerides Healthy Fats to choose more often: Type of Fat Monounsaturated Fat Polyunsaturated Fat Omega 3 Fats Healthy choice Canola oil Olive oil Peanut oil/ Peanuts Nuts and seeds Avocado Soybean oil Corn oil Walnut oil Grape seed oil Sesame seed oil Sunflower seed oil Sources Fish Seafood Ground flaxseed Flaxseed oil (do not use in cooking) Fish oil supplements Walnuts Effect on Blood Cholesterol Level LDL HDL LDL LDL HDL Triglycerides LDL = bad cholesterol ; HDL = good cholesterol ; Triglycerides = blood fat 14

There are no known health benefits associated with saturated fats or 'trans fats' 7 Ways to Eat More Omega-3's 1. 2-3 servings fish each week 2. Flax seeds (must be ground or in oil form for us to obtain the fat from these seeds otherwise they go through us whole! i.e. undigested) 3. *Born 3 eggs 4. *Walnuts and other nuts & seeds (5 servings per week) 5. *Canola oil margarine (non-hydrogenated) 6. *Tofu and soy milk 7. *Dark green leafy vegetables If you do not eat fish try to have 1 tsp flax oil (not heated) or 1 TBSP ground flax seeds every day. Do not eat more than 1 TBSP flax oil or 3 Tbsp of ground flax seed meal daily, as this may provide too much omega 3 s. See recipe section for instructions on how to make ground flaxseeds. * Omega 3 from fish is better utilized by the body than Omega 3 from plant sources i.e. flax. What about Coconut Oil? Coconut oil is a plant based saturated fat. Although it is considered cholesterol free the jury is still out and currently no strong research supports its use in replace of other healthy vegetables oils. That s not to say it may be used instead of butter or Trans fats. It is still important to use in moderation and ensure the coconut oil is non-hydrogenated. 15

Added Fats & Oils The following list represents 1 serving of fats/oils. (1 serving = 5 g fat) Choose 3-6 servings per day (in addition to your low-fat meals & snacks) Examples of 1 serving of fat: Oils: Olive oil 1 tsp Other oils 1 tsp Canola oil 1 tsp Coconut oil 1 tsp Butter/Margarine: Margarine (non-hydrogenated) 1½ tsp Butter mixed 50:50 with olive oil 1½ tsp Avocado: ¼ small Olives: Black or Green, large 2 Nut Butters: Peanut butter (natural) Cashew butter Almond butter Nuts/seeds: Chopped nuts or seeds 1 Tbsp Whole nuts 10 grams (1/3 oz) For example; Almonds 10 medium size nuts Peanuts 17 peanuts Salad Dressing: Regular Vinaigrette 1 Tbsp Low fat or Light Versions (Read the label to find out serving size = 5 g fat) Regular Creamy one serving is equal to approximately 5 grams of fat 1 tsp oil = 5 grams of fat Most of your fat choices should be 'healthful fats' (e.g. olives, avocados, nut/seeds). Limit butter & margarine to per day. Be sure the rest of your diet is low in fat. For example, in addition to limiting fat intake to 3-6 servings per day, choose lower fat food products whenever possible. This will result in approximately 30% calories from fat. 16