1. Heart Healthy Diet SADIA SHAUKAT Dietetic Inter 2012 SADIA SHAUKAT Dietetic Inter 2012

2. IMPORTANCE Heart disease is No.1 cause of death in Americans A healthy diet and lifestyle are best weapons in fight against heart disease They can reduce three of major risk factors for heart disease: –High blood cholesterol –Excess body weight –High blood pressure

3. Life’s simple 7 AHA identifies 7 health & behavior factors that can impact health and quality of life: 1.Don’t smoke 2.Maintain a healthy weight 3.Engage in regular physical activity 4.Eat a healthy diet 5.Manage blood pressure 6.Take charge of cholesterol 7.Keep blood sugar, or glucose, at healthy levels

4. Desirable cholesterol level Blood lipid levels provide a good measure of heart health –Cholesterol Produced by liver In diet from animal foods insulate nerves, form cell membranes& make hormones Too much cholesterol in the blood can build up in the arteries

5. Desirable cholesterol level –Lipoproteins: Fat & cholesterol with protein LDL- “Bad cholesterol” can build up on the walls of arteries HDL- “good Cholesterol” help remove the cholesterol from the arteries –Triglycerides Fat in the blood is in the form of triglycerides High levels of triglycerides are associated with increase blood cholesterol levels

6. Nutrients & blood cholesterol Total fat –Limit fat intake to 25%-35% of total calories –Choose heart healthy fats more often Saturated fat –Less than 7% of total calories (10-20g/day) –Increases blood cholesterol levels especially bad cholesterol –Animal sources: fatty meat, poultry skin, bacon, sausage, hot dogs, dairy products made from whole milk, butter, lard –Plant sources: palm & palm kernel oil, coconut oil, cocoa butter, shortening, hydrogenated fats

7. Nutrients & blood cholesterol Trans fats –Made by process called hydrogenation –Zero or as low as possible –Added to products to increase there shelf life –Raises total & bad cholesterol, may lower good cholesterol –Foods with hydrogenated oil in the ingredients list contain trans fats –Sources: stick margarine, shortening, some fried foods, commercially prepared crackers & cookies

8. Nutrients & blood cholesterol Cholesterol –Intake should be less than 200 mg/day –Found only in animal products –Sources: egg yolk, fatty meats, dairy products with whole milk, shrimp, lobster & crab

9. Nutrients & blood cholesterol Polyunsaturated fats –Up to 10% of calories –Can reduce total blood cholesterol but also decreases HDLs –sources: safflower, sunflower, soybeans, corn oil, cottonseed oil Monounsaturated fats –Up to 20% of total calories –Reduces blood cholesterol –Increase HDLs –Sources: canola oil, peanut oil, avocado, olive oil, nuts

10. Nutrients & blood cholesterol Omega-3 –Cardio protective: interfere with blood clotting, stimulate production of nitric oxide, lower blood pressure, triglyceride levels, risk of heart attack and stroke. –Consume fish high in omega-3 twice a week –Studies shown that eating fish is associated with decreased CVD risk –Sources: salmon, tuna, mackerel, sardines, flaxseeds and walnut

11. Nutrients & blood cholesterol Fiber –Heart disease risk decreases as fiber intake increases –Soluble fiber helps to lower cholesterol –Recommended intake for fiber is 25g-30g per day –Food sources: fruits, vegetables, whole grain, high fiber cereal, oat meal, legumes & beans.

12. Nutrients & blood cholesterol Plant sterols & stanols –Naturally occurring substance found in plants that compete with cholesterol for absorption and help low cholesterol level –2g per day divided over 2-3 meals –Sources: margarine spread made with esterified plant sterols, fortified orange juice. Don’t add unwanted calories to your eating plan

13. Nutrients & blood cholesterol Antioxidants –Help lower risk of heart disease –Include variety of colorful fruits and vegetables –Sources: fruits, vegetables, garlic, whole grain, nuts, red wine, purple grape juice, black or green tea, dark chocolate or cocoa

14. Nutrients & blood cholesterol Soy products –Soybeans are high in protein –Substitute soy foods instead of meat & cheese, which can be higher in saturated fat –Eating 25g soy protein per day may improve heart health –½ cup edamame + a soy burger + ¼ cup roasted soy nuts –Sources: soy beans, soy nuts, miso, tempeh, tofu, soy butter, soy milk, soy burger

15. Desirable blood pressure There are several ways to lower blood pressure and lighten the load on heart –A healthy weight is less work for heart –Include plenty of fruits & vegetables & –Include 3 servings of low fat dairy –Exercise; a strong heart muscle lowers blood pressure –Relax: try to reduce stress –Limit salt intake to 1500mg per day

16. Sodium 1500 mg per day High intake can raises the chance of high blood pressure, stroke, heart failure Food high in sodium –Processed meats –Salted, smocked, pickled, & canned fish –Regular canned vegetables & vegetable juice –Food processed in brine –Frozen dinners –Cheese products –Commercial soups –Snack items –Seasoned salt & sauces Desirable blood pressure

17. Aim for Healthy weight Healthy weight is crucial for good health Associated with healthy blood lipid levels, lowers the risk of heart diseases, diabetes & some cancers Decreasing as little as 5% can significantly reduce the risk for heart disease & stroke Healthy weight? BMI & waist measurement DIET and EXERCISE both are important to achieve healthy weight

18. Overall healthy diet Choose a variety of foods Include all food groups Grain group- make half your grains whole Fruits & vegetables- include variety of colorful fruits & vegetables Milk & dairy- include low fat calcium rich foods Meat & beans- include low fat meats Fats & oils- limit fat saturated & trans fat

19. Overall healthy diet http://www.choosemyplate.gov/fo od-groups/http://www.choosemyplate.gov/fo od-groups/ Super tracker http://www.choosemyplate.gov/su pertracker-tools/daily-food- plans.html http://www.choosemyplate.gov/su pertracker-tools/daily-food- plans.html Go meals My fitness pal Mediterranean food pyramid

20. Overall healthy diet Low incidences of CHD in Mediterranean's Can reduce recurrent CVD by 50% -70% Main source of fats is Olive Oil High in MUFA’s (replace butter with olive oil) Diet emphasis fruits & vegetables Linollenic acid (flax, canola oil), Nuts & seeds Red wine

21. Heart Healthy Label Source: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HeartSmartShopping/Reading-Food-Nutrition-Labels_UCM_300132_Article.jsp

22. Heart Healthy Shopping Plan meals ahead &Use shopping list Do not go hungry for shopping for food that do not have a lot of added ingredients such as salt, sugar or fats Learn your goal for fat, calories & sodium Use food labels to help make choices Start with fruits & vegetables Choose bread & cereals that are made from whole grain & are high in fiber Pick low fat or non fat dairy Look for protein that is low in saturated fat & sodium & high in fiber

23. Heart healthy cooking Choose recipes that use whole grain flour when baking Reduce amount of sugar in recipes Add dry beans & lentils in soups Take the skin off of poultry Bake, broil, roast, stew or stir fry lean meats, fish & poultry Cook ground meat and then drain off fat Use oil spray Use healthier oils Season foods with herbs, spices, garlic, onions, peppers& lemon

24. Heart Healthy Eating out Choose steamed, broiled, baked or roasted foods instead of fried, crispy, scalloped, pan fried, buttered, creamed Ask for sauces, salad dressing, & condiments on the side Drink water instead of soda Be careful at salad bar Split the dessert Use milk with your coffee instead of heavy cream

25. AHA recommendations Balance calories intake & physical activity to achieve & maintain a healthy body weight Consume a diet rich in vegetables & fruits Choose whole grain, high fiber foods Consume fish especially oily fish, at least twice a week Choose a diet low in fat, saturated fat, trans & cholesterol Minimize your intake of beverages & foods with added sugar Choose & prepare food with little or no salt If you consume alcohol, do so in modertaion

26. ANY QUESTIONS