1. Dietary Strategies for Healthy Hearts Therapeutic Lifestyle Change

2. What is Atherosclerosis? High blood levels of fat and cholesterol are common with Insulin Resistance and DM This can increase risk of plaque build-up in your arteries

4. You can reduce your risk of atherosclerosis and heart disease risk by: Maintaining a healthy weight Eating a Healthy Diet Being physically active

5. How Much Should you weigh? Body Mass Index or BMI Calculates your weight for height and is a way to tell if you are at a healthy weight

6. BMI = Body Mass Index a measure of weight for height click here to calculate your BMI click here to calculate your BMI click here to calculate your BMI click here to calculate your BMI

7. Calories (kcals) Do Count One extra Oreo Cookie a day = 5 pound weight gain in one year

8. Burn an extra 100 kcals/day = 10 lb weight-loss in one year Energy Out > Energy In

9. 1610 Kcals 237 g CHO 63 g FAT 16 g SFA 590 kcals 73 g CHO 23 g FAT 7g SFA Super Size Meal= Super Size Kcals The “kid's" meal is a reasonable portion!

10. READ labels for PORTION SIZE! Big Grab Bag 3.5 oz 490 kcals 60 g CHO 25 g Fat

11. Lipid Profile How do your numbers stack up? OptimalBorderline High risk LDL<100130-159>160 HDL>603545<35 TG<150150-199>200 Total CHOL <200200-239>240

12. TLC (Therapeutic Lifestyle Change) Essentials: Less than 7% of the day's total calories from saturated fat Less than 200 milligrams of dietary cholesterol a day Limit sodium (salt) maintain a healthy weight

13. Eating Saturated fat raises the level of “bad“ cholesterol in your blood more than anything else! “Good” Cholesterol “Bad” Cholesterol

14. Foods with Saturated Fat……

15. Finding Saturated Fat on Food Labels In one ounce of cheddar cheese 6 of the 9 fat grams are saturated

16. How much saturated fat is okay…? Aim for no more than 10-15 grams of saturated fat per day…. Remember- that’s less than you’ll find in some super size McDonald’s Meals Aim for no more than 10-15 grams of saturated fat per day…. Remember- that’s less than you’ll find in some super size McDonald’s Meals

17. Which is a better choice? 1 oz cheese 1 oz peanuts

18. The cheese has 3 times as much saturated fat (6 grams VS. 2 grams) cheesepeanuts

20. Avoid these artery clogging fats Saturated/Trans Fats Saturated/Trans Fats Butter cheese, Ice-cream Beef Fat Chicken Fat Shortening Fats that are hard at room temperature (stick margarine, shortening, lard, butter) Hydrogenated oils

21. Replace with these healthier Replace with these healthier Unsaturated Fats Liquid Vegetable Oils olive, canola, safflower AvocadoMayonnaise Nuts Almonds, Peanuts, Walnuts, Fish oil Salmon, Trout Olives

22. 2 slices pizza: ~ 12 grams saturated fat Turkey sub NO cheese Light mayo 1 gram saturated fat

23. Make informed fast food choices Taco Bell Bean Burrito: 3.5 grams sat fat (**only 2 g sat fat w/o the cheese!) Taco Bell Cheese Quesadilla: 13 g Sat Fat 370 kcals ( 340 kcals w/o cheese ) 490 kcals

24. Quarter Pounder with Cheese: 12 grams sat fat Regular Hamburger NO cheese: 3.5 grams sat fat

25. Cook heart healthy meals: 6 oz steak-filet mignon: 520 kcals 520 kcals 37 grams fat 37 grams fat 15 grams sat fat 15 grams sat fat 6 oz skinless chicken breast: 280 kcals 6 grams fat 1.7 grams sat fat

26. Choose low sat fat treats Ice Cream Bar: 300 kcals 300 kcals 22 grams fat 22 grams fat 11.5 grams sat fat 11.5 grams sat fat Juice Bar: 70 kcals 0 grams fat 0 grams sat fat

27. Just 2 ounces of cheddar cheese or 3/4 c Haagen Dazs has over 15 grams of saturated fat!

28. Limit Dietary Cholesterol Goal < 200 mg/ day Question? If you trim the fat off the meat, do you reduce the cholesterol?

29. Answer: No Cholesterol is found in most animal cells- not just the fat Cholesterol is found in most animal cells- not just the fat The best way to limit cholesterol intake is to limit intake of animal foods (meats/poultry/and seafood) and avoid organ meats such as liver. The best way to limit cholesterol intake is to limit intake of animal foods (meats/poultry/and seafood) and avoid organ meats such as liver.

30. What about Trans-fats? Check nutrition facts labels for sources of heart – clogging trans fats Check nutrition facts labels for sources of heart – clogging trans fats Remember- if you eat 2 servings you have to double the fat grams per serving

31. What if you have elevated levels of Triglycerides in the Blood? Reduce intake of alcohol Reduce intake of alcohol Reduce Calories Reduce Calories Lose Weight Lose Weight Reduce Carbohydrate intake Reduce Carbohydrate intake

32. High Carbohydrate diets can increase liver production of triglyceride and impair the body’s ability to remove triglyceride from the blood stream…

33. Carbohydrate-rich Foods: Breads and Grains Breads and Grains Fruits and Starchy vegetables Fruits and Starchy vegetables Milk and Yogurt Milk and Yogurt

34. Eat a little less Carbohydrate and a little more healthy fat- Nuts, avocados etc..

35. What does this type of eating look like….. Breakfast: 1 slice whole grain bread 1 Tbsp almond or peanut butter ¾ cup berries ½ cup nonfat plain yogurt Breakfast: 1 slice whole grain bread 1 Tbsp almond or peanut butter ¾ cup berries ½ cup nonfat plain yogurt

36. Breakfast: ½ cup Bran Flakes 4 oz 1% lowfat Milk ¾ cup fresh Blueberries 12 Walnut Halves Lunch: Turkey/Avocado Sandwich: 2 slices Whole Grain Bread ½ Avocado 2 oz lean deli Turkey breast Tomato/Lettuce 1 teaspoon Mayonnaise 1 Fresh Orange 2 Tbsps Roasted Almonds Dinner: 3 oz Salmon ½ cup black beans 1 Cup mixed salad greens 1 Tbsp olive oil 1 cup steamed asparagus 6 oz “light “yogurt 1 cup Fresh Strawberries 1525 kcals 40% FAT (6% SFA) 41% CHO 19% PRO 37 g Fiber

37. What else can you do to keep heart-healthy….?

38. Regular physical activity may lower LDL ("bad") cholesterol and raise HDL ("good") cholesterol levels.

39. Get Moving…… 20 minutes walking a day is a good place to start!

40. Each one hour per day of brisk walking associated with a 24% reduction in obesity and a 34% reduction in diabetes. Nurses health study cohort JAMA, volume 289 (14) April 9, 2003

41. Don’t Smoke You can’t afford to increase your risk of heart disease by smoking

42. In Summary…… Stay lean BE active Eat well and avoid saturated & trans fats