1. Nutrition and Heart Health Janet M. de Jesus, MS, RD National Heart, Lung, and Blood Institute Division for the Application of Research Discoveries

2. Objectives Learn the risk factors for heart disease Learn how good nutrition can decrease your heart disease risk factors.

3. Are you at risk for heart disease? Risk factors you can change: Overweight High blood pressure High blood cholesterol Diabetes Physical inactivity Cigarette smoking Risk factors you can’t change: Age (45 or older for men or 55 or older for women) Family History Father or brother with heart disease before age 55 Mother or sister with heart disease before age 65

4. Alarming Trends in Health of the U.S.

5. 1998 2007 1990 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 5’4” person)

6. Percentage of U.S. Children and Adolescents Who Are Overweight* >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts **Data are from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of age Source: National Center for Health Statistics

7. Why the Increase? Multiple causes Lifestyle, environment, and genes Calories ≠ physical activity= imbalance More calories consumed Larger food portions and sizes Eating out more often Increases in soda, pizza, and candy consumption Fewer calories being used up Declines in physically activity Increases screen time

8. Nutrition tips for weight control/loss Don’t drink your calories Decrease eating out-bring your lunch Read nutrition facts labels Keep a food journal of what you eat Eat small meals through out the day Eat slower- savor and enjoy each bite

9. If you drink one regular soda (12 oz can) every day for a year... How much weight would one lose in a year after switching from regular soda to water or calorie-free beverages? 5 lb bag How much sugar is that in a year? About 15.5 pounds* *Based on 150 calories for an average can of soda. 30 pounds of sugar

10. 8 oz12 oz16 oz20 oz34 oz Courtesy of Dr. Kelly Brownell

11. Tips for eating out Order an appetizer or only eat half the entree Avoid buffets Don’t be afraid to ask for substitutions Share an entree with a friend Order salads with dressing on the side

12. Introduction of New Larger Portions Young & Nestle. AJPH,92:246, 2002 Dinner plate diameter 25% larger in 2000 vs. 1990

13. Do you know how portions have changed in the last 20 years? http://hin.nhlbi.nih.gov/portion /

14. Turkey Sandwich 20 Years Ago Today 320 calories Calorie Difference: 500 calories How many calories are in this turkey sandwich? 820 calories *Based on 130 pound person How long would you have to bike to burn up 500 calories? How to burn 500 calories: Bike for 1 hour and 25 minutes

15. Courtesy of Dr. Kelly Brownell

16. The Nutrition Facts Label

17. Tips to control blood cholesterol Decrease saturated fat, trans fat, and cholesterol Increase soluble fiber Keep a healthy weight Be physically active

18. Be Heart Smart: Watch your saturated fat

19. Food lower in saturated fat

20. Decrease trans fat

21. www.badfatsbrothers.com

22. Increase soluble fiber

23. Tips to prevent or control high blood pressure Decrease sodium intake Limit alcohol Watch your weight Take your medicines

24. Tips to reducing Salt and Sodium: Buy fresh or frozen vegetables for snacks instead of chips or crackers. If you used canned products, look for no-salt-added versions. Choose fewer processed and canned foods like hot dogs, sausage, bacon, and lunch meat. Season foods with herbs and seasonings instead of salt. Take the salt-shaker off of the table. Eat more meals at home.

25. Sodium in Packaged meals

26. Sodium in restaurants

27. Grocery shopping for heart health Shop the perimeter of the store Buy fruits and vegetables when they are in season Plan weekly meals Shop with a list Look for sales Shop on a full stomach

28. Be physically active

29. New Physical Activity Guidelines Children- 1 hr a day- moderate or vigorous Adults- 2.5 hr a week- moderate 1hr 15 min vigorous

30. Thanks for your time! www.nhlbi.nih.gov Learn more about heart disease risk.