Learn About Your Heart...
Made Simple


By Nicolas Shammas, MD


A new, comprehensive sourcebook for
heart and vascular disease patients

Cardiovascular Health Topics



1.
Statistics about Heart and Blood Vessel Diseases in the United States
2.
Structure and Function of the Heart and Blood Vessels
3.
Diseases of the Blood Vessels of the Heart
4.
Surgical Therapies for the Cardiovascular Patient
5.
Peripheral Vascular Disease
6.
Diseases of the Blood Vessels of the Head and Neck
7.
Strokes: How to Survive Them and How to Prevent Them
8.
Valvular Heart Disease
9.
Heart Rhythms: How to Recognize Them and Treat Them
10.
Congestive Heart Failure
11. Understanding Cardiomyopathy, or Weak Heart Muscle
12. Children and Heart Disease
13. Diseases of the Pericardium
14. Systemic Illnesses, Infections and Drugs that Affect the Heart
15. Erectile Dysfunction: a Vascular Disease
16. Cardiovascular Disease Prevention
17. Heart Healthy Nutritional Tips
18. Cardiac Rehabilitation
19. Medications for Cardiovascular Disorders
20. Heart Tests You Need to Know
21. Learn What to Do in a Medical Emergency
22. How to Choose Your Doctor and Hospital
23. Medical Research and How You Can Get Involved
24. Taking the Next Step — A Few Community Resources to Help You Live More Healthfully
25. How Much Did You Learn from This Book: Take a Simple Test



HEART HEALTHY NUTRITIONAL TIPS

Nicole Nelson, RD, LD, and Elaine Guthrie, RD, LD/N

Does diet affect cardiovascular disease?

Nutrition plays an important role in the prevention and treatment of cardiovascular disease. Obesity, hypertension, diabetes, and high cholesterol are all risk factors for developing cardiovascular disease and are all impacted by diet. Therefore, it is important to become educated about proper diet and the best diet foods . Achieving and maintaining a desirable body weight in addition to following a diet low in saturated fat, cholesterol, and sodium are important in preventing cardiovascular disease.

What are saturated fats?

Saturated fats are fats that are solid at room temperature. Saturated fats increase low-density lipoprotein (LDL) , or the "bad cholesterol." They come primarily from foods of animal origin. Foods that are high in saturated fat include butter, fatty meats, full-fat dairy products, and cheese. Experts recommend that saturated fat and trans fat intake should not exceed 8-10% of your total calories. For example, if you are consuming 2,000 calories a day, you should eat 22 grams or less of saturated fat. To decrease your saturated fat intake, it is important to limit portion sizes of meats. It is also important to use lean meats and low-fat dairy products.

What are unsaturated fats?

Unsaturated fats are liquid at room temperature. There are 2 types of unsaturated fats: monounsaturated and polyunsaturated. Oleic acid is the most common form of monounsaturated fat. Olive oil and canola oil are high in oleic acid. Other sources of monounsaturated fats include avocados, peanuts, and pecans. Monounsaturated fats help to lower LDL and triglycerides without lowering high-density lipoprotein (HDL), or the "good cholesterol." Up to 15% of total calories should come from monounsaturated fat.

Polyunsaturated fats should equal up to 10% of total calories. There are 2 major categories of polyunsaturated fats: omega-3 and omega-6 fatty acids. Omega-3 fatty acids include flaxseed and fish oils that are found in cold-water fish. Therefore, it is recommended to consume fish at least twice a week. Omega6 fatty acids include certain vegetable oils (corn, sunflower, safflower, and soybean). Substitution of polyunsaturated fat for saturated fat in the diet helps to lower LDL and raise HDL cholesterol.

What are trans fats?

Trans-fatty acids are formed through a process called hydrogenation. Hydrogenation is the addition of hydrogen atoms to a liquid fat. This changes the fat's structure to a solid fat. Hydrogenated vegetable oils are the main source of trans-fatty acids. Hydrogenation is used to prolong the shelf life of many foods. Therefore, it is found in a lot of convenience foods or baked goods (crackers, cookies, potato chips, or puddings). Preliminary data suggest that the consumption of trans-fatty acids increases LDL and the risk for cardiovascular diseases. It is important to use soft, trans-free margarine and limit baked goods that are made with partially hydrogenated oils. Effective January 2006, food labels are required to list the amount of trans fat in a product.

How much cholesterol should I consume?

Cholesterol is a waxy, fatty substance that can harden your arteries. A diet high in cholesterol can increase LDL. Dietary cholesterol is found in foods of animal origin. The 2 foods that contain the highest amount of cholesterol are egg yolks and organ meats. Cholesterol is also found in foods that contain high amounts of saturated fat (cheese, cream, and fatty meats). The American Heart Association recommends that you limit your average daily cholesterol intake to 300 mg, unless you have heart disease. If you have heart disease, you should limit your average daily cholesterol intake to 200 mg. To limit your cholesterol intake, you should limit egg yolks (2-4 per week), organ meats, butterfat (found in whole-fat dairy products), and high-fat meats.

What should I look for on a food label?

First of all, you should pay attention to the portion size. This is important to know because all of the amounts listed on the food label are for that particular portion size. A person with heart disease should focus on total fat, saturated fat, cholesterol, and sodium. If a patient also has diabetes, it is important that he or she look at the total carbohydrate in the product.

For a product to carry the American Heart Association heart checkmark, it must meet certain criteria. The product must be low in fat (less than or equal to 3 g); low in saturated fat (less than or equal to 1 g); and low in cholesterol (less than or equal to 20 mg). The product also needs to have a sodium value of less than or equal to 480 mg per serving. It also must contain 10% of the Daily Value of 1 or more of the following: protein, vitamin A, vitamin C, calcium, iron, or dietary fiber.

Can a person with heart disease still eat at restaurants?

People with heart disease can still eat at restaurants. Upon arriving at the dining establishment, it is important to make wise decisions, and people must educate themselves before they even enter the restaurant. Most dining establishments have nutrition facts available to the public. It is important to choose a restaurant with a wide menu selection. Avoid restaurants that only serve fried foods. Also, be specific when ordering. People should ask for certain high-fat items on the side (butter, sour cream, or salad dressing). Do not be afraid to ask for substitutions. For example, a baked potato can be a substitute for French fries. It is also important to pay attention to certain key words that can indicate whether an item is heart-healthy or not. For example, steamed, broiled, roasted, and poached are terms that indicate a product is heart-healthy. Watch out for menu terms that signal extra fat: buttered, fried, crispy, creamed, hollandaise, and au gratin. Also, foods prepared in restaurants are usually very salty. Therefore, it is important not to add salt once food has arrived to the table.

What are the sodium recommendations?

Reducing the amount of sodium consumed may help reduce or avoid high blood pressure. This is important because high blood pressure is a risk factor in developing heart disease. The American Heart Association recommends individuals limit their sodium intake to 2,400 mg per day, which is equivalent to 1 teaspoon of table salt. To limit sodium intake in the diet, it is important to limit table salt and foods high in sodium. Some examples of foods high in sodium are salted, smoked, canned, and highly processed foods. Convenience foods, fast foods, and most restaurant foods are also very high in sodium. The Dietary Approaches to Stop Hypertension eating plan has also been recommended.

What is the DASH diet?

The Dietary Approaches to Stop Hypertension (DASH) diet is an eating plan that is low in saturated fat, cholesterol, and total fat. The DASH diet emphasizes fruits, vegetables, and low-fat dairy foods as well as whole grain products, fish, poultry, and nuts. Red meats, sweets, and sugar-containing beverages are limited. It encourages foods that are rich in magnesium, potassium, and calcium. The DASH diet encourages healthy weight loss while emphasizing protein and fiber. Based on consuming 2,000 calories per day, the DASH diet recommends:

  • 7-8 servings of grains or grain products to provide energy and fiber.This includes whole wheat breads, cereals, and oatmeal. One serving would equal 1 slice of bread, 1 oz dry cereal, or ½ cup cooked rice or pasta.
  • 4-5 servings of vegetables. Vegetables are good sources of potassium, magnesium, and fiber. A serving of vegetables is equivalent to 1 cup raw leafy vegetables, ½ cup cooked vegetable, or 6 oz vegetable juice.
  • 4-5 servings of fruits. Fruits are also good sources of potassium,magnesium,and fiber.A serving of fruit equals 1 medium fruit, ¼ cup dried fruit, ½ cup fresh, frozen, or canned fruit, or 6 oz fruit juice.
  • 2-3 servings of low-fat or non-fat dairy products that provide calcium and protein. A serving of dairy equals 8 oz milk, 1 cup yogurt, or 1 ½ oz cheese.
  • No more than 2 servings a day of meat, poultry, or fish. Meat is a good source of protein and magnesium. A serving of meat equals 3 oz, which is about the size of a deck of cards. Digital kitchen scales can provide accurate measurements.
  • 4-5 servings a day of nuts, seeds, or dry beans. These are good sources of energy, magnesium, potassium, protein, and fiber. A serving would be equal to 1/3 cup or 1 ½ oz nuts, 2 tbsp seeds, and ½ cup cooked dry beans.
  • 2-3 servings a day of fats and oils. A serving would equal 1 tsp soft margarine, 1 tbsp low-fat mayonnaise, 2 tbsp light salad dressing, or 1 tsp vegetable oil.
  • 5 sweets per week. A serving of sweets is equal to 1 tbsp sugar, 1 tbsp jelly or jam, or 8 oz lemonade.

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