“a healthy heart lifestyle”. risk factors associated with heart disease 1.genetics 2.weight...

“A Healthy Heart Lifestyle”

Risk FactorsRisk Factors Associated with Heart DiseaseAssociated with Heart Disease

1.1. GeneticsGenetics

2.2. WeightWeight• OverweightOverweight• ObeseObese

3.3. SmokingSmoking

4.4. DietDiet

5.5. InactivityInactivity

6.6. Excessive EtohExcessive Etoh

““The Steps”The Steps” For a Heart Healthy LifestyleFor a Heart Healthy Lifestyle

1.1. Eat lessEat less • Cholesterol• Saturated fat• Trans fat• Sodium

2.2. Eat moreEat more• Fiber• Soy-based products

““The Steps”The Steps” For a Heart Healthy LifestyleFor a Heart Healthy Lifestyle

3.3. Reduce your weightReduce your weight

4.4. Increase physical Increase physical activity levelactivity level

5.5. Learn toLearn to

• Shop smart• Cook smart• Dine out more

healthy

ATP III Classifications/GuidelinesATP III Classifications/Guidelines

TestTest LevelLevel Health ImpressionHealth Impression

Total Total

CholesterolCholesterol

<200 mg/dl<200 mg/dl200-239 mg/dl

>240 mg/dl

DesirableDesirableBorderline High

High

LDLLDL

CholesterolCholesterol

<100 mg/dl<100 mg/dl

100-129 mg/dl100-129 mg/dl130-159 mg/dl160-189 mg/dl

>190 mg/dl

OptimalOptimal

Near OptimalNear OptimalBorderline High

HighVery High

HDLHDL

CholesterolCholesterol<40 mg/dl

>60 mg/dl>60 mg/dlLow

HighHigh

TriglyceridesTriglycerides

<150 mg/dl<150 mg/dl150-199 mg/dl200-499 mg/dl

>500 mg/dl

NormalNormalBorderline High

HighVery High

Blood PressureBlood Pressure≥ 140 mm Hg (systolic BP)≥ 90 mm Hg (diastolic BP)

High High

Step # 1Step # 1“Lowering Cholesterol & LDL Levels”“Lowering Cholesterol & LDL Levels”

• Eat less fat.Eat less fat.– Avoid fried foods, fatty meats,

& whole milk products.

• Eat less cholesterol.Eat less cholesterol. – Cholesterol is found only in

foods from animals (foods from plants contain no cholesterol).

Step # 1Step # 1““Lowering Cholesterol & LDL levels”Lowering Cholesterol & LDL levels”

• Eat less saturated fat.Eat less saturated fat.

– Saturated fats are usuallyusually found in animal products.

– However you should should avoidavoid coconut, palm, coconut, palm, and palm kernel oiland palm kernel oil as they are high in saturated fat.

Step # 1Step # 1““Lowering Cholesterol & LDL levels”Lowering Cholesterol & LDL levels”

• Use lessUse less hydrogenated or partially hydrogenated or partially hydrogenated fats.hydrogenated fats.

– Select tub or liquid margarine vs. stick margarine.

• Consider adding specialty spreads.Consider adding specialty spreads.

– BenecolBenecol or Take ControlTake Control are made from plants and have been shown to help lower cholesterol.*

*Talk with a dietitian about adding these products.

Step # 1Step # 1““Lowering Trigylcerides”Lowering Trigylcerides”

• Avoid Alcohol.Avoid Alcohol.– Beer, wine, or hard liquor.

• Avoid Sugar.Avoid Sugar. – Candy & regular soda.

• Eat Fewer Carbohydrates.Eat Fewer Carbohydrates.– Breads, cereals, rice, pasta, fruits, &

dairy products.

What is Trans Fat?What is Trans Fat?• Also known as Trans fatty acids.Trans fatty acids.

• Type of fat formed when liquid oils are made into solid fats (process called hydrogenationhydrogenation).– Shortening– Hard margarine

• Trans fat can be found naturally,can be found naturally, in small amounts, in some animal-based foods.

• Trans fats are in packaged cookies, crackers, packaged cookies, crackers, other baked goods, commercially prepared other baked goods, commercially prepared fried foods, chips, doughnuts, some fried foods, chips, doughnuts, some margarines & most shortenings.margarines & most shortenings.

Why is it BadWhy is it Bad??

• Trans fat is as badis as bad for you as saturated fat.saturated fat.

• It has been shown to– raiseraise LDL levelsLDL levels – lowerlower HDL levels HDL levels– increaseincrease your risk for

heart disease

Step # 1Step # 1““Lowering Trans Fat”Lowering Trans Fat”

1. Choose liquid or soft tub margarines & use in moderation.

• 1 gm saturate fat/serving• First ingredient should read “liquid

vegetable oil”

2. Use olive or canola oil (natural, un-hydrogenated oils).

3. Look for processed foods that use un-hydrogenated oils.

4. Limit intake of foods high in trans-fat (see pictures).

Step # 1Step # 1““Decrease Sodium (Salt) Intake”Decrease Sodium (Salt) Intake”

• Eating a diet high in sodium (salt) can increaseincrease blood pressure.– Canned foods, dried meats or fish,

packaged foods, frozen meals, lunch meats, salad dressings, marinades, and any salted food item (i.e. pretzels)

• Having a normal blood pressure reduces the riskreduces the risk of heart disease.

– Talk to a dietitian about a low salt diet plan.

– Talk to a dietitian about the DASH diet.

Step # 2Step # 2““Increase Soluble Fiber Intake”Increase Soluble Fiber Intake”

• The type of fiber found in oats, barley, dry beans & oats, barley, dry beans & peas, fruits & vegetablespeas, fruits & vegetables may help to lowerlower cholesterol levels.

– Choose 5 or more servings of vegetables & fruits/day.

– Choose 6 or more servings of whole grain breads, cereals, pasta, rice, & dry beans/day.

Step # 2Step # 2““Increase Soy Intake”Increase Soy Intake”

• Soy protein has been shown to reducereduce the risk of heart disease.

• Add soy to your diet.– Tofu, soynuts, soymilk, or

other whole soy products.

– Don’t count on powdered soy drinks as a good source of soy protein.

““Heart Healthy” Diet RecommendationsHeart Healthy” Diet Recommendations

NutrientNutrient Recommended IntakeRecommended IntakeCalories Reduction of 500 to 1000

kcals/day

Total Fat* 30% or less of total kcals/day

Saturated Fat* 8 to 10% of total kcals/day

Monounsaturated Fat Up to 15% of total kcals/day

Polyunsaturated Fat Up to 10% total kcals/day

Cholesterol 200 to <300 mg/day

Protein 15% of total kcals/day

Carbohydrates 55% or more of total kcals/day

Sodium 2.0 mg to 4.0 mg/day

Calcium 1,000 to 1,200 mg/day

Fiber 20 to 35 gm/day

Soy ~ 35 gm/day*Total Fat/day = 40-60 gm/day **Saturated fat/day = 10-15 gm/day

The Benefits of Weight LossThe Benefits of Weight Loss

What is What is Ideal Body WeightIdeal Body Weight (IBW)? (IBW)?

• ““A term describing the weight that A term describing the weight that people are expected to weigh people are expected to weigh based on age, sex and height.”based on age, sex and height.”

• “A recommended weight for individuals as provided in the Suggested Weights for Adults chart published periodically by the USDA and US Health and Human Services Department.”

• “The weight appropriate for an individual that results in a body mass index of 20-25. “

What Does it Mean to Your What Does it Mean to Your Health?Health?

• Being underweightunderweight can also lead to health conditions such as:– Anemia, heart problems, and chronic fatigue

– An obsession with weight loss may also lead to eating disorders and nutritional deficiencies that may be life threatening

• People who are overweightoverweight are at increased health risk for diseases including: – Heart diseaseHeart disease, diabetes, stroke,

osteoarthritis, gallbladder disease, gout, and certain types of cancer.

What is What is Body Mass IndexBody Mass Index (BMI)? (BMI)?

• ““A measure to A measure to determine the amount determine the amount of body fat and amount of body fat and amount of lean body mass. “of lean body mass. “

• “The number, derived by using height and weight measurements, that gives a general indication if weight falls within a healthy range.”

BMI ClassBMI Class ValueValue(Kg/m(Kg/m22))

Underweight

< 18.5

Normal Weight

18.5-24.9

Overweight 25.0-29.9

Obese I 30.0-34.9

Obese II 35-39.9

Obese III ≥ 40.0

Health Risks of ObesityHealth Risks of Obesity

What is a What is a Waist CircumferenceWaist Circumference??

““A measurement A measurement of the waist.of the waist. “ “

What Does it Mean to Your What Does it Mean to Your Health?Health?

• Fat around the waist increasesincreases the risk of obesity-related health problems.

• WomenWomen with a waist measurement of more than 35 inchesmore than 35 inches have a higher riskhigher risk of developing obesity-related health problems.– Diabetes, high blood pressure, & heart heart

disease.disease.

Step # 3Step # 3““Reduce Your Weight”Reduce Your Weight”

• If you are overweight or overweight or obeseobese,, a 10% reduction10% reduction in BWT may help to…

– Lower Blood pressure– Lower Cholesterol level– Lower Triglyceride level– Lower Blood Sugar Levels– Improve overall health– Lower risk of heart

disease

Calculating KcalsCalculating Kcals““The Short Method”The Short Method”

Sedentary ModeratelyActive

VeryActive

Lose Lose

WeightWeight15 kcals/kg15 kcals/kg 20 kcals/kg20 kcals/kg 25 kcals/kg25 kcals/kg

MaintainMaintain


Gain Gain


*Pounds (lbs) can be converted into kilograms (kg) by dividing lb value by 2.2.

**To lose 1 pound of body weight in 1 week, you must reduce your intake by 500 calories each day.

**To lose 2 pounds of body weight in 1 week, you must reduce your intake by 1000 calories each day.

Convert Calories into Meal Convert Calories into Meal PatternsPatterns

• 1200 kcals/day– 2 D, 2 Fr, 6 Gr, 4 M, 3 V, & 2 F



• 1800 kcals/day– 3D, 3 Fr, 9 Gr, 6 M, 3 V, & 4 F



D dairy

Fr fruit

Gr grain

M meat

V vegs

F fat

*All kcals associated with meal patterns above are based on correct portion size/serving consumed.

What Counts as a Portion?What Counts as a Portion?

Food Group Serving SizeGrain 1 slice of bread, ½ small bagel, 1 oz. cold

cereal, ½ cup cooked cereal, or 4 small crackers

Vegetable 1 cup raw, leafy vegs, ¾ cup veg juice, or ½ cup other vegs chopped, cooked or raw.

Fruit 1 medium whole fruit, ½ cup chopped, cooked or canned, or ¾ cup juice.

Dairy 1 cup of milk or yogurt, 1 ½ oz. natural cheese, or 2 oz. processed cheese.

Meat & Meat Substitutes

2-3 oz. cooked lean meat, ½ cup cooked dry beans, 1 egg, or 2 T. peanut butter.

Fat 1 tsp. butter or margarine, 2 T. dry non-dairy creamer, 1 tsp. oil, or 4 T. whipped topping.

““Guesstimated” Portion SizesGuesstimated” Portion Sizes

• 1 cup1 cup of potatoes, rice, or pasta is equal to the the amount that would fit into a amount that would fit into a tea cup or the size of a tea cup or the size of a tennis ball.tennis ball.

• Bagels should be the size of a to-go coffee lidto-go coffee lid..


• Whole fruits should be about the size of a tennis tennis ball.ball.– apples – oranges – peaches– pears

• Bananas should be the size of a dollar bill.dollar bill.


• Fresh veggiesFresh veggies should be measured by “the ½ cup”“the ½ cup” and should look like 3 3 ice cubes.ice cubes.


• A serving of cheese cheese is equal to a tube of lipsticktube of lipstick or if sliced, a 3.5 3.5 inch computer inch computer disk.disk.


• MeatsMeats should be between 2-3oz. 2-3oz. servingsservings or the size of a palm of a a palm of a woman’s hand, or woman’s hand, or a deck of cards.a deck of cards.


• 3 oz. serving3 oz. serving of chicken or turkey with the bone equals:

– 2 thighs2 thighs– 2 drumsticks2 drumsticks– 1 drumstick & 1 1 drumstick & 1

thighthigh


• 2 T. of peanut 2 T. of peanut butterbutter should be the size of a golf a golf ball.ball.


• 1 tsp of butter1 tsp of butter equals the foil-foil-wrapped wrapped restaurant type (1 restaurant type (1 package).package).

• 1 tsp. of oil1 tsp. of oil is the is the correctcorrect serving serving size.size.

What Counts as a What Counts as a Portion/Serving?Portion/Serving?

Alcohol

Type

Serving

Size

Recommended # of Drinks/day

Beer 12 oz. Females = 1 drink/day* Males = 2 drinks/day*

Wine 5 oz. Same as above

Hard Liquor

1.5 oz. Same as above

Note: 4 or more drinks/setting is considered “binge” drinking for females. 5 or more drinks/setting is considered “binge” drinking for males.

Step # 4Step # 4““Increase Physical Activity & Raise HDL Increase Physical Activity & Raise HDL

level”level”• Regular physical activityRegular physical activity

– Reduces your risk of heart disease

– Aids in weight loss

• How do you do it?How do you do it?– Talk with your doctor beforebefore you

start a formal program.– Begin slowly.– Choose an activity you like.– Meet with an exercise professional.– Goal:Goal: at least 30 minutes or more

of moderate activity, most days of the week.

Step # 5Step # 5““Shop Smart”Shop Smart”

1. Shop the “outside” aisles of the grocery store, they contain healthier food choices.

2. Avoid the middle aisles, they contained processed/high calorie products.

3. Choose fresh fruits, vegetables, milk, breads, and meats.

4. Read food labels.

Food LabelsFood Labels“The Healthy Eater’s “The Healthy Eater’s

Guide”Guide”• Indicate portion size• Servings per container• Amount of Calories/serving• Amount of CHO/serving• Amount of Fat/servingAmount of Fat/serving• Amount of Saturated Fat/servingAmount of Saturated Fat/serving• Amount of Trans Fat/servingAmount of Trans Fat/serving• Amount of Cholesterol/servingAmount of Cholesterol/serving• Amount of Sugar/servingAmount of Sugar/serving• Amount of Sodium/servingAmount of Sodium/serving• Amount of Fiber/servingAmount of Fiber/serving• Amount of Protein/serving• Amount of Vit & Min/serving

Step #5Step #5 ““Cook Smart”Cook Smart”

1. Sauté vegetables in a non-stick pan.2. Use non-stick spray or broth instead of butter or

oil.3. Use egg whites or cholesterol-free egg

substitutes to replace eggs.4. Use skim milk to replace whole or 2% milk.5. Use unsaturated oils and liquid margarine to

replace butter.6. Use herbs, spices, flavored vinegars, lemon

juice, or fat-free/salt-free condiments to add flavor to foods.

Step # 5Step # 5“Dine Out Smart”“Dine Out Smart”

1. Split an entrée, or eat half and take the rest home.

2. Order baked, broiled, or grilled food.

3. Avoid breaded, fried, or creamed foods.

4. Ask for gravy, sauce, butter, and salad dressing on the side.

5. Limit fast food to 1x/week.

6. Ask a dietitian for a meal plan to be followed when eating out.

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