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EATING PLAN FOR HIGH CHOLESTEROL (HYPERLIPIDEMIA)Thisplanwilllimityourintakeofsaturatedfat,transfatandcholesterolwhileincreasingfruit,vegetablesandwholegrains.
Cholesterol Defined A serum lipid test is a measure of your blood cholesterol levels. Your blood sample will be measured for four different components. The total cholesterol, triglycerides, low density lipoprotein (LDL or bad cholesterol) and the high density lipoprotein (HDL or good cholesterol) are reported to your doctor. These levels are compared to target values appropriate for reducing your risk for heart disease. If your values are not at target, improving eating habits, becoming more active, avoiding smoking and taking medications can improve your cholesterol values.
10 Tips to Help Reduce Your Cholesterol Levels1. Eatplentyofvegetablesandfruits-7servingsormoreeachday2. Eatwholegrainfoodsrichinsolublefibre–oats,psylliumandbarley3. Include2Omega3richfishmealsperweek–salmon,trout,sardines4. Include2beanbasedmealsperweek–kidneybeans,chickpeas,lentils5. Eatnutssuchasalmondsandwalnuts–smallportions5timesaweek6. Improvethequantityandqualityoffatsyoueat7. Oilsarebestforaddedfat–usesmallamounts,avoidfrying8. Beactive–moveyourbody30minuteseachday9. Ifyouareoverweight,worktoreduceyourweightby10%10. Ifyourtriglyceridesarehigh,limitsugarsandalcohol.
Cholesterol Facts • Highcholesterolcanincreaseyourriskofheartdisease.• Cholesterolinyourbloodcomesfromwhatyourliverproducesand
whatyouconsumeinyourdiet.Highlevelsofcholesterolinyourbloodcanentertheliningofyourarteriesandformdepositsor“plaques”.Theseplaquescangrowovertimeandblocktheflowofbloodinyourarteries.Thisputsyouatriskforaheartattackorstroke.
• Makingchangestoyoureatingtoloweryourintakeofsaturatedfat,transfatandcholesterol,whileincreasingfibre,canloweryourcholesterolbyasmuchas35%.
Build a healthy heart from the ground up – an eating plan based on fruit, vegetables, whole grains, nuts and legumes with lean protein choices is the foundation for managing your cholesterol.
Healthier Eating Guidelines for Lowering Cholesterol• Focus on Quantity and Quality of Fat
– Quantity–1/4to1/3ofyourcaloriescancomefromfat.Thismeansthatyoucaneatbetween50to70gramsoffateachday.Thenumberoffatgramsthatarerightforyoumaybelessormorethanthisdependingonyourgender,activitylevelandweightgoals.ARegisteredDietitiancanhelpdeterminehowmuchisrightforyou.
– Quality–unsaturatedfatssupportahealthycholesterolprofile.Thesefatsareliquidorsoftsolidatroomtemperature.Oilslikeoliveoil,canolaoil,soyoilandnon-hydrogenatedmargarinesaregreatqualityfats.Useinmoderation.Oneteaspoonofoil,thesizeofyourthumbtip,adds5gramsoffat.
• Limit saturated and trans fats, or hard fats, to 15 grams or less per day.Thesefatsarefoundinfullfatdairyproducts,meats,poultryskin,lard,palmkerneloil,hydrogenatedoilsandbakedgoodsmadewiththesefatsandoils.
• Eat less cholesterol – aim for less than 300 mg of cholesterol per day. Cholesterolisfoundonlyanimalfoods.Reducingportionsofmeat,avoidinghighfatcutsofmeatandchoosinglowerfatdairychoiceswillhelp.
• Eggs–Recentstudieshaveshownthateatinganeggadaywillnotincreasecholesterolorriskforheartdisease.However,ifyouhavediabetesyoushouldlimityoureggconsumptiontonomorethan6eggsperweek.
• Nuts such as almonds, walnuts, pecans and pistachios can help lower cholesterol.Studiesshow1.5ozorabout36almonds5daysperweekhelpedreducebadcholesterol.Ifyouareworkingtoloseweightasmallerportionof10-12nutsisrecommended.
Fibre – yes, for your heart!Fibreisfoundinplantbasedfoods.Vegetables,fruit,wholegrains,nuts,seeds,beans,peasandlentilsareallgreatfibresources.Functionalor“soluble”fibrehelpstoreducecholesterolbybindingwithcholesterolinyourstomachandbowel.Thischolesterolistheneliminatedinyourstool.Studiesshowweshouldinclude10to25gramsofthisfibreeachday.Hereisalistofthesolublefibrefoodsandthegramsoffibretheyprovide.
Heart Health Mixture=1/3groundflax,1/3oatbran,1/3psyllium.Use2tbspeachdayaddedtoyourfood.Itmixeswellwithyogurt,hotcerealandsaladdressing.
Salt – Shake the HabitTips to reduce salt (sodium) intake:• Home prepared fresh or frozen foods are best. Ifusingcannedfoods,lookforlabelssuchas“noaddedsalt”or“low
sodium”.• Avoid adding salttoyourfoodandomitfromrecipeswherepossible.• Season your food with herb and spice blends. Checkingredientliststoavoidthosewithsalt.• Limit condiments such as ketchup, mustard, soy sauce etc. • Use Nutrition Facts Labels. Bestchoiceshavelessthan200mgsodiumperserving.Avoidpackagedfoodwithmorethan
400mgofsodiumperserving.Checklabelscarefully.• Use ingredient lists-foodslistingsaltorsodiumatthebeginningofthelistormultipletimesinthelistarehighinsalt.• Restaurant foods are often high in sodium. Trytoavoidfastfoodbutdousetherestaurants’NutritionInformationto
identifylowersodiumoptions.Wheneatingout,askyourserverifthemealcanbepreparedwithoutaddedsalt.Requestsaucesontheside.
Item Soluble Fibre (g) Item Soluble Fibre (g)
Barley (1/2 c) 1 Navy Beans (1/2c) 2
Oatmeal (1/2 c) 1 Chickpeas (1/2 c) 1
Oat bran (1/2 c) 2 Carrots 1
Apple 1 Brussels Sprouts 3
Citrus (oranges) 2 Psyllium Seeds (1 Tbsp) 5
Pears 2 Metamucil (1 tsp) 2
Kidney Beans (1/2c) 3 All Bran Buds (1/3c) 2
Omega-3 Fats Omega3’sareunsaturatedfatsfoundincoldwaterfattyfish(salmon,mackerel,arcticchar,sardines,troutandherring)andinplantfoodsincludingwalnutsandflaxseeds.The“fish”omega-3’sarecommonlyknownasEPAandDHA.The“plant”omega-3’sareknownasALA.ALAisconvertedtoEPAandDHAinyourbody.Foodshouldbeyourfirstchoicetoachieveyouromega3’s(seebelow).Aimtoeat2mealsincludingfisheachweekandusetheHeart Health Mixtureasnotedonthepreviouspage.Ifyouhaveheartdiseaseoryourtriglyceridesarehigh,yourdoctorordietitianmayrecommendanOmega3supplement.
If you have High TriglyceridesInadditiontotheguidelinesformanagingyourcholesterol,youmaybenefitfromthefollowingrecommendations:• Alcohol: Men-limittolessthan2drinksperdayor14perweek.Women–limitto1drinkadayor9perweek.• Dependingonyourtriglyceridelevel,yourdoctormayaskthatyoufurtherreducethisamount.• Sugars -reduceaddedsugare.g.tablesugar,syrup,jam,honey,molasses.Limitjuice,pop,candies,sweets,chocolate
andbakedgoods.• Ifyouhavediabetes,workwithyourhealthcareteamtoimproveyourbloodglucose(sugar)control• Omega 3 supplements–adding2000to4000mgofEPA+DHAfromfishoil.Thisshouldbedoneunderthesupervision
ofyourdoctor• Niacin by prescription–thisBvitaminmayberecommendedtoloweryourtriglycerides.ItalsohelpsraiseHDL(good
cholesterol)
Reducing alcohol can promote weight loss and help decrease triglyceride levels.
Decoding Food LabelsTheNutritionFactstablefoundonthesideofpackagedfoodcanhelpyoumakebetterfoodchoices.Alwayschecktheservingsizefirstandconsiderthisinrelationtohowmuchofthefoodyouusuallyeat.
Lookforchoiceswithlessfat,saturatedfat,cholesterolandsodium.Lookforchoicesthatgiveyoumorefibre.Learn more about using food labels to make healthy choices on the web:Health Canada –www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/cons/index-eng.phpHealthy Eating Is In Store for You –www.healthyeatingisinstore.ca
OMEGA 3 CONTENT OF FOODS
Fish (2.5 oz) EPA/DHA (mg) per serving
Nuts/Seeds/Oils ALA (mg) per serving
Enriched Foods Total Omega -3 (mg) per serving
Herring 1600 Almonds (1/4 c) 150 Milk + DHA (1 c) 20
Mackerel 1490 Wheat Germ (27 g) 190 Soy beverage + flax 700
Salmon 1300 Canola Oil (1tsp) 430 Eggs + DHA (2) 800
Sardines 1050 Soybeans 760 Omega 3 yogurt (3/4 c)
500
Trout 870 Flaxseed, ground (1Tbsp)
1600
Arctic Char 680 Tofu (3/4c) 2020
Tuna, white (canned)
650 English Walnuts (1/4 c) 2300
To Reduce Weight • Eatsmallerportionsoffoodsandrememberthebalanceoffoodsonyourplate:1/4protein,1/4starch(including
potatoes),1/2vegetables• Eat3mealsperday,nomorethan6hoursapart.Don’tskipmeals.Snackwithfruitbetweenmeals.• Choosefoodslowerinfatandsugar.Eatingstrategiesincludinglowglycemicindexchoicescanbehelpful.
Learnmorefromaregistereddietitian.• Aimforamaximumweightlossof1-2lbs(0.5-1kg)perweek.• “Waistloss”isasimportantasweightloss.FortipsonhowtotrimyourwaistseeourWaistingAwaynutrition
factsheet.
ForamoredetailedplanforweightlosspleasereadWaistingAway-HealthyWeightManagementavailableinourclinicoronthewebatwww.ottawacvecntre.com
Portions to Live By • Oneservingofwholegrainsis1/2cup
cooked,notthe3ormorecupsservedinmostrestaurants!Toomuchofagoodthingisnotagoodthing.
• FormoredetailsonhealthyportionsseeEating Well with Canada’s Food Guideon-lineatwww.healthcanada.gc.ca/foodguide.
Prepare for Success• Cookwithoutaddingfat–bake,broil,roast,barbeque,grill,steam• Limitpanfryingandavoiddeepfatfrying• Tryusing1/3lessfatthanyourrecipecallsfor• Addflavourtofoodwithherbsandspices–thinkgarllic,lemon,gingerandmore• Refrigeratesoupsandstewsandskimofffatwhensolid• Useasprayofoiltopreventstickingandaddflavour
Food and Medication InteractionsReviewyourmedicationswithyourDoctor,DietitianorPharmacist.• Cautionwithgrapefruit,grapefruitjuice,pomelosandSevilleorangesCertainmedicationsforcholesterol
andheartdiseaseinteractwiththesefoods.
Supplements for Cholesterol Control CheckwithyourDoctor,DietitianorPharmacistbeforestartingasupplement.• Heart Healthy Mixture=1/3groundflax,1/3oatbranand1/3psyllium.Use2Tablespoonsperdayadded
tofoodsorbeverages.• Omega 3 supplements
– ifyouhaveheartdisease:1000mgperdayasEPA+DHA– ifyourtriglyceridesareelevated:2000to4000mgperday(underthesupervisionofyourdoctor).
• PlantSterols–consuming2gramsofplantsterolsperdayfromenrichedfoods,suchasmargarinewithplantsterols,hasbeenshowntoreduceLDLcholesterol.
• Redyeastricecanbeeffectiveatloweringcholesterolbuttheseproductsareunregulated.Theircontentisunreliableandthereforetheyarenotrecommendedforuse.
• Supplementsofgarlic,soyandlecithindonotappeartoreducecholesterolbasedoncurrentresearch.• Lecithindoesnotappeartoreducecholesterol.• CoenzymeQ10–evidencetodatedoesnotshowthatCoQ10reducesmusclepainassociatedwithcholesterol
loweringmedications.
Protein
Fruit
Protein
Vegetables
StarchStarch
Breakfast Lunch & Supper
Move your body, lower your bad cholesterol, raise your good cholesterol• Includingatleast30minutesofbriskactivity,suchaswalking,four(4)ormore
daysperweekcanloweryourLDLandraiseyourHDL.• Startwithabrisk10minutewalkafewtimesperdayandincreasegraduallyfromthere.• Gentlestretchingexercisesincreaseyourflexibilityandreleasetensioninyourmusclesandjoints.Aimfor4ormore
stretchingsessionsperweek.• Strengthexercisesimprovemuscleandbonedensitykeepingyoustrongandstable.Includethese2-4timesper
week.• Remembertostartslowlyandconsultyourphysicianbeforestartinganew
exerciseprogram
Keeping active can lower your blood sugar, cholesterol, blood pressure, help you feel better, relieve tension and stress, improve your muscle tone and help you lose weight!
Eating Plan for High CholesterolCholesterollowering–maximum15mgofsaturatedfatperday,300mgofcholesterolReadfoodlabelsforlessfat,saturatedfat,cholesterolandsodiumandmorefibre.
Vegetables and Fruit• Freshandfrozenarebest• Unsweetenedcannedfruit,unsaltedcanned
vegetables• Limitfruitjuicewithelevatedtriglycerides• Lowsodiumvegetablejuice• Avocadosandolivesinmoderationforhealthyfat
• Vegetablespreparedwithbutter,creamorsauce;batteredanddeepfried
• Fruitpackedinheavysyruporsugar;sweetenedfruitjuice,fruitdrinks,sportsdrinks
FOODS TO CHOOSE FOODS TO LIMIT OR AVOID
Whole Grains• bread,buns,rolls,pitabread,Englishmuffinsand
tortillas• lowfatcrackers,breadsticks,melbatoast,soda
crackers(unsaltedtops)• Unsweetenedhotorcoldcereal–oats,oatbran,
psylliumforsolublefibre• Brownrice,barley• Wholegrainpasta• Lowfatbakedgoods–addoatbran,groundflaxto
boostfibre
• Avoid“white”products• Cheeseoreggbread,croissants,sweetrolls• Crackersover5gramsoffatperserving,commercial
crumbcoatings• Sweetenedcereals• Pastawithbutter,creamorcheesesauce,chowmien
noodles,ramennoodles• Commercialmuffins,cakes,donuts,Danish,high-fat
cookies
Milk and Alternatives• Anywith1%MilkFat(MF)orless• Cheesewithlessthan20%MF–occasionaluse
• Allmilkproductswhicharemorethan1%MF• Cheese21%MForhigher
Beverages• Water,sodawater,mineralwater• Sugar-freesoftdrinks• Coffee,Tea–limitto4cupsperday• Cerealbeverages(e.g.Postum,Ovaltine)
• Regulartonicwater• Regularsoftdrinks,lemonade,sweetenedicedtea,
regulardrinkcrystalmixes• Flavoredinstantcoffee• Liqueurs,Cocktailmixes
Note: Underlined foods are commonly higher in salt (sodium)– limit use in cases of hypertension or other condition requiring salt restriction.
FOODS TO CHOOSE FOODS TO LIMIT OR AVOID
Meat and Alternatives• Fishandshellfish:fresh,frozen-unbattered,cannedinwater• Poultry:chicken,turkey–withoutskin• Meat:leancuts,fattrimmed
– Beef:round,rump,sirloin,extralean/leanground– Veal:round,rump,tenderloin– Lamb:leg,loin,shank,leanground– Pork:tenderloin,backbacon,ham– DeliMeat:ham,roastbeef,pork,turkey,turkeyorreducedfatwieners
– WildGame:moose,venison,rabbit• Legumes:chickpeas,kidneybeans,lentils,limabeans,
soybeans,splitpeas,tofu• Eggs:ifyouhavediabetes,limitto6perweek• Nuts:unsaltedalmonds,walnuts,pecans,pistachios–
limit1/4cperday• Peanutbutter:naturalornon-hydrogenatedorlight• Seeds:flax,pumpkin,sesame,sunflower
• Fishcannedinoil,commerciallyfried,frozenbatteredfish• Poultry:duck,goose,friedorbatteredchicken,chicken
wings• Meat:fattymarbledmeats,ribs,medium/regularground
meat,organmeats,bacon,sausage(unlesslowfat),cannedmeats
• Delimeat:pate,bologna,salami,high-fatluncheonmeats,wieners
• Peanutbutterwithhydrogenatedoil
Fats and OilsLimitaddedfatsto3teaspoonsperday.• Oils:olive,canola,corn,peanut,sesame,soy,sunflower• Margarine:non-hydrogenatedsoft(regularorlight)• Saladdressing/Mayonnaise:lowcalorie,caloriereduced,
oil-free,homemadewithrecommendedoils• Lowfatsourcream,creamcheese• Gravy:defatted
• Hydrogenatedorblockmargarine,butter,lard,shortening,suet
• Saladdressingsmadewithcheeseorregularsourcream• “Tropical”oils:palmkernel,coconut• Fullfatgravy,creamsauces
Sweets• Sugar:substitutes(e.g.sucralose,),lowsugarjams,jellies,
syrups• Sugarfree:candies,gelatins,gum• Bakedgoods:lowinsugar,fatandhighfibre• Frozendesserts:lowfat,lowsugaricecream,icemilk,
frozenyogurtandsherbet• Cocoapowder
• Sugar–useinmoderation• Regularjams,jellies,syrups• Regularcandies,gelatins,gum• Bakedgoods-regularcakes,pies,cookies-avoid“white”foods• FrozenDesserts:regularicecream,icemilk,frozenyogurt,
sherbet• Chocolatebars,chocolate
Snack Foods• Popcorn:hotairpoppedorlowfatmicrowave• Pretzels,bakedchips,ricecrispsandcakes
• Popcorn–regularandhighfatmicrowave,cornchips,potatochips,cheesies
Miscellaneous• Condiments(ketchupetc),herbs,spices,vinegar,pickles• Soups:preparedwithskimmilkorfat-freestock,bouillon,
broth,consommé
• Soups-cream
Eating Plan for High Cholesterol, August 2010DanielleAldous,BSc,RD(FromOriginal,2005:HeleneCharlebois,BSc,RD&JasnaRobinsonDI)©ContinuingMedicalImplementation®Inc.
Ottawa Cardiovascular Centre502-1355BankStreetOttawa,ONK1H8K7Phone: (613)738-1584Email: admin@ottawacvcentre.com
Other Nutrition Fact Sheets Available: EatingPlanforHypertensionEatingPlanforCongestiveHeartFailureEatingPlanforType2DiabetesWaistingAway–HealthyWeightManagementPotassiumModifiedEatingPlanPlease visit www.cvtoolbox.com for more information
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