The Important Role of

Nutrition in Heart HealthJuly 16, 2020 at 3:00 PM ET

Presenter: Penny M. Kris-Etherton, PhD, RD, FNLA, CLS

Moderator: Andrea Baer, MS, BCPA

• All attendees are in listen only mode• If you can not hear, check the audio button on your

personal computer to assure the sound is on.• Please type your questions into the chat box at any

time during the presentation. The moderator will read your questions during the question and answer period.

• The PDF version of the slides, as well as the recording of this presentation will be available on the Mended Hearts website following the event.

• A Handout is available in the handout section of the website.

Mended Hearts’ mission is “to inspire hope and improve the quality of life of heart patients and their families through ongoing peer-to-peer support, education and advocacy.”

The National Lipid Association’s (NLA) mission is “to enhance the practice of lipid management in clinical medicine.”

The Foundation of the NLA’s mission is “to improve the welfare of patients and families affected by cholesterol and triglyceride problems.”

Andrea Baer, MS, BCPAExecutive DirectorMended Hearts

Penny M. Kris-Etherton, PhD, RD, FNLA, CLSEvan Pugh University Professor of Nutritional SciencesDepartment of Nutritional SciencesThe Pennsylvania State University

Penny Kris-Etherton, PhD RDN FAHA FASN FNLA CLS

Healthy, Delicious, Nutritious and Budget-Friendly Foods

DISCLOSURES

Research Grants Scientific Advisory Boards

• ACH Foods Inc

• American Pistachio Growers

• Hass Avocado Board

• American Pecan Council

• McCormick Science Institute

• The Peanut Institute

• Avocado Nutrition Sciences Advisors – Scientific Advisory Board

• HumanN Scientific Advisory Board

• Seafood Nutrition Partnership - Scientific Advisory Council

Topics for Discussion

• Dietary recommendations for heart health

• Health and economic disparities

• Navigating food deserts

• Meal planning for families with time and financial considerations

• Stretch your food dollar

• Answers to your questions

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Key Elements of Healthy Eating Patterns:

Key Recommendations

Consume a healthy eating pattern that accounts for all foods and

beverages within an appropriate calorie level.

A healthy eating pattern includes:

• A variety of vegetables from all of the subgroups—dark green, red and orange,

legumes (beans and peas), starchy, and other

• Fruits, especially whole fruits

• Grains, at least half of which are whole grains

• Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy

beverages

• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes

(beans and peas), and nuts, seeds, and soy products

• Oils

A healthy eating pattern limits:

• Saturated fats and trans fats, added sugars, and sodium

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Food Sources of Added SugarsFood Category Sources of Added Sugars in the U.S. Population Ages 2 Years and

Older (Figure 2-10)

Data Source: What We Eat in America

(WWEIA) Food Category analyses for the

2015 Dietary Guidelines Advisory

Committee. Estimates based on day 1

dietary recalls from WWEIA, NHANES

2009-2010.

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Food Sources of Saturated FatsFood Category Sources of Saturated Fats in the U.S. Population Ages 2 Years

and Older (Figure 2-12)

Data Source: What We Eat in America

(WWEIA) Food Category analyses for the

2015 Dietary Guidelines Advisory

Committee. Estimates based on day 1

dietary recalls from WWEIA, NHANES

2009-2010.

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Food Sources of SodiumFood Category Sources of Sodium in the U.S. Population Ages 2 Years and Older

(Figure 2-14)

Data Source: What We Eat in America

(WWEIA) Food Category analyses for the

2015 Dietary Guidelines Advisory

Committee. Estimates based on day 1

dietary recalls from WWEIA, NHANES

2009-2010.

Information adapted from the 2015-2020 Dietary Guidelines for Americans. Available at DietaryGuidelines.gov.

Healthy U.S.-Style Eating Pattern at the 2,000-Calorie Level

What is a Healthy Plate?

From the National Lipid Association:½ of the Plate is Vegetables and Fruits; ≈¼ is Fish, Poultry, Lean Meat, or Plant Protein and ≈¼ is Whole Grains (or Starchy Vegetables)

https://www.lipid.org/sites/default/files/tearsheet_nutrition.pdf

https://www.cdc.gov/nchs/hus/spotlight/HeartDiseaseSpotlight_2019_0404.pdf

Heart Disease Differs by Race & Ethnicity in the U.S.

Seven Simple Ways to Achieve Ideal Cardiovascular Health

Eat RightReduce Blood Sugar

Control Cholesterol

Manage Blood Pressure

Stop Smoking

Get Moving

Lose Weight

Living Better with Life’s Simple 7American Heart Association

Less than 1% of Americans are in ideal cardiovascular health.

Prevalence of meeting ≥5 criteria for ideal cardiovascular health among US adults and children by race/ethnicity (2007-2008 and 2015-2016)

Virani et al. Circulation. 2020 Mar 3;141(9):e139-e596.

Food Deserts are areas with both Poor Food Access and Low Area income. An Estimated 23.5 Million People Live in Food

Deserts in the United States

Kelli et al. J Am Heart Assoc . 2019;8:e010694.

Association between (A) food desert with incident myocardial infarction

Kelli et al. J Am Heart Assoc . 2019;8:e010694.

Living In A Food Desert is Associated with a Higher Risk of Adverse Cardiovascular Events in those with Coronary Artery Disease

THE EMPLOYMENT SITUATION — JUNE 2020

https://www.bls.gov/news.release/pdf/empsit.pdf

Jan 20First Patient With Wuhan Coronavirus Is Identified in the U.S.

Jan 30The WHO declared a global health emergency.

Mar 15The CDC recommended no gatherings of 50 or more people in the U.S.

Apr 2Cases topped one million, and millions lost their jobs.

May 27Coronavirus deaths in the U.S. surpassed 100,000

How the Covid-19 Crisis Upheaved Society

Etc…..

The Current Hunger Crisis in the U.S.Some Scenes at Food Banks

COVID-19 has Caused Record Levels of Food Insecurity in the U.S.

Before the pandemic, the Boston Food Bank distributed 4 to 5 million pounds of food a month.• In March, it distributed 8 million pounds; in April, 9.5 million pounds.• In May, it’s on track to distribute more than 10 million pounds.

https://www.marketplace.org/2020/05/22/record-levels-of-food-insecurity-in-the-u-s-because-of-covid-19/

The Cost of Eating in the U.S.

• The average meal cost was $3.02 in 2019.

https://www.feedingamerica.org/sites/default/files/2019-05/2017-map-the-meal-gap-food-price-variation_0.pdf

Healthy Eating on a Budget – General Tips

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

Find fruits and vegetables in the produce section, frozen foods and in the canned and pantry food aisles. Compare prices to find the best buys.• Buy “in season” produce. They are usually less expensive. Buy only what you can use

before it spoils. For more info check out the “Seasonal Produce Guide” from SNAP-Ed Connection.

• Try buying canned. Choose fruit canned in 100% fruit juice and vegetables with “low-sodium” or “no salt added” on the label. These products are just as nutritious as fresh, and often cost less.

• If you have the freezer space, buy frozen vegetables without added sauces or butter. They are as good for you as fresh and may cost less.

• Canned and frozen fruits and vegetables last much longer than fresh and it’s a quick way to add fruits and vegetables to your meal.

• For a great resource on selecting healthy and affordable produce, check out Smart Shopping for Veggies and Fruits.

Fruits and Vegetables

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

GrainsFind grains in many areas of the store, including the bread, cereal, snack, and pasta and rice aisles.• Make half your grains whole grains. Throughout the store, check ingredient lists and

pick the items that have a whole grain listed first.• Whole grains include whole wheat, brown rice, bulgur, buckwheat, oatmeal, whole-

grain cornmeal, whole oats, and whole rye.• Rice and pasta are budget-friendly grains.• Choose hot cereals like plain oatmeal or whole grain dry cereal.• Try new whole grain snacks, like switching to whole-wheat crackers or popping your

own popcorn.• For more information on grains, check out Choosing Whole-Grain Foods.

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

Protein FoodsFind protein foods throughout the entire store. They can be found in the fresh meat case, frozen foods section, dairy case, and canned and pantry food aisles.• Some great low-cost choices include beans and peas, such as kidney beans, split peas,

and lentils. Use these good sources of protein for main or side dishes. Beans and peas cost far less than a similar amount of other protein foods.

• To lower meat costs, buy the family-sized or value pack and freeze what you don't use. Choose lean meats like chicken or turkey. When choosing ground beef, make sure it's lean (at least 93% lean) ground beef.

• Seafood doesn’t have to be expensive. Try buying canned tuna, salmon, or sardines –they store well and are a low-cost option.

• Don’t forget about eggs! They are a great low-cost option that are easy to prepare.• For more tips on making healthy protein choices, check out Vary Your Protein Routine.

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

DairyFind dairy foods in the refrigerated aisles.• Choose low- fat or fat-free milk. They provide just as much calcium, but fewer calories

than whole and 2% milk.• Buy the larger size of low-fat plain yogurt instead of individual flavored yogurt. Then

add your own flavors by mixing in fruits.• When it comes to cheese, look for "reduced fat," or "low-fat" on the label.• Always check the sell by date to make sure you're buying the freshest dairy products.• See Got Your Dairy Today? to learn more.

Tips for Every Aisle – Healthy Grocery Shopping on a Budget

Other• Drink water instead of buying sodas or other sugary drinks. Tap water is easy on your

wallet and has zero calories. A reusable water bottle is a great way to have water with you on the go. For other drink ideas, see Make Better Beverage Choices.

• Save time, money and calories by skipping the chip and cookie aisles.• Choose the checkout lane without the candy, especially if you have kids with you.

https://choosemyplate-prod.azureedge.net/sites/default/files/cookbooks/HealthyEatingonaBudgetCookbook.pdf

https://choosemyplate-prod.azureedge.net/sites/default/files/printablematerials/MeetingYourMyPlateGoalsOnABudget.pdf

Grocery Shopping on a Budget at “Dollar-Type” Stores

Answers to Your Questions

• Is grape seed oil healthy?Yes – It is a liquid oil low in SFA and high in unsaturated fats.

• Is soy healthy? Any estrogen concerns?Soy protein is a healthy plant-based protein food and soybean oil is a healthy vegetable oil. The phytoestrogens in soy are not a health concern because they are present in small amounts in soy protein foods. However, avoid soy isoflavone supplements because they are high in phytoestrogens.

• Is highly refined canola oil heart healthy?Yes – All liquid oils are heart healthy because they are in SFA and high in unsaturated fat.

• What is the difference between homogenized vs non-homogenized milk?Homogenized milk has the milk fat globules broken up so that the milk fat does not separate (float to the surface) from the milk.

• What is the difference between organic vs non-organic milk?Compositionally and nutritionally, they are the same. The only difference is the standards of production (USDA Organic Standards must be followed for dairy cows). Also, organic milk typically is ultra-pasteurized (higher temperature) for longer shelf life.

Thank You!

For additional questions, please email:Andrea.baer@mendedhearts.org

Join us for the last session of the series:

Expert Answers to your Frequently Asked Questions about Managing LipidsJuly 29, 2020 at 6:00 PM ET

Presenter: James Underberg, MDModerator: Andrea Baer, MS, BCPA

This webinar series is brought to you by Mended Hearts, The National Lipid Association (NLA), and The Foundation of the NLA.This activity is supported by Amgen, Esperion, and Novartis.