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Heart Healthy Choices to Lower Your Cholesterol

Heart Healthy Choices to Lower Your Cholesterol. (Presentation adapted from Holly Nickels, Summit Medical Fitness Center). Why the concern about cholesterol?. Narrowing of arteries Major risk factor in heart disease and heart attacks. Cholesterol Basics.

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Heart Healthy Choices to Lower Your Cholesterol

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  1. Heart Healthy Choices to Lower Your Cholesterol (Presentation adapted from Holly Nickels, Summit Medical Fitness Center)

  2. Why the concern about cholesterol? • Narrowing of arteries • Major risk factor in heart disease and heart attacks

  3. Cholesterol Basics • Low-density lipoprotein (LDL): “bad” cholesterol • Too much causes a build up of plaque in the arteries • High-density lipoprotein (HDL): “good” cholesterol • Lowers risk for heart attack and stroke

  4. Optimal Cholesterol Levels • Total Cholesterol: <200 mg/dl • LDL: • < 160 mg/dl if no heart disease or diabetes • <130 mg/dl if 2 risk factors for HD • < 100 mg/dl if HD or diabetes • HDL: > 40 mg/dl • Triglycerides: < 150 mg/dl

  5. Nutrition Goals to Lower Cholesterol • Change TYPEof fat eaten • Reduce HOW MUCH fat is consumed • Increase intake of SOLUBLE FIBER • Reduce simple SUGAR and ALCOHOL intake if high triglycerides

  6. Types of Dietary Fat Monounsaturated fat Polyunsaturated fat Saturated fat Trans fat All fats are a combination of mono, poly & saturated fats

  7. Types of Fat • Monounsaturated fat • lowers total & LDL cholesterol • Sources: • olive/canola/peanut oil • cashews, peanuts, pecan, almonds, sesame seeds • avocado

  8. Types of Fat Polyunsaturated fat (PUFA) • lowers total & LDL chol • sources: • Corn/safflower/soybean oil • mayonnaise, Miracle WhipTM • walnut, pumpkin seeds, sunflower seeds

  9. Types of Fat • Saturated fat • solid at room temperature, raises total & LDL chol • converts to cholesterol in body • sources: • butter, lard, bacon grease • cream, sour cream, cream cheese, most cheeses • high-fat meats, poultry skin • tropical oils: palm oil, coconut oil, coconut, cocoa butter

  10. Types of Fat • Trans fat • solid at room temperature • raises total & LDL, lowers HDL • converts to cholesterol in body • Look for “partially hydrogenated” on food label

  11. Trans Fat Sources • Margarine w/ hydrogenated oil • Fast foods - fried chicken/fish, biscuits, fries • Donuts, muffins, crackers • Packaged cookies, • Cake mixes, icing, pie • Microwave popcorn

  12. Dietary Cholesterol • Raises blood cholesterol levels but not as much as saturated and trans fats • Recommendation: < 300 mg/day dietary chol if LDL normal • Sources: • eggs, shrimp

  13. Quantity of Fat …How much? • About 20-35% of your total recommended calories • limit saturated fat to 10% of calories

  14. Where do you find fat information? • Read food labels

  15. Why does the fat free product have more calories?

  16. Portion Distortion • Most Americans would lose weight by simply monitoring portion sizes • We tend to underestimate how much we have on our plate Slides marked by are adapted from “Portion Distortion” by the National Heart, Lung and Blood Institute at http://hin.nhlbi.nih.gov/portion

  17. COFFEE 20 Years Ago Coffee(with whole milk and sugar) Today Mocha Coffee(with steamed whole milk and mocha syrup) 350 calories 16 ounces 45 calories 8 ounces Calorie difference: 305 calories

  18. MUFFIN 20 Years Ago Today 210 calories 1.5 ounces 500 calories 4 ounces Calorie difference: 290 calories

  19. Portion sizes • Typical items to visualize your portions • Meats: 3 oz portion = size of deck of cards • Cheese: 1 oz = 4 dice • 1 cup = size of baseball • ¼ cup = golf ball • 1 teaspoon = a quarter

  20. Meat, Fish, Poultry • Beef/Pork: choose lean cuts like loin & round • Poultry: choose white meat without skin • Wild Game: venison, elk • Fish: aim for 2 servings/week

  21. Omega 3s • Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of — or who have — cardiovascular disease • Reduces inflammation • May improve HDL, reduce LDL, lower triglycerides • Essential to health but must be obtained from food

  22. Omega 3 Fatty Acids • Sources: • EPA & DHA sources: Fatty fish such as salmon, mackerel, lake trout, tuna, halibut • ALA sources (Plant): Flax seed, canola oil, walnuts, tofu, soybeans • Recommendation: daily

  23. Omega 3s-How Much? • Because of potential side effects and medication interaction, only take supplements under MD supervision • Maximum 3,000 mg (3 gm) total Omega 3 without MD supervision • Dosage based on amount of Omega 3, not total amount of fish oil – check label for Omega 3 amount per capsule

  24. Add Flavor in Preparation • Low fat cooking methods: • Bake, broil, grill, roast • Poach, steam, wrap (in parchment or foil) • Stir fry in low-sodium broth, wine or veg oil

  25. Add Flavor Without Fat • Spices & herbs • Rubs • Marinades • Salsas, chutneys • Fruit puree

  26. Dairy Choose: • 1% or nonfat milk • Low fat or nonfat yogurt/cream cheese/sour cream • Low fat cheese, < 3 gm fat per oz. • Sherbet, ices

  27. Added Fats • Use oils sparingly or nonfat sprays in cooking • Salad dressings: choose nonfat or light versions • Spreads (tub margarines) have less trans fats, such as: • PromiseTM • I Can’t Believe It’s Not ButterTM • Smart BalanceTM • Brummel & BrownTM

  28. Soluble Fiber • Helps lower total cholesterol and LDL • Slows rate of digestion, helps control blood sugar levels • Provides satiety • GI function

  29. Beans & Legumes • Beans: inexpensive alternative to meat 1/4 c = 1 oz meat • Cook after soaking dried beans • Canned beans OK but rinse to lower sodium  Aim for 2 cups of beans weekly

  30. Fruits and Vegetables • Soluble fiber comes from pectin • Fresh, frozen or canned produce are all OK • If canned, choose packed in juice or water •  Aim for 5-9 servings per day (1/2-cup serving)

  31. Soluble Fiber Sources & Amounts

  32. Whole Grains • Check label for word “whole” • Ways to add to diet • Try different kinds of grains  Make half your grains WHOLE, minimum of 3 servings per day

  33. Simple Sugars and Alcohol • Sugar and alcohol can raise triglycerides • Calorie dense but nutrient light • Extra calories over time can lead to weight gain • Limit “added sugar” and alcohol for special occasions

  34. Phytosterols (plant sterols) • Plant equivalent to animal cholesterol - blocks chol absorption in intestines, lowers amount in blood • Sources: vegetable oil (like corn/soybean), nuts and legumes • Fortified foods like Promise ActivTM or Benecol ChewsTM • May lower LDL cholesterol up to 15% • option in addition to diet and other lifestyle changes • Safe to use with statin medication • Must consume daily • Maximum effect – 2 gms per day

  35. Cocoa Flavanols • Type of antioxidant in cocoa & cocoa products • Higher cocoa concentration has more flavanols • LDL and blood pressure effect?

  36. Other Lifestyle Changes for Cholesterol Control • Be active at least 30 minutes per day or 150 min/week (for weight loss: 60-90 minutes) • Lose weight, if needed • Quit smoking

  37. Questions?

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