heart health nutrition - kaiser permanente

Heart Health NutritionRoseville & Sacramento Medical Centers

Health Promotion Department – Nutrition Services

2 | © 2011 Kaiser Foundation Health Plan, Inc. For internal use only.July 5, 2013

Agenda

Nutrition goals

Food labels

Cooking

Restaurant eating

Resources & class evaluations


Daily recommendations

Fiber: 25-38 grams/dayFat: 20-35% of total calories

– Women: 40-50 grams/day (28-38 g unsaturated fat)– Men: 50-60 grams/day (34-48 g unsaturated fat)– Saturated fat maximum 12-16 grams/day– Avoid trans fats

Cholesterol: 200-300 mg/daySodium: 1,500 mg/day


Nutrition goals

Less

Fat Sugar

(if high triglycerides)

Alcohol (if high triglycerides)

Sodium

MoreFruitVegetablesWhole grainsFish


Fiber

Why do we need it?

Where do we get it?

How much?


Fiber

Effects– Lowers cholesterol

Sources– Beans– Nuts– Whole grains– Fruits– Vegetables

Daily Goal: 25-38 g


How do I get my fiber?

Low fiberCorn Flakes 1 gram Shredded Wheat (1 cup)

½ banana 6 grams2 grams

Turkey sandwich on white bread 2 grams Turkey sandwich on wheat bread w/ lettuce, tomato, and cucumbers

6 grams2 grams

Flour tortilla with chicken Green salad

1 gram <1 gram

Whole wheat tortilla Black or pinto beans ( ½ cup) w/ ¼ cup avocado w/ 1 medium tomato

2 grams8 grams3 grams2 grams

Total 6 grams Total 31 Grams

Higher fiber


High fat foods and heart health

AvocadosBaconWalnutsPotato chipsSalmon

Which of these high-fat foods belong in a heart-healthy diet?


Types of fats in foods

SaturatedNaturally SaturatedHydrogenated/Trans

UnsaturatedPolyunsaturated– Omega-3 – Omega-6Monounsaturated


Saturated fat

Why do we limit it?

Where is it found?

How much is OK?


Saturated fat

Effects– Raises total cholesterol– Raises LDL cholesterol– Raises Inflammation

How much for most people?– 12-16 grams per day or less

Sources– Animal meats– Lard– Cocoa butter– Dairy fat– Palm Oil– Coconut oil– Margarine– Shortening– Hydrogenated oil


Trans fat

Why do we limit it?

Where is it found?

How much is OK?


Trans fat

Effects– Raises Total cholesterol– Raises LDL cholesterol– Raises Inflammation– Lowers HDL cholesterol

How much for most people?– As little as possible – 0 grams on the food label

Sources– Partially hydrogenated oil – Margarine– Shortening– Some processed foods– Animal meats– Dairy fat


Polyunsaturated fat

Effects– Lowers blood clots– Lowers triglycerides– Lowers inflammation– Lowers growth of plaque– Lowers arrhythmia– Lowers blood pressure (mildly)– Lowers risk of sudden death– Lowers risk of death from heart disease– Improves health of arteries

Omega-3 fatty acidsSources

– Fish– Flaxseed (ground, goal- up to

2 Tbsp/day)– Walnuts– Soybeans– Wheat germ– Canola oil


Polyunsaturated fat

Effects– Lowers total cholesterol– Lowers LDL cholesterol

Sources– Safflower oil– Soybean oil– Sunflower oil– Sesame oil– Corn oil– Cottonseed oil

Omega-6 fatty acids


Monounsaturated fat

Effects– Lowers total cholesterol– Lowers LDL cholesterol

Sources– Olive oil– Canola oil– Peanut oil– Olives– Nuts– Peanut butter– Avocados


Fats- Comparing similar breakfasts


Nutrition facts- Amount per serving


CholesterolWhat is it?

– Soft waxy substance

Why do we limit it? – Large amounts may increase blood cholesterol

Where is it found? – All foods from animals

How much is okay? – Limit to 200-300 mg per day


Sodium

Why do we limit it?– Lowers blood pressure– Reduces fluid retention

Where is it found?– Processed foods – Restaurant foods– Salt shaker

How much is OK?– 1,500 mg/day or less


High sodium day (4,004 mg)Breakfast: 3 slices bacon (303 mg) 2 fried eggs (324 mg) 2 slices whole wheat toast (296 mg)Total breakfast: 923 mg

Lunch: Fast food cheeseburger (750 mg)Large french fries (200 mg)16 oz Coke (18 mg) Total lunch: 968 mg

Dinner: 3 ½ oz chicken breast (roasted, without skin) (77 mg) 1 cup Rice-a-Roni (1,680 mg) 1 cup canned green beans (356 mg) Total dinner: 2,113 mg


Low sodium day (1,338 mg)Breakfast: 3 slices bacon (303 mg) 1 banana (1 mg)2 fried eggs (324 mg) 1 poached egg (280 mg)2 slices whole wheat toast (296 mg) Total breakfast: 923 mg 577 mg

Lunch: fast food cheeseburger (750 mg) Fast food hamburger (500 mg)large french fries (200 mg) Side salad (85 mg) with light vinaigrette (75 mg) 16 oz Coke (18 mg) Iced tea (0 mg)Total lunch: 968 mg 660 mg

Dinner: 3 ½ oz chicken breast (roasted, without skin) (77 mg) 1 cup Rice-a-Roni (1680 mg) 1 cup brown rice (20 mg)1 cup canned green beans (356 mg) 1 cup cooked green beans (fresh or frozen) (4 mg)Total dinner: 2,113 mg 101 mg


DASH diet

Dietary

Approaches to

Stop

Hypertension


Nutrition FactsServing Size 1 packet (45g) Servings per container 8Amount Per servingCalories 160 Calories from Fat 15

% Daily Value*Total Fat 2g 3%

Saturated Fat 0g 0%Trans Fat 0g 0%Polyunsaturated Fat 0.5g 0%Monounsaturated Fat 0.5g 0%

Cholesterol 0mg 0%Sodium 260 mg 11%Total Carbohydrate 34g 11%

Dietary Fiber 10g 40%Sugars 7g

Protein 4g

Vitamin A 360% · Vitamin C 8% · Calcium 2% · Iron 0%

*Percent Daily Values are based on the 2,000 calorie diet. Your daily value may be higher or lower depending on your calorie needs.

Calories: 2,000 2,500

Total Fat Less than 65g 80gSat. Fat Less than 20g 25g

Cholesterol Less than 300mg 300mgSodium Less than 2,400mg 2,400mgTotal Carbohydrate Less than 300mg 375mg

Dietary Fiber Less than 25g 30g

Calories per gram: Fat 9 - Carbohydrate 4 - Protein 4

Ingredients: whole grain rolled oats, maltodextrin, sugar, salt, natural and artificial

flavors, calcium carbonate, guar gum, oat flour, caramel color, sucralose, niacinamide, reduced iron, vitamin A palmitate, pyridoxine

hydrochloride…

% Daily Value Goals

Fat <5%

Saturated Fat <5%

Trans Fat 0%

Cholesterol <5%

Sodium <10%

Dietary Fiber >10%

Consider the following per serving

Total fat: 3 g or less

Trans Fat 0g

Sodium: 140 mg or less

Dietary Fiber: 3g or more

Added Sugar :<10 g per serving


Daily food log


American dietary guidelines


Options for nutritional changes

Change amount

Change how often

Find another food

Change preparation


Tips for eating out

Check the nutrition facts at the restaurant

What tips do you have?


Exercise

Exercise lowers LDL & triglycerides, and increases HDL Recommend 30 minutes or more per daySet small, do-able goals each weekTry the “talk test”Make it fun


Resources

Calorie King http://www.calorieking.comHealth Education Centers

– Plant-Based Nutrition by Julianna Hever– Healthy Living classes and resources catalog

kp.org/nutrition

MegaHeart.com For help with low sodium diet and recipes

Nutrition Advice Line 916-614-4979


www.kp.org

E-mail your doctorOrder prescription refills (mailed to your home at no additional cost)Schedule routine appointmentsView most lab test resultsExplore interactive health programs and research health topicsTo sign up, visit kp.org/registerHave questions? Call (800) 556-7677 for kp.org telephone support


Cancer screening

If you are not sure you are due for any of the above screenings, check with your provider.

AGE 18+ 30 40 50 60 70 80+

Breast Cancer ScreeningFor women: ages 40 – 69

Walk-in mammograms are available at North Valley Radiology.

Have a mammogram every 2 years.

Cervical Cancer ScreeningFor women: ages 21-64

Sign into kp.org to schedule an appointment for a Pap test.

Have a Pap test every 3 years.

Colorectal Cancer ScreeningAges 50 – 80

Sign into kp.org and email your doctor to order a FIT test, flexible sigmoidoscopy or colonoscopy.

Have a fecal immunochemical test (FIT) once a year and/or a flexible sigmoidoscopy every 5 years or colonoscopy every 10 years.

heart health nutrition - kaiser permanente

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