Nutrition and Coronary Heart Disease & Hypertension

Symptoms

&

Principles of Diet

By Chris Kokkola

Coronary Heart Disease(Coronary Artery Disease)

Signs and Symptoms

• Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms.

• Chest pain or discomfort

• It may feel heavy or like someone is squeezing your heart. You feel it under your breast bone (sternum), but also in your neck, arms, stomach, or upper back.

• The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.

• Other symptoms include shortness of breath and fatigue with activity (exertion).

What Are Angina And Coronary Artery Disease Symptoms in women?

Signs and Symptoms in Women

Can be different in women:

• Fatigue

• Shortness of breath

• Weakness

• Flu like symptoms

Diet For Coronary Heart Disease

• FRUITS AND VEGETABLES: 5 of more servings

• GRAINS: 6 or more servings

• Healthy Protein: Eat no more than 6 cooked ounces of meat, poultry, and fish daily.

• FATS, OILS, AND CHOLESTEROl

Definitions of Serving Size• Meat:

– about the size of a deck of cards

• Fruits Serving Sizes– 1/2 banana

1 small apple, orange, or pear1/2 cup of chopped, cooked, or canned fruit

• Vegetables Serving Sizes– 1 cup of raw leafy vegetables

1/2 cup of other vegetables; cooked, raw (chopped), or canned1/2 cup of vegetable juice

• Bread, Cereal, Rice, Starchy Vegetables, and Pasta Serving Sizes– 1 slice of bread

1/2 bun, small bagel, or pita bread1 6-inch tortilla4-6 crackers2 rice cakes1 ounce ready-to-eat cereal1/2 cup cooked cereal, pasta, or bulgur1/3 cup cooked rice1 small potato or 1/2 large potato1/2 cup sweet potatoes or yams1/2 cup corn kernels or other starchy vegetables such as winter squash, peas, or lima beans

• Milk and Yogurt Serving Sizes– 1 cup of low-fat milk

1 cup of low-fat yogurt (unsweetened or sweetened with aspartame or other artificial sweeteners)

Wet1 cup= 240 mL1 ounce= 28 g

Dry½ cup= 150 g

FRUITS AND VEGETABLES: 5 of more servings

• Most fruits and vegetables are part of a heart-healthy diet. They are good sources of fiber, vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol.

GRAINS: 6 or more servings

Eat low-fat breads, cereals, crackers, rice,

pasta, and starchy vegetables (such as peas,

potatoes, corn, winter squash, and lima

beans). These foods are high in the B

Vitamins, iron, and fiber. They are also low

in fat and cholesterol.

Include whole grains. Grain products

provide fiber, vitamins, minerals, and

complex carbohydrates. Be careful about

eating too many grains, however.

Avoid baked goods such as butter rolls,

cheese crackers, and croissants, cream

sauces for pasta and vegetables, and cream

soups.

HEALTHY PROTEIN

• Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, B vitamins, iron, and other vitamins and minerals.

• Eat no more than 6 cooked ounces of meat, poultry, and fish daily.

Dos of eating Protein

• Trim off all the visible fat before cooking the meat.

• Eat two servings of fish per week.

• Cook by baking, broiling, roasting, steaming, boiling, or microwaving rather than deep frying.

• For the main entree, use less meat or have meatless meals a few times a week. Use smaller amounts of meat to reduce the total fat content of the meal.

• Use skinless turkey, chicken, fish, or lean red meat to reduce the amount of saturated fat in your diet. You may occasionally eat lean, 3-ounce cuts of red meat.

• Milk and other dairy products are good sources of protein, calcium, the B vitamins niacin and riboflavin, and vitamins A and D. Use skim or 1% milk. Cheese, yogurt, and buttermilk should be low-fat or non-fat.

Cautions of Eating Proteins

• Avoid duck, goose, marbled meats (such as a ribeye steak), prime cuts of high-fat meats, organ meats such as kidneys and liver, and prepared meats such as sausage, hot dogs, and high fat lunch meats.

• Do not use more than three or four egg yolks per week, including the eggs you use in cooking.

• Eat less organ meat (such as liver) and shellfish (such as shrimp and lobster)

FATS, OILS, AND CHOLESTEROl

• Limit total fat intake to 25 - 35% of your total daily calories. Keep saturated fats to only 10% of your total daily calories.

• Foods with a lot of saturated fats are animal products such as butter, cheese, whole milk, ice cream, sour cream, lard, and fatty meats such as bacon.

• Some vegetable oils (coconut, palm, and palm kernal oils) also contain saturated fats. These fats are solid at room temperature.

• Use no more than 5 - 8 teaspoons of fats or oils per day for salads, cooking, and baking.

• Eat less than 300 mg of dietary cholesterol each day. (One egg yolk contains an average of 213 mg of cholesterol.)

• Some fats are better choices than others, but you should still use them in moderate amounts.

Other tips on Fats, Oils and Cholesterol

• Think about the following when picking a margarine:

• Choose soft margarine (tub or liquid) over harder stick forms.

• Choose margarines with liquid vegetable oil as the first ingredient. Even better, choose "light" margarines that list water as the first ingredient. These are even lower in saturated fat.

• Avoid hydrogenated and partially hydrogenated fats (read the ingredient labels).

• Trans fatty acids are unhealthy fats that form when vegetable oil hardens in a process called hydrogenation. They are often used to keep foods fresh for a long time, and for cooking in fast food restaurants.

• Trans fats can raise LDL ("bad") cholesterol levels in your blood. They can also lower your HDL ("good") cholesterol levels.

• Avoid fried foods, commercial baked goods (donuts, cookies, and crackers), processed foods, and hard margarines.

Signs and Symptoms of Hypertension

• Most of the time, there are no symptoms. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere.

• Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure.

• If you have a severe headache, nausea or vomiting, bad headache, confusion, changes in your vision, or nosebleeds you may have a severe and dangerous form of high blood pressure called malignant hypertension.

You have your diagnosis:What now?

Aim to eat a diet that's rich in:

• Fruits• Vegetables• Whole-grain, high-fiber foods• Fat-free and low-fat (1 percent) dairy products• Beans• Skinless poultry and lean meats• Fish, especially fatty fish contain omega 3 fatty acids such as salmon, trout and herring (eat at

least twice a week)

...And low in:

• Saturated and trans fats• Sodium

And limit:

• Added sugars• Be sure to work with the chefs in your household and plan together for any dietary changes that

are needed. When dining out, look for healthy options.

The D.A.S.H. eating plan

• contains less:

• Red meat

• Sodium (salt)

• Sweets, added sugars and sugar-containing beverages

Daily Nutrient Goals Used in the DASH Studies (for a 2,100 Calorie Eating Plan)

• Total fat 27% of calories Sodium 2,300 mg*

• Saturated fat 6% of calories Potassium 4,700 mg

• Protein 18% of calories Calcium 1,250 mg

• Carbohydrate 55% of calories Magnesium 500 mg

• Cholesterol 150 mg Fiber 30 g

Following the DASH Eating Plan

References

• Slides 3 and 5:

http://www.nlm.nih.gov/medlineplus/ency/article/007115.htm

• Coronary Heart Disease:

http://www.youtube.com/watch?v=G6df_vvaszc

• What Are Angina And Coronary Artery Disease Symptoms in women? http://www.youtube.com/watch?v=IU14rhjly-M

• Slides 6, 8-14 :

http://www.nlm.nih.gov/medlineplus/ency/article/002436.htm

• Serving Size:

http://diabetes.webmd.com/understanding-serving-sizes

• Slide 15:

http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm

• You have your diagnosis: What now?

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Managing-Blood-Pressure-with-a-Heart-Healthy-Diet_UCM_301879_Article.jsp

• Daily Nutrient Goals Used in the DASH Studies (for a 2,100 Calorie Eating Plan) and Following the Dash eating Plan:

http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf