"Red Wine and Dark Chocolate"
February 6, 2014
Sharon Smalling, MPH, RD, LD
Clinical Dietitian Specialist
Memorial Hermann Hospital Texas Medical Center
HEART HEALTH:
EMERGING
TOPICS!
Let the Guidelines Begin!
The 2013 AHA/ACC Lifestyle Guidelines are Released
This paper outlines the best diet pattern for preventing
and reducing cardiovascular risk
Reference:
Eckel, Robert, et al. 2013 AHA/ACC Guideline on Lifestyle Management to
Reduce Cardiovascular Risk. Circulation. Published online November 12,
2013; accessed online November 13, 2013.
http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740
.48606.d1
Today’s topics
• Consume the DASH dietary pattern for
positive effects on cardiovascular health
• Lower sodium intake
• Aim for saturated fat <6% of total calories
• Avoid trans fats from processed foods
Today’s topics
• Consume the DASH dietary pattern for
positive effects on cardiovascular health
• Lower sodium intake
• Aim for saturated fat <6% of total calories
• Avoid trans fats from processed foods
Dash to get on the DASH diet!
Although the DASH and Mediterranean
diets are similar, the DASH diet was
voted #1 by a distinguished group
of nutrition experts
Szokan, Nancy. The best diets according to US News and World Report; The
Washington Post; Jan 6, 2014; accessed online Jan 7, 2014.
http://www.washingtonpost.com/national/health-science/the-best-dietsaccording-to-us-news-and-world-report/2014/01/06/4dc78d12-7262-11e39389-09ef9944065e_story.html
Basic idea of DASH, as described
by the panel of experts…
“Emphasize the foods you’ve always been told
to eat (fruits, veggies, whole grains, lean
protein, and low-fat dairy), while shunning
those we’ve grown to love (calorie- and fatladen sweets and red meat). Top it all off by
cutting back on salt, and voilà!”
What is the DASH Diet?
• The Dietary Approaches to Stop Hypertension Diet is a
well balanced, nutritious eating pattern that incorporates
a variety of foods for cardiovascular health
• Here we will look at the servings given for a 2000 calorie
diet
To lose weight, eat one fewer servings of grains, meat, fruit,
and fat, and limit sweets/added sugars to 3 servings per week
What is the DASH Eating Plan? National Heart, Lung, and Blood Institute;
July 2, 2012; accessed online Jan 7, 2014.
http://www.nhlbi.nih.gov/health/health-topics/topics/dash/
Whole Grains
• Choose 6-8 servings of grains, especially whole
grains
– Whole wheat bread, whole grain pasta, brown rice,
oats, crackers, and cereal
• What’s a serving?
– 1 slice bread
– ½ cup pasta, rice, or hot cereal
– 1 oz crackers or dry cereal (about ¾ cup)
Fruits
• Choose 4 servings of fruit – in any form
– Fresh fruit
– Unsweetened frozen, canned, or dried fruit
– Fruit juice
Choose whole fruit more often than juice for fewer calories and
sugar, and more fiber
• What’s a serving?
–
–
–
–
1 medium fruit
½ cup cut-up fresh, canned, or frozen fruit
¼ cup dried fruit
½ cup fruit juice
Vegetables
• Choose 4 servings of vegetables in any form
– Fresh, frozen, canned, or dried vegetables
Check the label for sodium content
– Vegetable juice
Like fruit, choose whole vegetables more often than juice for fewer
calories, sodium and sugar, and more fiber
• What’s a serving?
– 1 cup raw leafy vegetables
– ½ cup cut-up raw or cooked vegetables
– ½ cup vegetable juice
Low Fat or Fat-Free Dairy
• Choose 3 servings of low fat or fat-free dairy foods
– Low fat (1% or 2%) milk, skim milk, or dairy-free
milk
– Light or fat-free yogurt
– Reduced-fat cheese, cheese made with 2% milk
• What’s a serving?
– 1 cup milk
– 1 cup yogurt
– 1 ½ oz cheese
Meat, Poultry, and Fish
• Choose 6 ounces or less of lean meat, poultry, and
fish
–
–
–
–
Broiled pork chop/trimmed steak
Baked skinless chicken or turkey breast
Grilled fish or tuna packed in water
Egg
• What’s a serving?
– 3 ounces meat, poultry, or fish
– 1 egg (limit yolk to 4 per week)
Nuts, Seeds, and Dried Beans
• Choose nuts, seeds, and dried beans/peas 4-5 times
a week
– Almonds, walnuts, pistachios, pecans, peanuts
– Pumpkin seeds, sunflower seeds, chia seeds
– Black beans, chickpeas, kidney beans
• What’s a serving?
– ⅓ cup nuts
– 2 Tbsp seeds
– ½ cup beans/peas
Heart-healthy Fats & Oils
• Choose 2-3 servings of heart-healthy fats and
oils to cook and flavor food
• What’s a serving?
– 1 tsp vegetable oil
– 1 tsp tub spread/margarine
– 2 Tbsp light salad dressing
What about the other stuff?
Enjoy SPARINGLY…
So…what should I eat for
breakfast?
Breakfast
• 1 cup quick-cooking oatmeal
– 1 tsp cinnamon
– ½ tsp Splenda® brown sugar blend
– ¼ cup raisins
– ⅓ cup chopped walnuts
• 1 cup fat-free milk
Lunch
• Turkey sandwich:
– 2 slices 100% whole wheat bread
– 3 oz low sodium turkey lunchmeat
– green leaf lettuce/tomato & cucumber slices
– 1 ½ oz low fat Swiss cheese
– 1 Tbsp light mayonnaise
• 1 cup grapes
Snack
• Morning snack:
– ½ cup baby carrots
(approximately 5)
– 16 almond crackers
• Afternoon snack
– 5.3 oz container non-fat Greek
yogurt
– ½ cup unsweetened peaches
Dinner
• Spaghetti
– 1 cup whole grain spaghetti noodles with ½ cup
“heart healthy” spaghetti sauce
– 3 oz lean ground beef (90/10)
– 2 Tbsp grated Parmesan cheese, reduced-fat
• Tossed salad
– 1 ½ cup lettuce & assorted vegetables
– 2 Tbsp reduced-fat French dressing
• ½ cup strawberries
Today’s topics
• Consume the DASH dietary pattern for
positive effects on cardiovascular health
• Lower sodium intake
• Aim for saturated fat <6% of total calories
• Avoid trans fats from processed foods
Different Strategies, Same Goal:
Lower Sodium
• Consume no more than 2,400 mg per day
• For those with high blood pressure, aim for
1,500 mg per day
• Reducing sodium intake by 1,000 mg daily will have
positive effects on blood pressure, even if intake is
still above 1,500 or 2,400 mg
Reducing Sodium
• Reducing your sodium
intake by 1,000 mg doesn’t
have to take a lot of work,
just make some easy
substitutions!
See if you can pick out the winner…
Round 1: Breakfast
1 packet of apple
cinnamon
flavored instant
oatmeal
versus
versus
Quick-cooking oats
with raisins, walnuts,
cinnamon, and
brown sugar blend
Round 2: Lunch
Sandwich with
2 ounces of
ham
versus
versus
Sandwich with
2 ounces premade tuna salad
from a pouch
Round 3: Snack
Cheddar cheese
and 10 saltine
crackers
versus
versus
Reduced-fat cheese
and 16 almond
crackers
Round 4: Dinner
¼ teaspoon
Creole seasoning
versus
versus
1 Tablespoon of your
own spice blend
(garlic, paprika,
pepper, etc.)
Go for the
•
Apple cinnamon
flavored instant
oatmeal
• Ham sandwich
• Cheese and crackers
• Creole-seasoned
chicken
and save 1000 mg!
•
Quick-cooking oats with
cinnamon, raisins, walnuts,
and brown sugar blend
• Sandwich with tuna salad
from a pouch
• Low fat cheese and lower
sodium crackers
• DIY-seasoned chicken
Today’s topics
• Consume the DASH dietary pattern for
positive effects on cardiovascular health
• Lower sodium intake
• Aim for saturated fat <6% of total calories
• Avoid trans fats from processed foods
Saturated Fat
Reduce percent of calories from saturated fat to
<6%
• In a 2000 calorie diet, that’s 13 grams total
• We talk a lot about limiting foods like high fat
meats, whole milk and cheese, and butter
Where are the rest of the saturated fats we eat?
Saturated Fat
Here are some other sources of saturated
fat to watch out for:
• Microwave popcorn
• Some peanut
butters/Nutella
• Baked goods
• Non-dairy creamers
• Ramen noodles
• Granola bars
• Chips – even bagel
crisps and veggie
chips
Saturated Fat
Here are some other sources of saturated
fat to watch out for:
• Microwave popcorn
3 c = 2.3gm
• Some peanut
butters/Nutella
2T =3+ gm
• Baked goods
2.5 gm
• Non-dairy creamers
1T = 2 gm
• Ramen noodles
1 pkt = 6.6 gm
• Granola bars
choc chip = 3.2 gm
• Chips –
bagel crisps
6 = 1.9 gm
veggie chips
1 oz = .5 gm
Today’s topics
• Consume the DASH dietary pattern for
positive effects on cardiovascular health
• Lower sodium intake
• Aim for saturated fat <6% of total calories
• Avoid trans fats from processed foods
Trans Fat
• 2005 Guideline: keep trans fat consumption as low as possible
• 2010 Guideline: avoid consumption from processed foods; limit to <.5% of
total calories consumed from natural sources; in a 2000 calorie diet this
equals 1-2 gm per day
• AHA/ACC Lifestyle Guideline: reduce consumption of trans fat in the diet
• Sources:
– Natural: milk, beef, goat, deer, buffalo
Reducing intake of saturated fat from meat and dairy will result in
lower trans fat intake
– Commercial: fried and baked foods; stick margarines; foods containing
partially hydrogenated vegetable oils
NOTE: A nutrition label may state “0” gm trans fat as long as a serving
contains <.5gm.
Our Quote for the Night…
“More than ever it’s time to
embrace the idea that eating
basic healthy foods throughout
the day is key to a strong immune
system, long-term health, and
energy to live the life you want to
live.”
Smart Bytes® Nutrition Blog
www.karencollins.com/smartbytes
heart.memorialhermann.org/heart-healthy-diets