The Red Dress Campaign:
“A Heart Healthy Lifestyle”
Tanya Williams, MS, RD, LDN
Bucknell University
February 5, 2008
The Facts
1. Women don't take their risk of
heart disease seriously—or
personally.
2. Women often fail to make the
connection between risk
factors* and their own chance
of developing heart disease.
–
HIGH blood pressure*
–
HIGH cholesterol*
–
Being Overweight or Obese*
–
Diabetes*
3. Heart disease is the # 1 killer
of American women.
Risk Factors
Associated with Heart Disease
1. Genetics
2. Weight
•
•
3.
4.
5.
6.
Overweight
Obese
Smoking
Diet
Inactivity
Excessive Etoh
“The Steps”
For a Heart Healthy Lifestyle
1. Eat less
• Cholesterol
• Saturated fat
• Trans fat
• Sodium
2. Eat more
• Fiber
• Soy-based products
“The Steps”
For a Heart Healthy Lifestyle
3. Reduce your weight
4. Increase physical
activity level
5. Learn to
• Shop smart
• Cook smart
• Dine out more healthy
ATP III Classifications/Guidelines
Test
Level
Health Impression
Total
Cholesterol
<200 mg/dl
200-239 mg/dl
>240 mg/dl
Desirable
Borderline High
High
<100 mg/dl
100-129 mg/dl
130-159 mg/dl
160-189 mg/dl
>190 mg/dl
Optimal
Near Optimal
Borderline High
High
Very High
<40 mg/dl
>60 mg/dl
Low
High
<150 mg/dl
150-199 mg/dl
200-499 mg/dl
>500 mg/dl
Normal
Borderline High
High
Very High
≥ 140 mm Hg (systolic BP)
≥ 90 mm Hg (diastolic BP)
High
High
LDL
Cholesterol
HDL
Cholesterol
Triglycerides
Blood Pressure
Step # 1
“Lowering Cholesterol & LDL Levels”
• Eat less fat.
– Avoid fried foods, fatty meats, &
whole milk products.
• Eat less cholesterol.
– Cholesterol is found only in foods
from animals (foods from plants
contain no cholesterol).
Step # 1
“Lowering Cholesterol & LDL levels”
• Eat less saturated fat.
– Saturated fats are
usually found in animal
products.
– However you should avoid
coconut, palm, and palm
kernel oil as they are high
in saturated fat.
Step # 1
“Lowering Cholesterol & LDL levels”
• Use less hydrogenated or partially
hydrogenated fats.
– Select tub or liquid margarine vs. stick
margarine.
• Consider adding specialty spreads.
– Benecol or Take Control are made from plants
and have been shown to help lower
cholesterol.*
*Talk with a dietitian about adding these products.
Step # 1
“Lowering Trigylcerides”
• Avoid Alcohol.
– Beer, wine, or hard liquor.
• Avoid Sugar.
– Candy & regular soda.
• Eat Fewer Carbohydrates.
– Breads, cereals, rice, pasta, fruits, &
dairy products.
What is Trans Fat?
• Also known as Trans fatty acids.
• Type of fat formed when liquid oils are made into
solid fats (process called hydrogenation).
– Shortening
– Hard margarine
• Trans fat can be found naturally, in small amounts,
in some animal-based foods.
• Trans fats are in packaged cookies, crackers,
other baked goods, commercially prepared fried
foods, chips, doughnuts, some margarines & most
shortenings.
Why is it Bad?
• Trans fat is as bad for
you as saturated fat.
• It has been shown to
– raise LDL levels
– lower HDL levels
– increase your risk for
heart disease
Step # 1
“Lowering Trans Fat”
1.
Choose liquid or soft tub
margarines & use in moderation.
•
•
1 gm saturate fat/serving
First ingredient should read “liquid
vegetable oil”
2. Use olive or canola oil (natural, unhydrogenated oils).
3. Look for processed foods that use
un-hydrogenated oils.
4. Limit intake of foods high in transfat (see pictures).
Step # 1
“Decrease Sodium (Salt) Intake”
• Eating a diet high in sodium (salt)
can increase blood pressure.
– Canned foods, dried meats or fish,
packaged foods, frozen meals, lunch
meats, salad dressings, marinades, and
any salted food item (i.e. pretzels)
• Having a normal blood pressure
reduces the risk of heart disease.
– Talk to a dietitian about a low salt diet
plan.
– Talk to a dietitian about the DASH
diet.
Step # 2
“Increase Soluble Fiber Intake”
• The type of fiber found in
oats, barley, dry beans &
peas, fruits & vegetables
may help to lower
cholesterol levels.
– Choose 5 or more servings of
vegetables & fruits/day.
– Choose 6 or more servings of
whole grain breads, cereals,
pasta, rice, & dry beans/day.
Step # 2
“Increase Soy Intake”
• Soy protein has been
shown to reduce the risk
of heart disease.
• Add soy to your diet.
– Tofu, soynuts, soymilk, or
other whole soy products.
– Don’t count on powdered soy
drinks as a good source of
soy protein.
“Heart Healthy” Diet Recommendations
Nutrient
Recommended Intake
Calories
Reduction of 500 to 1000 kcals/day
Total Fat*
30% or less of total kcals/day
Saturated Fat*
8 to 10% of total kcals/day
Monounsaturated Fat
Up to 15% of total kcals/day
Polyunsaturated Fat
Up to 10% total kcals/day
Cholesterol
200 to <300 mg/day
Protein
15% of total kcals/day
Carbohydrates
55% or more of total kcals/day
Sodium
2.0 mg to 4.0 mg/day
Calcium
1,000 to 1,200 mg/day
Fiber
20 to 35 gm/day
Soy
~ 35 gm/day
*Total Fat/day = 40-60 gm/day **Saturated fat/day = 10-15 gm/day
The Benefits of Weight Loss
What is Ideal Body Weight (IBW)?
• “A term describing the weight that
people are expected to weigh based on
age, sex and height.”
• “A recommended weight for
individuals as provided in the
Suggested Weights for Adults chart
published periodically by the USDA
and US Health and Human Services
Department.”
• “The weight appropriate for an
individual that results in a body mass
index of 20-25. “
What Does it Mean to Your Health?
• Being underweight can also lead to health
conditions such as:
– Anemia, heart problems, and chronic fatigue
– An obsession with weight loss may also lead to
eating disorders and nutritional deficiencies
that may be life threatening
• People who are overweight are at increased
health risk for diseases including:
– Heart disease, diabetes, stroke, osteoarthritis,
gallbladder disease, gout, and certain types of
cancer.
What is Body Mass Index (BMI)?
• “A measure to
determine the amount
of body fat and amount
of lean body mass. “
• “The number, derived by
using height and weight
measurements, that
gives a general
indication if weight falls
within a healthy range.”
BMI Class
Value
(Kg/m2)
Underweight
< 18.5
Normal
Weight
18.5-24.9
Overweight
25.0-29.9
Obese I
30.0-34.9
Obese II
35-39.9
Obese III
≥ 40.0
Health Risks of Obesity
What is a Waist Circumference?
“A measurement
of the waist. “
What Does it Mean to Your Health?
• Fat around the waist increases the risk of
obesity-related health problems.
• Women with a waist measurement of more
than 35 inches have a higher risk of
developing obesity-related health
problems.
– Diabetes, high blood pressure, & heart
disease.
Step # 3
“Reduce Your Weight”
• If you are overweight or
obese, a 10% reduction in
BWT may help to…
–
–
–
–
–
–
Lower Blood pressure
Lower Cholesterol level
Lower Triglyceride level
Lower Blood Sugar Levels
Improve overall health
Lower risk of heart disease
Calculating Kcals
“The Short Method”
Sedentary
Lose
Weight
Maintain
Weight
Gain
Weight
15 kcals/kg
Moderately
Very
Active
Active
20 kcals/kg 25 kcals/kg
20 kcals/kg 25 kcals/kg 30 kcals/kg
25 kcals/kg 30 kcals/kg 35 kcals/kg
*Pounds (lbs) can be converted into kilograms (kg) by dividing lb value by 2.2.
**To lose 1 pound of body weight in 1 week, you must reduce your intake by 500 calories each day.
**To lose 2 pounds of body weight in 1 week, you must reduce your intake by 1000 calories each day.
Convert Calories into Meal Patterns
• 1200 kcals/day
– 2 D, 2 Fr, 6 Gr, 4 M, 3 V, & 2 F
• 1400 kcals/day
–
2 D, 2 Fr, 7 Gr, 5 M, 2 V, & 3 F
• 1600 kcals/day
– 3 D, 2 Fr, 9 Gr, 5 M, 3 V, & 3 F
• 1800 kcals/day
– 3D, 3 Fr, 9 Gr, 6 M, 3 V, & 4 F
• 2000 kcals/day
– 3 D, 3 Fr, 10 Gr, 7 M, 3 V, & 4 F
• 2200 kcals/day
– 3 D, 3 Fr, 12 Gr, 7 M, 3 V, & 5 F
D
dairy
Fr fruit
Gr grain
M meat
V vegs
F
fat
*All kcals associated with
meal patterns above are
based on correct portion
size/serving consumed.
What Counts as a Portion?
Food Group
Serving Size
Grain
1 slice of bread, ½ small bagel, 1 oz. cold cereal,
½ cup cooked cereal, or 4 small crackers
Vegetable
1 cup raw, leafy vegs, ¾ cup veg juice, or ½ cup
other vegs chopped, cooked or raw.
Fruit
1 medium whole fruit, ½ cup chopped, cooked or
canned, or ¾ cup juice.
Dairy
1 cup of milk or yogurt, 1 ½ oz. natural cheese,
or 2 oz. processed cheese.
2-3 oz. cooked lean meat, ½ cup cooked dry
Meat &
beans, 1 egg, or 2 T. peanut butter.
Meat Substitutes
1 tsp. butter or margarine, 2 T. dry non-dairy
Fat
creamer, 1 tsp. oil, or 4 T. whipped topping.
“Guesstimated” Portion Sizes
• 1 cup of potatoes, rice, or
pasta is equal to the amount
that would fit into a tea cup
or the size of a tennis ball.
• Bagels should be the size of
a to-go coffee lid.
“Guesstimated” Portion Sizes
• Whole fruits should be
about the size of a tennis
ball.
–
–
–
–
apples
oranges
peaches
pears
• Bananas should be the size
of a dollar bill.
“Guesstimated” Portion Sizes
• Fresh veggies
should be
measured by “the
½ cup” and should
look like 3 ice
cubes.
“Guesstimated” Portion Sizes
• A serving of cheese
is equal to a tube of
lipstick or if sliced,
a 3.5 inch computer
disk.
“Guesstimated” Portion Sizes
• Meats should be
between 2-3oz.
servings or the size
of a palm of a
woman’s hand, or a
deck of cards.
“Guesstimated” Portion Sizes
• 3 oz. serving of
chicken or turkey
with the bone
equals:
– 2 thighs
– 2 drumsticks
– 1 drumstick & 1 thigh
“Guesstimated” Portion Sizes
• 2 T. of peanut
butter should be
the size of a golf
ball.
“Guesstimated” Portion Sizes
• 1 tsp of butter
equals the foilwrapped restaurant
type (1 package).
• 1 tsp. of oil is the
correct serving
size.
What Counts as a Portion/Serving?
Alcohol Serving Recommended # of
Drinks/day
Type
Size
Beer
12 oz.
Females = 1 drink/day*
Males = 2 drinks/day*
Wine
5 oz.
Same as above
Hard
Liquor
1.5 oz.
Same as above
Note: 4 or more drinks/setting is considered “binge” drinking
for females. 5 or more drinks/setting is considered “binge”
drinking for males.
Step # 4
“Increase Physical Activity & Raise HDL level”
• Regular physical activity
– Reduces your risk of heart
disease
– Aids in weight loss
• How do you do it?
– Talk with your doctor before you
start a formal program.
– Begin slowly.
– Choose an activity you like.
– Meet with an exercise professional.
– Goal: at least 30 minutes or more of
moderate activity, most days of the
week.
Step # 5
“Shop Smart”
1.
Shop the “outside” aisles of the
grocery store, they contain
healthier food choices.
2. Avoid the middle aisles, they
contained processed/high calorie
products.
3. Choose fresh fruits, vegetables,
milk, breads, and meats.
4. Read food labels.
Food Labels
“The Healthy Eater’s Guide”
•
•
•
•
•
•
•
•
•
•
•
•
•
Indicate portion size
Servings per container
Amount of Calories/serving
Amount of CHO/serving
Amount of Fat/serving
Amount of Saturated Fat/serving
Amount of Trans Fat/serving
Amount of Cholesterol/serving
Amount of Sugar/serving
Amount of Sodium/serving
Amount of Fiber/serving
Amount of Protein/serving
Amount of Vit & Min/serving
Step #5
“Cook Smart”
1. Sauté vegetables in a non-stick pan.
2. Use non-stick spray or broth instead of butter or
oil.
3. Use egg whites or cholesterol-free egg substitutes
to replace eggs.
4. Use skim milk to replace whole or 2% milk.
5. Use unsaturated oils and liquid margarine to replace
butter.
6. Use herbs, spices, flavored vinegars, lemon juice, or
fat-free/salt-free condiments to add flavor to
foods.
Step # 5
“Dine Out Smart”
1.
Split an entrée, or eat half and take the rest
home.
2. Order baked, broiled, or grilled food.
3. Avoid breaded, fried, or creamed foods.
4. Ask for gravy, sauce, butter, and salad
dressing on the side.
5. Limit fast food to 1x/week.
6. Ask a dietitian for a meal plan to be followed
when eating out.
Interested
in learning
more?
“On Campus”
Contact Information
Tanya Williams, MS, RD, LDN
Clinical Nutritionist
577-1401 (SHS desk)
tlw014@bucknell.edu
By appointment only
Hours available Monday-Friday*
Note: Not all Fridays are available
“Off Campus”
Contact Information
Tanya Williams, MS, RD, LDN
Kelly Hoffheins RD, LDN
Market Street Counseling
424 ½ Market Street
Lewisburg, PA
523-1212 or 745-3776
asktanyard@gmail.com
askkellyrd@gmail.com
Happy Birthday Roz!