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Nutrition
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Nutrition: Reduce Risk of Heart Disease  
Eating a nutritious, well-balanced diet offers one of the simplest, most effective ways of reducing your risk of heart disease, cancer, and other health problems. Good nutrition means eating a variety of foods, moderating your intake of certain foods and drinks, and controlling the amount of food and calories you eat. A balanced diet can help you reduce your risk of heart disease by lowering your cholesterol and blood pressure, as well as by helping you to lose weight. 

Food and Nutrients

Your body needs nutrients to work properly. The nutrients you need include carbohydrates, proteins, fats, vitamins, and minerals. Your body gets these nutrients from the foods you eat.

In the news . . .  2014 — "Best Diets"

US News & World Report Publishes Annual Best Diets Report
U.S. News evaluated and ranked 32 diets. To be top-rated, a diet had to be relatively easy to follow, nutritious, safe, and effective for weight loss and against diabetes and heart disease. The government-endorsed Dietary Approaches to Stop Hypertension (DASH) snagged the top spot. Ranked #2, Therapeutic Lifestyle Changes, or TLC, is a very solid diet plan created by the National Institutes of Health. It has no major weaknesses, and it's particularly good at promoting cardiovascular health. Read the full report.

      
The news is always filled with stories about diet and nutrition, making it hard to know what to eat and what not to eat. If you think that you are not eating a well-balanced diet, if you have health or weight problems, or if you are about to make major changes to your diet, talk to your doctor or a dietitian who can help you decide on a nutrition plan that works for you.


The US Department of Agriculture (USDA) and the Department of Health and Human Services provide guidelines to help us. Called the Dietary Guidelines for Americans, they focus on balancing calories with physical activity, and encourage you to eat more vegetables, fruits, whole grains, fat-free and low-fat dairy products, and seafood. They also urge you to eat less sodium, saturated and trans fats, added sugars, and refined grains. To learn more, see the Choose My Plate section at the end of this topic.

Recent studies have proven the benefits of the Mediterranean Diet in promoting cardiovascular health. To learn more, see The Mediterranean Diet section at the end of this topic.

Carbohydrates

Carbohydrates are the main source of fuel in a balanced diet. The body converts carbohydrates to "glucose," which is a type of sugar. Your body uses some of this glucose right away for energy, and any extra glucose is converted into a sugar called "glycogen." Your body stores glycogen in your liver and muscles for future use. Glycogen can be quickly changed back to glucose as needed. Once your body has made enough glycogen, the leftover glucose is stored as fat.

Sugars and starches are carbohydrates. Sugars are called "simple carbohydrates" or "simple sugars." The most common form of simple sugar is glucose. When glucose molecules link together, they create a number of larger molecules called "complex carbohydrates." Starches and fiber are examples of complex carbohydrates.

Most carbohydrates are in the form of starches, which are found in foods such as grains, potatoes, and other starchy vegetables. Another common source of starch in our diets is refined grains, like white bread and pasta. Starches also may be added to foods to thicken or stabilize them. Added sugars and added starches usually increase the calorie count of foods, but they do not add essential nutrients. Although most people consume an adequate amount of total carbohydrates, many people consume too much added sugar and refined grain and not enough fiber.

Sugars

Sugars, or simple carbohydrates, give the body a quick source of energy, because they can be used right away. Refined and brown sugars, syrups, and honey are examples of sugars. Added sugars are those found in foods like candy and soft drinks, but they add more calories than nutrients to your diet. According to the Dietary Guidelines for Americans, you should reduce the number of calories you get from added sugars. Instead, you should try to get your daily supply of sugars from fresh fruits, which will also add vitamins and minerals to your diet.

Starches

Starches are called complex carbohydrates because your body must break them down to use their sugars. Breads, cereals, corn, peas, potatoes, pasta, and rice are examples of complex carbohydrates. Many studies have shown that people who eat a lot of whole grains have a lower risk of coronary artery disease than people who mainly eat high-fat or high-sugar foods.

Fiber

Fiber is another form of complex carbohydrate. A diet high in fiber has been shown to reduce cholesterol levels and help protect against heart disease, cancer, and stomach and bowel problems. Fiber comes in two forms: insoluble and soluble. Insoluble fiber can be found in cereals, whole-grain breads, rice, and many vegetables. Soluble fiber is found in oatmeal, dried beans, peas, and many fruits, including apples, strawberries, and citrus fruits.

The latest dietary guidelines recommend eating 14 grams of fiber per 1,000 calories, or 25 grams per day for women and 38 grams per day for men. You should try to eat foods that contain both insoluble and soluble fiber. Both forms are important to your diet. A diet high in soluble fiber may lower your risk of heart disease by decreasing your blood cholesterol. Insoluble fiber helps speed the passage of food through your digestive tract, keeping your body "regular." Eating fiber-rich foods may also help you lose or control your weight because most high-fiber foods provide complex carbohydrates, protein, vitamins, and minerals with little, if any, fat. Also, fiber takes up more space in your stomach and digestive tract than fats and simple sugars do, so you may feel full without eating as many calories.

Proteins

Proteins give your body the building materials for the growth, maintenance, and repair of tissues and muscles. Proteins also help your body make hormones. Extra protein is converted and stored in your body as fat, which can be used as emergency fuel when carbohydrates and fats are not on hand.

There are two main types of protein: animal protein and vegetable protein. Foods rich in animal protein include beef, pork, fish, chicken, eggs, and dairy products. Some foods that contain vegetable protein are broccoli, lentils, potatoes, pasta, oatmeal, rice, nuts, chickpeas (garbanzo beans), soybeans, and kidney, lima, and navy beans.

Although animal products are a good source of protein, eating a lot of animal products can raise your cholesterol level since animal products are often high in cholesterol and saturated fat.

Dietary guidelines suggest that we should eat more protein in the form of seafood. Seafood contributes a range of nutrients, notably the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Studies have shown that eating about 8 ounces of seafood per week is associated with reduced number of heart-related deaths among people with and without heart disease.

Fats

Dietary fat is an important part of your daily nutrition, but you only need a small amount to keep your body's chemistry in balance.

Dietary fat comes in 2 basic forms: saturated and unsaturated. 

Saturated fat is the type of fat that raises your cholesterol and increases your risk of heart disease. Main sources of saturated fat are the butter fat in milk products, fat from red meat, and tropical oils such as coconut oil.Reduce Saturated Fat

Unsaturated fat is better for you. It comes in 2 forms: monounsaturated or polyunsaturated. Vegetable oils are the best-known sources of unsaturated fat. Keep in mind, though, that a "100% vegetable oil" product may not live up to its name. Hydrogenation, the process that turns liquid vegetable oil into hydrogenated or partially hydrogenated vegetable oil to make shortening, margarine, and other solids, turns unsaturated fatty acids into saturated fatty acids. In general, you can easily recognize saturated fats because they will be solid at room temperature. Think of butter, stick margarine, shortening, and coconut oil. On the other hand, olive oil, canola oil, peanut oil, and liquid margarine are liquid at room temperature because they contain mainly unsaturated fat.

Another good way to tell whether a fat is saturated or unsaturated is to look at the label. Food manufacturers are required to list saturated fat separately, so this type of unhealthy fat is easy to spot.

In addition to saturated fat, the hydrogenation process creates another kind of unhealthy fat: trans fatty acids. This type of fat is also listed on food labels. Trans fatty acids are made when unsaturated vegetable oils are hydrogenated. The unsaturated fatty acids that do not become fully saturated may instead become trans fatty acids, which also may contribute to heart disease. Trans fatty acids have been shown to lower levels of  "good cholesterol" and raise levels of "bad cholesterol." 

In general, you can lower your trans fatty acid intake by avoiding foods that contain ingredients such as margarine, shortening, and hydrogenated or partially hydrogenated oils. Also, you can avoid foods such as french fries, doughnuts, cookies, and crackers, which are often high in trans fatty acids as well as saturated fat. Since trans fatty acids rarely occur naturally, they are mostly found in processed foods made with hydrogenated vegetable oil.

Food labels, cookbooks, and nutrition books provide helpful information about the fat content, calorie content, and the percentage of calories from fat. You should limit your total dietary fat intake to 20-35% of your daily calories. (The typical American diet derives about 40% of its calories from fat.)

Understanding Food Labels

Reducing the amount of fat you eat will help you lose weight. Each gram of fat has 9 calories, compared with 4 calories for each gram of carbohydrate or gram of protein. So, replacing fat with protein and complex carbohydrates means eating fewer calories. Keep in mind, though, that many good protein sources like peanut butter, milk, and cheese may also be high in fat. Also, be careful of sweets and snack foods that are labeled "low fat" or "fat free." These foods often contain large amounts of sugar or added salt and are high in calories. Complex carbohydrates such as fruits, vegetables, and grain products are lower in calories than the refined carbohydrates often found in sweets and snack foods.

Ways to Reduce Saturated Fat in Your Diet

Vitamins

Vitamins are substances that perform specific functions for your body's reproduction and growth. Vitamins regulate your body's metabolism, which controls the amount of energy you have to do things like walking, sleeping, or thinking.

Doctors have also found that certain vitamins might help prevent coronary artery disease. Vitamins A, C, and E appear to deter plaque from forming on artery walls. Plaque forms because oxygen and LDL ("bad") cholesterol combine in a process called "oxidation." Vitamins A, C, and E are called "antioxidants" because they slow or stop the plaque-forming process.

Vitamins: What They Do and Where to Get Them

Minerals and Trace Elements

Minerals are chemical elements that your body uses for many biological processes. Like vitamins, minerals are found in the foods we eat. Trace elements are also chemical elements, but your body only needs small amounts of these substances.

Minerals: What They Do and Where to Get Them

Trace Elements: What They Do and Where to Get Them

Salt (Sodium)

Salt is a mineral. Although your body needs minerals to work properly, salt can raise blood pressure in people who are sensitive to its effects.

Ways to Reduce Salt in Your DietEven if you are not sensitive to salt's effects, you will not benefit from eating a lot of salty foods. Snack foods, luncheon meats, and various forms of fast and processed foods are main sources of salt. Also, many recipes for home-cooked meals may have more salt than is needed for good flavor.

In general, try to limit your sodium intake to less than 2300 mg a day, roughly the amount in a teaspoon of salt. The dietary guidelines recommend a limit of 1500 mg a day for adults over 51 years of age and for high-risk populations. Ask your doctor or dietitian about your sodium limit.



Where's the sodium? There's too much in many common foods
For American Heart Month, the February edition of CDC Vital Signs focused on the amount of sodium in Americans' diets and what we can do to reduce it. Too much sodium increases a person's risk for high blood pressure. High blood pressure often leads to heart disease, stroke, and other vascular diseases. Breads and rolls top the list of culprits.
www.cdc.gov/VitalSigns/Sodium/

Ways to Reduce Salt in Your Diet

Understanding Nutrition Facts Food Labels

Understanding Food Labels When was the last time you looked at a food label and completely understood what it said? Although the "Nutrition Facts" labels are on every packaged food item, few of us have had lessons on how to actually read these correctly.

Learn to read labels to guide your choice of heart-healthy foods. They provide valuable information about calories, fats, cholesterol, sodium, carbohydrates, fiber, sugars, proteins, and vitamins and minerals. Pay close attention to servings per container and to the % of daily value of each nutrient.

In the news ... September 2014
Read food labels correctly to lower heart disease risk, physician says
In an interview with the health and medical information site WebMD, cardiologist Mehdi Razavi, MD, says food labels can be your biggest friend or your worst enemy. While food labels contain useful information that can help you take charge of your health, they can also be confusing and even misleading if you don't know how to properly interpret the information they provide. To view tips and become food-label "savvy," read more in Web MD.

Understanding Food Labels


Body Fat

Taking control of your diet is one of the best ways you can lose weight and a healthy diet can give you more energy.

Obesity has been found to be a major risk factor for heart disease and researchers are now better able to define that risk. Many doctors measure obesity in terms of body mass index (BMI), which is a formula of weight in kilograms divided by height in meters squared (BMI =W [kg]/H [m2]). You can find out your BMI by using the calculator below. Then, take that value and find your body composition in the table below the calculator.

Body Mass Index
  Body mass index (BMI) is a formula to assess your body weight in relation to your height. This formula gives a measure of your body composition and has been shown to be an effective predictor of body fat. To calculate your BMI, enter your height and weight below.

Enter your height in inches: or centimeters:
Enter your weight in pounds: or kilograms:
Your result:  

Body Composition Body Mass Index (BMI)
Underweight Less than 18.5
Normal 18.5 - 24.9
Overweight 25.0 - 29.9
Obese Greater than 30.0

Body Shape: Apple or Pear?

Where we store extra fat on our bodies also plays a role in the risk for heart disease. Most men tend to be apple-shaped, meaning fat is stored between the waist and the chest. Women, on the other hand, tend to be pear-shaped, meaning fat is stored on the hips and legs. Those women who develop male-pattern fat storage appear to be at higher risk of heart disease and heart attack.

The waist-to-hip ratio is another tool for determining fat distribution and heart disease risk. To find your waist-to-hip ratio, divide your waist measurement by your hip measurement. A number above 1 shows an apple shape. A number below 1 shows a pear shape. Remember, a waist-to-hip ratio greater than 1 shows male-pattern fat storage, which has been linked to an increased risk for heart disease.

Snacking Tips

Fruits and vegetables are good snack choices. The American Heart Association (AHA) recommends that you eat 5 or more servings of fruits and vegetables each day. Remember that you can also meet your daily recommended serving of fruit by drinking fruit juices. Look for juices that are 100% juice. Stay away from juices that are a "blend" or "cocktail," because they contain less juice and a lot of sugar. Keep vegetables washed, cut, and stored in the refrigerator so they are easy to snack on when you want them. Try some low-fat or fat-free dips to eat with your vegetables.

Dairy items are also good snacks. Low-fat yogurt or a milkshake made from skim milk not only fills you up but also gives your body calcium along with other vitamins and minerals.

If you are constantly on the go, keep healthy snacks on your kitchen counter, in your desk drawer at work, or in your car. Most work sites have refrigerators where you can keep snacks like vegetables or yogurt. If you find that you feel tired by mid-morning or mid-afternoon, try eating a snack at these times to keep your energy up.

Holiday Eating Tips

The holidays are the hardest time to stay on a healthy eating plan. Keep in mind that the holidays are probably not the best time to start a diet, but it is possible to keep up your healthy eating habits during these times.

  • Eating Out. If you know that you will be going to a special event later in the evening, eat small, healthy meals during the day, so you can enjoy a few treats in the evening. Don't deny yourself these treats, otherwise you will just crave them more. You can also try eating a small, healthy meal or snack right before the event, so you do not feel overly hungry at the party. And instead of heading straight toward the food table, mingle and talk with the other guests. When you do become hungry, try not to eat the fried foods; eat the fresh fruits and vegetables instead. If you know that you will be pressured into a second helping, make your first helping small. That way, both helpings together will equal a regular-sized meal.
  • Exercise. Do not forget about your exercise program during the holidays. If you exercise, you will burn off those extra calories and make weight management much easier. And if you increase your activity during the holidays, you may be able to eat a few extra treats and not put on those extra pounds!

The Mediterranean Diet - Promoting Cardiovascular Health 

Mediterranean Diet PyramidPeoples around the Mediterranean Sea have long been known to live longer and suffer fewer cancers and cardiovascular ailments. Their diet—the Mediterranean diet—has long been touted as heart-healthy and now the longest and most scientific research study into the diet has confirmed it.

Working with the Harvard School of Public Health, Oldways, a nonprofit food think tank in Boston, developed a consumer-friendly Mediterranean diet pyramid that emphasizes fruits, veggies, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices; eating fish and seafood at least a couple of times a week; enjoying poultry, eggs, cheese, and yogurt in moderation; and saving sweets and red meat for special occasions. The base of the pyramid encourages a physically active lifestyle.

Choose My PlateChooseMyPlate.gov

The USDA has replaced the Food Pyramid with ChooseMyPlate. The dinner plate design makes it easier for you to choose healthy foods, because you can match the food amounts on your plate to what the USDA suggests. The dinner plate symbol is part of a bigger healthy-eating campaign that has 7 key messages:

  • Enjoy your food, but eat less of it.
  • Avoid oversized portions.
  • Make your plate half fruits and vegetables. Any fruit or vegetable or any 100% fruit or vegetable juice fits into this category. Fruits may be fresh, canned, frozen, or dried, and they can be whole, cut-up, or pureed. Vegetables may be raw, cooked, fresh, frozen, canned, or dried, and they can be whole, cut-up, or mashed.
  • Make at least half your grains whole grains. Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain. Whole grains contain the entire grain kernel. Some examples of whole grains are whole wheat flour, oatmeal, and brown rice.
  • Drink fat-free or low-fat milk.
  • Compare the amount of sodium in foods you buy and choose the foods with lower numbers.
  • Drink water instead of sugary drinks.

ChooseMyPlate also encourages you to choose lean proteins for the protein portion of your plate and to go with calcium-rich foods for your dairy portion. Daily exercise is also important. To learn more, visit www.ChooseMyPlate.gov

In the news . . . My Plate Kids Place MyPlate Kids' Place

Resource site for kids at ChooseMyPlate.gov
Kids (and parents/educators too) will find games, activities, videos, songs, recipes, and more nutrition tips designed just for them at the website MyPlate Kids' Place

      

Making Nutrition Fun for Kids

Cool-E
At Texas Heart Institute, we believe that children should get involved in their own heart health, and getting heart-healthy starts with nutrition! Our Project Heart program for kids in grades K-6 has fun tools just for them.



See also on this site:
  Making Nutrition Fun For Kids

 

 Nutrition at Heart - Read today's article


See on other sites:

MedlinePlus
www.nlm.nih.gov/medlineplus/nutrition.html
Nutrition

US Department of Agriculture, Center for Nutrition Policy and Promotion
http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm 
2010 Dietary Guidelines for Americans (Next update coming in 2015)

Eat Right 
Academy of Nutrition and Dietetics
www.eatright.org/Public
"It's All About Eating Right"
and promoting National Nutrition Month® every March.
  

  
American Heart Association Nutrition CenterAmerican Heart Association 
www.heart.org   
Nutrition Center
 

 Nutrition.gov
A service of the National Agricultural Library, USDA
www.nutrition.gov


Updated August 2014
 
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