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Diet / Nutrition

There are many factors which increase the risk of cardiovascular disease. They include: high levels of cholesterol in the blood, age (45 or older for males, 55 or older for women), premature menopause without estrogen replacement therapy, family history of premature coronary heart disease, smoking, high blood pressure (hypertension), sedentary life, and diabetes.

The foods you eat have an impact on these risk factors. For example, a diet high in cholesterol and fat may raise the level of cholesterol in your blood. A diet high in sodium (salt) contributes to hypertension for some people.

Obesity also increases your risk of heart disease. "Obese" is defined as being more than 30% overweight.

Overweight people often have a number of risk factors. They may have high levels of cholesterol, high blood pressure, and/or diabetes. They usually don't get enough exercise. If you are overweight, and you choose to slim down through proper diet and exercise, you may actually lower several risk factors at once.

Which is the best diet?
Even if you don't have to lose weight, you should strive to follow a food plan that is good for your heart.

Many diets focus on weight loss, not on permanent healthful eating. There are conflicting opinions about diet, even among professionals. Nevertheless, most health experts recommend a plan that includes: :30% or less of total calories from fat; no more than 8% to 10% of total calories from saturated fat; less than 200 to 300 milligrams (mg) of cholesterol; and 2400 mg or less of sodium.

The American Heart Association; The National Heart, Lung, and Blood Institute; The United States Department of Agriculture; and the American Dietetic Association; all suggest that you eat a variety of foods from the six food groups. These groups are illustrated in the pyramid below. Make most of your selections from the bottom of the pyramid and fewer selections as you work your way up.

What is serving of fats, oils, or sweets?
Limit added fat to no more than 1 to 2 tablespoons a day. Limit added sugar to no more than 2 to 6 teaspoons a day.

Use canola, safflower, corn, sesame, soybean, sunflower, and olive oil. Avoid coconut oil, palm oil, or hydrogenated fats. Try non-fat salad dressings.

What is a serving of dairy products?
A serving is one cup of milk, (cow's, soy or rice).; 1 cup of yogurt, 1/2 cup of cottage cheese; 1 1/2 ounces of natural or soy cheese a or 2 ounces of processed cheese.

Use low-fat or non-fat dairy products.

What is a serving of fish, meat, chicken, or beans?
One serving is 2 to 3 ounces cooked fish, poultry or lean mean; 1/2 cup cooked dry beans; 1/4 cup tofu or tempeh; 1 whole egg or 2 egg whites; 2 tablespoons peanut butter, nuts or seeds.

Eat up to 6 ounces (cooked) per day of meat, fish or poultry. Instead of using meat as the main ingredient, try adding it as a condiment in stews or casseroles. When you buy meat or poultry, choose the leanest cuts you can find.

Consume up to 3 to 4 egg yolks each week.

What is a serving of vegetables?
One serving is 1 cup of raw vegetables, or 1/2 cup cooked vegetables. A serving of vegetable juice is 3/4 cup.

Starchy vegetables belong in the bread and pasta group. These vegetables include: potatoes, corn, lima beans, green peas, winter squash, yams, and sweet potatoes.

What is a serving of fruit?
A serving of fruit is 1 medium-sized whole fresh fruit; 1 cup of berries or a medium slice of melon; 1/2 cup chopped, cooked, or canned fruit; 3/4 cup fruit juice. When you buy canned fruit, choose fruit in its own juices instead of fruit in heavy syrup.

Avoid coconut. Count olives and avocados as fats.

What is a serving of bread, rice, cereal, and pasta
A serving is 1 slice of bread; 1/2 of a bagel, bun, or English muffin; 1 ounce (1/2 to 1 cup), ready-to-eat cereal; 1/2 cup cooked cereal, rice, or pasta. Try corn tortillas, high-fiber cereals, kasha, millet, couscous, bulghur, air-popped popcorn, and unsalted pretzels. Cut down on donuts, muffins, and pastries.

Plan your meals before you shop and bring a list with you to the store.

Use light margarine, mayonnaise and salad dressing.

What kinds of snacks and desserts should I choose?
The best choice is fruit. Other good choices include: angel food cake, fat-free cookies, graham crackers, gelatin desserts, fat-free frozen yogurt, low-fat ice cream, sherbet or sorbet. Try baked snacks instead of fried ones.

What should I look for on food labels?
Food labels will tell you the total fat, saturated fat, cholesterol, and sodium content of the foods you eat. Labels also list the number of calories in a serving. Look for the box labeled, "Nutrition Facts". Be sure to check the serving size. You may be surprised at how small it is.

Then look at the list of ingredients. Limit your intake of products which list any fat or oil first or which list many fat and oil ingredients.

Sometimes a label will say that the product is "light" or "low fat". Although these terms and others may sound vague, they actually mean specific things. The National Heart, Lung and Blood Institute of the National Institutes of Health elucidates the meanings:

The Claim What it means
Saturated fat free less than 1/2 gram saturated fat/serving
Low saturated fat 1 gram or less of saturated fat/serving
Cholesterol free less than 2 milligrams (mg) cholesterol/serving
Low cholesterol 20 mg or less cholesterol/serving
Fat free less than 1/2 gram fat/serving
Low fat 3 grams or less fat/serving
Calorie free less than 5 calories/serving
Low calorie 40 calories or less/serving
Sodium free less than 5 mg sodium/serving
Low sodium 140 mg or less sodium/serving
Very low sodium 35 mg or less sodium/serving
Light product has half the fat or one-third fewer calories than the regular product. Light sodium in a low fat, low calorie food means sodium has been cut by 50%
Reduced/less/ lower/fewer Something has been reduced by 25%
Lean Less than 10 grams fat; 4.5 grams or less saturated fat, less than 95 mg cholesterol/serving
Extra lean Less than 5 grams fat, less than 2 grams saturated fat, and less than 95 mg cholesterol/serving.

How do I calculate the percent of calories from fat in a given product?
To determine the percent of calories from fat, take the total number of fat calories, divide this figure by the total number of calories and then multiply by 100. Total fat calories = total fat grams X 9. Each gram of fat equals 9 calories.

What is healthful cooking?
How you prepare the foods you eat, is important, too. Trim all visible fat from meat before cooking. Remove skin from chicken and turkey. If you roast poultry, you may do so with the skin on (to prevent dryness), and then remove the skin before serving.

Don't fry food. Broil, bake, stew, roast, poach. Roast meat, fish, and poultry on a rack to allow the fat to drip off. Buy nonstick pans and use cooking spray instead of oils. Chill soups and stews; then skim off the hardened fat before reheating. Drain off all fat after browning.

Cook with less or no salt. Use herbs, spices, lemon juice and vinegar. Add vegetables such as onions and garlic for flavor.

Use skim milk instead of whole milk or cream in soups, sauces, and puddings. Use low- or nonfat sour cream, cottage cheese or yogurt in dips.

How can I eat well when I dine out?
Plan in advance. Consume fewer calories and fat grams than usual at your other meals. Then you can eat a little more at the restaurant. Don't starve yourself. Starving can lead to bingeing. Some experts recommend having a light, healthful snack to curb your hunger before going to parties or restaurants.

Avoid temptation. If you are familiar with the restaurant, plan your order in advance. Many menus highlight heart-healthy dishes. If your restaurant does not do so, you can ask the waiter or waitress to recommend a dish that is low in fat and calories.

You can order off the menu. Ask for food which is prepared plainly, preferably broiled or baked. Ask the server to have dressings and sauces removed or served on the side. Order tomato based sauces instead of cheese or cream based ones.

Try to eat dry. Ask the server to have vegetables, corn, rice and potatoes prepared and served without butter or sour cream. Don't put butter or margarine on your rolls and bread.

If you have high blood pressure, ask the chef to refrain from salting your dishes. Most restaurants will accommodate your requests.

It's not wise to have an alcoholic beverage (high in calories), an appetizer and a dessert. If a main dish isn't enough, choose only one additional course.

If the portion of any course is large, eat half, and bring the rest home

What are some other tips for eating well?
Plan your meals before you shop and bring a list with you to the store.

Keep a diary in which you record what you eat, the amount, the time, and what prompts you to eat.

Eat a variety of foods. Cut down or eliminate organ meats, processed high-fat cold cuts, sausage, and bacon. Reduce or eliminate consumption of store-bought baked goods, snacks and other prepared foods which are high in saturated fats.

Eat foods which are high in fiber. These include fruits and vegetables, whole-grain breads and cereals, and beans.. Eat 20 to 35 grams of fiber each day.

Make changes gradually. For example, if you currently drink whole milk, first switch to 2%, then to 1%, then to non-fat milk.

Follow a low fat, high fiber food plan, but remember: calories still count. If you want to lose weight, you have to burn more calories than you consume.

How does exercise help?
Exercise is a good way to burn calories. The following is a brief list of exercises and the number of calories associated with an hour workout for a 150 pound person.

Exercise Calories burned per hour
Cycling 6 mph 240
Walking 2 mph 240
Walking 3 mph 320
Tennis-singles 400
Jogging 7 mph 920
Cross-country skiing 700
Swimming 25 yds/min 275

A lighter person burns fewer calories per hour; a heavier person burns more. To lose a pound, you would have to burn 3,500 calories.

Regular exercise positively affects many of the risk factors for cardiovascular disease. So, while you're burning calories, you'll be helping your heart in more ways than one.


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