Keep Your Heart Healthy During American Heart Month

The month of February allows us multiple opportunities to celebrate our hearts! Not only does this month feature Valentine’s Day as an appreciation of our love for one another, but it is also home to American Heart Month which calls to our attention the importance of heart health. Although heart disease is the leading killer of both men and women in the United States, it is in many cases preventable or controllable. There are numerous actions we can take to improve our heart health, and following a heart-healthy diet is one of many. The following list outlines ways we can highlight foods that protect and preserve our hearts and vessels:

 

• Substitute unhealthy saturated fats with heart-healthy unsaturated fats. Saturated fats are linked with higher cholesterol levels, which are a risk factor for heart disease. These fats are found in animal products (meats, full-fat dairy products/cheeses, and butter) and the tropical oils (coconut oil, palm oil, and palm kernel oil). Healthier choices that are associated with improved cholesterol levels are monounsaturated and polyunsaturated fats and include products such as nuts and seeds; fatty fish; and olive, canola, safflower, and sunflower oils. 
• Choose lean protein and low-fat dairy over higher-fat alternatives. Lean protein and 1% or skim milk, yogurt, and cheese contain less fat and therefore protect your heart and vessels. Limit your red meat intake to once per week and instead choose alternatives such as the white meat portions of chicken and turkey, pork tenderloin, soy products, egg whites, and beans and legumes.
• Feature fatty fish every week. Fatty fish are high in heart-healthy polyunsaturated fats. To obtain these benefits, choose fatty fishes like salmon, herring, mackerel, trout, and sardines at least twice a week.
• Snack on nuts and seeds. Nuts and seeds – particularly walnuts, pecans, almonds, flaxseed, and sesame seeds – are also high in polyunsaturated fats and make a great heart-healthy food choice. To up your intake of protective fats, protein, and fiber, snack on a handful of unsalted nuts and seeds per day.
• Balance your diet with fruits, vegetables, and whole grains. Not only do fruits, vegetables, and whole grains pack a punch with a multitude of vitamins and minerals, but they also contain fiber which keeps you full longer and lowers cholesterol levels. Balance a diet of heart-healthy fats with a wide variety of 3-5 servings of fruits and vegetables a day. Additionally, keep at least half of your grain intake from whole grains.
• Limit sodium to 2300 mg per day. Because high blood pressure is a risk factor for heart disease, it is important to keep an eye on your sodium intake. To limit your daily sodium intake, avoid cured or processed meats that are packaged with salt; choose fresh, frozen, or no-salt-added canned vegetables; and add salt-free spices or herbs to your foods instead of using table salt.

 

It is important to remember that the above tips are best practiced in combination with maintaining a healthy weight, exercising regularly, abstaining from smoking, and regularly monitoring blood pressure and cholesterol levels. However, by incorporating these tips into your diet, you are already taking healthy steps to protect your heart in the month of February and beyond!

 

Written by UTK Dietetic Intern

 

 

Fats: The Good, The Bad, & The Ugly

Fats get a bad rap, but your body actually needs certain fats to survive. In the body, fats provide energy, encourage cell growth, help protect your organs, keep your body warm, absorb some nutrients and produce hormones (2). 

Fats are perceived in a negative light because they are often to blame for weight gain. At 9 calories per gram, fats are the most concentrated source of energy (carbohydrates and proteins both provide  4 calories per gram). 

Fats are divided into three groups: unsaturated fats (the good), saturated fats (the bad), and trans fats (the ugly).

• The Good: The unsaturated fat group contains monounsaturated fats and polyunsaturated fats. These types of fats can actually help decrease your risk of heart disease (1). They help lower cholesterol levels and can be found in avocados, olive oil, and nuts. Fats are measured in your blood by cholesterol levels and triglycerides, which is usually a direct reflection of your dietary intake. Keeping your cholesterol  levels within the normal range is important to prevent chronic diseases such as cardiovascular disease. These fats are often termed “heart healthy” because they help to raise good cholesterol levels (HDL) and decrease bad cholesterol levels (LDL). Researchers found that an increase of 5% in polyunsaturated fat to replace saturated fat intake, resulted in a 10% decreased risk of developing coronary heart disease (3).
• The Bad & The Ugly: Saturated and trans fats, raise “bad” cholesterol and decrease “good” cholesterol levels (1).  These types of fats can be found in meat, fried foods, cakes, butter, biscuits, muffins, and some processed food. How do you know if a food has trans fat? Look for "partially hydrogenated oil" in the ingredients on the food label.

Because fats are a concentrated source of calories, they should be limited, but certainly not avoided.  About 30% of your total calories for the day should come from fats, which equates to about 6-8 teaspoons per day.  For a 2,000 calorie diet, that is about 600 calories or about 65-70 grams. 

So how do you ensure you’re eating enough of the good fats and not too much of the bad fats?  Of course sticking to whole grains, lean protein sources, low fat dairy, and plenty of fruits and vegetables will help you keep your fat intake on tract. 

 

 

Take Home Messages:

• Make most of your fat intake from “good” fat sources such as salmon, olive oil, canola oil, nuts
• Choose low-fat dairy: drink fat-free or 1% milk, choose low-fat cheeses, yogurt and cream
• Choose lean cuts of protein such as turkey, chicken, pork loin, beef tenderloin, lean ground beef, fish and legumes choose meat that is baked, broiled or grilled and not fried
• Switch to low-fat condiments such as low-fat or fat-free salad dressings and mayonnaise
• Limit cream based foods such as alfredo sauce and cream based soups
• Decrease your portion of fried foods; choose baked or grilled varieties instead
• Switch from cooking with butter to cooking with oil, specifically olive, canola oil or peanut oil
• Look at nutrition labels- if most of the fat source is saturated fat, limit your portion.

 

Sources:

1. American Diabetes Association, American Dietetic Association.  Choose your foods: Exchange list for diabetes. ADA 2008.

2. American Heart Association.  Fats 101. Available at: http://www.heart.org/HEARTORG/GettingHealthy/FatsAndOils/Fats-101_UCM_304494_Article.jsp.  Accessed on June 26, 2012.

3. Mozaffarian, D, Micha, R, Wallace, S.  Saturated Fat: A systematic review and meta-analysis of randomized controlled trials.  Plos Medline. 2010: 7(3).

Dark Chocolate: A Treat for Cardiovascular Health

I eat dark chocolate almost every day. Anyone who knows me well knows that my chocolate of choice is Ghirardelli’s Intense Dark 72% Cacao Twilight Delight – yum!

Thus, you can imagine that I was excited to stumble upon a CBS news article a couple weeks ago titled, “Daily dark chocolate good for the heart, study finds" (you can read the CBS news article here).

But what does that mean?

As a researcher, I was inspired to investigate further. The author cites a recent study (published in the British Medical Journal in May 2012) that examined dark chocolate consumption as a prevention therapy in people at high risk of cardiovascular (heart) disease. In short, these Australian researchers found that daily consumption of dark chocolate can reduce cardiovascular events (read the full study article here).

As I skimmed through the journal article, a few questions came to mind. I searched for answers (consulting other references when needed), summarized below:

1.      What was the study population?

The study population consisted of 2,013 people with high blood pressure who met the criteria for metabolic syndrome, with no history of cardiovascular disease and not receiving antihypertensive therapy. My first thought – this doesn’t apply to me.

2.      What is metabolic syndrome?

Metabolic syndrome is the name for a group of risk factors that occur together and increase the risk for coronary heart disease, stroke, and type 2 diabetes. It is present in individuals meeting 3 or more criteria for blood pressure, fasting blood sugar (glucose), waist circumference, HDL cholesterol, and/or triglycerides.

Read more about metabolic syndromeand diagnostic criteria here.

Prepare Heart-Healthy Foods for Your Family

The 29 days of February are dedicated to raising awareness of the leading cause of death in America, heart disease, and learning more about how you and your family can follow a heart-healthy diet.

The key to heart health is eating foods low in saturated fat, trans fat, cholesterol and sodium, and high in omega-3 fatty acids and fiber. Eating a well-balanced diet will include a combination of whole grains, lean proteins, fruits and vegetables and low-fat dairy.

Saturated and trans fats are found in some meats, dairy products, baked goods and deep-fried and processed foods. Both types of fat raise your LDL – or "bad" – cholesterol level. Instead, eat more plant proteins, fish, poultry and low-fat dairy foods. Start cooking with oils high in monounsaturated and polyunsaturated fat instead of butter, margarine or shortening, which are high in trans fat.

 

Healthy Substitutions

Switch refined grains, like white rice or bread, with whole-grain options, such as brown rice and 100-percent whole-grain bread or pasta. Throughout the day, sip on water and limit sugary beverages by choosing fat-free milk and 100-percent fruit juices.

Next time you are at the grocery store, pick up some of these heart-healthy items:

• Beans, peas and barley
• Soybeans, other soy-based foods
• Fruits and vegetables
• Salmon, tuna, sardines and mackerel
• Red grapes and purple grape juice
• Nuts like almonds, walnuts, pecans and hazelnuts

Move It

Another way to reduce your risk of heart disease is to be active. Regular, moderate physical activity lowers blood pressure and helps your body control stress and weight. Be physically active in your own way, and start by doing what you can, at least 10 minutes at a time. Children and teens should get 60 or more minutes of physical activity per day, and adults should get two hours and 30 minutes per week. Encourage your family to take a walk after dinner or play a game of catch or basketball.

For more heart-healthy cooking tips and information on reducing your risk for heart disease, consult a registered dietitian in your area.

Source:  Academy of Nutrition and Dietetics' Food and Nutrition Information

February is American Heart Month

Did you know the #1 killer of women is Heart Disease? More women die of heart disease than all forms of cancer combined. February is American Heart Month and Eat Right Knox wants to make sure you are eating plenty of heart-healthy foods.

Important foods (and examples) to include in your diet for heart health:

• Omega-3 fatty acids (salmon, tuna, olive oil, flaxseed)
• Beans (black, kidney, red beans)
• Nuts (almonds, walnuts)
• Whole grains (brown rice, oatmeal, whole wheat pasta)
• Vegetables (spinach, broccoli, asparagus, tomatoes, red bell pepper)
• Fruits (blueberries, oranges, cantaloupe, papaya)

There are plenty of other heart-healthy foods to try! Find out which ones you like the best and make it a habit to eat them more often! 

If you would like more information about Heart Disease, please visit the American Heart Association's website.

For help on creating a nutritious and heart-healthy diet, consult a registered dietitian in your area, and visit our Heart Health and Diet section.

Source: Academy of Nutrition and Dietetics' Tip of the Day. 

Knox Event: Celiac Disease

You don't want to miss this!!!!   Increase your awareness of Celiac Disease! Dr. Peter HR Green, Director of the Celiac Center at Columbia University in NYC and world renowned expert on celiac disease is speaking in Knoxville! The event is FREE! Wednesday October 26, 1:30 p.m. at the Wallace Memorial Baptist Church Ministry Center/ Auditorium. Event is open to everyone!

Healthy Gluten Free Snacks

Finding out that you have celiac disease can be scary. But, it is a condition that can be very well managed, by making the right dietary choices. This disease is an inflammatory condition of the small intestine, which improves when gluten is eliminated from the diet. Gluten is a protein most commonly found in food like wheat, barely, and rye. At first, it may be difficult for you to find foods that don’t contain gluten in some form. So keeping that in mind, here is a list of healthy snacks to help you maintain a gluten free diet:

1.       Natural Peanut Butter with Celery: Peanut butter is a very satisfying snack that is packed with protein which helps keep hunger under control. Natural Peanut Butter is healthier than the processed version. Try dipping celery sticks into 1 tablespoon of Peanut Butter

2.       Fruit: Fruit does not contain any gluten and the boost of nutrients it provides is important in your everyday diet.

3.       Dried Fruit and Nuts:  A small amount of dried fruit such as apples, pineapples, and apricots go very well with walnuts or almonds.

4.       Baked Corn Tortillas with Dip: Baked corn tortillas make a good alternative to chips. Brush both sides of the tortilla with vegetable oil, cut into triangles, spread onto a cookie sheet and season with salt and bake about 12 minutes until golden brown. NOTE: Make sure they are corn tortillas not flour tortillas as flour tortillas contain gluten.

5.       Lettuce Wraps: Take a large lettuce leaf and top it with a little tuna, hummus, and vegetables. Wrap it up to eat. Hummus is made from chickpeas blended with olive oil, lemon juice, salt and garlic. It is great served with fresh veggies.

6.       Chocolate Covered Fruit: Simply take a few squares of dark chocolate and melt it over your favorite fruit. Another good thing about this snack is that dark chocolate contains flavonoids which act as antioxidants. These offer a wide variety of health benefits such as lowering blood pressure and reducing LDL cholesterol.  NOTE: Double check your chocolate food label to make sure it is gluten free.

As you can see from above, eating gluten free does not have to be boring. You can eat very healthy and be creative and still maintain a gluten free diet. 

Submitted By: 

Brittany Bivins

Iowa State University Dietetic Intern

Are You Drinking Enough Water?

Did you know that every system of the body depends on water? In fact, water makes up approximately 60% of body weight. An important component of adequate nutritional status is ensuring that the body has enough water to carry out normal functions. With summer approaching and the weather warming, the risk for dehydration is even greater. If you’ve ever experienced dizziness, dry mouth, fatigue, excessive thirst, headache, or dark-colored urine you may have been deficient in your body’s fluid needs, a term referred to as dehydration.  Interestingly, most healthy adults on average produce 1.5 liters/day of urine output. An additional 1 liter of water/day is lost through breathing, sweating, and bowel movements. Therefore, a general recommendation of consuming approximately 2 liters of water/day, or a little over 8 cups, along with a healthy diet (i.e., fresh fruits and vegetables are higher in water) is sufficient to replace lost fluids.

So how can I check my hydration status?

To gauge your fluid needs you can examine your urine output. If it is clear and there is a normal amount of urine present this is usually a good indication that your body is sufficiently hydrated. You can always examine your thirst level. While some medications/ other factors may play a role, a persistent thirst may indicate dehydration. Nonetheless, fluid needs are individualistic and can vary widely.

When should I be drinking more water?

It is recommended to adjust fluid intake depending on your activity level, climate, health status, and even during pregnancy and lactation. Anytime you engage in physical activity it is important to remember to regularly replenish your body with fluids that were lost through sweat/ heat generated during activity. During bouts of illness it is extremely important to stay hydrated with water, Pedialyte, Powerade, or Gatorade (any beverage containing electrolytes) to promote recovery and replace any lost fluids.

Tips!

Make a conscious effort to stay hydrated! Try drinking 1 glass (8 oz) of water at each meal and between meals. This will not only improve hydration but keep you feeling full longer. If you are someone who enjoys coffee, instead of bringing your thermos full of coffee for an afternoon beverage, bring a water bottle and sip on it throughout the day.   

References:

www.rd411.com

Submitted by:

Kylie Weldon, UT Dietetic Intern

What's the deal with Organic Foods?

Before the 1900s, all farming practices were considered organic. It wasn’t until the 1960s and 1970s that the term “organic” started being used as a separate entity to the “normal” foods we were buying. Soon after this labeling hit the stores, the interest in and popularity of organic foods blossomed. Although multitudes of meats, fruits and vegetables started being labeled organic, they were not being held to any standards verifying their authenticity. In 1990, the USDA took control and the Organic Foods Protection Act (OFPA) was passed. OFPA, passed as a part of the 1990 Farm Bill, developed national standards for organically produced agricultural products to assure consumers that products marketed as organic met consistent, uniform standards. The USDA is the agency responsible for regulating these standards. If meat, poultry, eggs or dairy products are labeled organic, they must come from animals given no antibiotics or growth hormones. Organic produce must be raised without using most conventional pesticides; fertilizers made with synthetic ingredients or sewage sludge; bioengineering; or ionizing radiation. Although almost every fruit, vegetable, or fresh meat cut can be found organic, some are more important to buy organic than others. The Environmental Working Group, an organization consisting of scientists, researchers and policymakers, develops two lists each year; The Dirty Dozen and The Clean 15 (http://www.pbs.org/wnet/need-to-know/health/the-dirty-dozen-and-clean-15-of-produce/616/). The Dirty Dozen lists the fruits and vegetables you should always try to buy organic. Celery, peaches, strawberries, and apples top this list almost every year. The Clean 15 list outlines the produce that is acceptable to buy non-organic. These items usually have a thick peel or covering which prevents pesticides and chemicals from penetrating the fruit or vegetable inside. You can find onions, pineapples, avocados, and papayas on this list. Organic foods help in the preservation and conservation of the natural environment. They support biodiversity of plant and crop species, and can be more nutritious. Visit your local farmer’s market for the freshest selection of organically raised produce. Or, plant your own garden filled with all your favorite fruits and vegetables for an even closer to home organic collection!  Submitted by: Alice Jablonski, BS Nutrition 3997 Midland Ave Knoxville, TN 37919 alicejablonski@gmail.com

Preventing Childhood Obesity

 It has been noted that obesity runs in families.  It is true that genetic factors play a huge role in childhood obesity, but the interaction between environmental factors and genetics is what changes the degree of adiposity.  The build and stature of a child more often than not resembles that of their parent.  Therefore, many of the children who are obese have parents who are also obese.  All of this leads to a cycle of obese parents raising obese children.  “Genes don’t make us obese.  They allow us to be obese,” said Hill, who is the director of the Center of Human Nutrition at Colorado Health Sciences University (Ferguson).  Hill blames the American environment for the alarming rates of obesity in our society.    

Parents are the ones that can most influence the child’s eating habits by modeling a healthy diet.  This also goes for exercise; if children see their parents exercising, then they are also going to want to exercise.  Feelings about food and eating are created within the home.  If it is within the home that children are developing these poor eating habits, than it is within the home that we need to try to make the changes.  Parenting habits can be challenging and difficult to change directly.  However, adaptations can be made slowly if enough emphasis is provided by family and others.  

Parents need to promote healthy eating behaviors for children at an early age and allow them to learn to control their own eating patterns while they are young and have boundaries.  There is such a thing as being over controlling and this can cause undesired effects in a child.  This can cause children to become self-conscious about their weight, which can lead to eating disorders.  By enforcing good eating habits and reflecting those daily, parents can easily raise health conscious children who will grow to be healthy adults.    

Submitted by: 

Kristen Jackson Slusher, MS,RD, LDN
Clinical Nutrition Specialist
East Tennessee Children's Hospital
P.O.Box 15010 / 2018 Clinch Ave.
Knoxville, TN 37916
Phone:865-541-8395 / Fax:865-541-8681
E-mail:  kjslusher@etch.com

Vegetarian Diets

Vegetarianism is an adopted diet and lifestyle that 7.3 million Americans follow. Its popularity in America is increasing every year and it is the fastest growing category in food publishing.  The demand for more vegetarian recipes, magazines, and other vegetarian-based literature has inspired many to create extensive websites, blogs, and online cookbooks all devoted to helping others convert to the vegetarian diet.

                         

So what does being Vegetarian really mean? Well, the term can have different meanings to different people. Most people who claim to be Vegetarian are Lacto-ovo-vegetarians. This type omits all meat products (beef, poultry, fish, shellfish, or animal flesh of any kind. However, they will still enjoy eggs, milk, and milk products. Pescatarians refrain from eating all meat products, yet still allow fish and other seafood into their diet. Vegans do not eat meat of any kind, dairy, eggs, or any product which has been derived from an animal such as gelatin. They also do not purchase leather, angora, or pelts or fur of any kind. There is some debate as to whether certain foods, such as honey which comes from an animal, yet the animal is not hurt in the process, should be included in the Vegan diet. Vegan Raw foodists follow the vegan diet, yet also exclude any food that has been heated to above 115°F. They believe any food cooked above this temperature has lost a significant amount of its nutritional value and could be harmful to the body. Lastly, there are the Flexitarians. This group mostly abstains from meat products in an effort to promote a healthier lifestyle, yet will still have the occasional chicken dinner. There are 22.8 million Americans like Flexitarians who follow a vegetarian-inclined diet. 

No matter what kind of vegetarian diet is followed, the common ground for these Americans is a healthier lifestyle altogether. Scientific research suggests that the vegetarian diet comprised of whole grains, vegetables, legumes, fruits, and nuts, and strict avoidance of meat and high-fat animal products, combined with regular exercise has been  linked to lower blood pressure, lower blood cholesterol,  and less risk for obesity, heart disease, stroke, cancer, and diabetes mellitus. 


Submitted by:
Alice Jablonski, Tennessee Tech University Dietetic Student

3997 Midland Ave

Knoxville, TN 38501

Dietary Changes for Pre-Diabetes

If you've been diagnosed with pre-diabetes; it's time for a dietary tune-up.  You can take action to delay or even prevent getting diabetes through lifestyle changes!

Two major recommendations to reduce the chances that pre-diabetes will lead to diabetes are losing weight if you are overweight, and increasing your physical activity.  Those extra pounds are actually making hormones that increase your chances of getting diabetes.  You can decrease your chances of developing type 2 diabetes by up to 50% just by losing 7-10% of your weight.

The first step to changing your way of life is to evaluate yourself - are you the type of person who maintains change when it's done all at once or do you do better at gradually changing?  Most people maintain change   permanently if lifestyle changes are gradual.  Remember that it takes up to three weeks of practice for a new habit to take hold!

The Harvard School of Public Health recommends these four dietary changes:

• Eat more whole grains
• Eat less sugar
• Limit red meat and avoid processed meat
• Choose good fats instead of bad fats

Here are 10 tips for fitting these changes into your daily life:

1. If you eat breakfast cereal, choose a cereal containing at least 5 grams of whole grain fiber per serving.   Likewise, look for bread with at least 3 grams of whole grain fiber per slice.
2. Add beans to your diet:  Pinto beans, black beans and fat-free refried beans are some popular choices.
3. Make a meatless meal at least once a week.  Dishes based on beans, lean fish, roasted vegetables and salads can be tasty and satisfying.
4. This is huge:  Decrease or eliminate sugar-sweetened drinks.  This includes sodas other than diet sodas, and sweet tea, unless using artificial sugars.  If you choose to drink soda, experiment with different brands and flavors of diet sodas to find one that you enjoy.
5. When dining out, choose salads, grilled chicken or fish and fruit salads.  Restaurants are now serving many more healthy choices!
6. At home, switch to cooking with liquid canola or olive oil instead of with shortening and lard.
7. Switch from butter to margarines and spreads that do not contain trans fats.  Also use low-fat or light versions of foods like sour cream, cream cheese and mayonnaise.
8. Nuts contain good fats.  Enjoy them in moderation - no more than 15 - 20 nuts at a time!
9. Switch to skim or 1% milk and reduced fat cheeses.
10. Plan ahead: pack a fruit, a few nuts or another healthy snack before leaving home.  Peanut butter sandwiches on whole wheat bread are delicious!

By making these changes in your daily eating habits, you will be taking good care of yourself and investing in your health.  Remember to be patient with yourself:  It takes time to create new habits.

Submitted by:

Karin Adler RD, LDN

Clinical Dietitian

Parkwest Medical Center

kadler@covhlth.com