Cardiac Rehab and NutritionSession 1 Janice Holley MSc, RD Julie Snider MAN, RD Cardiac Rehab Dietitians St. Mary’s General Hospital
Overview of Nutrition atCardiac Rehab Nutrition education sessions (4) Individual appointment 45 minute assessment bring 3 day food records spouse/partner/grocery shopper/cook Possible follow-up
Ways to reduce risk Behaviour change in: daily eating habits daily physical activity tobacco use managing stress….. will help you to…… Reach target levels for blood fats: LDL, HDL, TG, Ratio Lower body weight (lower % body fat, WC) Control high blood pressure (less sodium) Control blood sugar to target levels
Today’s Session Types of cholesterol in blood Types of fat in foods where to find and how to limit Healthy body weight/body composition
What are the different typesof fats in blood? Low density lipoprotein (LDL) High density lipoprotein (HDL) Triglycerides(**Found in blood, not in foods)
What is Low-DensityLipoprotein (LDL)?Contributes to blockages in the arteries
What is High DensityLipoprotein (HDL)?Helps prevent blockages in the arteries
Desirable Blood Fat Profile LDL less than 2.0 HDL more than 1.1 Triglycerides less than 1.7 Cholesterol/HDL ratio less than 4.0
Types of fats in foods Monounsaturated fat Polyunsaturated fat Omega-3 fat Saturated fat Trans fat
Monounsaturated Fats Helps to lower LDL and keep HDL from decreasing Sources include: Olive and canola oil, Non-hydrogenated margarines made from olive and canola oil, Avocados, Nuts: almonds, filberts and cashews
Polyunsaturated Fats Helps to lower LDL; no 6 sources include: effect on HDL Sunflower, safflower,Sources include: corn, soybean and sesame seed Sunflower, safflower, corn, oils; nuts: soybean and sesame seed walnut, pine oils nut, brazil nuts; sesame & Nuts: walnut, pine nut, sunflower seeds brazil nuts, sesame and sunflower seeds
Omega 3 Fat Helps to lower LDL, keep blood thin, reduces inflammation and irregular heart beats EPA and DHA found in fish Highest amounts in salmon, trout, mackerel, sardines, tuna (bluefin, albacore) ALA found in ground flaxseed, nuts, canola oil, soy Much more on omega 3’s in next session!
Saturated and Trans Fat Solid fats at room temperature Mostly hidden in foods (meats, dairy, processed foods, hard stick margarines) Raise LDL and lower HDL cholesterol
Trans Fats – Processed Fats Avoid: Hard margarines Hydrogenated fats Vegetable oil shortening Fried fast foods Snack foods, cookies, crackers that contain Trans Fat (< 2 g/day)
How much fatshould you eat? Limit total fat to 60 g per day 5 g = 1 tsp 15 g = 1 tbsp 60 g = 4 tbsp
So how much saturated fat? Limit the saturated fat to 10-15 grams maximum per day by choosing lower fat foods.Remember 1 teaspoon has 5 grams fat.
Added Fat vs. Hidden Fat Keep added fats to 30 g or 2 Tbsp/day Other half (30 g or 2 Tbsp) is hidden fat
How to limit added fat Choose lower fat cooking methods what are examples? Less spreading! Less pouring! And Measure! Add less non-hydrogenated margarine, less oil Use lower fat salad dressings/mayo, fat-free sour cream
How to limit hidden fat #1 way is to limit portion sizes Choose fish, chicken/turkey, lean pork and plant protein more often than red meat skinless poultry butterfly pork chops or pork tenderloin lean red meat low fat soy foods lower fat dairy products.
Choose lower fat dairy products Skim or 1% milk Yogurt less than 0.5% M.F. Cottage Cheese less than 1% M.F Lower fat cheeses Less than 20% M.F. if 1-2 times/week 4-7% M.F. if use more often
Summary:How can we lower LDL? Limit total fat Limit saturated and trans fat Use soy products Eat more fiber (sessions 2 & 3)
Summary: How do we increase HDL? Aerobic exercise Healthy fats e.g canola & olive oils, almonds Alcohol (more in sessions 2 & 4) Lose abdominal fat
Aim for a healthy body weight Body composition analyses : weight, fat, muscle, water Waist circumference: Men – less than 40” Women – less than 35”
If you are overweight -…are you an apple or a pear?