Cardiac Rehab and NutritionSession 1   Janice Holley MSc, RD   Julie Snider MAN, RD   Cardiac Rehab Dietitians   St. Mary’...
Overview of Nutrition atCardiac Rehab   Nutrition education sessions (4)   Individual appointment       45 minute asses...
Ways to reduce risk       Behaviour change in:         daily eating habits         daily physical activity         tob...
5 F’s to Heart Healthy Eating   FAT*   FIBER   FISH*   FRUIT   FRESH*
Today’s Session   Types of cholesterol in blood   Types of fat in foods       where to find and how to limit   Healthy...
What are the different typesof fats in blood?   Low density lipoprotein (LDL)   High density lipoprotein (HDL)   Trigly...
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 ra...
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,   ...
Polyunsaturated Fats Helps to lower LDL; no       6 sources include:  effect on HDL                Sunflower, safflower,S...
Omega 3 Fat   Helps to lower LDL, keep blood thin, reduces    inflammation and irregular heart beats   EPA and DHA found...
Saturated and Trans Fat   Solid fats at room temperature   Mostly hidden in foods    (meats, dairy, processed foods, har...
Trans Fats – Processed Fats              Avoid:                 Hard margarines                 Hydrogenated fats      ...
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.Rem...
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...
How to limit hidden fat   #1 way is to limit portion sizes   Choose fish, chicken/turkey, lean pork and    plant protein...
Choose lower fat dairy products               Skim or 1% milk               Yogurt less than 0.5% M.F.               Co...
Summary:How can we lower LDL?   Limit total fat   Limit saturated and trans fat   Use soy products   Eat more fiber (s...
Summary:     How do we increase HDL?   Aerobic exercise   Healthy fats e.g canola    & olive oils, almonds   Alcohol (m...
Aim for a healthy body weight   Body composition analyses :      weight, fat, muscle, water   Waist circumference:      ...
If you are overweight -…are you an apple or a pear?
Energy in – energy out
Next Session   Omega 3 Fat   Label-reading   Mediterranean diet
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Nutrition 1

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Nutrition 1

  1. 1. Cardiac Rehab and NutritionSession 1 Janice Holley MSc, RD Julie Snider MAN, RD Cardiac Rehab Dietitians St. Mary’s General Hospital
  2. 2. 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
  3. 3. 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
  4. 4. 5 F’s to Heart Healthy Eating FAT* FIBER FISH* FRUIT FRESH*
  5. 5. 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
  6. 6. What are the different typesof fats in blood? Low density lipoprotein (LDL) High density lipoprotein (HDL) Triglycerides(**Found in blood, not in foods)
  7. 7. What is Low-DensityLipoprotein (LDL)?Contributes to blockages in the arteries
  8. 8. What is High DensityLipoprotein (HDL)?Helps prevent blockages in the arteries
  9. 9. 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
  10. 10. Types of fats in foods Monounsaturated fat Polyunsaturated fat Omega-3 fat Saturated fat Trans fat
  11. 11. 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
  12. 12. 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
  13. 13. 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!
  14. 14. 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
  15. 15. 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)
  16. 16. 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
  17. 17. 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.
  18. 18. 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
  19. 19. 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
  20. 20. 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.
  21. 21. 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
  22. 22. Summary:How can we lower LDL? Limit total fat Limit saturated and trans fat Use soy products Eat more fiber (sessions 2 & 3)
  23. 23. 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
  24. 24. Aim for a healthy body weight Body composition analyses : weight, fat, muscle, water Waist circumference: Men – less than 40” Women – less than 35”
  25. 25. If you are overweight -…are you an apple or a pear?
  26. 26. Energy in – energy out
  27. 27. Next Session Omega 3 Fat Label-reading Mediterranean diet
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