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Charlie Seltzer, MD, DABOM, CESwww.limitlesslongevity.com
Heart Healthy Nutrition                 Charlie Seltzer, MD, CES                        February 20, 2013
Information Overload
Where to start?
Definitions• Diet.com    – An eating plan designed to keep blood cholesterol low and      prevent the risk of heart diseas...
What should we be focusing on?•   Food, lifestyle, activity?•   Is one “diet” better than the others?•   Will certain food...
What causes heart attacks?                       i.e. What are CVD risk factors?• In the diet…   – Fat?   – Carbs?   – Cho...
Risk Factors (continued)• What are the major “modifiable” risk factors for heart  disease?   –OBESITY   – Insulin Resistan...
Risk Factors (continued)• Cholesterol?  – What percentage of people who have heart attacks have    “normal” LDL (or bad ch...
Risk Factors (continued)• Insulin Resistance (Pre-diabetes/diabetes)   – Journal of Obesity Research       • Insulin resis...
Insulin Resistance                     (continued)– What is the best way to prevent or reverse  insulin resistance?   • Ma...
Let‟s Talk About Fat
• Limit total fat intake to less than 25–35 percent of your total calories each  day    – ?????????• Limit saturated fat i...
Saturated Fat• Inuit  – Traditional diet     • ~75% saturated fat     • Whale blubber, seal, caribou, organ meats     • Li...
Saturated Fat   (continued)• Masai  – Diets very high in animal fats  – CVD essentially nonexistant  – Live active lifesty...
Saturated Fat         (continued)• Cochrane Collaboration  – Review of 27 studies involving more than 18,000    participan...
What About    ??
Carbs are bad…• From everydaypaleo.com    – “Grains are good for birds, not us.”    – “We lack the digestive abilities to ...
Carbs are bad…(Continued)• A Paleolithic diet improves glucose tolerance more than a  Mediterranean-like diet in individua...
Carbs are good…• Obesity is inversely related to whole grain  intake…• But intervention studies with whole grains  have no...
Carbs are good…(continued)•   Study: Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause    and Ca...
What About    ??
Dietary Cholesterol from Eggs Increases Plasma HDLCholesterol in Overweight Men Consuming a Carbohydrate-                 ...
The Consumption of Milk and Dairy Foods and the Incidence   of Vascular Disease and Diabetes: An Overview of the          ...
• Diets high in saturated fat may or may not  increase risk of heart disease.• Low fat diets may reduce risk of heart dise...
Is anything clear?                YES!!!!!!!!!!!!!Extra body fat significantly increases a person‟s        risk of heart d...
So what is heart healthy nutrition?• A MAINTAINABLE, PRACTICAL nutrition  plan that enables you to achieve and maintain  l...
So what is heart healthy nutrition?                       (continued)• Ideally (all other things being equal), one that  i...
Choose the healthier option…• Glazed donut + apple + scoop of protein powder  –   180 calories  –   60 calories  –   100 c...
Examples of Healthy Breakfasts• Uncured, organic ham, low fat cheese  and a cage free egg on a spelt English  muffin• Almo...
Examples of Healthy Snacks•     +•••
Examples of Healthy Lunches• Garden salad with grilled chicken and  low fat dressing• Salmon and low fat mayonnaise wrap  ...
Examples of Healthy Dinners• Chicken with asparagus•   Shrimp and pineapple skewers• Turkey Chili
Heart Healthy Nutrition
Heart Healthy Nutrition
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Transcript of "Heart Healthy Nutrition"

  1. 1. Charlie Seltzer, MD, DABOM, CESwww.limitlesslongevity.com
  2. 2. Heart Healthy Nutrition Charlie Seltzer, MD, CES February 20, 2013
  3. 3. Information Overload
  4. 4. Where to start?
  5. 5. Definitions• Diet.com – An eating plan designed to keep blood cholesterol low and prevent the risk of heart disease. – Eating foods that are low in saturated fat, total fat, cholesterol, and sodium. Some diets help people lower their cholesterol levels.• – Foods that decrease risk of cardiovascular and cerebrovascular disease –Foods that encourage fat loss or maintenance of a healthy weight (which then decreases essentially all major risk factors for heart disease) • Can be different for different people
  6. 6. What should we be focusing on?• Food, lifestyle, activity?• Is one “diet” better than the others?• Will certain foods kill you?• Will certain foods let you live to be 120?• What are quantifiable goals of “heart- healthy” nutrition – Reduce risk factors • Weight loss accomplishes total modifiable risk factor reduction
  7. 7. What causes heart attacks? i.e. What are CVD risk factors?• In the diet… – Fat? – Carbs? – Cholesterol?• In the body… – Triglycerides – Endothelial dysfunction • Lining of blood vessels becomes damaged, making plaque formation more likely – Inflammation – Insulin resistance or Metabolic Syndrome• In the … – Being a man – Family history
  8. 8. Risk Factors (continued)• What are the major “modifiable” risk factors for heart disease? –OBESITY – Insulin Resistance/diabetes • Related primarily to… OBESITY – Inflammation • Related to… OBESITY
  9. 9. Risk Factors (continued)• Cholesterol? – What percentage of people who have heart attacks have “normal” LDL (or bad cholesterol)? – About 50% – Different kinds of LDL » Small and dense -> 4x risk of CVD » Large and fluffy -> no increased risk of CVD• Triglycerides (TG) – Risk Factors for Myocardial Infarction in the Stockholm Prospective Study: A 14-Year Follow-up Focusing on the Role of Plasma Triglycerides and Cholesterol • Plasma triglycerides were more important as a risk factor than cholesterol – What‟s the best way to lower triglycerides? • Weight loss – Common for patients to halve TGs with 20 pound weight loss
  10. 10. Risk Factors (continued)• Insulin Resistance (Pre-diabetes/diabetes) – Journal of Obesity Research • Insulin resistance is primary cause of cardiovascular disease risk in children – American Heart Association • People with metabolic syndrome are at increased risk for the following: – Atherosclerosis – Peripheral vascular disease – Coronary heart disease and heart attack – Stroke – Type 2 diabetes » Major risk factor for heart attack
  11. 11. Insulin Resistance (continued)– What is the best way to prevent or reverse insulin resistance? • Maintain low body fat
  12. 12. Let‟s Talk About Fat
  13. 13. • Limit total fat intake to less than 25–35 percent of your total calories each day – ?????????• Limit saturated fat intake to less than 7 percent of total daily calories – ?????????• Limit trans fat intake to less than 1 percent of total daily calories – Trans fats =• The remaining fat: monounsaturated and polyunsaturated fats• Limit cholesterol intake to less than 300 mg per day, for most people. If you have coronary heart disease or your LDL cholesterol level is 100 mg/dL or greater, limit your cholesterol intake to less than 200 milligrams a day. – ????????
  14. 14. Saturated Fat• Inuit – Traditional diet • ~75% saturated fat • Whale blubber, seal, caribou, organ meats • Little to no fruit and vegetables – Prevalence of cardiovascular disease – Depends… » Traditional diet vs. “new, Western diet” » Smoking, activity, etc.
  15. 15. Saturated Fat (continued)• Masai – Diets very high in animal fats – CVD essentially nonexistant – Live active lifestyle – MAINTAIN HEALTHY BODYWEIGHTS!!!
  16. 16. Saturated Fat (continued)• Cochrane Collaboration – Review of 27 studies involving more than 18,000 participants – Cutting back on dietary fat may help reduce heart disease – Diets low in saturated fats have no significant effect on mortality, or even on deaths due to heart attacks.
  17. 17. What About ??
  18. 18. Carbs are bad…• From everydaypaleo.com – “Grains are good for birds, not us.” – “We lack the digestive abilities to eat grains without major problems.”• Kent Rieske (Bible Life Ministries) – Carbs (including fruit and whole grains) promote insulin release, causing… • Cancer • Heart disease • Stroke• 2013 Study from Johns Hopkins – Low carb diets reduce inflammation better than low fat diets
  19. 19. Carbs are bad…(Continued)• A Paleolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischemic heart disease. – Diabetologia, 2007 – 14 patients advised to consume an „ancient‟ diet for three months • Lean meat, fish, fruit, vegetables, root vegetables and nuts • NO grains, dairy foods and salt – 15 patients who were recommended to follow a Mediterranean-like prudent diet • Whole-grain cereals • Low-fat dairy products • Fruit and vegetables • Refined fats generally considered healthy. – Mediterranean diet group • increased blood sugar after carbohydrate intake and most of them had overt diabetes type 2 • In addition, all had been diagnosed with coronary heart disease
  20. 20. Carbs are good…• Obesity is inversely related to whole grain intake…• But intervention studies with whole grains have not produced weight loss• Visceral fat, however, may be affected favorably. Current Atherosclerosis Reports November 2010, Volume 12, Issue 6, pp 368-376
  21. 21. Carbs are good…(continued)• Study: Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause and Cardiovascular Disease–Specific Mortality Among Women With Type 2 Diabetes Mellitus• Whole-grain and bran intakes were associated with reduced all-cause and CVD- specific mortality in women with diabetes mellitus. Circulation. 2010 May 25;121(20):2162-8
  22. 22. What About ??
  23. 23. Dietary Cholesterol from Eggs Increases Plasma HDLCholesterol in Overweight Men Consuming a Carbohydrate- Restricted Diet• Carbohydrate-restricted diets (CRD) significantly decrease body weight and independently improve plasma triglycerides and HDL cholesterol.• Including eggs in a CRD results in increased HDL-C while decreasing the risk factors associated with Metabolic Syndrome. © 2008 American Society for Nutrition
  24. 24. The Consumption of Milk and Dairy Foods and the Incidence of Vascular Disease and Diabetes: An Overview of the Evidence• Reduction in risk in subjects with the highest dairy consumption relative to those with the lowest intake for: – All-cause deaths – Ischemic heart disease – Stroke – Diabetes• “In conclusion, there appears to be an enormous mismatch between the evidence from long-term prospective studies and perceptions of harm from the consumption of dairy food items.” Lipids October 2010, Volume 45, Issue 10, pp 925-939, Open Access
  25. 25. • Diets high in saturated fat may or may not increase risk of heart disease.• Low fat diets may reduce risk of heart disease• Omega-3 fatty acids (fish oils) may reduce risk of heart disease.• High intake of fruit and vegetables may reduce risk of heart disease.• Whole grain consumption is either great or horrible for your health, depending on who you listen to.
  26. 26. Is anything clear? YES!!!!!!!!!!!!!Extra body fat significantly increases a person‟s risk of heart disease and death.
  27. 27. So what is heart healthy nutrition?• A MAINTAINABLE, PRACTICAL nutrition plan that enables you to achieve and maintain low body fat levels with optimum muscle mass!!
  28. 28. So what is heart healthy nutrition? (continued)• Ideally (all other things being equal), one that includes: – Cage free eggs – Grass fed meat – Organic dairy – Fruit and vegetables – Whole grains – Things you like in moderation
  29. 29. Choose the healthier option…• Glazed donut + apple + scoop of protein powder – 180 calories – 60 calories – 100 calories – Total: 340 calories with 27 grams of protein• Large bowl of oatmeal with banana and almonds – 300 calories – 120 calories – 160 calories – Total: 580 calories with 16 grams of protein
  30. 30. Examples of Healthy Breakfasts• Uncured, organic ham, low fat cheese and a cage free egg on a spelt English muffin• Almond milk, low fat Greek yogurt, blueberry and natural peanut butter smoothie• “Pancakes” made with a touch of vanilla extract and equal parts low fat cottage cheese, oatmeal and egg whites and topped with microwaved strawberries and Stevia
  31. 31. Examples of Healthy Snacks• +•••
  32. 32. Examples of Healthy Lunches• Garden salad with grilled chicken and low fat dressing• Salmon and low fat mayonnaise wrap with lettuce and tomato• Chicken and broccoli stir fry with light soy sauce
  33. 33. Examples of Healthy Dinners• Chicken with asparagus• Shrimp and pineapple skewers• Turkey Chili
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