Cardiology Clinic Nutrition Guidelines for Heart Failure


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Cardiology Clinic Nutrition Guidelines for Heart Failure

  1. 1. Cardiology Clinic Nutrition Guidelines for Heart Failure
  2. 2. Nutrition Guidelines for Heart Failure This guide provides basic information to help you begin, or continue following, your heart failure diet. It is very important to plan for what you eat to help manage your heart health. This often means making some changes in your current eating habits. These guidelines will help you get started and are explained in more detail in the pages to follow. 1. Limit Sodium Intake: One of the most important ways to manage heart failure is to decrease the total amount of sodium you consume to 2,000 mg (2 grams) per day. 2. Learn to Read Food Labels: Sodium is added to many packaged foods. Reading the Nutrition Facts label will help you make the best low sodium food choices. 3. Eat a Heart Healthy Diet: There are a wide variety of foods to enjoy for heart health and to help satisfy your appetite. Fruits, vegetables, whole grains, legumes, plant oils, poultry, fish, lean meats, and skim and low fat dairy products are the basics of most meals and snacks. 4. Achieve and Maintain a Healthy Body Weight: Losing a few pounds can help to lower blood pressure and cholesterol. It can also improve blood glucose control, and lower your risk for other health problems. 1
  3. 3. 2 Gram Sodium Diet Our body does in fact need about 500 mg of sodium per day to maintain fluid balance. Yet, the average person consumes much Purpose: Sodium is the mineral in the human body that helps more, often 3000-6000 mg daily. to balance fluid volume. Following a low-sodium diet helps But, I never use the Salt Shaker! control high blood pressure (hypertension), swelling and water build-up (edema), and/or decrease shortness of breath. For people who have Congestive Heart Failure (CHF), the heart is unable to pump enough blood to meet the body’s needs. If you limit the amount of sodium in the foods you eat, it can help prevent fluid overload on the heart. The heart will not have to pump as hard if there is less fluid to move through the blood vessels. You need to remove the salt shaker from the table and to avoid A low-sodium diet is necessary for the health of your heart using any salt when preparing food. It is also important to realize even if you do not have any symptoms, or if you are taking diuretic that the sodium in our diet comes mostly from processed and medication. convenience foods. A 2 gram (g) sodium diet is equivalent to 2000 milligrams Processed Foods make up the largest source of sodium in our (mg). diets. Processed foods include canned foods (soups), cured meats (hotdogs, bacon, ham, etc.) packaged-convenient foods (instant Where does Sodium come from? potatoes), many condiments (mustard, pickles) snack foods (potato chips, pretzels) and many more foods. In addition to the sodium in our body, it is also found in almost all foods. The most common food source of sodium is Salt (sodium chloride), of which 40% is pure sodium. Many people refer to sodium and salt as one and the same. One teaspoon of salt contains about 2300 mg of sodium. Although a whole teaspoon of salt may not be used at the table or in cooking, the total amount of sodium can add up quickly when combined with all foods eaten in a day. 2 3
  4. 4. A Matter of Taste Learn to Read Food Labels Humans were born with a preference for sweet tastes. Yet, Food labels tell you what you need to know about choosing over time, our taste buds have learned to prefer salty foods. If you foods that are lower in sodium. Learning to read food labels takes gradually decrease the sodium and salt in your diet, you can re- just a few simple steps. train your taste buds and reduce your desire for salt. 1. First look at the Serving Size. Food companies use both salt and sodium to enhance the 2. Next look at the amount of sodium and compare to your flavor and preserve the food. Check food labels for some of these 2000 mg daily ‘budget’. common sodium sources: 3. Finally, look at the % Daily Value, which should be 5% or • Sodium nitrate – curing agent for ham, sausage less. • Monosodium Glutamate (MSG) – flavor enhancer Sodium should be as low as possible, certainly less than 140 • Sodium saccharin – artificial sweetener mg per serving. • Sodium bicarbonate – leavening agent • Sodium benzoate – preservative • Soda or Brine – sodium added, salty liquid 1 Examples: Sodium Content of Processed Foods Food Item Serving Size Sodium (mg) Deli Meats 3 ounces 500-900 Cheese 1 ounce/1 slice 170-400 Instant Potatoes 1 cup 550-700 Potato Chips 10 chips 175 Bacon 1 slice 185 2 3 Canned Corn ½ cup 325 Canned Soup 1 cup 800-1000 Instant Pudding 1 cup 150-700 Ketchup 1 Tablespoon 165 Mustard 1 teaspoon 80 Instant Noodles 1 cup 1345 USDA National Nutrient Database for Standard Reference Note: Fat Free does not mean Sodium Free! 4 5
  5. 5. Compare Fresh to Canned Foods Avoiding High-Sodium Foods These labels show that fresh food is naturally much lower in To help lessen your heart failure symptoms, you must cut back sodium than processed foods. A serving of canned tomatoes contains and further rid of all high sodium foods from your diet. The foods 6 times as much sodium as a serving of fresh tomatoes! below are usually high in sodium (but read the labels, because some may be available as low-salt or unsalted). Sodium is much • Canned soups and dry soup mixes higher for canned tomato products. • Canned meats and fish • Deli Meats, Cold Cuts • Cheese 1 cup ½ cup • Ham, Bacon, Hot Dogs and Sausage • Salted nuts and salted peanut butter • Instant cooked cereals 66 mg • Salted butter and margarine 360 mg • Prepared mixes (pancake, muffin, cornbread, etc.) • Prepackaged frozen dinners (unless eating only one serving, having less than 400 mg of sodium) • Preseasoned mixes (tacos, chili, rices, sauces, gravies, etc.) • Pretzels, potato chips, olives, cheeses, pickles • Salad dressings, Marinades, Soy Sauce More Food Label Terms • Fast foods, Fried Foods Food companies are allowed to use these claims to help • Prepared Tomato or Vegetable Juice highlight the amount of sodium per serving in certain foods: * Sodium Free – contains 5mg or less * Very Low Sodium – contains 35mg or less * Low Sodium – contains 140mg or less * Reduced Sodium – at least 25% less sodium than usual * No Salt Added – no salt was added during processing, but the product may still contain sodium by nature. American Dietetic Association Fact Sheet 2003 6 7
  6. 6. Foods to Enjoy for Heart Health What about Salt Substitutes? These lower sodium foods should make up the bulk of your diet: Check with your doctor or registered dietitian to see if the use of a salt substitute is safe for you to use. Many salt substitutes are • Fresh or Frozen Fruits high in potassium which may conflict with one or more of your • Fresh or Frozen plain Vegetables in abundance! medications. Too much potassium may also be harmful to your • “No salt added”, “low-salt” or “low-sodium” canned or kidneys. It’s better to avoid these substitutes and use either a salt- packaged foods. However, it’s still important to read the free herb and spice blend (such as Mrs. Dash®) or make your own. label to see exactly how much sodium it contains. The less See the recipe section for more information. Be aware that Sea salt, the better! Salt, Kosher Salt and Lite Salt all contain high amounts of sodium and should also be avoided. • Fresh skinless Poultry, Fish, Lean meats • Unsalted Nuts and unsalted Peanut Butter Other Sources of Sodium • Whole grain Cereals (Shredded Wheat, Oatmeal) • Barley, brown rice, whole wheat pasta cooked without salt Over-the-counter drugs — Some over-the-counter drugs contain • Whole grain breads, crackers, chips, pretzels with little or lots of sodium. Make a habit of carefully reading the labels no salt of all over-the-counter drugs. Look at the ingredients list and warning statements to see if sodium is listed. A statement of • Home cooked beans or chili without salt sodium content must appear on labels of antacids containing • Low or nonfat Dairy products (limit to 2 servings per day) 5 milligrams or more per dosage unit (tablet, teaspoon). Some companies produce low-sodium over-the-counter products. If • Salad dressings made with Heart Healthy Oils, Vinegar, in doubt, ask your physician or pharmacist if the drug is OK for herbs and no salt spices you. • Unsalted Butter or ‘Liquid’ Margarine (sparingly) Prescription drugs — Consumers can’t know whether a • Low Salt Cheese in moderation prescription drug contains sodium. If you have high blood • No added salt condiments (ketchup, etc.) pressure, ask your physician or pharmacist about the sodium content of prescription drugs. NEVER stop taking your medication without checking with your doctor. 8 9
  7. 7. How to Change Eating Habits to Lower Sodium Example of a High Sodium-Intake Day… Amount of Compare the two menus below for food choices and the Food sodium amount of sodium. Look at the differences in the sodium content Breakfast Scrambled eggs, 2 large 342 mg just by making a few food changes. For example, switching from salted butter to unsalted peanut butter can save you over 50 Bacon, 1 slice 192 mg mg of sodium. The peanut butter also has a healthy type of fat Whole-wheat bread, 1 slice 148 mg (monounsaturated) for your heart. Butter, 2 teaspoons 54 mg Total sodium for meal 736 mg Think about the foods that you prefer and how you can avoid those that are high in sodium. Choosing a cup of yogurt instead Lunch Whole-wheat bread, 2 slices 296 mg of salted pretzels helps to cut about 400 mg of sodium out of your diet. Making the switch from canned green beans to frozen green Ham, luncheon meat, 1 slice 350 mg beans helps to cut out 170 mg of sodium. These types of changes Mayonnaise, 1 tablespoon 105 mg and more all help you stay within your 2000 mg (2 gram) sodium Dill pickle, 1 spear 385 mg budget for the day, and helps you to prevent harmful fluid build-up. Pretzels, 1 ounce 485 mg Orange, 1 medium 1 mg The low sodium menu example also shows that there is room Total sodium for meal 1,622 mg for some heart-healthy snacks and still stay within your sodium limit. For example, 7 whole-grain, Reduced Sodium Triscuits® have only 75 mg of sodium. You can enjoy these with 2 ounces of Dinner Spaghetti noodles, 1 cup 140 mg reduced sodium Swiss cheese that has 70 mg of sodium. Spaghetti sauce, 1/2 cup 515 mg Parmesan cheese, 1 tablespoon 76 mg Green beans, canned, ½ cup 177 mg Keep in mind these key points: Garlic bread, 1 slice 200 mg 1. Read labels and choose low sodium products. Total sodium for meal 1108 mg 2. Buy fresh or frozen products, or no salt added canned goods. 3. Use fresh Poultry, Fish, and Meat, not Deli or processed. Total sodium for the day: 3,466 mg 4. Cook with Herbs and Spices and salt free seasoning blends. Source: Department of Agriculture, Nutrient Data Laboratory, 2004 10 11
  8. 8. Example of a Low Sodium-Intake Day… Season Instead of Salt Amount of The American Heart Association has published a listing of Food sodium herbs and spices to add at the table and in cooking. These flavors Breakfast 2 Hard Boiled Eggs 125 mg are matched with foods to taste great. Banana, 1 medium 1 mg Pepperidge Farm, Natural Whole 115 mg Allspice — Lean ground meats, stews, tomatoes, peaches, Grain Oat Bran bread, 1 slice applesauce, cranberry sauce, gravies, lean meat Unsalted Peanut Butter, 1 tablespoon 3 mg Almond extract — Puddings, fruits Total sodium for meal 244 mg Basil — Fish, lamb, lean ground meats, stews, salads, soups, sauces, fish cocktails Lunch ½ Whole Wheat Lavash Bread 125 mg ½ chicken breast, baked w/herbs, no salt 60 mg Bay leaves — Lean meats, stews, poultry, soups, tomatoes Sliced tomatoes, Red onion slice, 12 mg Caraway seeds — Lean meats, stews, soups, salads, breads, 2 Romaine lettuce leaves cabbage, asparagus, noodles Olive oil vinaigrette, no salt, 1 T. 10 mg Chives — Salads, sauces, soups, lean meat dishes, vegetables Blueberry Fat-free yogurt 100 mg Cider vinegar — Salads, vegetables, sauces Orange, 1 medium 1 mg Cinnamon — Fruits (especially apples), breads, pie crusts Total sodium for meal 308 mg Cilantro – Vegetables, pairs well with lime juice Dinner 1 cup Barilla Plus Thin Spaghetti 75 mg Curry powder — Lean meats (especially lamb), veal, chicken, Fresh tomato, basil, olive, oil, garlic 60 mg fish, tomatoes, tomato soup, mayonnaise and herb sauce, 1.5 cups Dill — Fish sauces, soups, tomatoes, cabbages, carrots, Part skim, Parmesan cheese, 1 T. 76 mg cauliflower, green beans, cucumbers, potatoes, salads, Green beans, frozen, 1/2 cup 8 mg macaroni, lean beef, lamb, chicken, fish ½ cup Cannellini beans, no salt added 40 mg Garlic (not garlic salt) — Lean meats, fish, soups, salads, Whole grain roll w/ olive oil, garlic 125 mg vegetables, tomatoes, potatoes Total sodium for meal 384 mg Ginger — Chicken, fruits Total sodium for the day: 936 mg Lemon and Lime juice — Lean meats, fish, poultry, salads, vegetables Source: Department of Agriculture, Nutrient Data Laboratory, 2004 12 13
  9. 9. Mace — Hot breads, apples, fruit salads, carrots, cauliflower, When Eating Away From Home squash, potatoes, veal, lamb Mustard (dry) — Lean ground meats, lean meats, chicken, Let friends and family know that you have to limit your salt fish, salads, asparagus, broccoli, Brussels sprouts, cabbage, intake. Be selective where you dine and ask the waiter or chef to mayonnaise, sauces prepare your order without added salt. Avoid Fast Food restaurants and convenience take-out foods which are prepared and preserved Nutmeg — Fruits, piecrust, lemonade, potatoes, chicken, fish, with sodium. Keep these tips in mind: lean meat loaf, toast, veal, pudding • Use oil and vinegar for salad dressing Onion (not onion salt) — Lean meats, stews, vegetables, salads, soups • Request that butter not be added to your vegetables or other meal items Paprika — Lean meats, fish, soups, salads, sauces, vegetables • Ask for sauces and broths to be served on the side Parsley — Lean meats, fish, soups, salads, sauces, vegetables • Avoid smoked, pickled or foods in a brine Peppermint extract — Puddings, fruits • Avoid casseroles, or mixed dishes, and dishes made with cheese Pimiento — Salads, vegetables, casserole dishes • Your best choice is to order something which is steamed, Rosemary — Chicken, veal, lean meat loaf, lean beef, lean baked or broiled with wine, lemon juice, herbs and pepper pork, sauces, stuffings, potatoes, peas, lima beans • Take a portion home with you for the next day Sage — Lean meats, stews, biscuits, tomatoes, green beans, fish, lima beans, onions, lean pork Key Words for Menu Items to Avoid Savory — Salads, lean pork, lean ground meats, soups, green Au gratin Cream Gravy beans, squash, tomatoes, lima beans, peas Crispy Hash Hollandaise Casserole Scalloped Potpie Thyme — Lean meats (especially veal and lean pork), sauces, Cheese Sauce Fried Parmesan soups, onions, peas, tomatoes, salads Sautéed Stuffed Turmeric — Lean meats, fish, sauces, rice Better Menu Choices Baked Broiled Grilled Steamed Poached Stir Fry 14 15
  10. 10. ♥ Eating Well for Heart Health ♥ PLANT OILS, such as olive, canola, soy, corn, sunflower, peanut, are good sources of healthy unsaturated fats. Replace high sodium foods with the many other foods you’ll • Limit amounts to 2-3 Tablespoons daily for spreads, want to include for a healthy heart. dressings, cooking • If using a spread, choose one with liquid vegetable oil as VEGETABLES – Enjoy a variety of non-starch vegetables in first ingredient abundance! POULTRY • Enjoy at least 4 cups daily • Enjoy dark-green, leafy vegetables; yellow, orange, and red • Choose/Enjoy chicken or turkey breast (skinless or ground) vegetables and cooked tomatoes every week • Limit/Avoid fried chicken and skin from chicken/turkey FRUITS – Enjoy a variety of 2-3 pieces, ½ cup of fresh, or ¼ cup FISH dried fruit servings daily • Choose/Enjoy twice per week : salmon, tuna (if canned, low salt) and most white fish WHOLE GRAIN FOODS are the best sources of carbohydrates. • Limit/Avoid fried fish and excess shellfish • At most meals, enjoy oatmeal, whole grain bread, brown rice, barley, or one of many other whole grains EGGS – Limit to 3-5 egg yolks per week LEGUMES, such as black beans, kidney beans, lentils, garbanzos, DAIRY – Choose nonfat/skim or 1% milk products soy beans and other beans, are excellent sources of protein, fiber, vitamins, and minerals. CHEESE – Low fat cheeses such as 50-75% Reduced-Fat Cabot Cheddar, limit portions • Enjoy at least two meals a week using legumes in place of meats. MEAT NUTS, such as almonds, walnuts, pecans, peanuts, hazelnuts, • Choose/Enjoy very lean red meats such as: eye round, and pistachios, contain healthy monounsaturated and ground round, pork tenderloin polyunsaturated fats • Limit/Avoid: sausage, bacon, fatty steaks, regular ground • Choose unsalted varieties and limit portions to 2-3 chuck, bologna, and hot dogs Tablespoons a day. Note: Portion Sizes for Meat, Fish and Poultry are 3-4 ounces, about the size of a deck of cards 16 17
  11. 11. Lean Red Meats to Enjoy Menu Ideas One serving is a 3-4 oz serving - about the size of a deck of cards. Breakfasts • Eye Round 1. 1 cup Fresh Berries • Top Round Steak 1 cup Skim or 1% Milk • Chuck mock tender steak 1 cup plain Oatmeal or Shredded Wheat Cereal • Top Sirloin Steak ½ Whole Wheat English Muffin • Round Tip 1 T. Unsalted Peanut Butter • 95% Lean Ground Beef • Brisket (flat half) 2. 1 egg, poached, scrambled or fried in non-fat cooking spray • Shank Crosscuts 2 slices whole grain toast • Chuck Shoulder Roast 1 Kiwi or Favorite Fruit • Chuck Arm Pot Roast 1 low fat, low sugar yogurt • Chuck Shoulder Steak 3. Whole Wheat Blueberry Pancakes Source: National Cattleman’s Beef Association 2 T. Maple Syrup Turkey Breakfast Sausage – low sodium 1 cup Skim Milk Examples of Lower Sodium Deli Choices 140 mg sodium or less Lunches 2 Ounce Serving of Meats Sodium in mg 1. Whole wheat tortilla Vegetarian chili made with no salt added tomatoes, beans • Boar’s Head Brand Deluxe Roast Beef 80 2 ounces Reduced Fat and Salt Cheddar Cheese • Dietz & Watson Gourmet Lite Turkey Breast 55 Raw carrots and sugar snap peas with yogurt/herb dressing 1 Ounce Serving of Cheeses Sodium in mg ½ cup Sliced Strawberries, Blueberries or Raspberries • Boar’s Head Emmentaler Swiss 50 • Land O’Lakes 35 2. 4 oz. Broiled Salmon • Saputo Lorraine Swiss 14 ½ cup Steamed Spinach • McKenzie Swiss Premium 60 ½ cup Cooked Barley • Finlandia Swiss 60 ¼ cup Mushrooms, sautéed in garlic and Olive Oil • North Country Smoked Swiss 75 Fresh Peach 18 19
  12. 12. 3. Homemade Low Sodium Chicken & Rice Soup Recipes 8 Triscuit crackers, reduced sodium Low fat yogurt Salt-less Surprise Seasoning Blend 2 Graham Crackers • 2 tsp Garlic Powder (not salt) Apple • 1 tsp Dried Basil • 1 tsp Dried Oregano Dinners • 1 tsp Powdered Lemon Rind 1. Lemon BBQ chicken Mix well in a bowl with a whisk. Can be stored in shaker Grilled Zucchini and Tomato kebabs container with some rice to prevent caking. Corn on the Cob with Lemon-Basil Vinaigrette 3 cups Dark green tossed salad w/Olive Oil/Vinegar dressing Sliced cantaloupe 2. Pork Tenderloin ½ cup Brown Rice, with chopped apricots, herbs, and toasted almonds Broccoli, Garlic Stir Fry Sliced Tomatoes with olive oil and fresh basil “Salt” Substitute Sliced banana and low fat vanilla yogurt • 3 tsp. Dried Basil 3. Baked Halibut w/wine, olive oil, herbs, pepper • 2 tsp Dried Savory ½ Baked Sweet Potato • 2 tsp. Celery Seed 1/3 cup steamed Green Beans • 2 tsp. Ground Cumin Spinach salad toasted pine nuts, mandarin oranges and • 2 tsp. Dried Sage nonfat yogurt herb dressing. • 2 tsp. Dried Marjoram Fresh Strawberries • 1 tsp. Dried Lemon Thyme Note: Enjoy Water, Iced Tea or other non-caloric beverages Mix well, then crush with mortar and pestle. with meals. A cup of skim or 1% milk may be added to lunches or dinners. 20 21
  13. 13. Vegetable Stir-Fry Lemon Barbeque Chicken Ingredients Ingredients • 1 cup uncooked Whole grain Brown Rice • 2 whole Boneless, Skinless Chicken Breasts or 4 halves • 2 T. extra virgin Olive Oil • ¼ cup Fresh Lemon Juice • 1 large Carrot, sliced thinly • 2 T. Honey • 1 small Onion, sliced thin • 2 T. Olive or Canola Oil • 6 cloves fresh Garlic, minced • Dash of Cayenne Pepper • 1 T. Fresh Ginger, minced • ¼ tsp. of Paprika • 10-12 Asparagus spears, sliced into bite size pieces • ½ tsp. Dried Italian Seasoning • ½ head Broccoli, sliced into florets • 1 T. Sesame Seeds Toasted (either over medium temp range • 1 teaspoon Sesame Oil top or in 350ºF oven for a few minutes) • 1 yellow Summer Squash, sliced thin • 16-20 whole Snow Pea Pods Directions • 4 ounces or so of Mushrooms, sliced 1. Place chicken in a dish to marinade • ½ cup dry-roasted, unsalted Peanuts or Cashews 2. Combine all other ingredients, except sesame seeds, together and mix well with a whisk or in blender. Directions 3. Pour over chicken and marinate 30 minutes – 2 hours 1. Cook rice according to package directions (basically add 4. Prepare oven broiler or grill. rice to 2 cups boiling water, stir, cover, lower heat to simmer ~35-40 minutes). 5. Cook chicken 15 minutes per side 5 inches under broiler or 5-10 minutes per side on grill until tender and the center is 2. Prepare vegetables by washing and slicing or mincing. white. 3. Heat Olive oil in large nonstick skillet or wok set over 6. Sprinkle with sesame seeds to serve. medium-high heat. 4. Add Carrot first. After a few minutes add, Onion, Garlic, Serves 4 Asparagus, Broccoli and Sesame Seed Oil. Stir fry for about 3 minutes. 5. Add Ginger, Squash, Snow Peas, Mushrooms, (and Tofu if desired). Stir fry for another 4-5 minutes, turning continuously. 6. Serve hot over rice and sprinkle with nuts. 22 23
  14. 14. Corn Toppers Baked Beans Traditionally, corn on the cob is eaten slathered and dripping Ingredients with butter and heavily salted. Try these imaginative, heart-friendly • ½ pound (1 cup) dried Navy Beans (or 3 cans No Salt alternatives, low in saturated fat and sodium free. Each recipe Added Beans – Eden is one brand) makes enough for 4 ears. These are also great toppings for steamed • 4 cups Water (if soaking beans) vegetables and fresh salads. • 1 Loin-end Pork Chop, Very Lean • 1 cup No Salt Added Chili Sauce or Tomato Sauce Lemon-Basil Vinaigrette • ¾ cup chopped Onion In a small bowl, whisk together 1 T. fresh Lemon Juice, 2 tsp. • 2 T. Light Molasses extra virgin Olive Oil, and 2 tsp. fresh Basil, minced. Season to • 1 T. packed Brown Sugar taste with pepper. • 1 ½ tsp. Dry Mustard Powder • ¼ tsp. Garlic Powder, or more to taste Azetec Lime • 1 cup Water In a small bowl, whisk together 1 ½ T fresh Lime Juice, 1 tsp • Optional spices: Cumin, Chili Powder, experiment! extra virgin Olive Oil, and ½ tsp Chili powder. Season to taste with pepper. Directions 1. Place beans and water in large saucepan over high heat. Moroccan Spice Bring to a boil and cook 2 minutes. In a small bowl, mix together 2 tsp ground Cumin, 2 tsp 2. Remove from heat and let stand 1 hour. ground Coriander, 1 tsp dried oregano, and ½ tsp ground 3. Return beans to heat and simmer 1 more hour or until beans ginger. Brush ½ tsp. extra virgin Olive Oil over ear of hot are tender. Drain, rinse, set aside. corn and then sprinkle with spice mixture. 4. Preheat oven to 350ºF. Eating Well Magazine 2004 5. Lightly spray a 1 ½ quart casserole dish with vegetable oil spray or grease lightly with canola or olive oil. 6. Place beans in prepared casserole and set aside. 7. Brown pork in a small non-stick skillet over medium-high heat. Cut into small cubes and add to beans. 8. Add remaining ingredients and mix well. Cover, bake 4 hours. If needed, add additional water during cooking. Reprinted with permission: American Heart Association Low-Salt Cookbook. 24 25
  15. 15. Baked Apples Cookbooks Ingredients No-Salt, Lowest Sodium Cookbook • 4 Apples, cored, unpeeled Donald A. Gazzaniga, 2001 • 1 T. unsweetened Apple Juice or Water ISBN 0-312-29164-7 • 2 T. Chopped Walnuts • 1 T. Raisins American Heart Association Low-Salt Cookbook, • 1 tsp. ground Cinnamon Second Edition : A Complete Guide to Reducing Sodium and Fat in Your Diet. 2002 • ¼ tsp. grated nutmeg ISBN 0-609-80968-7 Directions The No-Salt Cookbook 1. Preheat oven to 350F. David C. and Thomas D. Anderson, 2001 2. Place apples and juice or water in baking dish. ISBN 1-58062-525-8 3. Mix together walnuts, raisins and spices and fill center of apples. Get the Salt Out 4. Cover and bake for 30-45 minutes. Ann Louise Gittleman, MS, CNS, 1996 ISBN 0-517-88654-5 Optional: Serve with Non fat plain or vanilla yogurt Pocket Guide to Low Sodium Foods Bobbie Mostyn, 2003 ISBN 0-9673969-1-3 For patients with Heart Disease AND Diabetes The Diabetes & Heart Healthy Cookbook American Diabetes Association, 2004 ISBN 1580401805 26 27
  16. 16. Resources American Heart Association New Hampshire Ellen McCooey Communications Director Phone: 603-518-1554 Fax: 603-669-6745 Email: National Heart Lung and Blood Institute Healthy Heart Market – DHMC HF Clinic Contact Info • Clinic Emergencies: Call 603-650-2929 • Dietitian Kc Wright, MS, RD, LD 603-650-9495
  17. 17. Dartmouth-Hitchcock Medical Center is a charitable organization and has a financial assistance policy. Cardiology One Medical Center Drive Lebanon, NH 03756-0001 (603) 650-9495 Revised / PE 11/19/05 RL: 8.8