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Hearthealthy Newsletter

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For my Hospice rotation, here is a newsletter that I wrote.

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Page 1: Hearthealthy Newsletter

Mark your calendar: February 5th is GoRedForWomen day!

“Go Red for Women” is an organization to decrease heart disease and stroke. They also are working to change the perception that heart disease is a “man’s disease.” Currently their goal is to reduce heart disease and stroke by 25% in 2010.

Cardiovascular disease includes disease of the heart and blood vessels. Most cardiovascular disease develops over time and involves a gradual buildup of plaque inside your arteries. Plaque is a substance that contains fat and cholesterol, and if it grows large enough, can reduce blood flow through an artery. If a plaque ruptures, blood clots can form. These clots then can block blood flow at the site of the rupture or can travel to another part of the body. This can cause a heart attack or stroke.

Stroke is the #3 killer of women. When an artery leading to the brain gets either blocked by a clot or bursts, the brain can’t get the blood and the oxygen blood carries, so it starts to die. This then affects the part of the body the brain controls. Strokes can cause paralysis, affect vision and language, and other problems.

The Lowdown on Fat

Dietary fat is an essential nutrient. They help the body absorb certain vitamins (like vitamin A, D, E, and K), protect your organs, produce important hormones, and of course give you calories to give you energy. It is important to have a moderation, as you will often here Registered Dietitians say, the keys to healthy nutrition are “balance, variety, and moderation.”

One reason you need to have moderation is that fat is very energy dense, having 9 calories in every gram of fat (regardless of what type of fat is) whereas protein and carbohydrates only have 4 calories per gram. This makes it easier to consume excess calories when having fat.

Variety is important when it comes to the types of fat you eat. There are 4 kinds of fat: saturated fats, trans fats (aka trans fatty acids), monounsaturated fats, and polyunsaturated fats. These 4 types are all fat; they just have different chemical structures, leading to different physical properties.

1) While saturated fats are essential, too much of it can increase your cholesterol level, which is a major risk factor for heart disease and stroke. Saturated fat is mainly found in animal sources, such as meat and dairy products. Certain plant foods such as palm oil, palm kernel oil, and coconut oil also contain primarily saturated fats. The American Heart Association recommends limiting the amount of saturated fats you eat to < 7% of total daily calories. So if you eat 2000 calories a day, no more than 140 calories should come from saturated fats. This is about 16 grams of saturated fat.

2) Trans fat are created in an industrial process to make liquid vegetable oils more solid. It also helps increase the shelf life of the product and are inexpensive. Trans fats, also called “partially hydrogenated oils,” are found in baked products, fried foods, and stick margarine and shortenings. Trans fats raise your LDL (low-density

Page 2: Hearthealthy Newsletter

lipoprotein) cholesterol and lower your HDL (high density lipoprotein) cholesterol, a very bad combination. HDL cholesterol is needed to “sweep” the human body of excess cholesterol to be eliminated, whereas LDL cholesterol can form plaques. Eating a lot of trans fats increase your risk of developing heart disease and stroke, and is also associated with a higher risk of developing type 2 diabetes.

3) Monounsaturated fats are considered a “good” fat for when eaten in moderation and replace saturated fats, they can help reduce your LDL cholesterol and lower your risk of heart disease and stroke. Monounsaturated fats are typically liquid at room temperature but start to turn solid when cold. Olive oil, canola oil, sunflower oil, sesame oil, avocados, peanut butter, and many nuts and seeds are good sources of monounsaturated fats. This fat is also typically high in vitamin E, an antioxidant vitamin most Americans need more of.

4) Polyunsaturated fat is another “good” fat, like monounsaturated fats, when eaten in moderation and consumed in place of saturated fats and trans fats they can help reduce the cholesterol levels in your blood and lower your risk of heart disease. Polyunsaturated fats include the essential omega-6 and omega-3. These must be consumed in the diet and are crucial for the normal growth and development of your body. Foods rich in omega-6 include corn oil and soybean oil. Omega-3 rich sources are fatty fish (salmon, mackerel, trout, tuna), flaxseed, and walnuts.

Balance is needed for you need fat in your diet, just remember to balance the amount of calories you eat with the amount of calories you burn. Aim to eat more fruits and vegetables, whole-grain/high fiber foods, fat-free or low-fat dairy products, lean meats, poultry, and fish (at least 2x a week). This will give you a low intake of saturated fats and trans fats. You won’t have to avoid sugary or salty treats entirely, but you do need to eat less of these foods since they are energy dense, not nutrient dense.

Heart Healthy Recipe: Chicken Pot Pie

This version of pot-pie is loaded with vegetables, gets rid of the cream or milk usually called for in other recipes, and the crust is trans-fat-free. You may feel intimidated by the thought of making a piecrust from scratch, but not to worry this easy recipe will cure your fear!

Serves 8

Ingredients for the chicken2 tablespoons olive oil6 cloves crushed garlic1 tablespoon picked thyme leaves or 1 teaspoon dried1 tablespoon chopped fresh oregano or 1 teaspoon dried1 tablespoon chopped fresh tarragon or 1 teaspoon dried1 bay leaf

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2 teaspoons salt-free all-purpose seasoning1 teaspoon ground black pepper1/2 teaspoon salt2 cups frozen pearl onions, thawed1 cup carrots, peeled and cut into 1-inch cubes1 cup celery, cut into 1-inch pieces2 cups button mushrooms, quartered4 tablespoons flour3 cups low-sodium chicken stock1 pound skinless, boneless chicken breast, cut into 2" cubes1 cup frozen sweet peas, thawed1/2 cup chopped parsley

Ingredients for the crust1 and 1/3 cups flour1/2 teaspoon salt (optional)1/2 cup trans fat free margarine spread3 tablespoons ice water

Directions

In a large sauté pan over medium-high heat, heat the olive oil until hot. Stir in the garlic, thyme, oregano, tarragon, bay leaf, salt-free all-purpose seasoning, pepper, salt and sauté for one minute. Add the onions, carrots, celery, and mushrooms and sauté for two minutes. Stir in the flour and coat the vegetables well. Add the chicken stock and stir to blend well. Allow the mixture to come to a simmer. Stir in the chicken and simmer for five minutes. Stir in the peas and parsley. Remove from heat and pour the mixture into a 3-quart oval casserole. Cover loosely with foil and set aside.

Preheat the oven to 375°F. Line a rimmed baking sheet with foil and set aside. To make the crust, placed the flour (and salt, if using) in a medium-sized bowl and add the margarine spread, cut into in one-inch pieces. Cut the margarine spread into the flour with a fork or pastry cutter (this can all be done in a food processor) until crumbly. Avoid over-working the dough. Add the ice water and mix (pulse in a food processor) until the dough just comes together. Roll the dough between two pieces of film wrap until it matches the size of the casserole. (Hold the dish above the dough to check for correct size.) Peel off the top layer of wrap and bring the casserole next to the dough. Lift the dough by the bottom wrap and use it to help invert the crust onto the casserole. Trim the outside edges of the crust and gently press the dough so that it fits perfectly around the inside perimeter of the casserole dough. Cut eight, evenly spaced 1-inch vents in the dough as demarcations of portions and to release steam while baking.

Place the casserole on the foil-lined baking sheet and bake until the crust is golden brown and the juices are bubbling, about 45 minutes. Let the casserole rest for ten minutes before serving.

Note: This filling for the pie can be made a day or so in advance. Feel free to put an egg wash (one egg whisked with a tablespoon of water) on the finished pastry before baking if you prefer a sheen on your crust.

Nutrition Analysis (1/8 slice of pie)Calories 295Total Fat 9.0 gSaturated Fat 0.5 gTrans Fat 0.0 gPolyunsaturated Fat 1.5 gMonounsaturated Fat 5.0 gCholesterol 33 mgSodium 493 mgCarbohydrates 33 gSugar 4 gFiber 3 g

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Protein 19 gDietary Exchanges: 2 lean meat, 1 1/2 starch, 1 vegetable, and 1/2 fat

Recipe courtesy David Hagedorn, brought to you by the American Heart Association's Face The Fats program. Recipe copyright © 2007 by the American Heart Association.

Warning SignsHeart Attack Warning Signs:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

• Shortness of breath. This feeling may occur with or without chest discomfort. • Other signs of discomfort. These may include breaking out in a cold sweat,

nausea or lightheadedness. • As with men, women's most common heart attack symptom is chest pain or

discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

If you or someone you are with has chest discomfort, especially with one or more of the other signs, don't wait longer than five minutes before calling 9-1-1 for help.

Stroke Warning Signs• Sudden numbness or weakness of the face, arm, or leg, especially on one side of

the body • Sudden confusion, trouble speaking or understanding • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden, severe headache with no known cause

Not all these warning signs occur in every stroke. If you or someone with you has one or more stroke symptoms that last more than a few minutes, don't delay! Immediately call 9-1-1 or the EMS number so an ambulance (ideally with advanced life support) can quickly be sent to you.

Also, check the time so you'll know when the first symptoms appeared. It's very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.

Prepared by: Robin Lukas, WVU Dietetic Intern with Janie Godfrey Jennelle, RD, LD, LDN HCC Corp. Dietitian