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In June 2006 the
American Heart Associ-
ation (AHA) released
their latest Diet and
Lifestyle Recommenda-
tions for healthy Ameri-
cans. These guidelines
are an update to their
2000 dietary recom-
mendations.1
The new recommen-
dations focus on long-
term changes in diet
and other lifestyle fac-
tors associated with car-
diovascular disease.
• While the AHA
new guidelines con-
tinue to recommend
a modest reduction
in total dietary fat
to less than 30% of
energy, the empha-
sis remains on cut-
ting the LDL-cho-
lesterol raising
saturated and trans
fatty acids.
• In 2000, the AHA
recommended all
Americans cut their
intake of saturated
plus trans fat to no
more than 10% of
total calories and
limit cholesterol to
no more than
300mg per day. The
new guidelines go
even further reduc-
ing saturated fat
and trans fat intake
to no more than 8%
of total calories.
The average Ameri-
can diet contains
about 17% of calo-
ries from these two
cholesterol-raising
fats. The new
guidelines recom-
mend saturated fat
intake be reduced to
no more than 7% of
calories and cuts
trans fats to no
more than 1% of
calories.
• Unfortunately,
while the new state-
ment continues to
recognize the im-
pact of dietary cho-
lesterol in raising
I N S I D E
Consumer Education:Food News You Can Use
59
Recipes: Cook once, eat threetimes!
60
Handout: Heart Healthy Diet61
Handout: Food Log62
For Professionals:
Educators’ Idea File:Swiss Lifestyle Report
63
Dr. Jay’s Review: Vitamin K and Bones
64
Supplement:
Online PasswordSubscriber Benefits
Back Issue Highlights
N E X T I S S U E :
Soups
Portion Control
Healthful Plate
A U G U S T 2 0 0 6Continued on page 58
New Recommendations for Heart DietThe new 2006 Amer-
ican Heart Associa-
tion guidelines take
another step in the
right direction for
preventing cardiovas-
cular disease but still
have a ways to go
before they could be
considered optimal.
58 Communicat ing Food for Health Au g u s t 2 0 0 6
LDL and promoting
cardiovascular dis-
ease, the AHA con-
tinues to say up to
300mg of dietary
cholesterol a day is
acceptable. Adult
men currently con-
sume about 341mg
and adult women
about 242mg of cho-
lesterol a day so the
AHA guideline for
cholesterol intake
would have little or
no impact on LDL
levels even if all
American adults
adopted this guide-
line.
• The AHA for the first
time discourages the
consumption of re-
fined sugar and par-
ticularly in soft
drinks because of
growing evidence it
promotes weight gain
and adds “empty
calories” to the diet.
• The new statement
discontinues their
earlier recommenda-
tion to increase soy
protein to lower LDL
levels.
• Despite the Institute
of Medicine’s state-
ment indicating even
healthy young Amer-
icans should ideally
consume no more
than 1,500mg sodi-
um per day, the AHA
continues to recom-
mend sodium be lim-
ited to less than
2,300mg per day
even though they
agree with the Insti-
tute of Medicine’s re-
port that blood pres-
sure rises with
sodium intakes above
1,500mg/day. Why?
They believe the sci-
entifically more ap-
propriate goal “…is
not easily achievable
at present.”
No one can argue with
the AHA’s current rec-
ommendation to attain
and maintain a healthy
body weight and be more
physically active. How-
ever, the AHA continues
to recommend calorie
counting for weight con-
trol even though there is
little reason to believe it
is effective in the long
run by itself. A far better
approach would be to
recommend even greater
amounts of whole fruits,
vegetables, beans and
whole grains. Indeed, the
evidence is fairly good
that reducing dietary fat
aids weight loss largely
because it reduces calorie
density and increases
satiety per calorie.
Bottom Line: Clearly the AHA con-
tinues to move in the
right direction. The less
saturated fat and trans fat
the better. However, giv-
en the growing evidence
of the adverse effects of
trans and saturated fats
on human health they
should have recommend-
ed limiting trans fat as
much as possible and sat-
urated fat to less than 4%
of energy. The AHA’s
failure to take more ag-
gressive stands on
salt/sodium and choles-
terol despite recognizing
that greater reductions
are certainly safe and
more effective for reduc-
ing heart disease risk fac-
tors makes it clear that
the AHA is still far from
recommending an opti-
mal diet for reducing car-
diovascular disease.
By James J. Kenney,PhD, RD, FACN.
1. Circulation2006;114:1-15
Continued from front page
For Americans age 2 and older, the AHA recommends:
• further reducing saturated and trans fatty acids in the diet;
• minimizing the intake of food and beverages with added sugars;
• emphasizing physical activity and weight control;
• eating a diet rich in vegetables, fruits and whole-grain foods;
• avoiding use of and ex-
posure to tobacco prod-
ucts; and
• achieving and maintain-
ing healthy cholesterol,
blood pressure and blood
glucose levels. Source:
http://www.american-heart.org
New Guidelines from American Heart Association
Current Intake 2000 Guide 2006 GuideFat 34% ≤30% ≤30%
Saturated Fat 15% ≤10% ≤7%
Trans fat 2.6% n/a ≤1%
Cholesterol(mg) 242-341 ≤300 ≤300
Sodium(mg) ~4,000 ≤2,300 ≤2,300
Sources: Am J Clin Nutr 1999;70:992–1000, www.cfsan.fda.gov≤ less than or equal to - these are the upper limits - less is better!
Most popular fastfood places
McDonald's, KFC,
and Burger King are the
top three chain restau-
rants, according to the
Restaurants & Institu-
tions 2006 ranking of
the Top 400 chains. All
three of these establish-
ments have online re-
search tools to deter-
mine the nutrition facts
for their foods:
mcdonalds.combk.comkfc.com
Whole grainstamp change
The Whole Grains
Council has changed
their Whole Grain
Stamp design. The new
design retains the same
black-and-gold graphics
as the original stamp,
but it now offers more
information for con-
sumers.
“Each stamp now de-
clares the whole grain
content of the food in-
side the package, such
as ‘27g or more per
serving’,” explained
Jeff Dahlberg, Chair-
man of the Whole
Grains Council. To re-
mind consumers how
this amount contributes
to their daily needs for
whole grain, text direct-
ly below the Stamp
says, “Eat 48g or More
of Whole Grains Dai-
ly.” This information
replaces the former
wording of “Good
Source” and “Excellent
Source” of whole
grains.
Standards for quali-
fying products remain
the same as in Phase I.
Products must contain
at least 8g (half a
“Pyramid serving’) of
whole grain to use the
Stamp. Stamps on
products with at least
16g (a full ‘Pyramid
serving’) of whole
grain may also add
‘100%’ if all the grain
in the product is whole
grain.
The Whole Grain
Stamp has become fa-
miliar to many con-
sumers. In a recent sur-
vey conducted by
Harris Interactive for
Uncle Ben’s,
51% of con-
sumers said that
they would be
more likely to
buy a product
bearing the
Whole Grain
Stamp. Origi-
nally introduced
in January of
2005, the
Stamps now ap-
pear on over
650 products
from 61 compa-
nies, on grocery shelves
across the nation.
“Consumers trust the
Stamp,” said K. Dun
Gifford, President of
Oldways, as he com-
mented on the success
of Phase I. “The Stamp
makes it easy for har-
ried shoppers to find
healthy whole grains –
and the new Phase II
design makes product
comparisons even
easier.”
For more informa-
tion, visit online at
www.wholegrains.org.
Eat at home daySeptember 25th is
Eat At Home Family
Day. For more informa-
tion, see their site at
www.casafamilyday.org
Family Day is celebrat-
ed on the fourth Mon-
day in September. Sep-
tember is also Choles-
terol Education Month
and it is also National 5
A Day month. What a
great idea to combine
healthy eating and
cooking at home with
family.
MyPyramidbrochure available
The U.S. government
has released a printed
brochure designed to
make MyPyramid in-
formation more accessi-
ble to a wider range of
consumers. It is being
printed and will be
available in stores soon.
To access this new 6-
page brochure online,
go to www.ific.org and
click on Publications
then Brochures. See the
title, “Your Personal
Path to Health: Steps to
a Healthier You!”
ht t p : // w w w. fo o d a n d h e a l t h . co m 59
F o o d N e w s Y o u C a n U s e
Garlic Chicken - Day 18 chicken breasts, boneless, skinless
Grated peel and juice of 1 lemon
Black pepper to taste
Crushed garlic - 2 cloves
Pinch dried thyme leaves
8 cups steamed brown rice
Directions:
1. Place chicken breasts in
large shallow baking pan and top
with lemon, pepper, garlic and
thyme. Preheat oven to 350 de-
grees. Bake chicken until done,
about 15 minutes.
2. Meanwhile, cook rice in
rice steamer or according to
package directions..
3. Put half of rice and 4 chick-
en breasts in refrigerator for
Days 2 and 3. Serve chicken
with rice and large tossed salad.
Serves 4. Each 1.5 cup serv-
ing: 359 calories, 4.5 g fat, 1 g
saturated fat, 0 g trans fat, 72 mg
cholesterol, 73 mg sodium, 47 g
carbohydrate, 31 g protein, 4 g
fiber.
Penne Bake - Day 28 oz penne, cooked
26 oz jar low-sodium pasta sauce
2 cooked chicken breasts, diced
2 cups peas and carrots
2 Tbsp. grated Parmesan cheese
Directions:
1. Combine chicken, cooked
pasta, pasta sauce and peas and
carrots in large microwave con-
tainer.
2. Cook on high until heated
through, about 6 minutes. Stir
and top with cheese.
Serve Penne Bake with large
tossed salad or steamed spinach.
Serves 4. Each 2 cup serving:
397 calories, 3.7 g fat, 1 g satu-
rated fat, 0 g trans fat, 38 mg
cholesterol, 380 mg sodium, 64 g
carbohydrate, 26 g protein, 7 g
fiber.
Chicken Fried Rice - Day 31 tsp vegetable oil
1 cup sliced green onions
2 cups sliced mushrooms
1/2 cup nonfat egg substitute
2 cooked chicken breasts, diced
Light soy sauce to taste (2 Tbsp)
Sesame oil to taste (1 Tbsp)
Garlic powder to taste
Red pepper flakes to taste
4 cups cooked brown rice
Directions:
1. Heat oil in large nonstick
skillet over medium-high heat.
Saute green onions and mush-
rooms.
2. Add the eggs and scramble
until done.
3. Add the chicken, season-
ings, rice and a little water. Cov-
er and heat through. Serve hot.
This dish goes great with a large
tossed salad or sliced cucumbers.
Serves 4. Each 2 cup serving:
358 calories, 8 g fat, 1.5 g satu-
rated fat, 36 mg cholesterol, 296
mg sodium, 47 g carbohydrate,
22 g protein, 3.5 g fiber.
60 Communicat ing Food for Health Au g u s t 2 0 0 6
Save time in your
kitchen! Cook
rice, pasta,
chicken or fish one night
and serve again as a dif-
ferent dish the next
night!
Cook extra chicken,
pasta, fish or rice so you
have it for tonight’s
meal. Then put aside half
to make a different meal
the next night. Make sure
you refrigerate extras
promptly!
Here are some ideas:
• Chicken and Rice:
Serve rice and baked
chicken one night.
Make a chicken-rice
main dish salad or
chicken-vegetable-stir
fry the next night.
• Fish: Serve baked fish
one night. Use flaked
fish the next night for
tacos or use in a main
dish salad the next
night.
• Pasta: Serve a hot pas-
ta dish one night and
then vegetable pasta
soup the next night. It
is best to use small-
shaped pasta like maca-
roni.
Ta ke T h re eCook one night,
eat three nights
61 Communicat ing Food for Health Au g u s t 2 0 0 6
Are You Eating Right for Your Heart?
The American Heart Association updated
its guidelines for a heart-healthy diet
and lifestyle. Here is an overview of
their recommendations:
1. Lower Consumption of Bad FatWhat: Saturated fat and trans fat clog arteries
so they have to be limited.
Where: Saturated fats are typically found in all
fatty animal products including meat and dairy,
especially cheese. Trans fats are usually found in
fried foods and processed foods made with par-
tially hydrogenated fats, like margarine, crackers,
cookies, baked goods and frozen entrees and
desserts.
How much: Limit saturated fat to no more than
7% of calories and trans fats to less than 1% of
calories. Here is a guide according to calorie in-
take:
Calories Saturated Fat (g) Trans Fat (g)
1,200 9 1.2
1,500 11.5 1.5
2,000 15 2
All fat in the diet needs to be 30% or less of
total calories. Many studies have shown that
decreasing the fat in the diet, while increasing
fiber from fruits, vegetables, beans and whole
grains, is the key to long-term weight control.
Cholesterol, also found in animal products
like meat, poultry, seafood and egg yolks,
should be limited to 300 mg per day. Studies
show that less is than 100 mg is optimal.
2. Lower Consumption of SugarThe AHA discourages the consumption of
sugar, especially from beverages because it
promotes weight gain. Sugar is commonly
found in beverages, cookies, desserts, ice
cream and sweetened cereals.
3. Lower Consumption of SodiumMost individuals need to cut their sodium
consumption by at least half. The AHA recom-
mends no more than 2,300 mg of sodium per day.
But the Institute of Medicine has a more ideal
limit of 1,500 mg and this is agreed in the Di-
etary Guidelines for Americans who are at risk
for or who have high blood pressure. If you don’t
use the salt shaker, you are not off the hook!
Most people eat too much sodium from processed
foods and meals eaten away from home.
4. Make Your Lifestyle HealthierIf you smoke you should quit. Attain and
maintain a healthy body weight and be more
physically active. You should
increase your physical activi-
ty so you are getting at least
30 minutes of exercise per
day on most days.
Here is what you need to know to have a healthier diet for your heart. This advice is great for every-one - whether you already have high cholesterol or your want to avoid it. This is the latest advicefrom the American Heart Association. For more information, visit www.americanheart.org.
Common Sources of Satu-rated Fat and Trans Fat inthe American Diet
Food Saturated Fat(g)Trans Fat(g)
Prime rib steak, 12 oz 36 n/a
Cupcake 15 5
Pot Pie 15 14
Cheeseburger, double 11.5 1.5
Cheese, 1 oz 6 n/a
French fries, large 6 8
Cake donut 5 4
Chicken Nuggets, 10 5 2.5
Cake, 1 slice 5 1
Pizza, 1 slice 4.5 n/a
Whole milk, 1 cup 4.5 n/a
Mac and Cheese 3.5 1
Oatmeal Raisin Cookie 2.5 4.5
Fried chicken, drumstick 2.5 1.5
Biscuit 2 3.5
Sources: mcdonalds.com, kfc.com, starbucks.com,dunkindonuts.com, USDA database
ht t p : // w w w. fo o d a n d h e a l t h . co m 62
What and how much did you eat? Time of day: Hunger Calories in: rating (1-5):
Total calories in:
What exercise did you do? For how long? Calories out:
Total calories out:
Calories in - calories out = total calorie intake:
Notes: Write down everything you eat and drink each day. Record meals, snacks, little tastes, bever-
ages, candy, drinks and foods eaten at the gym, rolls and butter at a restaurant, etc. Look up calories at
www.thecaloriecounter.com.
For the hunger rating, 1 is not very hungry while 5 is extremely hungry.
Write down exercise completed. Look up exercise calories burned at www.caloriecontrol.org.
Food and Activity Log
Daily Checklist:__ Are you eating
at least 4.5 cups of
fruits and vegeta-
bles?
__ Are meals
evenly spaced,
with about 4-5
small meals, in-
cluding breakfast?
__ Are you eating
at least 3 whole
grain foods?
__ Are you getting
at least 3 cups of
skim milk or non-
fat yogurt?
__ Are protein
choices lean and
small in size (3
oz)?
Daily Checklist:__ Are you get-
ting at least 60
minutes of exer-
cise most days?
ht t p : // w w w. fo o d a n d h e a l t h . co m 63
Walk more, buy lessWhile on tour in Switzerland
with my son this summer, I be-
gan noticing something very
different. Everyone was fit and
active and a healthful weight.
We noticed a few things right
off the bat that were different
that could explain how the peo-
ple there are more active and
eat less than in the U.S. Gas is
about $6 per gallon. So people
tend to walk more and drive
less. And since the cities are
small and well connected, this
is easy and fun to do. Most of
the trains, buses and trams ac-
commodate bicycles and people
carrying backpacks. We really
didn’t miss our car!
The grocery stores, whether
in small towns or large cities,
were VASTLY different from
ones we know in the U.S. I
would think they are the
antonym for the Super Wal-
mart! We absolutely LOVED
our grocery shopping experi-
ences. And we were fortunate
enough to have rented a small
studio apartment ($400 for 12
days) so we could cook every
morning and night.
Forget about the large cart
that you push - they don’t have
those and there is no room for
carts. And forget about the
aisles and aisles of refined
foods and packaged foods be-
cause they don’t have those ei-
ther. The stores are small, about
the size of a drug store here.
One store only had 3 or 4
choices of boxed cereal. The
rest of the breakfast grain
choices were whole grains like
rolled oats, most of which go
into a delicious breakfast dish
called muesli. Muesli is a mix-
ture of oats, yogurt and fruit.
We did not see a whole aisle of
chips or soda - only a few
choices and they were expen-
sive by our standards.
You use a small hand basket
and only buy enough food for 1
or 2 days. The produce section
was usually the largest in the
store. Meat prices were expen-
sive ($6-8 for one chicken
breast) so the portions would be
small for most people. We ate a
huge fresh salad for lunch and
dinner accompanied most often
with pasta, lentils and fresh
bread.
Lunch for two at a McDon-
alds cost us $20. My son or-
dered a cheese sandwich, fries
and a soda. I ordered a ham-
burger, large tossed salad and
diet soda. This meal here in the
U.S. would only cost us about
$6. I must say this was our
cheapest meal out. Dinner for
two at a casual Italian style cafe
topped $90 and we only shared
a pizza, pasta and salad dish be-
tween the two of us.
The Swiss eat a lot of high-
fat dishes that are rich in
cheese. But they eat LESS. And
there are far fewer refined,
processed foods like chips, ce-
reals, cookies, pretzels, crackers
and cakes. They do have the
most wonderful chocolates and
pastries, but the portions are at
least 1/8th of the size as to what
you find here. A whole cake in
the windows of a Swiss bakery
would be about the size of one
slice of cake offered here in the
Cheesecake Factory. The cook-
ies are much smaller, too. Even
coffee, served in most of the
bakeries, is a single serve
proposition - there are no re-
fills.
Hiking was so easy and so
fun. Every town had numerous
signs for so many places to go
by foot, along with the time it
takes to walk to them! You
could hike 20 minutes to a hotel
or park, 2-5 hours to city or top
of a mountain or 5 days across
many mountains. We often en-
joyed taking a cable car to the
top of a mountain and then
walking down - this is easy and
enjoyable for most people.
We do have pictures of our
trip, complete with food shots
and hiking trails online at
http://www.foodandhealth.com/Highlights/.
A great class idea from this?
To publish many local walks
and the time and distance they
take. Encourage everyone to
share their favorite walks - and
to keep practicing portion con-
trol and disciplined shopping!
E d u c a t o r s ’ I d e a F i l e
Most people have heard it is im-
portant to get enough calcium and
vitamin D to grow and maintain
strong bones that can resist frac-
tures. But few have heard of the
bone strengthening effects of vita-
min K. There are two main forms
of vitamin K. Vitamin K1 is called
phyoquinone or phytonadione and
is found mainly in green vegeta-
bles like spinach, broccoli, lettuce,
and kale. Vitamin K2 is made up
of menaquinones that can be syn-
thesized in the human gut by mi-
cro-organisms. There are several
kinds of these menaquinones and
small amounts occur in meats and
fermented products like cheeses
and natto. However, about 90% of
the vitamin K in the American diet
comes from vegetables. There is
also a synthetic form of vitamin
K3 but it is not recommended for
human consumption.
People who have heard of vita-
min K may be familiar with its im-
portant role in blood coagulation
but few realize it is also necessary
for making a protein called osteo-
calcin. Osteocalcin is a protein
needed to bind calcium to the bone
matrix. An inadequate intake of vi-
tamin K may reduce this protein to
the point where bone mineral den-
sity is reduced and bone structure
is compromised.
A recent meta-analysis examined
7 studies in which elderly subjects
were given either 15 (one study) or
45mg of vitamin K2 or a placebo.
Remarkably those taking the sup-
plements of vitamin K had reduc-
tions in hip fractures of 77% com-
pared to those given a placebo.
Fractures of the vertebrae were cut
by 60% and all other fractures
were reduced by 81%. None of the
individual studies reported any se-
rious side effects from the vitamin
K supplements although there did
appear to be some increase in GI
problems. The authors of this study
conclude “From a clinical perspec-
tive, the results of this review sug-
gest that patients at risk for frac-
tures should be encouraged to
consume a diet rich in vitamin K,
which is chiefly obtained from
green leafy vegetables and certain
vegetable oils.”1
By James J. Kenney, PhD, RD,FACN.
1. Arch Intern Med2006;166:1256-61
Vitamin K Improves Bone Health
3979 Nighthawk Drive, Weston, FL 33331Phone: 800-462-2352, Fax: 800-433-7435
www.foodandhealth.com
E X E C U T I V E E D I T O R
Judy Doherty
C O N T R I B U T I N G E D I T O R S
James Kenney, PhD, RD, LD, FACN;Sarah Mohrman, RD, MA; Victoria Shanta-Retelny, RD, LD
C O P Y E D I T O R S
Victoria Shanta, RD, LD;Lou Yovin, Marjory Yovin
I L L U S T R A T I O N S
Marjory Yovin, Daniel Jackler
E D I T O R I A L A D V I S O R Y B O A R D
Diana Dyer, MS, RDAuthor, Dietitian’s Cancer Story
Connie Evers, MS, RDChild Nutrition Consultant, 24 Carrot Press
Janet Harris, MS, RDWIC Nutritionist, Deschutes County
Barbara Hart, MS, RD, LDNWIC Nutritionist, State of Tennessee
Alice Henneman, MS, RD, LMNTUniversity of Nebraska Cooperative Extension
Christine Hoban, MS, RD, CD, CNSDConsultant Dietitian
Nancy Kennedy, MS, RDNutritionist, Ministrelli Women’s Heart Center
James Kenney, PhD, RD, LD, FACNNutrition Research Specialist, Pritikin Longevity Center
Barbara Miller, MEd, CHEPenn State Cooperative Extension
Beth Payne, MS, RD, LDConsultant Dietitian
Margaret Pfeiffer, MS, RD, CDNutrition Educator, Heart Care Center
Linda Rankin, PhD, RD, FADAAssociate Professor, Idaho State University
Beth Rosen, MS, RD, CDNNutrition Consultant, Worksite Wellness
• • •Communicating Food for Health
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