"Red Wine and Dark Chocolate" February 6, 2014 Sharon Smalling, MPH, RD, LD Clinical Dietitian Specialist Memorial Hermann Hospital - Texas Medical Center

"Red Wine and Dark Chocolate"February 6, 2014

Sharon Smalling, MPH, RD, LDClinical Dietitian Specialist

Memorial Hermann Hospital -Texas Medical Center

HOTHOT

HEART HEALTH:EMERGING

TOPICS!

This paper outlines the best diet pattern for preventing and reducing cardiovascular risk

Reference:Eckel, Robert, et al. 2013 AHA/ACC Guideline on Lifestyle Management to

Reduce Cardiovascular Risk. Circulation. Published online November 12, 2013; accessed online November 13, 2013. http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437740.48606.d1

Let the Guidelines Begin!The 2013 AHA/ACC Lifestyle Guidelines are Released

• Consume the DASH dietary pattern for positive effects on cardiovascular health

• Lower sodium intake• Aim for saturated fat <6% of total calories• Avoid trans fats from processed foods

Today’s topics



Today’s topics

Dash to get on the DASH diet!

Although the DASH and Mediterranean diets are similar, the DASH diet was

voted #1 by a distinguished group of nutrition experts

Szokan, Nancy. The best diets according to US News and World Report; The Washington Post; Jan 6, 2014; accessed online Jan 7, 2014. http://www.washingtonpost.com/national/health-science/the-best-diets-according-to-us-news-and-world-report/2014/01/06/4dc78d12-7262-11e3-9389-09ef9944065e_story.html

Basic idea of DASH, as described by the panel of experts…

“Emphasize the foods you’ve always been told to eat (fruits, veggies, whole grains, lean protein, and low-fat dairy), while shunning those we’ve grown to love (calorie- and fat-laden sweets and red meat). Top it all off by cutting back on salt, and voilà!”

What is the DASH Diet?• The Dietary Approaches to Stop Hypertension Diet is a well balanced, nutritious

eating pattern that incorporates a variety of foods for cardiovascular health• Here we will look at the servings given for a 2000 calorie diet

To lose weight, eat one fewer servings of grains, meat, fruit, and fat, and limit sweets/added sugars to 3 servings per week

What is the DASH Eating Plan? National Heart, Lung, and Blood Institute; July 2, 2012; accessed online Jan 7, 2014. http://www.nhlbi.nih.gov/health/health-topics/topics/dash/

Whole Grains• Choose 6-8 servings of grains, especially whole

grains– Whole wheat bread, whole grain pasta, brown rice,

oats, crackers, and cereal• What’s a serving?– 1 slice bread– ½ cup pasta, rice, or hot cereal– 1 oz crackers or dry cereal (about ¾ cup)

Fruits• Choose 4 servings of fruit – in any form– Fresh fruit– Unsweetened frozen, canned, or dried fruit– Fruit juice

Choose whole fruit more often than juice for fewer calories and sugar, and more fiber

• What’s a serving? – 1 medium fruit– ½ cup cut-up fresh, canned, or frozen fruit– ¼ cup dried fruit– ½ cup fruit juice

Vegetables• Choose 4 servings of vegetables in any form– Fresh, frozen, canned, or dried vegetables

Check the label for sodium content

– Vegetable juiceLike fruit, choose whole vegetables more often than juice for fewer calories, sodium and sugar, and more fiber

• What’s a serving? – 1 cup raw leafy vegetables– ½ cup cut-up raw or cooked vegetables– ½ cup vegetable juice

Low Fat or Fat-Free Dairy• Choose 3 servings of low fat or fat-free dairy foods– Low fat (1% or 2%) milk, skim milk, or dairy-free

milk– Light or fat-free yogurt– Reduced-fat cheese, cheese made with 2% milk

• What’s a serving?– 1 cup milk– 1 cup yogurt– 1 ½ oz cheese

Meat, Poultry, and Fish • Choose 6 ounces or less of lean meat, poultry, and

fish– Broiled pork chop/trimmed steak– Baked skinless chicken or turkey breast– Grilled fish or tuna packed in water– Egg

• What’s a serving?– 3 ounces meat, poultry, or fish– 1 egg (limit yolk to 4 per week)

Nuts, Seeds, and Dried Beans• Choose nuts, seeds, and dried beans/peas 4-5 times

a week– Almonds, walnuts, pistachios, pecans, peanuts– Pumpkin seeds, sunflower seeds, chia seeds– Black beans, chickpeas, kidney beans

• What’s a serving?– ⅓ cup nuts– 2 Tbsp seeds– ½ cup beans/peas

Heart-healthy Fats & Oils• Choose 2-3 servings of heart-healthy fats and

oils to cook and flavor food

• What’s a serving?– 1 tsp vegetable oil– 1 tsp tub spread/margarine– 2 Tbsp light salad dressing

Enjoy SPARINGLY…

What about the other stuff?

So…what should I eat for breakfast?

Breakfast

• 1 cup quick-cooking oatmeal – 1 tsp cinnamon– ½ tsp Splenda® brown sugar blend– ¼ cup raisins– ⅓ cup chopped walnuts

• 1 cup fat-free milk

Lunch• Turkey sandwich:– 2 slices 100% whole wheat bread– 3 oz low sodium turkey lunchmeat– green leaf lettuce/tomato & cucumber slices– 1 ½ oz low fat Swiss cheese– 1 Tbsp light mayonnaise

• 1 cup grapes

Snack• Morning snack:– ½ cup baby carrots (approximately 5)– 16 almond crackers

• Afternoon snack– 5.3 oz container non-fat Greek yogurt– ½ cup unsweetened peaches

Dinner• Spaghetti– 1 cup whole grain spaghetti noodles with ½ cup

“heart healthy” spaghetti sauce– 3 oz lean ground beef (90/10)– 2 Tbsp grated Parmesan cheese, reduced-fat

• Tossed salad – 1 ½ cup lettuce & assorted vegetables– 2 Tbsp reduced-fat French dressing

• ½ cup strawberries



Today’s topics

• Consume no more than 2,400 mg per day• For those with high blood pressure, aim for 1,500

mg per day• Reducing sodium intake by 1,000 mg daily will have

positive effects on blood pressure, even if intake is still above 1,500 or 2,400 mg

Different Strategies, Same Goal: Lower Sodium

• Reducing your sodium intake by 1,000 mg doesn’t have to take a lot of work, just make some easy substitutions!

Reducing Sodium

See if you can pick out the winner…

versusversus1 packet of apple cinnamon flavored instant oatmeal

Quick-cooking oats with raisins, walnuts, cinnamon, and brown sugar blend

Round 1: Breakfast

186 mg186 mgsavedsaved

versusversusSandwich with 2 ounces of ham

Sandwich with 2 ounces pre-made tuna salad from a pouch

Round 2: Lunch


versusversusCheddar cheese and 10 saltine crackers

Reduced-fat cheese and 16 almond crackers

Round 3: Snack


versusversus

Round 4: Dinner

1 Tablespoon of your own spice blend (garlic, paprika, pepper, etc.)

¼ teaspoon Creole seasoning


Go for the and save 1000 mg!• Apple cinnamon

flavored instant oatmeal

• Ham sandwich• Cheese and crackers• Creole-seasoned chicken

• Quick-cooking oats with cinnamon, raisins, walnuts, and brown sugar blend

• Sandwich with tuna salad from a pouch

• Low fat cheese and lower sodium crackers

• DIY-seasoned chicken1,060 mg1,060 mgsavedsaved



Today’s topics

Reduce percent of calories from saturated fat to <6%

Saturated Fat

• In a 2000 calorie diet, that’s 13 grams total• We talk a lot about limiting foods like high fat

meats, whole milk and cheese, and butter

Where are the rest of the saturated fats we eat?

Here are some other sources of saturated fat to watch out for:

Saturated Fat

• Microwave popcorn• Some peanut

butters/Nutella• Baked goods• Non-dairy creamers

• Ramen noodles• Granola bars• Chips – even bagel

crisps and veggie chips

Here are some other sources of saturated fat to watch out for:

Saturated Fat

• Microwave popcorn 3 c = 2.3gm

• Some peanut butters/Nutella 2T =3+ gm

• Baked goods2.5 gm

• Non-dairy creamers1T = 2 gm

• Ramen noodles1 pkt = 6.6 gm

• Granola barschoc chip = 3.2 gm

• Chips –bagel crisps 6 = 1.9 gmveggie chips1 oz = .5 gm



Today’s topics

• 2005 Guideline: keep trans fat consumption as low as possible• 2010 Guideline: avoid consumption from processed foods; limit to <.5% of

total calories consumed from natural sources; in a 2000 calorie diet this equals 1-2 gm per day

• AHA/ACC Lifestyle Guideline: reduce consumption of trans fat in the diet• Sources:

– Natural: milk, beef, goat, deer, buffaloReducing intake of saturated fat from meat and dairy will result in

lower trans fat intake– Commercial: fried and baked foods; stick margarines; foods containing

partially hydrogenated vegetable oils

NOTE: A nutrition label may state “0” gm trans fat as long as a serving contains <.5gm.

Trans Fat

“More than ever it’s time to embrace the idea that eating basic healthy foods throughout the day is key to a strong immune system, long-term health, and energy to live the life you want to live.”

Smart Bytes® Nutrition Blog www.karencollins.com/smartbytes

Our Quote for the Night…

heart.memorialhermann.org/heart-healthy-diets

Documents

"Red Wine and Dark Chocolate" February 6, 2014 Sharon Smalling, MPH, RD, LD Clinical Dietitian Specialist Memorial Hermann Hospital - Texas Medical Center