Heart Healthy Nutrition
By: Dr. Peggy Malone
Happy Thanksgiving to all my Canadian readers. You may be sitting down to a delicious Thanksgiving feast today so this post may be well timed
Cardiovascular disease is the number one killer of North Americans so anything that you can learn to prevent it is very important.
On this week’s episode of my television show Living Well, I chatted with Public Health Dietician Cathy MacPherson about nutrition and heart health. I also interviewed Ryan Meloche from Douglas Laboratories and Pure Encapsulations. We had so much to talk about with these two experts that today is part one on this topic.
Here is what Cathy had to say about heart disease and nutrition:
What is Cardiovascular Disease (CVD)?
-Most of us are born with healthy hearts designed to function for 80 years or more
-Very few of us reach that age without some form of CVD (diseases of the heart and the blood vessels)
-Despite great medical advances, CVD remains the leading cause of death in Canada
-One of the most common types of this disease is atherosclerosis, or hardening of the arteries (fatty deposits on the inner lining of the artery walls reduce the artery’s width, slowing the flow of blood and increasing the risk of blockage leading to HEART ATTACK or STROKE)
-Many experts believe that these deposits are, in part, caused by high blood cholesterol levels affected by both genetics and lifestyle
-Good news, evidence suggests that narrowing of the arteries can be slowed down by eating a healthy diet and enjoying an active, healthy lifestyle.
What are some of the risk factors for cardiovascular disease?
Inherited risk factors:
-Family history—greater risk if one of your parents or a sibling suffers from angina (chest pain); has had a heart attack; has elevated blood cholesterol; has high blood pressure or diabetes
-Greater risk if male and over 55
-Greater risk if female over 65; once a woman reaches menopause, as susceptible to heart disease as a man (estrogen provides protective affect)
-Aboriginal or South Asian carries greater risk
-Diabetes is a risk factor
Risk factors you can change:
-High blood cholesterol
-High blood pressure
-Lack of physical activity
-Being overweight or obese
-High levels of triglyceride
What are some of the warning signs of a heart attack?
Knowing these signs can help you to get medical treatment quickly:
-Sudden discomfort or pain that does not go away with rest
-Pain that may be in the chest, neck, jaw, shoulder, arms or back
-Pain that may feel like burning, squeezing, heaviness, tightness or pressure
-In women, pain may be more vague
-Chest pain or discomfort that is brought on with exertion and goes away with rest
Shortness of Breath
-Cool, clammy skin
What are some of the stroke warning signs?
Knowing the signs can help you to get medical treatment quickly, significantly improving survival and recovery:
-Sudden loss of strength or sudden numbness in the face, arm or leg , even if temporary
-Sudden difficulty speaking or understanding or sudden confusion, even if temporary
-Sudden trouble with vision, even if temporary
-Sudden severe and unusual headache
-Sudden loss of balance, especially with any of the above signs
Why is being overweight or obese is a risk factor?
-Obesity is an independent risk factor for CVD (excess weight adversely affects CVD risk factors)
-A Body Mass Index of 25 or over (BMI shows you the range of weights that can be healthy for you); see www.heartandstroke.ca for more information
-An apple-shaped body carries extra pounds around the waist and a pear-shaped figure has extra weight around the hips and thighs; an apple shape carries with it a greater risk of CVD:
-Women waist more than 35” (88 cm) greater risk
-Men waist more than 40” (102 cm) greater risk
-Best news is, a weight loss of as little as 5-10% can improve your risk (e.g. 200 lbs, losing 10 to 20 lbs)
Since high blood fat is a risk factor, could you give us some ideas on how to keep them healthy?
Keep your blood fat healthy by looking at the type of fat that you eat, and keeping the amounts of fat that you consume moderate (about 20-35% of energy from fat).
There are different types of cholesterol in your bloodstream:
-HDL cholesterol– hauls excess cholesterol back to the liver to be removed from the body; this is the ‘good’ cholesterol, so you want it high
-LDL cholesterol–leaves plaque deposits in the artery walls; ‘bad’ cholesterol, so you want it low
There are different strategies that you can take to increase HDL and decrease LDL:
-Boost HDL cholesterol in your blood by quitting smoking; exercising regularly; eliminating trans fat; and maintaining a healthy weight
-Lower LDL cholesterol in your blood by decreasing your intake of saturated and trans fat, and replacing them with healthy unsaturated fat; increasing your soluble fibre intake (soluble fibre is plentiful in oats/oat bran, barley, legumes, fruit such as berries, oranges and apples, vegetables such as carrots and broccoli); and maintaining a healthy weight
Another important blood fat is triglyceride:
-High levels are consistently associated with a higher risk of cardiovascular disease
-Triglyceride is the main way fat is stored in both food and the body
Ways to keep Triglyceride low:
-Work towards a healthy weight
-Minimize your intake of sugars (pop, candy, sweet desserts)
-Increase omega 3 fat
Saturated fat (raises blood cholesterol levels)
-Found mostly in firm fat that comes from animal food sources such as meat, butter, full-fat milk, cream and cheese
Trans fat (raises LDL and lowers HDL)
-Industrially produced (liquid oil to hard fat with a longer shelf life)
-Found mainly in processed food that contain shortening or partially hydrogenated vegetable oil (like hard margarines, some cookies/crackers/deep fried food)
-Not only can increase LDL, also shown to decrease HDL
-Trans fat also occurs naturally in smaller quantities in ruminant sources (milk, butter and meat)
Polyunsaturated fat (lowers blood cholesterol levels)
-Found mainly in vegetable oils such as safflower, canola and corn oil
-Must come from the diet (can’t be produced by the body)
-Omega-3 fat, a type of essential polyunsaturated fat, is found in fatty fish, canola oil, ground flaxseed, and some soft, non-hydrogenated margarines (more and more being added to foods like yogurt)
-To reduce CVD risk, you are advised to consume two servings/week of preferably fatty fish (char, herring, mackerel, salmon, sardines, trout); two food guide servings can contribute 300-450 mg/day EPA and DHA; if you do not eat fish consistently, talk to your health care provider about omega-3 supplements
Monounsaturated fat (tends to lower blood cholesterol)
-Found in olive and canola oil, and foods such as soft margarines that contain these oils
Dietary cholesterol (may increase blood cholesterol in some people)
-Animal products (meat, full-fat dairy products like butter and cheese), egg yolks and organ meat are major sources of dietary cholesterol
-Effect of dietary cholesterol less profound than saturated and trans fat
-Less than 300 mg per day may help to prevent CVD
Other than maintaining a healthy weight and healthy blood fats, is there anything else we need to keep in mind?
Consume a diet rich in whole grains and dietary fibre:
-Greater whole grain intakes are associated with a lower incidence of CVD
-Reducing the intake of refined carbohydrate and sugar is critical to achieving a healthy weight and maintaining healthy triglyceride levels
-Recommended to consume at least half of all grain products eaten each day as whole grains and to limit foods and beverages high in calories and added sugars
-Beware of sugar found in beverages!
Consume a plant-based diet rich in fruit and vegetables:
-These foods tend to contribute key nutrients (e.g. vitamin C) and soluble fibre that may protect against CVD
-These foods do not tend to supply substantial calories, so a high intake may help achieve a healthier body weight
-There is consistent evidence to suggest that a diet rich in vegetables and fruits (more than five servings per day) is associated with a decreased risk of CVD
Choose ‘Low Glycemic Index’ (GI) carbohydrate food choices:
-The Glycemic Index (GI) is a scale that ranks carbohydrate-rich foods by how much they raise blood glucose levels compared to a standard food (glucose or white bread)
-Choosing low GI foods may help you to:
Control blood glucose
Lower risk of heart disease
Lower risk of Type 2 Diabetes
-Vegetables, fruit, low-fat milk products, whole grains, legumes tend to have low GI
-Check the Canadian Diabetes Association website for more information on the GI of some common carbohydrates at www.diabetes.ca
You mentioned keeping a healthy weight is important, what are some key points to keep in mind to achieve this?
-The above diet recommendations are not only important to decreasing your risk of CVD, they also translate into a healthier body weight
-Use Canada’s Food Guide for direction on healthy eating for a healthy weight (visit www.hc-sc.gc.ca for details)
-Eating regular meals and snacks is key to achieving a healthy body weight
-The importance of physical activity cannot be stressed enough
-Focus on not only what and when to eat, but begin to understand WHY you eat the way you do (what are the problematic eating triggers for you, understand how the environment influences our choices)
-‘Craving Change’ is a series held at Elgin St. Thomas Public Health about 3 times each year to help you understand the ‘why’ of eating and to provide practical ideas to deal with it
What lifestyle strategies (other than nutrition) can prevent CVD?
-Absolutely don’t smoke (increases the rate at which plaque builds up on artery walls; it also increases blood pressure and heart rate meaning the heart pumps faster but blood has less room to move; smoking interferes with the production of estrogen in women; call Elgin St. Thomas Public Health or see your health care provider for ideas and help to quit smoking
-Get moving (Inactivity raises your risk of developing CVD, perhaps as much as high blood pressure, high blood cholesterol and smoking does; 30 to 60 minutes of moderate intensity activity most days of the week may improve your blood lipid profile and help you to control other CVD risk factors—walk, run, garden, cycle, or whatever you like to do to keep moving. Physical activity may also help you to manage your stress)
-Manage stress (if you tend to use food, alcohol or cigarettes to cope with stress, seek help from your health care provider; boost your energy and reduce your stress by participating in physical activity—consider yoga or tai chi)
If you would like to contact Cathy, here is her information.
Cathy Macpherson RD
Public Health Dietitian
Elgin St. Thomas Public Health
Check back in on Thursday where we will continue this topic by reviewing my interview with Ryan Meloche from Douglas Laboratories and Pure Encapsulations about nutritional supplementation for a healthy heart.
Have a Happy Thanksgiving!
Dr. Peggy Malone is a Chiropractor and an Athlete who helps other athletes to overcome injury and get back to their sport. Her weekly Television Series 'Living Well" inspires people from all walks of life to take control of their health to be as happy and as healthy as they can be.
A former varsity Basketball and Rugby player, she has since entered the world of endurance athletics where she has completed 2 Ironman Triathlons, 3 Marathons, several Half Marathons and many other Triathlons, Road Races and Off-Road Adventure races of varying distances.
Her own athletic endeavors and injuries have given her valuable insight into working with athletes in her practice for both the care of injuries as well as for the improvement of athletic performance.
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