Women and Heart Healthy Nutrition
Coronary artery disease (CAD) is a leading cause of death in the United States. In CAD, deposits of fat, cholesterol, and calcium buildup inside the artery (atherosclerosis). These deposits are called plaque. Like the inside of a rusty water pipe, the wall of the artery becomes rough, hard, and more narrow. The flow of blood and oxygen is slowed or blocked. This may cause chest pain or a heart attack. Atherosclerosis is also a major cause of stroke and vascular disease.
Reduce your risk for heart and vascular disease by making healthy food choices. An important first step is to be aware of you blood cholesterol levels.
Your blood tests
Total Blood Cholesterol
levels should be less than 200 mg/dl. Your liver can make all the
cholesterol you need but we also eat cholesterol in food. As your
cholesterol rises above 200, your risk for heart attack and stroke also
increases.
Low Density Lipoprotein (LDL) are also known as the "bad" cholesterol. They cause the build up of cholesterol in the arteries. High levels may increase the risk of heart attack and stroke. Desirable levels are less than:
- 160 mg/dL if you are at low risk for heart and vascular disease (0 to 1 risk factors)
- 130 mg/dL if you have two or more risk factors
- 100 mg/dL if you have cardiac or vascular disease or are a diabetic
High Density Lipoprotein (HDL) are known as the "good" cholesterol. They carry the cholesterol away from the body cells and tissues to the liver for excretion. Higher levels of HDL are linked with lower risk of heart attack. Desirable levels are greater than 40 mg/dl for men and 50mg/dL for women.
Triglycerides are a type of fat in your body. They are carried in the blood and are broken down for energy. Sugar, alcohol, and saturated fat may increase triglyceride levels. High triglyceride levels may add to your risk of heart attack. Desirable levels are less than 150 mg/dl.
Food Definitions
Learning more about fats found in foods will help guide you in making good nutrition choices.
Fat is one of the three nutrients that supply calories to the body. Fat provides 9 calories per gram. (Protein and carbohydrate provide 4 calories per gram). There are 4 types of fat:
- Monounsaturated fat is an unsaturated fat. It lowers total and LDL (bad) cholesterol levels without decreasing the HDL (good) cholesterol levels. Sources of these fats include olives and olive oil, canola oil, peanuts and peanut oil, and avocados. These oils are liquid at room temperature.
- Polyunsaturated fat is an unsaturated fat that may lower total blood cholesterol levels. These fats include liquid vegetable oils such as safflower, sunflower, corn, soybean, sesame and cottonseed oil.
- Saturated fat raises blood total and LDL cholesterol levels and is common in animal fats. A few vegetable oils are high in saturated fat including coconut oil, palm oil, palm kernel oil and cocoa butter. This type of fat is generally solid at room temperature.
- Trans fat forms when vegetable oil is hardened to a solid form through a process called "hydrogenation." Trans fats raise blood total cholesterol levels and may lower HDL cholesterol levels. Examples include margarine and shortening.
Cholesterol is a waxy substance only found in foods from animals such as meat, eggs and dairy. Eating foods high in cholesterol may increase the cholesterol level in your blood.
Plant sterols and plant stanols are found in plant oils. Since structure is similar to cholesterol they may block cholesterol from being absorbed by the intestines. It is believed that plant sterols and stanols decrease LDL (bad) cholesterol. Sources include some butter substitutes, vegetable oils, nuts and soybeans.
Fiber is the part of foods that cannot be digested. Sources include fruits, vegetables, whole grains, nuts, seeds, beans and legumes. There are two main types of fiber:
- Soluble fiber breaks down in water. Sources include oats, beans, and fruit. Soluble fiber helps lower blood LDL (bad) cholesterol levels.
- Insoluble fiber does not dissolve in water. This type of fiber is found in whole grains, rice and vegetables.
Therapeutic Lifestyle Change Guidelines
Lifestyle changes help to reduce the risk of CAD. The Therapeutic Lifestyle Change (TLC) Guidelines suggest that you:
- Limit fat to 25 to 35 percent of your total calories with no more than 7 percent of the total calories from saturated fat
- Take in no more than 200 mg of cholesterol per day
- Add 2 grams of plant sterols/stanols per day to your diet
- Limit sodium intake to 2400 mg (unless told otherwise by your doctor)
- Set a goal of 10 to 25 gm soluble fiber per day as part of your total fiber intake of 25 to 35 grams per day
- Eat whole grains, fruits and vegetables daily
- Maintain a healthy body weight
Making wise food choices can help you meet all your nutrition needs and keep your heart healthy.
Cooking and Dining Guidelines
- Roast, bake or broil meats, trim excess fat and remove skin from poultry.
- Choose fish, poultry and legumes more often and eat smaller portions of meat.
- Avoid fried foods and fat in cooking.
- Avoid adding excess margarine, butter, salad dressing and oils to foods.
- Choose skim or 1% milk, low or reduced fat milk products and cheeses.
- Choose high fiber foods such as fruits, vegetables and whole grains.
- Limit the amount of salt used in cooking or at the table.
Label Reading
Food
labels are an easy way to help you increase your knowledge of the fat,
cholesterol and sodium in the foods you choose. Food labels provide
information to help you follow the TLC guidelines and lead a healthy
lifestyle.
For More Information
Northwestern Memorial's Center for Integrative Medicine and Wellness
helps patients set and achieve specific goals to improve their quality
of life. For more information about heart healthy eating or diet
concerns, call the Center for Integrative Medicine and Wellness at (877) 926-4664.
The Health Learning Center has a wealth of both print and electronic health information resources. Visit the Health Learning Center (3rd Floor of the Galter Pavilion) or call (312) 926-LINK (5465).
Food Guidelines
Breads and Grains
6-11 servings
1 slice
3/4 cup most dried cereals
1/2 cup all other cereals
Breads – whole-grain bread, English Muffins, bagels buns, corn or flour tortillas
Cereals – oat, wheat, corn, multigrain, most hot or cold cereals
Pasta
Rice, rice cakes
Low fat crackers, graham, soda crackers, breadsticks, melba toast
Homemade baked goods using
unsaturated oil, skim or 1% milk,
and egg substitute – quick breads,
biscuits, cornbread muffins, bran muffins, pancakes, waffles
Biscuits, cornbreads, croissants, muffins
Most granolas
Pasta or rice dishes made with cream, butter or cheese sauces
Butter crackers, cheese crackers
Commercial baked pastries
Lean Meat, Poultry, Fish,
Legumes
Less than 5 ounces per day
Beef, pork, lamb - lean cuts, well trimmed before cooking
Poultry without skin
Fish, shellfish, tuna packed in water
Lunch meats with less than 3gm. fat per serving
Beef, pork, lamb - regular ground beef, fatty cuts, spareribs, organ meats
Poultry with skin, fried chicken
Fried fish, fried shellfish, tuna packed in oil
Regular luncheon meat, e.g. bologna, salami, sausage, frankfurters
Legumes
1/2
cup cooked Dried Beans and peas, split peas, blackeyed peas, kidney or
navy beans, lentils, tofu, natural peanut butter without added salt
Peanut butter made with hydrogenated oils
Refried beans made with lard
1/2 cup
1/3 cup cooked rice
Food Group Choose Decrease
Vegetables
3-5 servings/day
1/2 cup cooked
1 cup raw
Fresh, frozen or canned, without added fat or salt
Vegetables fried or prepared with butter, cheese or cream sauce
Fruits
2-4 servings/day
1 cup cut fruit
3/4 cup juice
1/4 cup dried fruit
1 medium fruit
Fresh, frozen, canned or dried
Fresh, frozen or canned fruit juice
Fried fruit or fruit served with butter or cream sauce
Eggs
Less
than 2 yolks/week Egg whites (two whites can be substituted for one
whole egg in recipes), cholesterol-free, low fat egg substitute
Dairy Products
2-3 servings/day
1 cup of milk or yogurt Milk - skim, 1/2 or 1% fat (fluid, powdered, evaporated)
Yogurt - nonfat or low fat yogurt or yogurt beverages
Cheese - low fat natural or processed cheese
Less than 5 grams fat per ounce
Low fat or nonfat varieties, e.g. cottage cheese - low sodium, low fat, nonfat, or dry curd (0 to 2% fat)
Frozen dairy dessert - ice milk, frozen yogurt (low fat or nonfat)
Whole milk (fluid, evaporated, condensed), 2% fat milk (lowfat milk), imitation milk, butter milk
Whole milk yogurt, whole milk yogurt beverages
Regular
cheese (American, blue, Brie, cheddar, Colby, Edam, Monterey Jack,
whole-milk mozzarella, Parmesan, Swiss), cream cheese, Neufchatel
cheese
Cottage cheese
Ice cream
Fats and Oils
Less than 6 - 8 teaspoons (Includes fats and oils used in food preparation)
Unsaturated oils - safflower, sunflower, corn, soybean, cottonseed, cannola, olive, peanut
Coconut oil, palm kernel oil, palm oil
Egg yolks
1 ounce of cheese
1/4 cup cottage cheese
1/2 cup frozen dairy dessert
Food Group Choose Decrease
Soups
Low fat and low-sodium varieties such as chicken or beef noodle,
minestrone, tomato, vegetable, or potato. Cream soups made with skim
milk Soup containing whole milk, cream, meat fat, poultry fat or
poultry skin Limit these foods, especially if you need to lose weight
Beverages - fruit-flavored drinks, lemonade, fruit punch Sugar, syrup,
honey, jam preserves, candy made without fat (candy corn, gumdrops,
hard candy), fruit-flavored gelatin
Frozen desserts - low fat and nonfat yogurt, ice milk, sherbet, sorbet, fruit ice, popsicles
Cookies,
cake, pie, pudding - prepared with egg whites, egg substitute, skim
milk or 1% milk, and unsaturated oil or margarine; ginger snaps, fig
and other fruit bar cookies, fat free cookies, angel food cake
Candy made with milk chocolate, coconut oil, palm kernel oil, palm oil Ice cream and frozen treats made with ice cream
Commercial baked pies, cakes, doughnuts, high fat cookies, cream pies.
Fats and Oils
(Continued) Margarine - made from unsaturated oils listed above, light or diet margarine, especially soft or liquid forms
Salad dressings - made with unsaturated oils listed above, low fat or fat free
Low fat coffee creamer
Low fat or nonfat sour cream
Seeds and nuts - peanut butter, other nut butters
Cocoa powder Butter, lard, shortening, bacon fat, hard margarine
Dressings made with egg yolk, cheese, sour cream, whole milk
Cream, half & half, whipping cream, nondairy creamer, whipped topping, sour cream
Coconut
Milk Chocolate
Sweets and Modified-Fat Desserts
Guidelines
• Roast, bake or broil meats, trim excess fat and remove skin from poultry.
• Choose fish, poultry and legumes more often and eat smaller portions of meat.
• Avoid fried foods and fat in cooking.
• Avoid adding excess margarine, butter, salad dressing and oils to foods.
• Choose skim or 1% milk, low or reduced fat milk products and cheeses.
• Choose high fiber foods such as fruits, vegetables and whole grains.
• Limit the amount of salt used in cooking or at the table.
Definitions
Fat is one of the three nutrients that supply calories to the body.
Fat provides 9 calories per gram. (Protein and carbohydrate provide 4
calories per gram).
Monounsaturated fat is an unsaturated fat which lowers total and LDL (bad) cholesterol levels without decreasing the HDL (good) cholesterol levels. These are liquid at room temperature and include olive, cannola and peanut oil.
Polyunsaturated fat is an unsaturated fat which may lower total blood cholesterol levels. These are liquid at room temperature and include vegetable oils such as safflower, sunflower, corn, soybean, sesame and cottonseed oil.
Saturated fat is a type of fat that raises blood cholesterol levels and is common in animal fats. A few vegetable oils are high in saturated fat including coconut oil, palm oil, palm kernel oil and cocoa butter.
A Menu Example:
Breakfast Lunch Dinner Snack
1 cup cooked oatmeal
1 banana
1 cup skim milk
1 tsp margarine or plant sterol substitute
1-1/2 to 2 cups bean soup
Whole grain roll
1 cup tossed salad with oil and vinegar dressing
1 cup low fat fruit yogurt
2 to 3 ounces fish (any variety) broiled with lemon juice or wine
1 cup steamed broccoli
Large baked potato
2 Tbsp margarine or plant sterol substitute
1/2 cup rainbow sherbet
1/4 cup dried fruit
3 Tbsp mixed unsalted nuts
Trans fat is formed when vegetable oil is hardened to become margarine or shortening through a process called “hydrogenation.” Trans fats raise cholesterol more than saturated fats but not as much as saturated fat.
Plant Sterols are found in plant oils. Their structure is similar to cholesterol so they interfere with cholesterol absorption in the intestines. It is believed that plant sterols, found in some butter substitutes, decrease LDL (bad) cholesterol.
Cholesterol is only found in foods from animals such as meat, eggs and dairy. Eating foods high in cholesterol and saturated fat increases the amount of cholesterol in your blood
Your Blood Tests
Cholesterol: Your total blood cholesterol level should be less than
200 mg/dl. All the cholesterol you need can be made by your liver but
we also eat cholesterol in food. As your cholesterol rises above 200,
your risk for heart attack also increases.
High density lipoprotein (HDL): HDL carries the cholesterol away from the body cells and tissues to the liver for excretion. Higher levels of HDL are associated with lower risk of heart attack. Desirable levels are greater than 40 mg/dl.
Low density lipoprotein (LDL): LDL contributes to the buildup of cholesterol in the arteries. High levels are associated with increased risk of heart attack. Desirable levels are less than 130 mg/dl.
Triglycerides: Triglycerides are the type of fat in your body. These are transported in the blood and are broken down for energy. Sugar, alcohol, saturated fat may increase triglyceride levels. Normal levels are less than150 mg/dl.
Label Lingo for Heart Health
Fat Free: Less than 0.5 grams of fat/ serving
Low Fat: 3 grams or less fat/serving
Reduced fat: 25% less fat compared to similar food
Cholesterol free Less than 2 milligrams cholesterol and 2 grams or less of saturated fat/serving
Low cholesterol 20 milligrams cholesterol and 2 grams or less of saturated fat/serving
Sodium Free
Salt Free: Less than 5 milligrams sodium/serving
Very Low Sodium: 35 milligrams or less sodium/serving
Low Sodium: 140 milligrams or lesssodium/serving
Nutrition Facts
Serving Size: 1/2 cup (55g)
Servings Per Container: about 8
Cereal + 125 ml.
Vitamin A & D
fortified skim
Amount Per Serving Cereal milk
Calories 240 280
Calories from fat 60 70
%Daily Value**
Total Fat 7g* 11% 11%
Saturated Fat 2g 10% 10%
Cholesterol 0mg 0% 0%
Sodium 200mg 8% 11%
Total
Carbohydrate 37g 12% 14%
Dietary Fiber 5g 20% 20%
Sugars 11g
Protein 7g
Vitamin A 0% 8%
Vitamin C 10% 10%
Calcium 2% 15%
Iron 20% 20%
Vitamin D 0% 10%
Thiamine 40% 45%
Riboflavin 25% 35%
Niacin 2% 2%
Vitamin B6 20% 25%
Folate 8% 10%
Pantothenic Acid 4% 10%
*Amount in Cereal. One half cup skim milk contributes an additional 40 calories, 65mg sodium, 6g total carbohydrate (6g sugars), and 4g protein.
** Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.
Calories: 2,000 2,500
Total Fat Less than 65g 80g
Sat Fat Less than 20g 25g
Cholesterol Less than 300mg 300 mg
Sodium Less than 2,400mg 2,400mg
Total Carbohydrate 300g 375g
Dietary Fiber 25g 30g
Calories per gram:
Fat 9 Carbohydrate 4 Protein 4 8
The following foods are good sources of soluble fiber
Food Source Soluble Fiber (g) Total Fiber (g)
CEREAL GRAINS (1/2 cup cooked)
Barley 1 4
Oatmeal 1 2
Oatbran 1 3
FRUITS
Apple 1 4
Banana 1 3
Blackberries (1/2 cup) 1
Citrus fruit 2 2-3
Nectarines 1 2
Peaches 1 2
Pears 2 4
Plums 1 1.5
Prunes (1/4 cup) 1.5 3
LEGUMES (1/2 cup cooked)
Black Beans 2 5.5
Kidney Beans 3 6
Lima Beans 3.5 6.5
Navy Beans 2 6
Northern Beans 1.5 5.5
Pinto Beans 2 7
Lentils 1 8
Chick peas 1 6
Black eyed peas 1 8
VEGETABLES (1/2 cooked)
Broccoli 1 1.5
Brussel Sprouts 3 4.5
Carrots 1 2.5
Review Date: 03/03
