Heart Healthy Eating
The Heart Healthy Diet encourages long-term changes in eating habits to help reduce the risk and progression of heart disease. Eating a balanced, healthy diet is the first step into heart healthy eating. Other general guidelines and instructions include:
SPREAD OUT THE CALORIES
By consuming 6-8 small, balanced meals a day rather than 1-2 large ones, calories are distributed throughout the day and lead to less overeating at meals.
REDUCE TOTAL FAT INTAKE
Limit fat intake to 40-60 grams per day. Choose lean, well-trimmed cuts of meat; these usually include round and loin cuts. Don’t forget to remove the skin on poultry! Also, use low-fat/fat-free dairy products and limit fried/fatty foods.
KEEP SATURATED FATS TO A MINIMUM
Saturated fats stimulate cholesterol production in the body. They are typically solid at room temperature and mostly found in animal products including beef, lamb, pork, poultry skin; dairy products such as whole milk, cream, and some cheeses; stick butter/margarine; shortening; egg yolks. Try to limit these fats to no more than 10-15 grams per day.
This fat increases LDL (bad) cholesterol. They come from partially hydrogenated vegetable oils often found in fried foods and processed foods such as crackers, mixes and baked goods. It is recommended that these fats be eliminated from the diet. Read the ingredient lists on food labels for the words, “hydrogenated oils.”
USE UNSATURATED FATS VS. SATURATED FATS
Unsaturated fats may lower your risk of heart disease and are those that are liquid at room temperature. Olive, corn, canola, and peanut oils; avocados; walnuts, pecans, almonds and pumpkin/sunflower seeds are some examples.
FIBER, FIBER, FIBER
Increase intake of foods that are naturally high in fiber, especially soluble fiber. Try to eat 15 grams of soluble fiber (legumes, fruits, root vegetables – carrots/potatoes, oats, barley and flax) a day. Every 1-2 grams of soluble fiber consumed can reduce LDL (bad) cholesterol by 1%. Foods high in fiber may promote a greater reduction in cholesterol than a low-fat, low-cholesterol diet alone.
INCREASE FRUITS AND VEGETABLES
5-9 servings a day are recommended. Keep in mind that bright, colorful fruits/veggies are more beneficial.
BE MORE CREATIVE WITH SOY
Soy protein leads to a diet low in saturated fat and cholesterol, which lowers blood cholesterol levels and may reduce the risk of heart disease. Examples of soy include soy milk, soy nuts, edamame, textured soy protein, roasted soy nuts, etc.
LOWER CHOLESTEROL INTAKE
Dietary cholesterol comes from foods of animal origin including meat, milk, ice cream, cheese, and eggs. Egg yolks are very high in cholesterol. Limit intake to no more than three egg yolks per week.
COOK WITH LESS FAT
Use low-fat cooking methods, like baking, steaming, grilling, broiling, poaching, or roasting. Remove skins and trim leftover fat from meats/poultry. Cook with unsaturated oils like canola, corn, or olive oils. Use no more than one tablespoon of oil for sautéing or use a nonstick cooking spray. For dips or toppings, use low-fat products such as low fat sour cream, cottage cheese, or yogurt.
INCREASE FISH INTAKE TO AT LEAST TWICE PER WEEK
Research shows that oils naturally present in fish (such as Omega-3 fatty acids) may be helpful in reducing the risk of cardiovascular disease. Choose low-fat cooking methods such as baked, broiled or poached fish. Avoid fried fish. Fish rich in Omega-3 fatty acids include salmon, tuna, mackerel, herring, and trout.
REDUCE THE SODIUM IN YOUR DIET
Research suggests that high sodium intake can be related to high blood pressure. If you are on a salt restriction, it is recommended to consume no more than 2,400 mg of sodium per day. Read food labels carefully and look for high-sodium ingredients such as salt, sodium chloride, monosodium glutamate, or broth. Do not add salt to your food at the table or when cooking. Limit processed or pre-packaged foods, as sodium is often used as a preservative.
CHOOSE MEATLESS SUBSTITUTIONS
Legumes (dry beans, peas, lentils) can be used as meat alternatives. One cup of cooked legumes provides less saturated fat and cholesterol; however, the same amount of protein as two oz. of meat.
These help reduce the amount of cholesterol that is absorbed in the digestive tract. Research shows that Benecol Spread? (plant stanols) and Take Control Spread? (plant stanols) may lower total and LDL cholesterol by 10-14%. Two tablespoons of these margarine spreads per day are recommended.
THE KEY TO SUCCESS = EXERCISE
Exercise will help with weight management, may lower triglycerides, and help control blood cholesterol. Exercise is recommended, but should always be approved by your physician.
WHAT DO THESE WORDS MEAN?
- Cholesterol: A fat-like substance that is essential for life. It does not dissolve in the blood and therefore, has to be transported to and from the cells by special carriers called lipoproteins. Cholesterol is composed of several different lipoproteins.
- LDL: (Low Density Lipoprotein) is the “bad” cholesterol. This can slowly build up on inner walls of arteries and can help to form plaque which may increase your risk of heart disease. An LDL level above 150 is considered a high risk for heart disease. To achieve a healthful LDL level/cholesterol level; eat less saturated fat and cholesterol, eat more high-fiber foods, and lose excess weight.
- HDL: (High Density Lipoprotein) is the “good” cholesterol. Research indicates that this carries cholesterol away from the bloodstream and out of the body. A high level of HDL seems to protect against heart disease. A healthy level for men is greater than 40 mg/dL and for women is greater than 50 mg/dL. To achieve this, maintain a healthy weight, quit smoking, and get regular aerobic exercise such as jogging, swimming, biking, or walking.
- Triglycerides: The chemical form of fat in which most fat is found in foods as well as in our bodies. Stored fat in our body is made of triglycerides. Extra calories not used immediately for energy are converted to triglycerides and stored in fat cells. Alcohol causes the liver to release more triglycerides into the blood. A normal range of triglycerides is less than 150. To achieve this, be physically active, avoid high sugar beverages, reduce alcohol intake, eat a diet moderate in fat.
EAT HEALTHY FOR YOUR HEART
BREAD, CEREAL, RICE, PASTA (number of servings are based on individual needs)
Breads Serving sizes =
1 slice of bread
¼ bagel (4 oz.)
Choose: Whole wheat, multi-grain, oat bran, whole French, Italian, Pita, bagels, English muffins, buns, tortillas (not fried)
Look for > 2 grams of fiber per serving.
Choose less often: Breads that are fried or made with cheese or egg products; butter rolls, croissants, Danish pastries, sweet rolls, doughnuts, quick breads, and cornbread Cereal Cereal Serving sizes =
½ cup cooked cereal
¾ cup ready-to-eat cereal
Choose: Low-fat ready-to-eat and cooked varieties, high-fiber cereals (greater than 5 grams of Dietary Fiber per serving) Choose less often: Granola cereals made with coconut, coconut oil, palm oil, animal or vegetable shortenings, sugar-coated cereals Pasta Pasta Serving size =
½ cup cooked
Choose: Whole grain pastas, spaghetti, macaroni and no-yolk noodles Choose less often: Pasta made with butter, whole milk, cheese or cream sauce, egg noodles, chow main noodles, commercially prepared pasta mixes Crackers
Crackers Serving sizes =
3 cups popped popcorn
Choose: Wheat crackers, saltine, animal, graham, rye or oyster crackers, melba toast, bread sticks, matzo, pretzels, popcorn (low-fat) Wasa.
Choose crackers with less than 3 grams of fat per oz.
Choose less often: Crackers that are high in fat or made with cheese, butter, coconut or palm oil VEGETABLES Serving sizes =
½ cup cooked
1 cup chopped, raw
Choose: Any vegetables, except those prepared with ingredients to limit, fresh or frozen vegetables Choose less often: Fried vegetables or those prepared with butter, whole milk, cheese, or cream sauce FRUIT
Serving sizes =
½ cup canned or frozen
1 medium size raw
½ cup juice
Choose: Fresh, frozen, canned or dried fruit
Fruit juices: fresh, frozen or canned
Choose less often: Coconut, fruit salad made with high-fat dressing/cream sauce BEEF, VEAL, PORK, LAMB, POULTRY, FISH (5-6 ounces per day)
Serving size =
5-6 oz. per day
Choose: USDA Select or Choice grades trimmed of fat (round, sirloin, flank, tenderloin, rib, chuck, and rump roast, T-bone, porterhouse, cube steak, ground round, lean ground beef (> 90% lean) Choose less often: Prime grades of beef, prime rib, heavily marbled and fatty meat, regular ground beef Veal Serving size = 5-6 oz. per day Choose: Lean chop, roast, leg Choose less often: Ground or processed, rib roasts Pork
Serving size =
5-6 oz. per day
Choose: 95-98% fat-free ham, lean top or sirloin chops and top or sirloin roast, tenderloin (unbreaded), Canadian Bacon
Choose less often: Spare ribs, ground pork, pork sausage, bacon
Serving size =
5-6 oz. per day
Choose: Skinless chicken, turkey (preferably white meat), Cornish hen, duck or goose (well-drained of fat)
Choose less often: Fried chicken, poultry skin, turkey or chicken hot dogs (unless < 3 grams of fat per oz.)
Serving size =
5-6 oz. per day (include 2 servings of baked, broiled, or grilled fish per week)
Choose: Fresh, frozen, or canned fish and shellfish
Choose less often: Fried fish, fried shellfish, commercially breaded fish
Choose: Meats with < 3 grams of fat per oz.
Choose less often: Processed meat with > 3 grams of fat per oz. such as bologna, pimento loaf, salami, sausage; such as bratwurst, Italian, knockwurst, Polish; hot dogs, bacon
MILK, YOGURT, CHEESE (2-3 servings per day)
Milk and Yogurt
Serving sizes =
8 oz. milk
8 oz. yogurt
½ cup low fat ice cream
Choose: Skim, 1%, nonfat or low fat dry milk, low fat buttermilk, non fat yogurt, non fat/low fat frozen yogurt, ice milk, sherbet, puddings or custards made with skim milk and no egg yolk, non fat sour cream
Choose less often: 2% or whole milk, cream, half & half, coffee creamer, non-dairy cream substitutes, evaporated whole milk, condensed milk, commercial milk shakes, whole milk yogurt and ice cream, whipping cream, non-dairy whipped topping, sour cream, non-dairy sour cream (Imitation diary products should also be avoided. Many are “cholesterol free” but may contain large amounts of coconut or palm oil.)
Serving size =
Limit to no more than 1 oz. (1 slice)
Choose: Those with no more than 3 grams of fat per oz., skim milk, farmer, mozzarella, low-fat ricotta, low/non-fat ricotta, dry parmesan, dry 1% or 2% cottage cheese, non-fat cream cheese
Choose less often: All varieties made with whole milk or cream such as cheddar, American, Swiss, whole milk mozzarella, Monterey Jack, Colby, cheese spreads, regular cream cheese, creamed or full-fat (4%) cottage cheese, all varieties of full-fat cheese products
Eggs Serving size =
Limit egg yolks to 3 per week
Choose: Egg whites (2 whites can be substituted for one whole egg in recipes), cholesterol-free egg substitute Choose less often: More than 3 egg yolks per week, egg substitutes made with saturated fat Dry Beans and Meatless Alternatives Choose: Beans: black, garbanzo, kidney, lima, pinto, navy, soybeans; peas: black-eyed, chick, field, split, lentils, tofu Choose less often: Meatless dishes prepared with high-fat sauces or full-fat cheese Nuts and Seeds
Choose: Walnuts, pine nuts, pecans, almonds, chestnuts and peanuts; sesame, pumpkin, soybean and sunflower seeds, non-hydrogenated peanut butter (limit to one tablespoon per day)
Choose less often: Coconut, corn nuts (may be roasted in coconut oil), cashews, macadamia nuts, pistachios FATS, OILS, SWEETS (use sparingly)
Choose: Unsaturated oils: canola, olive, peanut, avocados, nuts; almonds, cashews, peanuts, pecan halves, peanut butter, and other nut butters, olives (ripe or green)
Choose less often: Coconut oil, palm kernel, and palm oil Macadamia nuts, Brazil nuts, pistachios, pine nuts Polyunsaturated Fats Choose: Margarine: tub or squeeze made from allowed oils, light or diet margarine (especially soft, tub or liquid forms) Oil: corn, safflower, sesame, soybean, sunflower Salad Dressing: regular or low-calorie made with allowed oils, skim milk, or low-fat yogurt, vinegar and oil, lemon juice, low-fat mayonnaise Nuts: walnuts, pumpkin seeds, sunflower seeds Choose less often: Butter, lard, shortening, bacon fat, stick margarine, dressing made with egg yolk, cheese, sour cream, or whole milk; coconut, milk skin Sweets Choose: Angel food cake, commercially prepared cookies and cakes labeled 2 grams of fat or less per serving, gelatin, sherbet, ice milk, fruit ice, fudgesicles, popsicles, Newton-type cookies, ginger snaps, sourballs; Lifesavers, gum drops, candy corn, jelly beans, hard candy, jelly, jam, marmalade, preserves, molasses, honey, syrup, marshmallows, sugar Choose less often: Sweets made with animal fat, coconut, cream, egg yolk, chocolate, carob, solid shortening or whole milk; commercially made pie, pie crusts, cookies, cakes, muffins, sweet rolls, doughnuts, ice cream, commercially prepared cookies made with hydrogenated fat
HEARTY SUBSTITUTES – One-for-one Substitutions
Rather than: Try this: Whole milk, 2% milk Skim or 1% milk, nonfat dry milk Nondairy creamer Nonfat dry milk, skim or 1% milk Evaporated whole milk Evaporated skim milk Ice cream Low-fat or fat-free ice cream, frozen yogurt, sherbet, soft-serve, popsicles, fudgesicles, fruit ice Sour cream Low-fat/fat-free sour cream, plain non-fat yogurt Whole milk cheese (American, cheddar, Swiss, Velveeta, etc.), cream cheese Cheeses labeled less than 3 grams of fat per oz., dry cheeses, 1% or 2% cottage cheese, fat-free cream cheese, Parmesan cheese Butter, lard, shortening, stick margarine Tub margarines without trans fatty acid: Brummel & Brown®, Canola Harvest®, I Can’t Believe It’s Not Butter® Light, Smart Balance®, Promise®, Fleishmann’s® Original and Light Mayonnaise and Salad Dressing Low-fat/fat-free varieties, plan non-fat yogurt Whole egg Egg whites, egg substitute Coconut, corn nuts, cashews, macadamia nuts Almonds, chestnuts, peanuts, pecans, pistachios, pumpkin seeds, sesame seeds, walnuts (occasionally) Bacon, bacon bits Canadian bacon, imitation bacon bits French fries Baked fries (homemade, not precooked varieties) Chips Pretzels, fat-free microwave popcorn, baked chips, low-fat crackers Doughnuts, pastries, etc. Oat bran muffins, English muffins, bagels, graham crackers, vanilla wagers, animal crackers Bologna, salami, hot dogs Turkey or chicken breast, lean ham, lean roast beef, soy or fat-free hot dogs Hamburger 90% lean ground turkey breast, chicken or beef, texturized soy protein Sausage (Polish, Italian, pork) 85% lean sausage (turkey, beef or pork) Prime Rib, New York Strip, T-bone, Ribeye Filet mignon, sirloin, flank steak, round, lean roast beef
Recipe calls for: These substitutes will decrease
Baking chocolate (1 oz.) 3 TBSP unsweetened cocoa power + 1 TBSP oil Whole milk or cream (1 cup) 1 cup milk or 1 skim milk + 2 TBSP oil or 1 cup evaporated skim milk Buttermilk (1 cup) 1 cup skim milk + 1 TBSP; let stand 5 minutes Sour cream (1 cup) Non-fat yogurt or mock sour cream: blend until smooth, 1 cup low-fat or dry cottage cheese, 1 TBSP lemon juice, 2 TBSP skim milk White sauce (1 cup) Heat 1 cup skim milk; add 2 TBSP flour to thicken Creamed soup Skim milk, add 2 TBSP flour Nuts Healthy choices include adding almonds, peanuts, pecans or walnuts Egg 2 egg whites or ¼ cup substitute = 1 egg Homemade egg substitute: 1 egg white, 2 tsp oil, 2 tsp nonfat dry milk, yellow food color 2 eggs: 1 whole egg and 2 egg whites Margarine/Shortening (1 Tbsp) ¼ TBSP liquid oil Oil Half amount of oil can be replaced with pureed plums or prunes, mashed bananas, applesauce for bread recipes
COOKBOOK RESOURCE LIST
American Heart Association Low-Fat, Low-Cholesterol Cookbook
American Heart Association Low-Fat & Luscious
American Heart Association Quick & Easy Meals
American Heart Association Low-Salt Cookbook: A complete guide to reducing sodium and fat in your diet
Delicious Food for a Healthy Heart: Over 120 Cholesterol-Free, Low-Fat, Quick & Easy Recipes, by: Joanne Stepaniak, 2001.
Cooking with Herbs & Spices: Easy, Low-Fat Flavor, by: Judy Gillard, 1999.
Lickety Split Meals: for Health Conscious People on the Go! by: Zonya Foco, 1998.
American Heart Association, Inc. “Diet and Lifestyle Recommendations.” 2006.
American Heart Association “Diet and Nutrition: 2004. Nutrition Fats. 10 Nov. 2004.
Carle Clinic Association, “Eat for your Heart Health” handout, 7/05.
Carle Clinic Association, “Hearty Substitutions” handout, 4/03.
Communicating Food for Healthy Newsletter. 2002.
Heart Health Partnership. Turning Over a New Leaf: Your Heart-Healthy Living Guide. Vol. 4 No 2. 2003.
McNeil Nutritionals. Benecol®. 2000-2004. “Benecol® Products.” 9 Nov. 2004.
Sodexho, Inc. Nutrition Guidelines for a Healthy Heart. Sodexho.
SportWell Center Heart Healthy handout.
you are a registered University
of Illinois student and you have questions or concerns,
If you are concerned about any difference in your treatment plan and the information in this handout,
you are advised to contact your health care provider.
Visit the McKinley Health Center Web site at: http://www.mckinley.illinois.edu
© The Board of Trustees of the University of Illinois, 2008.
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