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DIETARY PREVENTION OF CHRONIC DISEASE Sonja L. Connor, MS, RD, LD.

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Presentation on theme: "DIETARY PREVENTION OF CHRONIC DISEASE Sonja L. Connor, MS, RD, LD."— Presentation transcript:

1 DIETARY PREVENTION OF CHRONIC DISEASE Sonja L. Connor, MS, RD, LD

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4 New Eng J Med 1995;332:481-487

5 White Fish & Shell- fish PoultryRed Meat Cheese 2 Lrg Egg Yolks LiverShell- fish Cholesterol Content Of Selected Foods

6 White Fish Clams Oysters Scallops Poultry Shrimp Crab Lobster Red Meat 10% fat Cheese2 Lrg Egg Yolks Red Meat 25% fat Liver Cholesterol-Saturated Fat Index

7 CSI in Salad Dressings

8 Recipe Comparisons CSI/Svg* Spinach Lasagna (low fat)** 8 Meatless Lasagna (traditional) 16 Lasagna with Meat Sauce 30 * 1 piece 3 x 4 1/3 inches ** From The New American Diet

9 LOVASTATIN & DIET STUDY DESIGN 6 subjects 40 mg lovastatin per day 4 week diet periods (randomly assigned) cholesterol, saturated fat ( CSI) cholesterol, saturated fat ( CSI) Plasma lipids & lipoproteins

10 LIPIDS & LIPOPROTEINS Cholesterol mg/dl High CSILow CSI % Total325280-15% LDL207174-16% HDL6249-21% Triglyceride117136+16%

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14 Reduce Fat Intake by One-Half Learn the art of skinny frying Reduce fat in baked goods by 1/3 Limit added fat to 2-4 teaspoons/day (margarine, mayonnaise, salad dressing) Include nuts but not too many –Peanut butter sandwich –Add crunch to casseroles, breads, desserts

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16 Where Can I Get the Most? Seafood – 3 ½ ozFat, gOmega-3, g Shellfish 2.50.9 Whitefish 2.10.9 Tuna, water-packed 0.80.3 Salmon, Chinook 12.02.0 Sardines, canned 20.13.3 Fish oil capsule, one 1.00.3

17 Eat More Fish 2 or more times a week

18 Polynesian Fried Rice Recipe from Gourmet Magazine

19 Double Complex CHO Intake Eat 2 to 5 servings at each meal (whole grain bread, brown rice, pasta, potatoes) Eat 3 to 5 cups legumes each week Eat 2 to 3 cups vegetables each day

20 Standby Favorite Dishes 1 cup servings CSIFat g Fat tsp kcals Four Star Pasta Salad*13½154 Typical Macaroni Salad7367510 Potato Salad*141206 Typical Potato Salad10265392 Skinny French Fries*141134 Typical French Fries5173 ½392 * From The New American Diet

21 Phase 1 -- Substitutions Avoid foods high in cholesterol & saturated fat Delete egg yolk, butterfat, lard & organ meat Substitute vegetable oils & shortening for lard skim milk for whole milk egg whites for whole eggs Use Lite Salt NCEP Step I diet, AHA Step I diet

22 Phase 2 – Try New Recipes Gradually transition to eating meat once a day Use less fat & cheese Eat more fruits, vegetables, grains & beans Use fewer products with large amounts of salt Acquire new recipes Mediterranean, DASH, NCEP Step II & AHA Step II diets

23 Mediterranean Diet The Lyon Diet Heart Study More bread, root & green vegetables, fish Fruit at least once daily Less red meat (replaced with poultry) Replace butter with margarine, use olive and Canola oil Wine in moderation Circulation2001;103:1823-1825; Lancet 1995;345:738

24 Phase 3 – Everyday Eating Use meat as a condiment Use only low CSI cheeses Decrease amount of salt in cooking Use these foods for special occasions Extra meat Regular cheese Chocolate Salty foods Forks Over Knives; Beyond Phase 3 – Pritikin, Ornish

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26 Newsletters

27 Magazines Cookbooks

28 Translating Science to the Practical

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30 IT IS POSSIBLE!! If the masses can love tofu TOBYS TOFU PATÉ www.tofupalace.com The masses can find products & recipes they like that fit a low-fat, high complex carbohydrate eating style Light Jalapeno

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32 _________________________ _______ Name _________________________ _______ Date Dietitian-scored Examining Your Eating Habits! SELF-SCORED SURVEY ___________________________________ _________ Name ___________________________________ _________ Date J Amer Diet Assoc 1992;92:41-47

33 DHS QUESTION How often do you eat fish? 1 Do not eat fish or eat fish less than once a month 2 One to 3 time s a month 3 Once a week 4 Two times a week 5 Three or more times a week or eat vegetarian with no added fat

34 DIET HABIT SURVEY US Diet30% fat28% fat20% fat10% fat Meat, Fish, Poultry Dairy/Eggs Fats/Oils Sweets/Snacks Grain/Bean/Veg/Frt Beverages Salt Restaurants/Recipe Seafood TOTAL

35 DIET HABIT SURVEY Addresses all areas of eating (fat, fiber, sugar, salt, recipes, eating out) Can be done at home (~30 minutes) Can be scored in less than 5 minutes Visit focused on patients ideas about making changes

36 DIET HABIT SURVEY-Mr Win-Win US Diet30% fat28% fat20% fat10% fat Meat, Fish, PoultryBL Dairy/EggsBL Fats/OilsBL Sweets/SnacksBL Grain/Bean/Veg/FrtBL BeveragesBL SaltBL Restaurants/Recipe SeafoodBL TOTALBL

37 Tips for Low-Fat Eating-28% Entrée 10 grams fat or less Other dishes 5 grams fat or less Meat, Fish Poultry –Limit chicken, very lean red meat and low-fat cheese to a total of 6-8 ounces (men) or 4-5 ounces (women) per day –Choose chicken, turkey or low-fat vegetarian dishes

38 DIET HABIT SURVEY-Mr Win-Win US Diet30% fat28% fat20% fat10% fat Meat, Fish, PoultryBL Dairy/EggsBL Fats/OilsBL Sweets/SnacksBL Grain/Bean/Veg/FrtBL BeveragesBL SaltBL Restaurants/Recipe SeafoodBL TOTALBL

39 IDEAS FOR CHANGING EATING HABITS - 1 mo Cut down on evening snacks Eat breakfast Limit coffee and alcohol Try and use low-fat cheese

40 Typical Cheese 9 grams fat/oz Trader Joes Celtic Cheddar 4 g/oz Kraft Sharp Reduced Fat Cheddar 4.5 g/oz Jarlsberg Light Reduced Fat Swiss 3.5 g/oz Laughing Cow Light 3 g/oz

41 IDEAS FOR CHANGING EATING HABITS - 2 mo Eat breakfast at home Limit coffee Eat low-fat cheese Increase veggies with summer salads

42 IDEAS FOR CHANGING EATING HABITS - 6 mo Try low-fat salad dressings (Best Foods Low-fat) Try reduced fat Vermont Cabot Cheddar Cheese Pack lunch when on the go

43 IDEAS FOR CHANGING EATING HABITS - 12 mo Increase fruits and veggies Decrease coffee and tea Walk about 1 mile a day

44 DIET HABIT SURVEY-Mr Win-Win US Diet30% fat28% fat20% fat 10% fat Meat, Fish, PoultryBL12 mo Dairy/EggsBL12 mo Fats/OilsBL12 mo Sweets/SnacksBL12 mo Grain/Bean/Veg/FrtBL12 mo BeveragesBL12 mo SaltBL12 mo Restaurants/Recipe BL, 12 mo SeafoodBL TOTALBL12 mo

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46 Family Heart Study

47 Tarahumara Indian

48 All That Makes Good Sense Healthy Eating Physical Activity

49 Normal Coronary Artery

50 Blocked Coronary Artery

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