1. Foods As Good As Your Heart Medicine Richard Collins, MD Susan Buckley, RD

2. Sobering Statistics According to a new report from the National Institutes of Health (NIH), National Research Council and Institute of Medicine, Americans from all socio- economic classes die sooner and seem to be sicker than people in other high-income countries. The United States was compared to 16 affluent democracies that include Australia, Canada, Japan, and many western European countries. Of the 17 countries included in the study, the U.S. ranked last for life expectancy at birth for men and No. 16 for life expectancy at birth for women

3. Sobering Statistics Specifically, we have significantly higher rates than other countries of infant mortality, injuries and homicides, adolescent pregnancy and sexually transmitted diseases, HIV and AIDS, drug-related deaths, obesity and diabetes, heart disease, chronic lung disease, and disability.obesity and diabetes

4. Sobering Statistics Health behaviors. We're more likely to be overweight, abuse drugs, be in traffic accidents involving alcohol, and be victims of violence and firearms. We're also less likely to use seatbelts. Physical environments. Our landscape is built around transportation via automobiles, leading to less physical activity and more obesity. This shows that while we know how to live longer, healthier lives, a large portion of our population is just not doing it. This advantage -- knowing what we should do -- seems to be used chiefly by people who take the time to educate themselves about healthy behaviors and have the economic means to act on their insights.

5. Healthy Diet Each year, at least 20 million people worldwide survive a heart attack or stroke People with cardiovascular disease (CVD) and diabetes are at increased risk of another event or new CVD event compared with healthy individuals

6. Healthy Diet Drugs such as antiplatelet agents, statins, angiotensin modulators and beta blockers each reduce the risk of CVD by about one quarter and their combined effects are substantial

7. Healthy Diet Lots of epidemiological studies have shown a lower risk of developing CVD in people eating a healthy diet Very few studies of diet quality and CVD outcomes in people with established CVD Does a healthy diet have additive benefits in addition to drug treatment in preventing a second heart attack?

8. Healthy Diet Research published in Circulation, Journal of the American Heart Association, in December 2012 5- year study of almost 32,000 people Average age 66 Involved 40 countries

9. Healthy Diet The study looked at people who had suffered a heart attack or stroke or had type 2 diabetes and were thought to be getting the best medicine possible

10. Healthy Diet Those who ate a heart-healthy diet had: 35% reduction in risk of cardiovascular death 14% reduction in risk for new heart attack 28% reduction in risk for congestive heart failure 19% reduction in risk for stroke These % are in addition to drug benefits in lowering risk of secondary event

11. Healthy Diet Researchers used Food Frequency Questionnaires Participants were asked In the last 12 months how often did you eat foods from each food category They did not ask about portion size Researchers measured intake of: vegetables, fruits, nuts, soy protein, whole grains, deep- fried foods, and ratio of fish to meat, eggs, poultry, and alcohol intake

12. Healthy Diet Of the 31,546 people in the study: 5,190 experienced a CV death, heart attack or stroke or went into congestive heart failure

13. Healthy Diet Researchers observed a significantly reduced risk of CV death, heart attack, stroke or congestive heart failure with increased intake of vegetables, fruit, whole grains, nuts, legumes, soy protein, and higher intake of fish relative to meat, poultry and eggs Increased risk with greater intake of meat, poultry and eggs

14. Researchers found a heart-healthy diet offered a consistent benefit over and above the benefits of taking medications to reduce the risk of heart attack or stroke.

15. Healthy Eating Those people in the study eating the healthier diets tended to: Be older Be less likely to smoke Consume more alcohol Be more active Have a lower BMI

16. Healthy Diet Researchers stated: It is a very common misconception that medications for heart disease, high blood pressure, high cholesterol and other cardiovascular problems will solve or cure the issues at hand. The medications give patients a false sense of protection and security!

17. Healthy Diet Even if someone is taking medications, eating a lot of bad foods - like saturated or trans fats, fast and junk foods, red and processed meats, sweets and refined and processed foods – will still wreak havoc in the body These foods increase inflammation, contributing to the deregulation of sugar and insulin and to the exacerbation of the cardiovascular diseases

18. Healthy Diet It is important to consider our food as medicine and be as thoughtful and dedicated to healthy eating as we are to taking prescribed medications Researchers concluded, Physicians should advise their high-risk patients to improve their diet and eat more vegetables, fruits, whole grains and fish. This could substantially reduce cardiovascular recurrence beyond drug therapy alone and save lives globally.

19. Healthy Diet Protective Foods: Vegetables: Leafy green vegetables, cooked and raw vegetables Serving: 1 cup raw, ½ cup cooked Shoot for 5 servings a day

20. Healthy Diet Tips for eating more vegetables: Pick up pre-washed bags of salad greens and spinach Choose no-chop veggies like baby carrots, cherry tomatoes, broccoli and cauliflower, pre-cut celery and sugar snap peas Make a big salad for several days Use frozen veggies!

21. Healthy Diet Eat twice the servings of vegetables as starches per meal: 2 cups veggies for every 1 cup rice, potato, or pasta Eat 2 or more meatless, vegetable-rich meals per week. Meatless Mondays! Drink low-sodium tomato juice as a snack Add vegetables to sandwiches – try onion, bell peppers, bean sprouts, broccoli sprouts, cucumber, tomato, lettuce, etc. Add salsa to your dishes!

22. Healthy Diet Use lots of low-sodium canned tomatoes, tomato sauce, tomato paste in soups, stews, casseroles, spaghetti. Also POM tomatoes Roast veggies in a 400 degree oven for great caramelized flavor: spritz yams, carrots, zucchini, bell peppers, onions, mushrooms, etc. with olive oil/spices and bake 30-40 minutes Stir-fry! Use fresh or bagged broccoli, cabbage, cauliflower, etc Mash carrots and cauliflower into mashed potatoes or mashed butternut squash

23. Healthy Diet Buy frozen bags of vegetables; thaw and stir- fry with chicken or lean ground beef or tofu/edamame. Add a sauce. Add peas, carrots, celery, onion, green pepper, mushrooms to casseroles and mixed dishes and stews Make spinach or broccoli dips, using yogurt or cottage cheese as base Make a veggie pizza with whole grain crust

24. Healthy Diet Fruit: Includes all fruit and natural fruit juice Watch the fruit juice – high in sugar Serving: 1 cup berries, 1 apple, orange, pear, etc. ¾ cup juice, ¼ cup dried Shoot for 2-4 servings/day

25. Healthy Diet Tips for eating more fruit Buy fruit!! Choose fresh fruit in season when it is less expensive and more flavorful Frozen fruits are wonderful too Bring an apple, pear, orange with you to work or on errands Mix small amounts of dried fruit/nuts

26. Healthy Diet Have a snack of fruit and nuts; apple and 10 almonds, pear and walnut halves, banana and peanut butter Have fruit for dessert drizzled with dark chocolate Add diced fruit to tuna salad: apple or grapes Add apples, pears, oranges to tossed salads Puree frozen fruit and pour over yogurt; heat and pour over pancakes

27. Healthy Diet Whole grains: whole wheat flour, cracked wheat, brown/wild rice, corn, oats, couscous, barley, whole wheat pasta Serving: 1 slice bread, ½ cup cooked grains, 1 small potato, ½ cup corn/beans 3-6 servings/day

28. Healthy Diet Nuts/Seeds: Peanuts, almonds, sunflower seeds, cashews, walnuts Serving: 1 oz nuts, 2 Tbsp nut butter 1 serving/day

29. Healthy Diet Soy Protein: Soy milk, tofu, soybeans, textured vegetable protein Serving: 3 oz tofu, ½ cup edamame, 1 cup soymilk 1-2 servings/day

30. Healthy Diet Fish: fresh-water and sea-water fish, canned fish, shellfish and crustaceans Serving size: 4-5 oz 3-5 servings/week

31. Healthy Diet Increased risk with greater intake of meat, poultry and eggs Meat/poultry: beef, pork, lamb, mutton, goat, veal, rabbit, chicken, turkey, duck, pheasant, liver and sausages

32. Healthy Diet Eggs: Chicken, duck

33. Healthy Diet Remember: Your choices matter... Treat yourself well Cook well, live long!

34. Lets Get Cooking!