1. Lowering Your Cholesterol with Healthy Eating Cindy Sass, RD, CDE February 8, 2011

2. Lower your cholesterol ….. Lower your heart disease risk

3. Cardiovascular Disease Risk Factors UncontrollableControllableChangeable Family history Man 40 years or older Woman 45 years or older Diabetes High blood pressure Smoking High LDL cholesterol Low HDL cholesterol High blood triglycerides Overweight (esp. at waist) Inactive lifestyle Stress

4. Target Blood Fat Levels Based on Your Risk Level Low to Moderate Risk High Risk or Existing Disease or Diabetes Total Blood Cholesterol 5.2 or less4.6 or less LDLLess than 3.5Less than 2.0 HDL1.3 ormore TriglyceridesLess than 1.7Less than 1.5 Total Chol to HDL Ratio Less than 5.0Less than 4.0

5. Types of Fat In The Blood  HDL – high density lipoprotein  the “HEALTHY” cholesterol  works to remove cholesterol from the blood and carry it back to the liver  LDL – low density lipoprotein  the “LOUSY” cholesterol  contributes to build up of plaque in the artery walls  Triglycerides  Another form of fat in the blood that can contribute to plaque build up in the arteries

6. A Heart Healthy Eating Plan Limit Bad Fats Use Good Fats Eat less Cholesterol Eat more Soluble Fibre Whole diet approach

7. The Bad Fats Saturated Fat  Solid at room temperature.  Found mostly in meats, dairy and tropical oils (palm oil, cocunut oil).  Increases LDL and decreases HDL.

8. Saturated Fat  Saturated Fat represents 14% of total caloric intake for Canadians.  It raises your blood cholesterol more than anything else in your diet.  Hard to avoid - pizza, hamburgers, steak, tacos, ice cream, cheese, butter.

9. Dietary Sources of Saturated fat (listed in decreasing order)  Cheese  Beef  Milk  Oils – Tropical  Ice Cream  Cakes/cookies  Butter

10. Saturated Fats  To lower blood cholesterol: Keep your saturated fat intake to less than 7% of your calories for the day.

11. Sample Saturated Fat Intakes If you consume:Eat no more than: Calories a daySaturated Fat 1,50010 grams 1,80012 grams 2,00013 grams 2,50017 grams

12. Saturated Fat content  Pumpkin pie 1/8 of pie4 g  Swiss cheese 1 ¼ inch cube 7 g  Ground Beef, lean 3.5 oz7.2 g  Bacon, 2 slices5.8 g  Milk 2 %, 250 ml4.7 g  Big Mac, Mcdonald’s10.1 g

13. Nutrition Facts Label

14. How do I limit Saturated Fat?  Trim visible fat off meat.  Skin poultry before eating.  Limit eating out.  Have more meatless meals.  Use less cheese.  Switch to low fat dairy products.

15. Trans Fats  Trans fats raise LDL (bad) cholesterol and decrease HDL (good) cholesterol.  Limit intake of Trans fatty acids to 2 grams or less per day.

16. Dietary Sources of Trans Fats (listed in decreasing order)  Cakes/cookies/crackers/pies  Animal products ( meat, milk, butter)  Margarine  Fried potatoes (french fries)  Potato chips/pretzels/corn chips  Household shortening

17. Nutrition Facts Label

18. Trans Fats  Formed when liquid oils are made into solids by the process of hydrogenation  Trans fats extend shelf life and help consistency

19. Where do you find Trans fats?  Vegetable shortening, some margarines, cookies, crackers, processed foods, cakes, icing, donuts, fast food.

20. Trans Fats  Burger King Large Fries Trans Fat 8 grams, Saturated Fat 7 grams

21. Trans Fats  Tim Horton’s Donuts – Trans Fats 5 grams, Saturated Fat 5 grams

22. Trans Fats  Trans Fat 6 grams  Saturated Fat 4 grams Per snack size bag

23. Trans Fats  Pudding Trans Fat 1.5 grams

24. How do I limit Trans Fats?  Check the Nutrition Facts Labels.  Limit intake of commercially prepared baked goods like cakes, muffins, cookies, donuts, pies.  Limit your intake of convenience foods.  Limit eating out.

25. Cholesterol  The cholesterol in your diet raises the cholesterol level in your blood – but not as much as saturated fat.  The two are often found in the same foods.

26. Dietary Sources of Cholesterol (listed in decreasing order)  Eggs  Beef  Poultry  Cheese  Milk  Fish/shellfish

27. What about Fibre? Soluble Fibre -helps to lower bad cholesterol (LDL) -aim for 7-13 grams per day Insoluble Fibre - helps to relieve and prevent constipation Psyllium Legumes Barley Oats, oatbran, oatmeal Some fruits Some vegetables Wheat bran Whole grain foods Whole fruits and vegetables

28. Soluble fibre 7-13 g/day  Psyllium seed husks, 1 Tbsp. 4.0 g  All Bran Buds 1/3 cup3.5 g  Psyllium supplement – 1 dose3.4 g  Orange2.5 g  Kidney beans – ½ cup2.5 g  Oat bran 1/3 cup1.5 g

29. Good Fats: Use in Moderation Fat TypeSourcesEffect Poly- Unsaturated Omega-3 fat Seafood and fatty fish (mackerel, sardines, salmon, herring, trout), wild game Canola oil, ground or crushed flaxseed, flax oil, hemp seed and oil, and non- hydrogenated margarine made with these oils. Walnuts, pumpkins seeds, and soybean products. Functional Foods: Omega-3 eggs, Omega-Pro liquid eggs, omega-3 milk, omega-3 yogurt, omega-3 cheese Decreases triglycerides May increase HDL Thins the blood Many heart health benefits

30. Good Fats: Use in Moderation Fat TypeSourcesEffect Poly- unsaturated Omega-6 fat, Omega-9 fat Oils: grapeseed, corn, safflower, sunflower, soybean. Sunflower seeds, wheat germ, non- hydrogenated margarine made with these oils. Decreases LDL May decrease HDL Mono- unsaturated Oils: olive, canola, peanut, sesame. Nuts: chestnuts, hazelnuts, pistachios, almonds, macadamias, pecans, peanuts, and their butters. Other: fish, seafood, olives, avocado, mayonnaise, sesame seeds, non-hydrog. margarine (with these oils) Decrease LDL May increase HDL

31. Healthy Eating  Diets low in refined carbohydrates work best Choose whole grain breads, cereals, pasta, rice and keep intake moderate (not too much.) Eat more vegetables, and some fruits such as apples and pears.

32. Healthy Eating  Eat more fish, poultry and beans/lentils, eggs and less red meat.  Avoid saturated and trans fats and use more plant oils -canola oil, olive oil, peanut oil, healthy margarines, mayo and salad dressings.

33. Harvard Food Pyramid

34. Tips For Heart Healthy Cooking  Avoid deep frying or pan frying; use a non-stick pan  Try a vegetable oil spray  Cook meat by broiling, roasting with a rack, barbecuing, boiling, steaming or poaching  Use small amounts of water, juice or broth in the bottom of the pan to cook meats or vegetables  Try low-fat sour cream or yogurt instead of cream sauces

35. More Tips For Heart Healthy Cooking  Instead of regular cheese sauces, try a small amount of low-fat cheese with milk and a thickener (corn starch or flour)  Use salad dressings in small amounts  Refrigerate home-made soups, stews, meat drippings or cooked ground meats to skim off fat before serving  Cook with no or minimal salt

36. Dining Out  Choose meals that have lower fat ingredients:  Pasta with tomato sauce instead of cream sauce  Plain rice instead of fried  Baked/broiled/poached/steamed foods instead of fried/deep fried foods  Ask for dressings and sauces “ on the side ” so that you can control how much you are eating  Choose 2 appetizers instead of a main meal, share an entree, or take home half  Get nutrition guides for the fast food places you enjoy so you can make healthier choices.

37. Review  Limit saturated fat, trans fat and cholesterol.  Choose small amounts of healthy fats.  Eat more soluble fibre. What change will you make tomorrow?

38. Thank You!