So, we're going to talk about nutrition for heart health. If you've been watching my Facebook Lives,
you know that for American Heart Month, I decided to come live and give you some information about
heart health to help you lead a heart-healthy lifestyle. The first video was just on my personal experience
with heart disease - surviving a heart attack 10 years ago - and the symptoms of a heart attack as well as
risk factors. The second one, I focused more on exercise and stress and things that we have control over
and can change to minimize our risk. Tonight, finally, my passion. We are talking food / nutrition for heart health.
I'm going to try to be brief. I could probably talk about this for three hours without taking a breath.
I'm going to do my best to keep it short for you guys tonight.
Eating for a healthy heart - there's a lot of information out there and the information I'm giving to you tonight is
based on the research, the evidence we have. It is always changing so new things are coming up as we
learn more and so that's always a challenge - to keep up with the latest research but this is on peer-reviewed
journal articles, American Heart Association guidelines, information from the Framingham study, and the
Mediterranean and DASH diets and all of those wonderful ways that are heart healthy ways to eat.
I'm going to give you 4 simple tips to eat for a healthy heart.
#1 - and if you are at home and you can grab some kind of food package with a food label that might be helpful
as we go through this tonight, just to have a label to look at. Or if you've got a bottle or a drink in your hand
that will do as well. So, first of all, tip #1 to eat for a healthy heart: Add more fiber.
Americans are horribly deficient in their fiber intake. I think the average intake is around 15 or so grams
of fiber a day and the recommendations range from about 25 to 38 grams of fiber a day. So Americans are
not eating enough fiber and fiber is wonderful for heart health. There's two types of fiber in food:
soluble and insoluble. No food is just one type of fiber although some have more of one type than the other.
Any food with fiber will have both types of fiber so don't get hung up on "does this food have more of the
better fiber for my heart" because all foods are going to help you get to your fiber targets.
So, the two types of fiber - one helps with regularity, providing bulk to our system to move things along,
which is also important; but the other helps with heart health and what it does is it basically grabs on to
cholesterol in your system and pulls it out so it helps to reduce your blood cholesterol, specifically your LDL or
the "bad cholesterol." So, more fiber in the diet can help reduce your bad LDL cholesterol which can help reduce
your risk for heart disease - and it has a million other wonderful benefits as well: it helps you feel full longer
and fill up faster. If you're trying to manage your weight, more fiber can help you feel satisfied - or satiated - from
your meal, which can help. And many of the foods with fiber are lower in calories so that's a great bonus too for
weight management. That's why fiber is so beneficial for your heart health.
Which foods have fiber is the next question and the answer is fruits, vegetables, and whole grain foods.
Fruits - the recommendation for most Americans is 2-3 servings of fruit for most of us a day.
Now, I'll caution you that a serving is smaller than you might think. It is 1 cup of measured fruit,
which is not that much. Think of the small apple you get at Panera - that's a serving of fruit, not those big apples
you get at the grocery store. Or a half of a banana is a serving of fruit so a banana is most of the time
two servings of fruit. So, so it's very easy to get to your fruit recommendations. Many people that I talk to
to when I'm counseling are trying to watch their blood sugar and they are afraid to eat fruit because of the
sugar and other people, because sugar has gotten to be so demonized lately and, yeah sugar is a concern -
added sugars - we'll get to that in a minute, but the sugar in fruit, nature has packaged fruit with fiber and
with all these wonderful vitamins and minerals and phytochemicals which help our health in millions of
ways. The research is amazing. Because the sugar in fruit is packaged with fiber, it slows down how quickly
that sugar gets into our bloodstream and so it tends to raise our blood sugar slower than candy bars
or soda because there's fiber in the fruit. So, don't be afraid of fruit unless, of course, you're sitting
down to a whole bowl of fruit cocktail and eating it all. Then we'll have a different conversation but in general,
try to add more fruit to your diet. Vegetables as well contain fiber. Now, we know there are starchy and
non starchy vegetables. I would recommend more non-starchy vegetables because there are very few calories
per bite. So, it's easier to tell you the starchy veggies because there's tons of non starchy.
We know the starchy vegetables are corn, peas, potatoes, winter squash like butternut and pumpkin,
legumes or beans, if you consider those a vegetable, which botanically they are even though they are a
protein source nutritionally. So those are the starchy veggies, so pretty much anything else is non-starchy.
Any of your greens, lettuce, tomatoes, carrots, celery, cucumbers, summer squash, cauliflower, broccoli,
parsnips. I could go on and on. So those are the veggies to focus on. One great idea is to try to have maybe 4-5
colors on every plate and, if you stick to whole foods, you have to put vegetables on or fruits to get the colors.
That's a really good way to improve your heart health, to get 4-5 colors on your plate and build those colors with
fruits and vegetables. The last food that has fiber is whole grains. And again, a lot of people stay away from
carbohydrate foods and grains specifically. Yes, you want to reduce your white rice, white pasta, white bread,
all of those refined grains because what they do in the food manufacturing is actually strip away the fiber along
with a lot of the nutrition in the wheat or whatever grain they're processing and then they've got to add it back.
So, it's fortified and that's why you see long ingredient lists on grain products. If it has been stripped, refined,
and then fortified because they have to put all those vitamins and minerals back. If you stick to the basics:
whole foods, brown rice, whole wheat pasta, wheat bread - not multigrain bread because that can be a
bunch of refined grains - it has to be whole-grain. One trick is to look at your ingredients listing on your food
labels and make sure "whole" comes before the grain so whatever it is - whole wheat flour, whole durum semolina
flour if it's a pasta, any of those - if you see the word "whole" first, you're in business. Now if you're looking at
a food label, fiber - and I have my food labels over to the side here so I'm kind of going to look off at my label -
fiber is going to be listed, it falls under the carbohydrates on your food label. So, you'll see
carbohydrates and then you'll see fiber. Now the fiber is already included in the total carbs.
If something says total carbs: 20 grams, fiber: 5 grams that means that 5 of those 20 grams are fiber.
You don't add them together. It's indented, which a lot of people don't notice, because it's part of the total
carbohydrates. So that's where we would look for fiber on your food packaging. More fiber is better.
If you're trying to increase your fiber, next time you go to the store go to your general choice of whole grain bread,
pasta, whatever you're eating, and look at the label and see how much fiber is in it. Try to find a brand that has a
little bit more fiber. That's a real easy way to up your fiber intake without changing how you're eating at all.
Just by looking for products with more fiber in them. So that's tip #1, you want to increase with your fiber.
Tip #2 for heart healthy eating is change up your fats. There are a few different types of fats in foods
and some of them are really good for your heart health and some of them not-so-good for your heart health.
The two types of fats that are not good for your heart health are saturated fat and trans fat. The way I tell
to remember this is think of saturated fat saturates your heart with fat. We don't want a heart saturated with fat
so try to avoid that. And trans is the opposite of what you want. So, saturated and trans try to reduce those
fats. The reason is they also raise your HD - I'm sorry raise your LDL, your "bad cholesterol" and they can also
trans fat can decrease your HDL, or your "good cholesterol." Now if you didn't know it, your good
cholesterol's job, so to say, is to take that bad cholesterol, pick it up, and take it out of your system,
back to the liver for processing so high HDL is actually cardio-protective. It's good for your heart risk because
it's helping to bring down your LDL so we want to avoid saturated and trans fats because they can (whoops!)
I'm sorry - reduce HDL - reduce the good stuff - it can increase the bad stuff so that's not what we want.
The fats that are amazing for your heart health are the unsaturated fats and you're going to see these on a food
label as polyunsaturated and monounsaturated and that just refers to the number of chemical bonds. It's not
really important for you to know all the chemistry. But the unsaturated fats are the ones that can bring your
good cholesterol up - beautiful - and bring your bad cholesterol down, which that swap will help bring your
total cholesterol down. So when you look at... So, saturated fats are in animal foods. Saturated fat is
found in animal products, so any of your meats and when I say meats I include poultry and fish - and
anything that comes from those animals - so your dairy foods will also have saturated fat in them.
Alternative dairy products may or may not depending on the source of the milk when they make it.
If you can reduce, that's one reason that going meatless a couple nights a week can help reduce your heart
disease risk because it helps you bring down saturated fat. Now, if you're not ready for a meatless meal or some
vegetarian options you can just reduce your portion sizes. Put a little less meat on your plate and fill that
space up with some vegetables and you still get a full plate but it's more heart-healthy.
Trans fats and saturated fats are also in bakery products. Trans fats can be in anything honestly.
It's added by food manufacturers. It's very rarely found in nature. It is something that was created to improve
spreadability of products and increase shelf-life of products so it's added to tons of foods,
everything from butters and salad dressings to breads and, you know, frozen dinners it can be in any
food product. This is where it gets a little tricky. Well, before I say that, unsaturated fats are found mostly in
vegetable products, nuts and seeds and things like that so avocado, olives, fatty fish, those are all unsaturated
fat sources. So when you're looking at your food label, again, you're going to see total fat as one of the lines on
your food label and underneath that you are going to see at the very least saturated fat and trans fat.
You may or may not see polyunsaturated or monounsaturated. As of right now, it's not required to be
on the food label. But this is one place on the food label that you can actually just do simple math.
If you're looking at a label and it says total fat 20 grams and saturated fat 5 grams, trans fat zero you know that
20 minus 5 grams - the other 15 grams are unsaturated fat, so that would be a great heart healthy choice.
You can also use the daily values - that percentage on the food label. A lot of people don't really know how to
use that. It may or may not be your specific percentage; it just depends how much you eat. They had to have a
standard number to get a percent. But you can look for things that are 5% or less are going to be low.
So if you see something that's 4% saturated fat that's low in saturated fat or 20% or more is high so if
something has 25% of monounsaturated fat that would be high in unsaturated fat - what you would want.
What the research shows us on these fats is that if you replace saturated and trans fats with unsaturated fats,
it improves your heart health, it reduces your risk. There may be some value in just in adding unsaturated fats -
add a handful of nuts a day... have some guacamole with some carrots... have some salmon for dinner -
so there may be benefit to just adding but they have a lot of calories because they're fats.
The idea is to swap it out so if you would usually cook with, you know, a regular vegetable or soy oil
and you swap that out for a canola oil or an avocado oil or a walnut oil, that would be a healthier swap.
And it's that swap out that's important for reducing heart disease risk. So that is your unsaturated fats.
Tip # 3 for heart health. So far, we've got # 1: increase your fiber and # 2 change out your fats so tip # 3 is
reduce your added sugars and salt. So here we go with the sugars and yes, we have a bunch of research that
shows us that added sugars in foods are not good for your health - I'm talking heart health, I'm talking cancer
outcomes, I'm talking on all kinds of negative health outcomes from a high intake of added sugars.
So we want to reduce added sugars. Now, again this doesn't apply to fruit, the natural sugar in fruit, or
the natural sugar lactose in dairy products or maltose in some grains but it does apply to added sugars in food.
How do you know, right? Right now our food label does not break out added sugars so if you look at a current
food label, you're going to look under the carbohydrates line - and we've already talked about the first line
under that is fiber, which you want to boost up, the next line under that will be sugars and it's going to have a
total number of grams. But it doesn't tell you if that's added or natural. So if you're looking at a cup of milk,
for example, you're going to see around about 12 grams of sugar. It's all natural but you have no way of knowing
that so how do we tell? You have to look at the ingredients. So look at the ingredients and goodness
there's probably 40 to 50 code names for sugar these days. Look for any of those code names for sugar.
It could be cane syrup, it could be agave syrup, it could be honey, molasses, any of those -OSE words
like dextrose, maltose, sucrose and a whole lot of other words. Now, even if it's organic, it's still sugar.
Your body does not differentiate between organic added sugar and conventional added sugar so even if
it's organic agave or organic honey, that's beautiful, but it's still added sugars and you want to bring those down.
That is sugar added in manufacturing which is why it's going to be listed in the ingredients and not broken out
on the label. If you do not see any of those code words for sugar in the ingredients listing then the sugar in the
product is natural. Don't worry about it. Enjoy the food.
Now - good news. A change is coming! Although the food lobbyists keep managing to push it back; but new
labels are coming and the latest dates I heard today, I think are depending on how much profit or revenue the
food companies make - they have to implement these changes either by 2020 or 2021 so we still have some
time before we see these changes. But I've seen it on a couple labels already because some people realize that
consumers, we want this information and they're giving it to us and if we see it we're more likely to buy
their products so I applaud those companies. So on some food labels and coming whenever, you will see a
change to now have sugars and added sugars. So the new food labels are going to actually list
added sugar grams, which makes you not have to put on your detective hat and go reading through all that
really tiny print in the ingredients listing. So that's great news. We just don't know when it's coming.
You also want to reduce your salt or your sodium in your diet. Now, I've done a series of videos on my
YouTube Channel on salt. I'm in the process of posting them but the research is kind of mixed on this.
Some people are salt sensitive which means if they reduce the salt in their diet, they will see a
corresponding reduction in blood pressure which will reduce heart disease risk.
But not everybody has that genetic makeup so some people don't respond to that and others, if they reduce
salt, their blood pressure goes up. So you're going to have to see what happens for you but for the majority
of us - we eat probably three times the recommendation for salt so we have a lot of salt in our diet and that's
because it's in convenience foods, it's in grab-and-go foods, it's in packaged processed foods,
and it's in restaurant foods so if you turn to these foods, eat out a lot, and don't do a lot of home cooking
then you probably have a lot of salt in your diet and it might be something to look at bringing down. In addition
to the potential impact it might have on your blood pressure, salt can also influence your body weight
because the more salt you have in the diet the more your body has to hold on to water to maintain that
equilibrium, basically so your blood doesn't get too salty and your body tissues don't get to salty, so your body
holds water and that shows up on the scale. A lot of people find if they drop their salt down to a more
realistic health level, they will drop a few pounds without really changing anything else because the body
can let go of that water. So play with that if you're struggling with a couple of pounds. There is a minimum
though - you do need salt but it's in everything pretty much, natural food, so many people don't worry about
not eating enough so don't worry about that because many of us eat way too much sodium or salt.
Those are the three tips. We've got add fiber, swap out your fats, and reduce your added sugars and salt.
The last tip for heart healthy eating really is just focused on maintaining a healthy body weight.
I put that with nutrition because weight balance, while it's dependent on a whole host of factors:
genetics, weight history, your gut microbiome - we're learning more about that impact on weight so there's
much of it that may be not as easy for a lot of people to control, which I think we need to recognize.
There is also a component of your weight that does come down to your energy balance -
your calories in / calories out - so that's why I kind of put this with nutrition because if you are trying to
change your weight and your body is set up in a way that it will let you make a big change to your weight,
then nutrition is really where it's at. And it is all a game with the calories and the quality of food in your diet.
We want to pay attention to not only how much you are eating, but the quality of foods that you're eating can
make a big impact on your weight as well. And as I said, there's a lot more that goes into weight management.
That would be a whole nother series of videos but that I'm just throwing in here as another tip for
reducing your heart disease risk. So, that's all I've got for you tonight. I am glad that you guys have joined me
I hope that you have found this informative and that it has inspired you to maybe make some changes and
try out some new things to reduce your heart disease risk. It is still the number one killer in our country
and I'm passionate about getting the word out there so share this information with your loved ones
and ask me any questions. I'll monitor this Facebook video feed after the fact so if you've got any nutrition
questions post them and I'd be happy to answer them, you might even inspire another set of videos!
Thank you for watching. It's been my pleasure. Follow me on YouTube for videos. I will be posting those it's
YouTube.com/AlexiaLewisRD or follow me on Facebook and reach out to me
if you have any questions. Thank you so much.
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