Colleague's email address:
Your email address:
Subject:	A colleague recommends Diet and Nutrition
Message:

Balanced eating habits help the body function properly and resist disease. It is important for general good health as well as cardiac health to eat properly. While decreasing saturated fats, hydrogenated (trans) fats, and cholesterol is important, it is equally important to eat foods that maintain artery health and protect against vascular disease. For weight loss you must decrease the amount of calories eaten and increase the amount of calories burned. It is calories, not the type of food eaten, that affect weight. EAT LESS AND EXERCISE MORE.

A healthy diet promotes good health and decreases the chance of disease. Limit the amount of foods containing saturated fat, hydrogenated fat (trans fat), refined flour, salt, and sugar to a few small servings per day.

Decreasing Fat and Dietary Cholesterol:
Fat is an essential nutrient in your diet. However, the total amount of fat should be limited to 25-35 percent of daily calories. If you are not on a low calorie diet, fat intake for men is about 60 to 75 grams per day and for women 40 to 60 grams per day. The lower amount of fat is for those who are more sedentary. The higher amount is for those that are very active.

Monounsaturated and polyunsaturated fats are the healthiest types of fats. These are fats that come from plants, such as olive, canola, peanut, walnut, and corn oil. Other healthy sources of fat are nuts, seeds, avocado, and fatty fish (salmon). The majority of your daily fat intake should come from these healthy fats. YOU STILL MUST LIMIT THE AMOUNT OF FAT TO 25-35 PERCENT OF DAILY CALORIES.

Saturated fats and hydrogenated (trans) fats in the diet increase blood cholesterol and LDL levels. Some sources of saturated fat are dairy products such as milk, ice cream, cheese, butter, high fat cuts of meat, pork, and lamb, poultry skin, and tropical oils. Your body converts saturated fat into cholesterol and other fats that can damage your blood vessels. Trans fat is formed when liquid oil is hydrogenated or made solid. Trans fats have been found to increase the risk of heart disease. Trans fat can be found in many baked goods such as crackers and cookies, as well as stick margarine and Crisco. Saturated and trans fats are not essential nutrients. These types of fats should be limited. Of the 25-35 percent of daily calories coming from fat no more 7 percent of daily calories or about 12 to 19 grams per day should be from saturated and trans fats.

Cholesterol from food may affect your blood cholesterol and LDL levels, particularly with excessive intake. Dietary cholesterol is found only in animal products such as meat, poultry, eggs, and dairy products. Dietary cholesterol intake should be limited to 300 milligrams per day or 200 milligrams for those at risk.

A realistic way to reduce dietary fat is to substitute lean meats for higher fat selections, substitute nonfat or 1% dairy products for whole or full fat versions, using less "pourable" or "speadable" fats (salad dressing, gravy, butter, margarine), and eating more whole grains, vegetables and fruits.

Salt/Sodium:
The amount of sodium in the diet is important for people who have congestive heart failure or high blood pressure. Excess sodium may cause your body to retain fluids, which can increase blood pressure or worsen congestive heart failure symptoms. The food labeling regulations establish 2,400 milligrams or less as the advisable limit. Most people with heart disease should reduce sodium intake to 2,000 milligrams or less.

Most Americans consume more than 4,000 milligrams of sodium per day. The source of sodium in the American diet as reported in the Journal of the American College of Nutrition:

• 77% from sodium added to processed food
• 12% from sodium naturally contained in foods
• 6% salt added at the table
• 5% salt add in cooking

Cardio Protective Diet:
Many nutrients contribute to a healthy heart and healthy blood vessels. Most research has shown that getting the nutrients from food provides a benefit not achieved with supplements. For this reason it is recommended that you eat a wide variety of food that includes several choices from the following list on daily basis.

Omega 3 Polyunsaturated Fatty Acids:
Certain fish and ocean mammals contain a high concentration of a unique fat - omega-3 polyunsaturated fatty acid. There is evidence that omega-3 can reduce atherosclerosis. Omega-3 decreases triglyceride levels, weakens the activity of platelets (therefore reducing the tendency for blood clots), and reduces the risk of irregular heart rhythms. Omega-3 fatty acid is also found in flax seeds and other plant fats. Studies have shown that the Omega-3 found in fish provides unique benefits. Obtain from foods listed below:

A diet that includes fish 2-3 times per week is recommended. If you don't eat fish ask your physician about supplementing with fish oil capsules.

Fish (excluding shell fish)

Soluble Fiber Sources:
Soluble fiber helps to regulate the body's production and elimination of cholesterol. Obtain from foods listed below:

Recommended 20-30 grams total fiber and 10-25 grams soluble fiber per day

LEGUMES > 1.5-4.0 g soluble fiber; 5-10 g total fiber

Dried or Canned Beans
Peas
Lentils

GRAINS >1.5-2.0 g soluble fiber; 2-3 g total fiber
Barley
Oats
Brown Rice
Corn

VEGETABLES >0.5-2.5 g soluble fiber; 2-3 g total fiber
Broccoli
Cabbage
Carrots
Cauliflower
Corn
Green Beans
Potatoes & Sweet Potatoes
Winter Squash

FRUITS >0.5-2.0 g soluble fiber; 2-3 g total fiber
Apples
Berries
Citrus
Cranberries
Pears
Plums

Antioxidants:
Considered disease fighters for their ability to sweep up unstable molecules known as free radicals and their ability to stimulate the release of anticancer enzymes. A diet high in these nutrients is important to over-all good health. (vitamins E, A, & C)

Vitamin E food sources
Nuts
Seeds
Wheat Germ
Whole Grains

Vitamin A food sources
Deep Green Leafy Vegetables
Bright Yellow & Orange Fruits & Vegetables

Vitamin C food Sources
Asparagus
Berries
Cabbage Family
Cantaloupe
Citrus Fruits
Deep Leafy Greens
Mangoes
Papaya
All Peppers
Potatoes
Tomatoes

Phytochemicals are protective plant chemicals, naturally present in foods, which may reduce risk for heart disease. Food Sources high in phytochemicals:
Artichokes
Blueberries
Garlic
Deep Green Leafy Vegetables
Red Grapes & Grape Juice
Tofu (Soybeans)

B Vitamins prevent elevated levels of Homocysteine. Homocysteine is an amino acid. When blood levels of homocysteine are elevated there is an increased risk of heart disease. Eat food sources containing the following B vitamins to lower homocysteine:

Folic Acid (Folate)
Beans
Cereals (fortified)
Leafy Greens
Orange Juice
Seeds
Whole Grains
Salmon
Your doctor may prescribe a Folic Acid supplement

B6
Beans
Chicken
Leafy Greens
Seafood
Whole Grains

B12
Milk
Seafood
Tofu
Meat
Yogurt

Nutrition References:
Group classes and individual nutrition counseling are available at John Muir Medical Center, Walnut Creek Campus and John Muir Medical Center, Concord Campus. Call (925) 947-5313 (Walnut Creek) or (925) 674-2518 (Concord).

On line resources include:
The American Dietetic Association
The California Dietetic Association
The Center for Science in the Public Interest
The American Heart Association

Diet Cookbooks:
DON'T EAT YOUR HEART OUT COOKBOOK ; CONTROLLING YOUR FAT TOOTH, Joe Piscatella, Workman or www.joepiscatella.com.

GREAT ADVENTURES IN FOOD: A FRESH MARKET COOKBOOK, Ellen Haas, www.FoodFit.com.

RESTAURANT CONFIDENTIAL, Michael F. Jacobson, Ph.D. & Jayne G. Hurley, RD

LOW-FAT, LOW-CHOLESTEROL COOKBOOK, The American Heart Association, Scott Grudy

365 WAYS TO GET OUT THE FAT, The American Heart Association

EATING ON THE RUN, Evelyn Tribole, Leisure Press

ALMOST VEGETARIAN, Diana Shaw & Kathy Warinner

Diabetes Resources:
For information, education, exercise program, and support contact the John Muir Medical Center Diabetes Center at (925) 941-5076 (Walnut Creek) or (925) 674-2077 (Concord). Online information can be found through the American Diabetes Association web site.