HEALTHY EATING

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CARDIAC RISK FACTORS

NON-MODIFIABLE

• Age• Gender• Heredity

MODIFIABLE• Food habits• Stress• Smoking• Drinking alcohol • Obesity• Hyperlipidemia• Hypertension• Hyperglycemia

HEART HEALTHY GUIDELINES

• Appropriate body weight• Cholesterol profile• Blood pressure• Overall healthy eating pattern

APPROPRIATE BODY WEIGHT

• Slow and steady wins the race! Lose no more than 1/2 to 1 kg / week.

• Beware of weight loss products• Find out your ideal body weight from your

dietician or doctor.• Exercise regularly and keep up an active

lifestyle as allowed by the physician

What is What is Body Mass IndexBody Mass Index (BMI)? (BMI)?

BMI ClassBMI Class ValueValue(Kg/m(Kg/m22))

Underweight

< 19

Normal Weight

19 -24

Overweight 25.0-29.9

Obese I 30.0-34.9

Obese II 35-39.9

Obese III ≥ 40.0

Health Risks of ObesityHealth Risks of Obesity

““Reduce Your Weight”Reduce Your Weight”

• If you are overweight or overweight or obeseobese,, a 10% reduction10% reduction in BWT may help to… – Lower Blood pressure– Lower Cholesterol level– Lower Triglyceride level– Lower Blood Sugar Levels– Improve overall health– Lower risk of heart disease

CHOLESTEROL

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Cholesterol

‘Bad Cholesterol’ (LDL) sticks to artery walls andcontributes to plaque build-up‘Good Cholesterol’ (HDL) is stable and carries‘Bad Cholesterol’ (LDL) away from the arteries.

Cholesterol is a waxy fat circulating in our blood

HDLHigh DensityLipoproteins

‘Good cholesterol’

LDLLow DensityLipoproteins

‘Bad cholesterol’

Normal Artery

Clogged Artery

Cholesterol

DESIRABLE BLOOD LIPID VALUES

Total cholesterol 160-200mg/dlTriglycerides 50-180mg/dlHDL-C 35-55mg/dlLDL-C 100-130mg dl

DIETARY CHOLESTEROL

• Cholesterol is found only in animal foods.• It increases LDL-C but not as much as

saturated fats.• Red Meat, organ meat, egg yolk need to be

restricted in the diet as they are high in cholesterol. Poultry, egg white and fish could be had in the diet.

• Allowance - 150 mg / 300 mg /day.

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Cholesterol

CHOLESTEROL CONTENT OF SOME FOODS

Food Serving Cholesterol (mg)Egg yolk 1 272Chicken liver 50 g 316Cow’s milk 244 ml 35Chicken (no skin) 86 g 73Pomfret 100 g 80Ghee 1 tbsp 33Cheddar cheese 28 g 30Lamb (lean) 64 g 60

FAT IN MILK AND MILK PRODUCTS

• Whole cream milk may contain as much as 6% fat! (>1 tsp ghee per 100ml)

• Toned milk is 3 – 3.5% fat (3/4 tsp ghee /100ml)• Milk fat is saturated• Look for low fat milk

– Skim milk is available in ‘Long Life’ milk– 1.5% Fat double-toned fresh milk

may come to the market soon

““Lowering Trigylcerides”Lowering Trigylcerides”

• Avoid Alcohol.Avoid Alcohol.– Beer, wine, or hard liquor.

• Avoid Sugar.Avoid Sugar. – Candy & regular soda.

• Eat Fewer Carbohydrates.Eat Fewer Carbohydrates.– Breads, cereals, rice, pasta, fruits, &

dairy products.

TRIGLYCERIDES

• Eating too much carbohydrate (starch and sugar) can lead to high blood triglycerides and lower HDL- C (good cholesterol)

• Unprocessed / fibre rich starchy foods are better than sugars and refined products.

• Excessive alcohol will raise triglycerides.• Uncontrolled blood sugar in diabetes will also have

this effect.

ALCOHOL• Limited alcohol intake may be beneficial• Higher consumption has undesirable effects• Alcohol may affect blood pressure• It is a source of ‘empty’ Calories -

beware if trying to lose weight. • May increase triglycerides

Normal Value - 120/80 mm/Hg

BLOOD PRESSURE

SODIUM

• Reduce the sodium in your diet to control the hypertension.

• Limit salt intake to one teaspoon or less per day.• Reduce salt in cooking.• Do not add salt at the table.

SODIUM -Foods to avoid or limit

• Table salt / cooking salt• Salted snacks, chips• Papads, vadakams• Cheese• Baked goods• Salted nuts• Pickles • Commercial soups

• Processed meats• Bottled sauces• Convenience foods• Salt-preserved meats• Monosodium glutamate

(Ajinomoto)• Canned foods• Dry fish• Instant noodles

CAFFEINE

• Caffeine is found in coffee, tea, cocoa, chocolates and colas.

• It is a stimulant that can affect blood pressure and heart rhythm.

• Limit to two medium cups of coffee or equivalent per day.

OVERALL HEALTHY EATING PATTERN

• Cereals and grains 5 - 12 servings• Fruits and vegetables 5 - 10 servings• Milk and milk products 2 - 4 servings• Meat and alternatives 2 - 3 servings

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Basic & PlanningThe food that you eat gives you……….• Proteins• Carbohydrates• Fat• Vitamins & Minerals• Water• Fiber• Antioxidants

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Fats• Fats are used as source of energy. There are 2 main types of fats.• Animal fats (saturated) • Plant fats (unsaturated)

HOW MUCH OIL/ FAT SHOULD YOU CONSUME IN A DAY?

• Limit the amount of cooking oil. 4-5 teaspoons per day per person recomended.

• Not more than 25% of your energy intake (calories) should come from fat.

• This means 40-50 g fat per day on a 1800 kcal diet.

• But don’t forget the hidden fats!

DIETARY FATSTypes of dietary fat - • Saturated • Unsaturated

– Polyunsaturated– Monounsaturated

• NOTE: All fats are a mix of many types of fatty acids

TYPES OF DIETARY FATSSATURATED POLY-MONO-

UNSATURATED UNSATURATEDButter Sunflower oil Olive oilCoconut oil Safflower oil Canola oilGhee Corn oil Groundnut oilPalm oil Soybean oil (Peanut)Lard Gingelly oil Mustard oilDalda (Sesame)Blended vegetable oilAnimal fats

NOTE: All fats are a mix of many types of fatty acids

AVOID / LIMIT FOODS SUCH AS THESE!

““Lowering Cholesterol & LDL levels”Lowering Cholesterol & LDL levels”

• Eat less saturated fat.Eat less saturated fat.– Saturated fats are

usuallyusually found in animal products.

– However you should should avoidavoid coconut, palm, coconut, palm, and palm kernel oiland palm kernel oil as they are high in saturated fat.

Why is it BadWhy is it Bad??

• Trans fat is as badis as bad for you as saturated fat.saturated fat.

• It has been shown to– raiseraise LDL levelsLDL levels – lowerlower HDL levels HDL levels– increaseincrease your risk for

heart disease

TRANS-FATTY ACIDS

• These are formed during hydrogenation.• They increase LDL-C and reduce

HDL-C• They are found in margarines, daldas -

and made using them in bakery products.

MONO-UNSATURATED FATTY ACIDS

• A diet high in this type of fat lowers total cholesterol LDL-C & triglycerides

• It does not lower HDL-C• Heart disease risk is reduced• Good sources are:

Olive oil Peanut (groundnut) oilCanola oilMustard oilNuts

OMEGA-3 FATTY ACIDS• These are found in fish oils, canola, soy bean oil, some

seed, and nuts.• Two servings of fish/ week contain adequate amounts. • Omega 3 fatty acids reduce -

•Heart rhythm problems•Triglycerides•Blood clotting tendency •Heart disease and heart attack in women•LDL cholesterol.

• They also increase HDL cholesterol

WHAT FOODS ARE HIGH IN PROTEIN?

• Animal products - eggs, meat, chicken, fish, etc.• Milk, cheese, curds, paneer, etc.• Pulses and legumes - dhals, grams, dry peas,

soybeans, rajma, etc.• Nuts and seeds - peanuts, almonds, cashews, etc.

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Carbohydrates

• The carbohydrates you consume may be simple or complex carbohydrates

• Prefer complex to simple carbohydrates• Take more complex carbohydrates like Cereals and

whole grains • Avoid simple carbohydrates like sugar and chocolate• It should be about 60% of total diet.• E.g.: wheat, bajra, jowar, nachni, corn, roti, bread,

bhakri, idli, dosa, thepla, rice, pulav.

Carbohydrates are utilized for energy.

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Vitamins and Minerals

• Vitamins are available from the various fruits we eat• Minerals are available from the vegetables we eat• Regular intake of Fruits and Vegetables will ensure

adequate intake of vitamins and minerals.• E.g.Citrus fruits like oranges, sweet lime rich in vit C Papaya, carrots rich in Vitamin A. Palak, beet,pomegranate rich in iron. Dudhi rich in calcium.

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Anti-Oxidants

Free radicals are produced in our body due to oxidation

Lead to aging, loss of memory, increased risk of CHD

Anti-oxidants help combat free radical production They delay aging, improve memory and reduce

risk of CHD. E.g. lime, Soya, almond, walnut, pista, flax seeds, green tea, all citrus fruits.

DIETARY FIBREDietary fibre is of two typesSOLUBLE• Pectins, gums, mucilages, hemicelluloses• Found in oats, legumes, dhals and fruit

INSOLUBLE• Cellulose and lignin• Present in skins and seeds

of fruit and vegetables and whole grains

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Fiber There are 4 main advantages of having fiber regularly• Reduction in cholesterol• Reduction in blood sugar• Reduction in body weight• Reduction in stomach/ digestion related problems.E.g. : Oats, barley, nachni, whole wheat,bran, nuts, flax

seeds, Psyllium husk, raw salad, fruits & vegetables with skin.

HOMOCYSTEINE

• High levels of homocysteine is associated with heart disease.

• Vitamins folic acid, B6 and B12 are needed to reduce homocysteine in the blood. Low folic acid and B6 have been connected with heart disease.

• Be sure to eat foods containing these vitamins - – B6 - Whole grains, meats, chicken, potatoes, bread,

cereals, dark green vegetables, nuts– Folic acid - Dark green leafy vegetables, liver, eggs,

legumes

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Water• Regular Water intake necessary to keep us hydrated• At least 10 – 12 glasses required daily. (1 glass = 200 ml) • Deficiency may lead to : Dehydration Fatigue. Urinary infections Kidney stones

EATING OUT• Eat a small low fat snack before going out• Choose baked, steamed or dry roasted items such as

idlis, idiappams, plain rice, pulkas or naans• Limit or avoid dishes with coconut or cream.• Choose unsweetened low calorie beverages instead of

sweet, creamy or alcoholic beverages.• Order fruit for dessert instead of rich

desserts, ice-cream or Indian sweets• Avoid salty snacks and foods.• Eat in moderation.

THE HEART HEALTHY DIET

• Low total fat• Low saturated fat• Low cholesterol• Low sodium• Low simple sugars• Moderate

carbohydrate

• Moderate energy• Moderate protein• High fibre

THANK YOU!