S T . M I C H A E L ’ S H O S P I T A L

J E N N Y A C C E T T U R A , R D

Heart Healthy Eating to Improve Cholesterol

Overview

Types of cholesterol

Effects of high cholesterol on health

Steps for heart healthy eating

Healthy weight

Exercise

Healthy fats

Fibre

Sugars and sweets

Cholesterol lowering foods

Heart healthy eating FAQs

Types of Cholesterol

Cholesterol Marker Impact Factors

LDL (lousy cholesterol) Increases risk of coronary artery disease

Overweight, smoking, lack of exercise, bad fats, low fiber

HDL (healthy cholesterol) Picks up bad cholesterol to bring to liver to remove

Overweight, smoking, lack of exercise

Triglycerides Increases risk of coronary artery disease

Overweight, smoking, alcohol, sugar

What is Coronary Artery Disease?

1. Normal blood flow

2. Plaque causing abnormal blood flow

3. Clot forms after plaque bursts blocking blood flow completely

Step 1: Maintain a Healthy Weight

What is a healthy weight?

Weight is assessed using BMI (kg/m²):

Healthy BMI: 19-25

Overweight BMI: 25-30

Obese BMI: >30

Weight Loss

Healthy weight loss: 1-2 pounds per week

Weight loss strategies:

Record what you eat (write it down, app using mynetdiary or myfitness pal)

Plan your meals in advance

Reduce portions

Reduce calories from liquids

There is no single weight loss strategy that works for everyone!

Weight Loss

Shame

Guilt

Indulgence

Will power

Thoughtfullness Organized Planning Skill power

Step 2: Regular Physical Activity

Benefits of Physical Activity

Lowers LDL and increases HDL

Weight Maintenance

Improved sleep and stress relief

How to Increase Your Physical Activity

1. Choose an activity…that you enjoy

2. Pick a time

3. Pick a place

4. Aim for at least 20-30 minutes per day

5. Combine both cardio and resistance activities

http://www.cntrp.ca/canrestore-exercise-rehabilitation

Step 3: Include Healthy Fats

Unsaturated Fat

Good for our heart, lowers LDL and

triglycerides

Fish, vegetables oils, nuts, avocado

Saturated Fat

Some are bad for our heart, increases LDL

Meat, butter, coconut oil, dairy

Trans fat

Bad for our heart, increases LDL and

decreases HDL

Hard stick margarine, fried

foods

Types of Fat

Omega-3 Unsaturated Fats

Health benefits:

Reduces risk of heart disease

May help prevent Alzheimer’s and dementia

Where do we find them?

Fish (especially salmon, mackerel, rainbow trout, sardines, herring and char) 2x/week

Canola or soybean oil

Ground flaxseed/flaxseed oil

Walnuts

Tofu

Omega-3 fortified eggs and milk

Monounsaturated Fat (Good Fat)

Choosing a Cooking Oil

Saturated Fat (Bad Fat)

Step 4: Eat More Fibre

Benefits of Fibre

Lowers LDL (10g of fibre may lower LDL

by 5%)

Blood sugar control

Bowel regularity and feeling of fullness

How to Include More Fibre

Breakfast

• Old fashioned or steel cut oats

• Cereal with >4g fibre/serving

• High fibre oat muffins

• Whole grain bread

Lunch & Dinner

• Whole grain bread, rice and pasta

• Whole grains council website to choose starches

• Legumes (beans, lentils, chickpeas) or barley 2-3x/week

Snacks

• Fruits and vegetables

• Ground flaxseed and/or chia seeds added to yogurt

• Nuts or seeds

Step 5: Eat Less Sugar

Sugar Sources

Added sugar vs. naturally occurring sugar

Limit added sugars to a maximum of 6-12tsp per day (based on 2000kcal diet)

Common sources to avoid: Sugar (white, brown, honey, icing, syrups)

Fruit juice

Regular pop

Candy

Baked/fried desserts

Chocolate, cookies, donuts, muffin, cake

Sauces/condiments (ketchup, BBQ sauce)

Glycemic Index (GI)

A way of ranking carbohydrates based on how quickly they raise blood sugar levels

Low GI foods raise blood sugar levels slowly

High GI foods raise blood sugar levels quickly

Choose lower GI foods more often

May improve blood cholesterol and blood sugar levels

Food Group Low GI Medium GI High GI

Breads Spelt bread Sourdough bread Whole grain tortilla

Chapati Pita bread Pumpernickel bread Roti Rye bread Whole grain whole wheat bread

White bread or naan

Cereal All bran cereals Oat bran Steel cut oats

Cream of wheat Instant oats Quick oats

Corn flakes Rice Krispies Special K

Grains Barley Bulgar Pasta Quinoa Parboiled rice

Basmati rice Brown rice Cornmeal Rice noodles White rice

Jasmine rice Sticky rice Instant white rice

Food Group Low GI Medium GI High GI

Other starches Peas Sweet potato Winter squash

Beets Corn Parsnip Red or white potatoes (cooled)

Carrots Instant potatoes Red or white potatoes (hot) Rice cakes Soda crackers

Fruits Apple Banana (unripe) Berries Cantaloupe Grapefruit Honeydew melon Mango Orange Peach/Pear/Plum Pomegranate Prunes

Banana (ripe) Cherries Cranberries Figs Grapes Kiwi Lychee Pineapple Raisins

Banana (brown, overripe) Watermelon

Naturally occurring sugar Added sugar

Added vs. Naturally Occurring Sugar

Artificial Sweeteners

Is it safe to replace sugar with artificial sweeteners?

Yes, artificial sweeteners are safe to use in moderation

Extensively tested and found to be safe

When used to replace high calorie sugar foods, can assist with weight loss

Lack of research on long term side effects and/or benefits

Step 6: Include Cholesterol Lowering Foods

Nuts

All nuts are a good source of unsaturated fats

Walnuts especially are high in omega-3 fats

Goal – 1 handful of nuts per day (1/4 cup)

Pulses

Black beans, kidney beans, chickpeas and lentils

Excellent source of soluble fibre

Goal – ½ cup daily

Beta-glucans

Specific type of beneficial fibre found in oats and barley

Goal –1/2 cup, 3-4 times per week

Soy Products

Includes soy milk, tofu, roasted soy nuts

Reduces LDL cholesterol

Goal – 2-3 servings per week

Heart Healthy Eating FAQ

What does the media say? What does the research say?

Natural is best….

Margarine is not a good alternative because it is close to plastic

Recent research still shows that eating butter increases LDL (lousy) cholesterol

Larger increase than cheese

Butter

Butter – Good or Bad?

Cigarettes are made from all natural ingredients…natural is not always best!

Margarine is one molecule away from the same compound as plastic (you can make the same comparison between water and hydrogen peroxide)

Bottom line: For those with existing high cholesterol, it is still best to limit butter consumption

Choose margarine or unsaturated oils for cooking most often Use small amounts to cook eggs or spread thinly if needed

What does the media say? What does the research say?

Can withstand higher cooking temperatures

92% saturated fat

Most of the claims are based on populations in peru

Traditional diets contained coconut flesh or cream Other aspects of diet not

comparable to Western diets

Cannot attribute benefits to coconut alone

Coconut Oil

Coconut Oil – Good or Bad?

Should not be relied on as sole source of added fat

Caution for those with existing high cholesterol due to potential for further increase in LDL

Use a variety of unsaturated oils instead

Eggs

Previously recommended to limit egg intake due to concerns about cholesterol in egg yolks

Recent evidence – dietary cholesterol intake has minimal impact on blood cholesterol

Blood cholesterol controlled mostly by the liver

How many can you eat?

1 per day (7 per week)

Black Bean Sweet Potato Wrap

Ingredients: 1 can black beans

1 small yellow onion

½ red pepper

½ green pepper

Cumin and chili powder to taste

1-2 sweet potatoes

2 tsp of canola oil

Whole wheat tortillas

Cheddar cheese

Directions: 1.Rinse canned beans.

2.Wash and dice onion and peppers.

3.Sautee onion with oil until translucent. Add in peppers and beans.

4.Add spices as per taste (cumin and chili powder).

5.Rinse and place sweet potatoes on a foil sheet.

6.Bake at 425°F for 30-40 minutes or until soft.

7.Spread sweet potato on tortilla. Place bean mixture on top and

sprinkle cheese on top.

Oat Muffins

Ingredients:

1 cup plain Greek yogurt

2 ripe bananas, mashed

½ cup frozen or fresh blueberries

2 eggs

1 ½ cups rolled oats

¼ cup wheat germ

¼ cup ground flaxseed

¼ cup of brown sugar or substitute

1 ½ tsp baking powder

½ tsp baking soda

½ tsp cinnamon

Directions:

Preheat oven to 400F. Combine ingredients in a bowl. Spoon into lined muffin pan. Bake for 15-20 minutes.

T H A N K Y O U !

Additional Questions?