5. Definitions
• Diet.com
– An eating plan designed to keep blood cholesterol low and
prevent the risk of heart disease.
– Eating foods that are low in saturated fat, total fat,
cholesterol, and sodium. Some diets help people lower their
cholesterol levels.
•
– Foods that decrease risk of cardiovascular and
cerebrovascular disease
–Foods that encourage fat loss or
maintenance of a healthy weight
(which then decreases essentially all
major risk factors for heart disease)
• Can be different for different people
6. What should we be focusing on?
• Food, lifestyle, activity?
• Is one “diet” better than the others?
• Will certain foods kill you?
• Will certain foods let you live to be 120?
• What are quantifiable goals of “heart-
healthy” nutrition
– Reduce risk factors
• Weight loss accomplishes total modifiable risk factor
reduction
7. What causes heart attacks?
i.e. What are CVD risk factors?
• In the diet…
– Fat?
– Carbs?
– Cholesterol?
• In the body…
– Triglycerides
– Endothelial dysfunction
• Lining of blood vessels becomes damaged, making plaque formation more
likely
– Inflammation
– Insulin resistance or Metabolic Syndrome
• In the …
– Being a man
– Family history
8. Risk Factors (continued)
• What are the major “modifiable” risk factors for heart
disease?
–OBESITY
– Insulin Resistance/diabetes
• Related primarily to…
OBESITY
– Inflammation
• Related to…
OBESITY
9. Risk Factors (continued)
• Cholesterol?
– What percentage of people who have heart attacks have
“normal” LDL (or bad cholesterol)?
– About 50%
– Different kinds of LDL
» Small and dense -> 4x risk of CVD
» Large and fluffy -> no increased risk of CVD
• Triglycerides (TG)
– Risk Factors for Myocardial Infarction in the Stockholm Prospective Study: A 14-Year Follow-up Focusing on the Role of Plasma
Triglycerides and Cholesterol
• Plasma triglycerides were more important as a risk factor
than cholesterol
– What‟s the best way to lower triglycerides?
• Weight loss
– Common for patients to halve TGs with 20 pound weight loss
10. Risk Factors (continued)
• Insulin Resistance (Pre-diabetes/diabetes)
– Journal of Obesity Research
• Insulin resistance is primary cause of cardiovascular
disease risk in children
– American Heart Association
• People with metabolic syndrome are at increased risk
for the following:
– Atherosclerosis
– Peripheral vascular disease
– Coronary heart disease and heart attack
– Stroke
– Type 2 diabetes
» Major risk factor for heart attack
11. Insulin Resistance
(continued)
– What is the best way to prevent or reverse
insulin resistance?
• Maintain low body fat
13. • Limit total fat intake to less than 25–35 percent of your total calories each
day
– ?????????
• Limit saturated fat intake to less than 7 percent of total daily calories
– ?????????
• Limit trans fat intake to less than 1 percent of total daily calories
– Trans fats =
• The remaining fat: monounsaturated and polyunsaturated fats
• Limit cholesterol intake to less than 300 mg per day, for most people. If
you have coronary heart disease or your LDL cholesterol level is 100 mg/dL
or greater, limit your cholesterol intake to less than 200 milligrams a day.
– ????????
14. Saturated Fat
• Inuit
– Traditional diet
• ~75% saturated fat
• Whale blubber, seal, caribou, organ meats
• Little to no fruit and vegetables
– Prevalence of cardiovascular disease
– Depends…
» Traditional diet vs. “new, Western diet”
» Smoking, activity, etc.
15. Saturated Fat (continued)
• Masai
– Diets very high in animal fats
– CVD essentially nonexistant
– Live active lifestyle
– MAINTAIN HEALTHY BODYWEIGHTS!!!
16. Saturated Fat (continued)
• Cochrane Collaboration
– Review of 27 studies involving more than 18,000
participants
– Cutting back on dietary fat may help reduce heart
disease
– Diets low in saturated fats have no significant
effect on mortality, or even on deaths due to heart
attacks.
18. Carbs are bad…
• From everydaypaleo.com
– “Grains are good for birds, not us.”
– “We lack the digestive abilities to eat grains without major
problems.”
• Kent Rieske (Bible Life Ministries)
– Carbs (including fruit and whole grains) promote insulin
release, causing…
• Cancer
• Heart disease
• Stroke
• 2013 Study from Johns Hopkins
– Low carb diets reduce inflammation better than low fat
diets
19. Carbs are bad…(Continued)
• A Paleolithic diet improves glucose tolerance more than a
Mediterranean-like diet in individuals with ischemic heart disease.
– Diabetologia, 2007
– 14 patients advised to consume an „ancient‟ diet for three months
• Lean meat, fish, fruit, vegetables, root vegetables and nuts
• NO grains, dairy foods and salt
– 15 patients who were recommended to follow a Mediterranean-like
prudent diet
• Whole-grain cereals
• Low-fat dairy products
• Fruit and vegetables
• Refined fats generally considered healthy.
– Mediterranean diet group
• increased blood sugar after carbohydrate intake and most of them had overt
diabetes type 2
• In addition, all had been diagnosed with coronary heart disease
20. Carbs are good…
• Obesity is inversely related to whole grain
intake…
• But intervention studies with whole grains
have not produced weight loss
• Visceral fat, however, may be affected
favorably.
Current Atherosclerosis Reports
November 2010, Volume 12, Issue 6, pp 368-376
21. Carbs are good…(continued)
• Study: Whole-Grain, Cereal Fiber, Bran, and Germ Intake and the Risks of All-Cause
and Cardiovascular Disease–Specific Mortality Among Women With Type 2 Diabetes
Mellitus
• Whole-grain and bran intakes were
associated with reduced all-cause and CVD-
specific mortality in women with diabetes
mellitus.
Circulation. 2010 May 25;121(20):2162-8
24. The Consumption of Milk and Dairy Foods and the Incidence
of Vascular Disease and Diabetes: An Overview of the
Evidence
• Reduction in risk in subjects with the highest dairy
consumption relative to those with the lowest intake
for:
– All-cause deaths
– Ischemic heart disease
– Stroke
– Diabetes
• “In conclusion, there appears to be an enormous
mismatch between the evidence from long-term
prospective studies and perceptions of harm from the
consumption of dairy food items.”
Lipids
October 2010, Volume 45, Issue 10, pp 925-939, Open Access
25.
26. • Diets high in saturated fat may or may not
increase risk of heart disease.
• Low fat diets may reduce risk of heart disease
• Omega-3 fatty acids (fish oils) may reduce risk of
heart disease.
• High intake of fruit and vegetables may reduce
risk of heart disease.
• Whole grain consumption is either great or
horrible for your health, depending on who you
listen to.
27. Is anything clear?
YES!!!!!!!!!!!!!
Extra body fat significantly increases a person‟s
risk of heart disease and death.
28. So what is heart healthy nutrition?
• A MAINTAINABLE, PRACTICAL nutrition
plan that enables you to achieve and maintain
low body fat levels with optimum muscle
mass!!
29. So what is heart healthy nutrition?
(continued)
• Ideally (all other things being equal), one that
includes:
– Cage free eggs
– Grass fed meat
– Organic dairy
– Fruit and vegetables
– Whole grains
– Things you like in moderation
30. Choose the healthier option…
• Glazed donut + apple + scoop of protein powder
– 180 calories
– 60 calories
– 100 calories
– Total: 340 calories with 27 grams of protein
• Large bowl of oatmeal with banana and almonds
– 300 calories
– 120 calories
– 160 calories
– Total: 580 calories with 16 grams of protein
31. Examples of Healthy Breakfasts
• Uncured, organic ham, low fat cheese
and a cage free egg on a spelt English
muffin
• Almond milk, low fat Greek
yogurt, blueberry and natural peanut
butter smoothie
• “Pancakes” made with a touch of
vanilla extract and equal parts low fat
cottage cheese, oatmeal and egg whites
and topped with microwaved
strawberries and Stevia
33. Examples of Healthy Lunches
• Garden salad with grilled chicken and
low fat dressing
• Salmon and low fat mayonnaise wrap
with lettuce and tomato
• Chicken and broccoli stir fry with light
soy sauce
34. Examples of Healthy Dinners
• Chicken with asparagus
• Shrimp and pineapple skewers
• Turkey Chili
