Ask a Dietitian

As seen February 4/03

Heart disease and stroke are the leading causes of death in B.C. 16% of British Columbians over the age of 65 are living with heart disease. 60% of British Columbians have at least one risk factor.

So what are the risk factors?

The first 3 risk factors are the ones that unfortunately you can’t change.

The first one is your family medical history. You are at greater risk if your parents or siblings suffer from angina (chest pain), or has had a heart attack, has elevated blood cholesterol levels, or has high blood pressure or diabetes.

The second major risk factor is based on age and gender. The risk for heart disease increases with age and men are affected 6-10 years earlier than women and once a women reaches menopause, she is as susceptible as a man.

The third risk factor that you can not change is diabetes. However, your risk for heart disease is reduced if your diabetes is well controlled.

The next 3 risk factors you can change.

If you smoke you can quit.

If you have high blood cholesterol
If your total cholesterol is greater than 5.2 or your LDL is grater than 3.5 or your HDL is lower than 0.9, take this as a clear warning sign that you are at risk for heart disease. You can reduce your total and LDL cholesterol significantly through dietary changes which we will discuss in this program.

The third major risk factor you can change is high blood pressure. This can be lowered by reducing your stress level, achieving a healthy body weight, reducing your salt intake and reducing your alcohol consumption.

Along with reducing your stress level and achieving and maintaining a healthy body weight, increasing your physical activity is key to reducing your risk of Heart Disease.

What is Heart Disease?

Heart disease is characterized by the hardening of the arteries know as atherosclerosis. Normally blood flows freely throughout the arteries. Problems arise when oxidized or damaged cholesterol starts to stick to the inside wall of the artery. This buildup, alos called plaque, can cause a narrowing of the artery, restricting blood flow or even blocking blood flow. In some cases the rough surface of the plaque causes blood clots to form. These clots can also block the flow of blood. If the blockage is in the artery leading to the heart it can cause a heart attack and if the artery is leading to the brain it can cause a stroke.

There are 2 types of cholesterol:
– Blood (serum) cholesterol
– Dietary cholesterol

Cholesterol in the blood is made primarily by the liver. Our bodies do need some cholesterol to function properly. Problems can arise if the level of cholesterol in the blood get too high and start to build up on the artery walls.

There are two types of blood cholesterol:
HDL – high density lipoproteins “GOOD” cholesterol
LDL – low density lipoprotein “BAD” cholesterol
HDL is good because it gathers up excess cholesterol in the blood and carries it back to the liver to be excreted by the body.

LDL is bad because this is the form of cholesterol that will build up on the artery walls. Foods high in saturated and trans fatty acids and/or cholesterol can increase the levels in the blood.

So what food choices can you make today to help reduce your risk of heart disease?

Well there are 6 main steps to a heart healthy diet and once you have achieved these then there are more specific dietary recommendations that we will go through next week.

The first sep is to reduce all added fats.
To do this you can

• limit the fat you add to food and in your cooking to 3-6 teaspoons per day.
• broil, bake steam or microwave your food and avoid frying and deep frying.
• Choose healthier oils such as olive oil or canola oil and soft tub, non-hydrogenated margarines.
• use butter and margarine less often.

Second, Eat more whole grain products like:

• 100% whole wheat breads and pastas
• eat whole grans like oatmeal and barley, kamut and millet
• use brown rice

Eat more fruits and vegetables, especially the bright red and orange ones like red peppers, carrots, sweet potatoes and squash.
Also dark green leafy vegetables like kale, bok choy and broccoli.
Delicious healthy fruit choices include apples, oranges, papaya, mango, bananas and strawberries.

The fourth step is to choose lower fat milk products such as skim or 1% milk, lower fat cheeses and low or no fat yougurt.

The fifth step is to select smaller, leaner portions of meat and alternatives.
A serving of meat should be the size of a deck of cards.
Choose fish at least twice a week.
Instead of meat choose baked beans, chick peas and lentils at least once a week
And remember to take off the skin from your chicken and turkey
And choose leaner cuts of beef.

The sixth step to a heart healthy diet is to limit high fat snacks and desserts such as chips, cheezies, pastries and ice cream.
Instead, snack on fresh fruit and vegetables, low fat milk products and choose low fat puddings, angle food cake or sherbet for dessert.

Watch for the Eating for Energy segment every Tuesday on Global TV’s Noon News Hour!