Fiber and Your Heart

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High fiber foods can help prevent constipation and they can lower your LDL cholesterol levels. We need approximately 14 grams of fiber for every 1,000 calories we eat. So, for someone who eats 1,800 calories per day, that’s about 25 grams of fiber. Are you getting enough? If not, you can easily add fiber by switching your pasta, rice, and bread to whole grain varieties. In addition, try adding at least one fruit or vegetable serving to every meal. Here are a few more of my favorite tips:

– If you are making protein shakes, throw berries in there.
– Switch up your cereal by adding high fiber cereal to your dish (you can mix cereals you know). My favorite has always been All Bran (yes, I loved this cereal even when I was a kid!) but, other high fiber cereals include Kashis, Fiber One and granola.
– “Hide” vegetables. There are a few cookbooks out there that tell you how to sneak veggies into your child’s food. Do the same thing with your own if you have to. Stews and soups are easy but you can also add processed carrots to your pasta sauce; dried fruit to your oatmeal and onions and celery to meatloaf. The key is thinking creatively.
– Use oatmeal as the base of your meatloaf
– Buy a new cookbook, choose a different recipe and try it!

High Fiber Foods I love:
– Fruits and Vegetables
– Renew Life Organic Fiber Bars (these are fruit based so they fulfill sweet cravings)

Even if you are on the go, you can get all the fiber you need if you snack on cereal, choose whole grain dishes when eating out and incorporate fruits and veggies into every meal.

Inflammation and Your Heart

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A few days ago I mentioned the link between inflammation and heart disease. Inflammation may actually spark cardiovascular events by increasing the likelihood that atherosclerotic plaque ruptures, blocking blood flow and leading to a heart attack or stroke. Local or systemic inflammation isn’t just linked to cardiovascular disease; it plays a role in many chronic diseases and conditions such as osteoarthritis, rheumatoid arthritis, COPD (chronic obstructive pulmonary disease), Parkinson’s disease, eczema, sleep apnea and obesity.

When it comes to heart disease, physicians may measure the level of inflammation in your body by ordering a highly sensitive C-reactive protein test (hs-CRP). Though there is some controversy over CRP tests (partly because high CRP levels may be indicative of other other things such as bacterial or viral infections), many studies do indicate that hs-CRP tests can predict increased risk for heart attacks.

So how do you lower inflammation in your body? First, lose weight if you are overweight or obese. Being over-fat itself can lead to increased levels of systemic (throughout the body) inflammation. Secondly, decrease your intake of foods that may lead to inflammation and increase anti-inflammatory foods:

Inflammatory foods – man-made trans fats (see my previous post on this), refined sugar and high glycemic index foods, an overabundance of polyunsaturated fats in the absence of omega 3 fats (i.e. too much vegetable oil and too little fish fat).

Anti-inflammatory foods – omega 3s (fatty fish), berries (all!), minimally processed berry juice (like CherryPharm), ginger, tumeric, betaine and choline rich foods (wheat germ, eggs, walnuts). Also choose a variety of colorful fruits and vegetables to ensure you are getting a wide spectrum of antioxidants.

You do have some control over the inflammation levels in your body. And, eating a healthy diet can make a difference!

Trans Fat Alternatives

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The Center for Science in the Public Interest (CSPI; aka the food & beverage police) are against banning trans fats from foods. In fact, they indicate that banning them “could be more harmful from a public health perspective.” Instead they favor a gradual phasing out of trans fats. How would a gradual phase out be more beneficial than an outright ban? According to CSPI, gradually phasing out trans fats will give restaurants and food companies more time to find suitable alternatives. I’m not totally sure I agree with this since most things need a deadline of some sort or they’ll get pushed to the very back of the “to do” list. And, if most companies operate the way people do – a quicker deadline just means they’ll get it off their plate sooner. Give them more time and they’ll take more time but won’t necessarily produce a better result. Not to mention the companies that care about health will look for better alternatives and the ones who don’t will stick what they have to in their food just to meet trans fat bans.

So what do companies replace trans fats with? There are several alternatives such as unsaturated fats, saturated fats, fully hydrogenated oils (vs. partially hydrogenated oils), blended oils, gums, cellulose and interesterified fats. Are these alternatives better or worse than trans fats? Most are probably better (even saturated fats) though fully hydrogenated oils and interesterified fats have huge question marks by them.

Interesterified fats have been around for many years and are basically a blend of saturated fats and oil. Older studies show that these have no effect on blood lipids. However, health effects may depend on the type of fat inserted and where it is inserted. Think of a long chain of links and inserting different links into this chain. The chain may kink or not bend at all in the places where links are inserted but this depends on the type of links inserted. The same is true for an interesterified fat.

Right now, I’m not a big fan of this type of fat. Some studies have seen increased blood glucose, increased LDL and decreased HDL associated with the consumption of interesterified fats. How will you be able to spot these fats? Look for interesterified fats on the food label or fully hydrogenated oil. In restaurants it is much harder to detect food prepared with interesterified fats. You would have to find out if they use shortening or any hard fat instead of liquid oil. And, many restaurant workers don’t seem to know.

Until research comes out and proves that all interesterfied fats are healthy, I think I’ll opt out of consuming food made with these blended fats.

Unhealthy fats and Cardiovascular disease

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Tomorrow is National Wear Red day – in support of women’s heart disease awareness. http://www.nhlbi.nih.gov//educational/hearttruth/materials/wear-red-toolkit.htm

As things gear up for heart health awareness, I’m stuck wondering why partially hydrogenated oils are still in so many foods. Partially hydrogenated oils make up man-made trans fats. Now that trans fats have been on food labels for a few years, many companies have worked to get their trans fats content down to 0 grams. But, 0 grams per serving really means less than 0.5 grams per serving. So, if you eat a few of those tiny packages of pretzels on an airtran flight, you are probably getting a gram or more of trans fats. Sure, that sounds like nothing but over the course of a day, by combining a bunch of foods that contain partially hydrogenated oils, you could be getting a reasonably sized dose of these unhealthy fats.

Man-made trans fats wreck havoc on your heart. They lower your HDL levels (good cholesterol), raise your LDL levels (bad choleserol) and increase your risk for coronary heart disease. Consumption of trans fats can also contribute to insulin resistance when paired with excess calorie intake (and if you are eating foods with trans fats you are likely to overconsume calories as well) and they may contribute to abdominal obesity, systemic inflammation and endothelial dysfunction. Man-made trans fats aren’t just the a one-two punch. And I know the whole mantra about “all foods fit” but seriously, man-made trans fats don’t in anyone’s diet. There is no reason for them or for food to still be made with them. With as many food choices as we are lucky to have here in the United States and other well developed countries there is absolutely no reason why one should choose something with man-made trans fats.

Now, I keep saying man-made because there are healthy naturally occuring trans fats (found in dairy products and meat for instance).

If you are lucky enough to live in a place like Montgomery County, MD, which has banned (man-made) trans in restaurants, you don’t have to worry about it when you eat out. If you don’t live somewhere that bans trans, figure out what the restaurants you frequently eat at cook with. Let’s take Chipotle for example. They don’t list what they fry their chips in. For restaurants that don’t list this or the nutrition information, I’m going to assume they fry them in shortening vs. vegetable oil and stay far, far away.

Aside from figuring this out in restaurants, take a peek at your favorite packaged foods and opt for those without man-made trans fats or consume very little of these foods. Your heart and your body will thank you!

Heart Health Month

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When it comes to preventive health, cardiovascular disease is on the top of my list. My passion for spreading the word about heart health came a young age and grew over time as every single person I knew was touched in some way or another by cardiovascular disease (CVD). That should come as no surprise – CVD is the leading cause of death for both men and women in the United States. According to the Centers for Disease Control and Prevention, every 25 seconds an American will have a coronary event. The most common one – heart attack.

What is CVD? This umbrella term refers to diseases of the heart and blood vessels such as heart disease, aneurysm, stroke, congestive heart failure, hypertension, peripheral arterial disease, and congenital heart disease.

Luckily, it is never to late to start working on preventing CVD by incorporating a good diet and fitness routine into your daily life.
Some of the diet recommendations from the CDC include:
– choose lean meats and poultry without the skin and don’t fry them!
– select fat free or 1% fat dairy products
– cut back on foods high in saturated fat, trans fats and partially hydrogenated oils (actually I say cut out partially hydrogenated oils completely)
– choose foods with little or no salt (unless directed otherwise by a sports dietitian or physician)
– if you drink, do so in moderation

Tomorrow I’ll get into fats, especially partially hydrogenated oils, a bit more.

Is the range for Healthy LDL levels too high?

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A January 2009 American Heart Journal study is garnering quite a bit of attention lately.  This study examined lipid levels in over 136,000 patients who were hospitalized with coronary artery disease from 2000-2006 in 541 participating hospitals.  Now, according to the American Heart Association, our LDL (bad cholesterol) levels should be less than 100 mg/dL.  However, in this particular study almost 1/2 of the patients admitted had LDL levels within the “healthy” range.

For years, total cholesterol and LDL levels have been recognized as prominent, modifiable risk factors for cardiovascular disease.  Keep both low and your risk for cardiovascular disease is low. But, there are many additional pieces to the cardiovascular disease puzzle.  In this particular study, upon further examination of the data, it is evident that a greater number of these patients with LDL within the normal range also had low HDL (<40 mg/dL)

And, there is another, newer piece to the puzzle that is absolutely fascinating though not examined in this particular study:  inflammation.   LDL, as it makes it’s way through our body, can be deposited on arterial walls.  However, scientists now believe that inflammation signals the cascade that makes arterial plaque burst leading to blood clots and cardiovascular events (heart attack, stroke).

What causes inflammation?  Many things including high blood pressure, smoking, high blood sugar levels, atherosclerotic plaque and certain viruses and bacteria.  How do you lower your levels of inflammation?  That’s something that I’ll expand on more tomorrow (diet-wise) but cholesterol-lowering statin drugs play a role in decreasing inflammation.

How do you measure systemic inflammation? Ask your physician for a highly sensitive C-reactive protein assay (hs-CRP).

Cardiovascular disease is the number one cause of death among men and women in the U.S.  It is never too early to start looking at ways to prevent cardiovascular disease and over the next several days, I’ll examine many of the diet and exercise factors that will help you lower your risk of CVD.

Super Bowl XLIII

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Today I am frantically editing references and finalizing a textbook that I am co-authoring (all in time to watch the Super Bowl).  As I look ahead at the party I am going to in a few hours I realize that Super Bowl parties could be a train wreck for people who are consciously trying to watch their weight and pull through 2009 carrying around less weight and healthier than they started this year off.

And, it isn’t really about the food and blowing it for one day.  Instead it’s about the change in one’s perception or attitude after they feel like they “failed” for a day.  Unless you are a bodybuilder or fitness competitor, blowing it out one day probably won’t hurt you (though a good amount of food in a short period of time can bring on an attack of acute pancreatitis or even a heart attack if you are at risk).  However, when this one day becomes two then three and soon a week and so on, that’s when you know you’ve carried out the “one day won’t hurt” attitude too far.  On the flip side, some people view their food intake or exercise regimen as all or nothing.  Just one slip and they throw in the towel.  Let me remind you though that making changes in your physique and your health take some time and should be viewed like a marathon and not a sprint.  Those who have the endurance will indeed persevere.  
That being said, here are a few tips to keep you feeling good about yourself today:
 – Eat beforehand.  Never “diet” all day before a party.  Even cardboard will look appetizing at that point.
– Fill up first on the healthy stuff – deli turkey, cut up veggies and fruit
– Watch the game.  Seriously, who cares about the food when the Super Bowl is on the line (right?)
– Alternate water with your alcoholic beverages (not just a sip, a good 8 oz).  If you hate water, try something that is lower in calories (then beer) and tastes good, selzer, Crystal Lite, vitaminwater etc.
– Eat slowly and savor every bite
– Concentrate on portion control when it comes to the heavy foods
– Wait for quite a while before going up for second helpings.  The longer you wait the more likely others will have devoured them before you get a chance to dig in.
Lastly, enjoy!  

Nuts for Good Health

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I’ve mainly been talking about goals and weight (a common January theme) for the past month. And I also threw in a few of my favorite Superbowl Sunday appetizers a few days back.  Among the chips, dips and spread of food this Sunday, there will be a common snack food: nuts.  People seem to fall into one of two camps when it comes to nuts.  They either eat them or avoid them because they are high in fat and calories (yet snack on nutritionally-empty chips instead).

However, nuts are a fantastic snack (skip the honey roasted, sugar-coated ones though).  You only need a shot glass full (or think of a golf ball size quantity) and they all have a variety of different vitamins and minerals + healthy fats.  My personal favorites are peanuts, pistachios and walnuts. And here’s another interesting tidbit about nuts – a recent study showed that people who ate in the shell nuts (pistachios for instance) ate significantly fewer calories than those who just ate the unshelled nuts.  Why?  For one thing, it takes some time to crack open a nut and that little bit of effort slows you down.  And, the shells themselves provide a visual reminder of how much you have eaten.  
So take a look this Sunday at the spread.  If it comes down to chips, nuts and a bunch of fried appetizers or baked goods, opt for the nuts.  A little goes a long way.

Whey Less Weight

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This week I’ve had the pleasure of editing textbook chapters.  Aside from re-formatting references, the rest has truly been fun and rewarding.  I have a fantastic detail-oriented co-editor and top notch authors who wrote each chapter.  

While reading through the protein chapter today, Dr. Richard Kreider (Texas A&M) included a great section the various types of protein, including whey.  Men and women alike who pump iron and make frequent appearances at their gym may be familiar with whey protein.  However, this isn’t just a bodybuilding supplement.  And, Dr. Kreider noted that whey protein may help augment weight loss efforts and boost the immune system.
A 2004 review article by Layman (J Am College Nutr) reviewed some of the research behind higher protein diets and weight loss.  He postulated that whey protein, due to it’s leucine content (leucine is an essential amino acid that stimulates fatty acid oxidation), may boost weight loss efforts.  Since his review, two additional studies have come out in support of whey’s weight loss benefits.
In addition to it’s potential to augment weight loss, whey is full of immune-boosting compounds (though some whey processing techniques can destroy these healthy compounds). For more information on whey see www.wheyoflife.org).
If you are aiming for weight loss, preventing muscle loss associated with aging (and lack of use!), want to boost your immune system functioning or build muscle, consider adding whey to your diet. 

Intuitive Eating vs. Counting Calories?

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I’ve seen many dietitians decide between using intuitive eating and counting calories with their clients.  Intuitive eating, coined by dietitian Evelyn Tribole, means separating the emotional and physical aspects of food and learning to eat entirely on physiological hunger and satiety cues (read this article for more information:  www.figureathlete.com/readArticle.do?id=2392335). Counting calories means, well, counting calories (food logs etc. – see previous post from a few days ago).  However, I view the two as not mutually exclusive.  When it comes to nutrition there isn’t a one-size-fits-all approach that works nearly as well as individual customization.  

How do you know which one to use or whether you should use both?  First, it comes down to your goals.  Granted, many people are solely motivated by weight loss for physical appearance purposes.  Others realize that losing weight is the ticket to help them break free from hypertension medication, Type 2 diabetes medications, osteoarthritis knee pain etc. (the list goes on and on).  And there are also those who realize they better start engaging in resistance exercise and good eating to build muscle mass so they can lift their grandchild out of their crib safely.  
After writing down your specific goals, it is important to realize what works for you.  Does counting calories help hold you accountable or aggravate those nagging and deep rooting emotional eating issues that you cling on to during times of stress?  Is intuitive eating enough to help you gain the weight and muscle mass you need to get stronger after a round of chemo and radiation?  If your answers to these questions are not immediately evident, read more on intuitive eating and consider working with a dietitian who can help design an individual approach specifically for you.  Though there are many great group programs out there (I’ll cover these tomorrow), nothing beats a one-on-one setting to help you meet your goals.