Something to Chew On

A Guide to Eating Right and Living Well


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Cholesterol Month – Part 2

Diet:

  • Limit saturated and trans fats.
    • Saturated and trans fats are found in fatty or fried meats such as: bacon, sausage, hotdogs, bologna, pepperoni, salami, poultry skin, fried chicken, fried pork tenderloin and fried fish.salmonheart
    • They are also found in whole milk products, high-fat cheese, ice cream, butter, cream, margarine and lard.
    • Foods made with hydrogenated oils (pizza and other packaged food items), candy bars, crackers, chips, pastries, doughnuts and muffins are additional ways these bad fats can be found in our diets.
    • Take Away Message: Try to avoid/limit red meat, fried foods, processed pastry/bakery items and dairy products made with whole milk.
  • Limit total amount of fat that you eat (good and bad) to 25%-35% of the total calories you eat.
    • Even if you’re not a calorie-counting whiz, the simplest way to accomplish this is to stick to heart-healthy fat sources such as: fish, nuts, seeds, peanut butter, avocados and olive oil and limit/avoid the sources of unhealthy fats.
    • A small popcorn from the movie theater contains 42 grams of fat, which would be 25% of total calories for a person following a 1500 calorie diet. Here’s an example of a healthier way to incorporate fat into the diet: Try adding ½ medium avocado (15 g) with breakfast, 1 Tbsp of peanut butter (8.5 g) with a snack and 4 oz of salmon (12 g) with dinner to create nutritious, well-balanced meals.
    • Become more familiar with reading food labels  and utilizing online resources for finding fat content of foods. A great website is www.calorieking.com for finding nutritional information on foods and menu items. This is very useful when dining out or ordering in! Pizza is a very common source of unhealthy fats in our diet. Two slices of pepperoni pizza plus garlic dipping sauce contains 37 grams of fat.
  • Increase Omega-3 fatty acid intake.
    • This recommendation goes right along with choosing healthier sources of fats in one’s diet. The benefits of omega-3 fats go well beyond heart health. They can also help with reducing inflammation and supporting eye and brain health.
    • Omega-3 fats, specifically Alpha-linolenic acid (ALA) are found in canola, soybean and flaxseed oil.
    • The most potent sources of omega-3 fats include salmon, albacore tuna, mackerel and sardines (EPA and DHA sources).
    • Ground flaxseed and walnuts (ALA) are two wonderful ways to incorporate omega-3 fats into your diet, especially if you are not a fan of fish.
    • The American Heart Association recommends that people with heart disease get 1 gm of omega-3 fatty acids from a combination of EPA and DHA per day. Consult with your physician before adding a fish oil supplement into your regimen as this may have possible interactions with other medications.
  • Increase dietary fiber intake to at least 20-30 grams per day.
    • Fiber is Mother Nature’s cholesterol lowering medication. While total fiber is very important, try to include sources of soluble fiber into your daily intake.
    • Soluble fiber is found in oats, oat bran, kidney beans, broccoli, ground flaxseed, apples, bananas and potatoes with the skin. It is also added in fortified fiber products such as Fiber One and Fiber Plus cereals and snack bars.
    • Fiber is only found in plant-based foods; fruits, vegetables, nuts/seeds, beans/legumes and whole grains. When choosing a grain (pasta, bread, cereal), make sure it is made with 100% whole wheat or whole grain. Barley, quinoa and brown rice make great choices too. Focus on filling ½ your plate with fruits and/or vegetables. Add nuts/seeds to salads, cereals or simply enjoy them by themselves.

Patients often ask me, “But Amanda, I don’t eat fried foods and I never eat red meat; why do I have high cholesterol?” In many cases, it’s not a matter of consuming too much of the bad stuff, it’s that you may not be consuming enough of the good stuff, specifically the omega-3 fatty acids and enough fiber.

Read part one of Cholesterol Month here!cholesterol colors


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Apples to Apples

Apples are one of the most iconic fruits of the fall season. Fall marks back to school themed apple decor and the fun tradition of bobbing for apples. Apples serve as a symbol for healthy eating. Many families use apples in theirapples everyday diet from a snack to an apple pie.  In fact, most are familiar with the saying, “An apple a day keeps the doctor away”. But is there any truth behind this old proverb? This happens to be one saying worth repeating.

  • Apples under the microscope:
    • Quercetin, a flavonoid found in apples has been studied for its possible protective benefits against prostate cancer.
    • Researchers at Cornell University showed that nutrients found in the skin of apples inhibited the reproduction of colon cancer cells by 43%.
    • The National Cancer Institute released a statement saying that the flavonoids, like the ones found in apples, may reduce the risk of lung cancer by as much as 50%.
    • Other studies have shown that apples can also help reduce the risk of asthma and possibly type 2 diabetes.
    • Apples contain pectin, which is a valuable source of soluble fiber (1.0 gram per medium-sized apple). Soluble fiber can help reduce cholesterol levels and possibly help control blood sugars. The average apple contains 3-5 grams of total fiber, which can help support digestive health.
  • Choosing your perfect apple:
    • Apples come in many varieties. They can be sweet, tart, crisp, soft, red, yellow, green; the combinations are endless! I personally love a sweet, crisp apple so I tend to stick with Gala, Fuji or the Honeycrisp varieties. Picking the perfect apple can depend on your usage of the apple. Different varieties are recommended if you’re simply snacking or using apples for cooking/baking purposes. Below is a list of apples, their profiles and recommended uses. appleVarietiesChart

    Eating an apple a day can definitely be part of a healthy diet. The phytochemicals and antioxidants found in apples help our bodies defend itself from oxidative stress. However, processed apple products, such as juice, typically do not retain these nutritious properties. When choosing an applesauce, opt for the no-sugar added variety. You can naturally sweeten it with cinnamon, if needed. For a balanced snack, combine an apple with 1-2 Tbsp of peanut butter or a low-fat cheese stick. Apple chunks can be added to salads, cereal and make creative slaws and salsas! Apples are so versatile; everyone can enjoy the fruit of the season!

 

 


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Dinner’s Ready

Dinner time is often the one chance for everyone to sit down together, share a meal and discuss life’s events that day. However, in today’s busy world, this Norman Rockwell scene often is replaced with everyone jammed into the car and going through a drive-thru window. Did you know that families who sit together at home for three or more meals per week are more likely to consume:Norman-Rockwell-Freedom-from-Want-1943

  • More fruits and vegetables
  • Less fried food and soda
  • Less saturated fat and trans fat
  • More fiber, calcium, iron and vitamins B6, B12, C and E

When you think about these facts, it makes perfect sense that a home-cooked meal is going to be more nutritious than one purchased from the fast-food, drive-thru window. Most fast-food purchases include fried foods (chicken nuggets or chicken tenders, fries, fish fillets, onion rings) and a sugary-sweetened beverage, resulting in meals that are loaded with saturated and trans fats, sodium and added sugars. When meals are prepared at home, they are more likely to include a fruit and/or vegetable, a lean protein that has been grilled or baked, a whole grain product and either water or low-fat milk to drink.

Two nutrients that most American kids do not consume enough of are dietary fiber and potassium. Additionally, we are not getting enough plant-based foods. Eating more plant-based foods can help easily increase both dietary fiber and potassium intake. Foods that are excellent sources of potassium include: acorn and butternut squash, avocados, baked beans, bananas, broccoli, cantaloupe, mushrooms, nectarines, kiwi, spinach, sweet potatoes, white potatoes, oranges, tomatoes. Dietary fiber can be found in whole wheat bread and whole wheat pasta, nuts and seeds, beans (all varieties), berries, apples, pears, oranges, oats and peas to name a few. Adding these foods to familiar recipes or serving them by themselves is a wonderful way of improving nutritional intake at the dinner table.

Eating together as a family not only sounds like a great idea, research is showing that there are both social and health benefits that can be experienced by all family members.1 Additionally, children and adolescents who share family meals three or more times per week are2:

  • More likely to be in a normal weight range
  • Have healthier eating patterns

Additional benefits of family meal times include:

  • Better academic performance
  • Better connectedness and communication at home
  • Better language and communication skills
  • Opportunities to model healthy eating habits
  • More family time

As our families grow and take on more extracurricular activities, it can be more difficult to have everyone sit down at the same time for dinner. Making time in everyone’s schedules for a family meal has benefits that go beyond nutritional health. In a report published by the National Center on Addiction and Substance Abuse at Columbia University, 2011, they found that teens who consumed dinners with their families 5-7 times per week compared to those who sat down with the family less than 3 times per week were3:

  • 4x less likely to use tobacco
  • 2x less likely to use alcohol
  • 2.5x less likely to use marijuana

To limit distractions, make mealtimes a no-phone zone and turn off the television. Remember to make family meal time fun! Discussing bad grades or negative events should not occur at the dinner table. Positive family talks can be stemmed from questions like:

  • What was the best thing that happened today?
  • What was the funniest thing you saw or heard today?
  • Did you learn anything new today?
  • If you could eat the same vegetable every single day, what would it be?
  • What has been your favorite memory so far this year?

1.Family Dinner and Diet Quality Among Children and Adolescents. Arch Fam Med. 2000;9:235-240.

2.Is Frequency of Shared Family Meals Relate to the Nutritional Health of Children and Adolescents? Pediatrics, Official Journal of the American Academy of Pediatrics. May 2011.

3.The Importance of Family Dinners VII. The National Center on Addiction and Substance Abuse at Columbia University. September 2011.


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High-Fiving Fiber

It was the spring semester of my junior year in college. I was engaging in conversations with my classmates as we were being handed back the results of our cholesterol screenings. I glanced down at the sheet that had been deposited on my desk and quickly went to my professor because I clearly had someone else’s results. She replied, “No, those results are yours, Amanda, and you have high cholesterol.” I thought this can’t be! I’m 21 years old, I run, teach group fitness classes, watch what I eat; how could I have high cholesterol???

This was a major scare to me, especially since heart disease runs in both sides of my family. After coming to terms with the news, I had a good hard look into how much fiber I was consuming in my diet.

Fiber has been referred to as many different things: bulk, roughage, even cardboard. Essentially, fiber is the indigestible part of plant products. It is found in whole grains, fruits, vegetables, beans, legumes, nuts and seeds. The average American needs at least 20-30 grams of fiber daily, but, unfortunately, most people miss this mark…by a lot. This is due largely to our high consumption of refined carbohydrate sources and processed food items, in addition to a poor intake of fruits and vegetables. But fiber has many benefits.

  • Fiber has shown to help keep you fuller longer between meals, aiding in weight management.
  • Choosing foods that are higher in fiber has shown to benefit blood glucose control.
  • A diet high in fiber can decrease one’s risk for diverticulosis/diverticulitis. Fiber can play a role in treating both constipation and diarrhea.
  • Increased fiber can help children’s constipation problems (check out this article for tips), as well as those of adults.
  • Another great thing a high fiber intake can do (and the focus of this blog) is help lower one’s cholesterol and, therefore, reduce the risk for heart disease.

Fiber is split into two categories: soluble and insoluble, and most fiber-containing products have both. Insoluble fiber can aid as a laxative by moving intestinal contents more rapidly. Soluble fiber forms a gel-like product when entering the digestive system. Soluble fiber absorbs bile salts in the intestines, which are important for digesting and absorbing fat. In order to keep our pool of bile salts at a proper level, the body utilizes cholesterol, specifically LDL found in the blood stream, to manufacture more bile salts. The National Cholesterol Education Program’s Therapeutic Lifestyle Changes recommends consuming at least 5-10 grams of soluble fiber per day to reduce LDL cholesterol by 5%. Check out the complete list of recommendations.

Good sources of soluble fiber:

Broccoli and Walnut Salad

Broccoli and Walnut Salad

  • Kidney beans
  • Oatmeal
  • Orange
  • Oat bran
  • Broccoli
  • Ground flaxseed
  • Apple
  • Banana

Other sources of fiber:

  • Blueberries/raspberries/blackberries
  • All beans/legume varieties
  • Brussel sprouts
  • Artichokes
  • Almonds
  • Shredded wheat cereal
  • Pears
  • Prunes
  • Sweet potatoes
  • Strawberries
  • Whole wheat bread/pasta

Assorted fruitIn addition to consuming more fiber, there are other diet recommendations for reducing one’s cholesterol level. This includes limiting trans and saturated fats from the diet (fatty red meats, fried foods, whole fat dairy products, snack crackers, chips, candy, cookies). It is encouraged to replace saturated fats with omega 3 and unsaturated fats from sources like salmon, walnuts and ground flaxseed. Fat intake should be limited to no more than 35% of total calories. Plant foods are recommended more often. Engaging in physical activity can also be very beneficial, as recommended by one’s physician.

How does my high cholesterol story end, you ask? I first began with choosing foods higher in fiber. I replaced my regular granola bars with high-fiber bars, consumed more vegetables, snacked on nuts more often, added fruit as part of my breakfast routine and chose cereals, English muffins and bread with higher fiber contents. In six months, I dropped my cholesterol level down from 216 mg/dL to 167 mg/dL. Today, I am still going strong with my fiber intake, omega-3 fatty acid intake and consuming low amounts of saturated and trans fats. Physical activity is a priority every day, and I am constantly finding new ways to challenge my body. My most recent cholesterol level taken was 151 mg/dL and I couldn’t be happier.

When increasing fiber in one’s diet, it is recommended to make sure you consume an adequate amount of water. Although it is rare with mixed diets, too much fiber can also be a problem causing poor absorption of calcium, iron, zinc and magnesium. Always consult with your physician or dietitian before making changes to your diet.

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