University Health Network (UHN) dietitians can meet with you to talk ... Phone: 416 596 0857 .... A half plate of vegeta
Healthy Heart Eating UHN Information for patients and families Read this booklet to learn: • what healthy heart eating is • how a registered dietitian can help • how to choose the right balance of foods • how much and what types of foods to choose
Use the information in this booklet with instructions and help from a Registered Dietitian. Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca © 2015 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: Dietitians of University Health Network Revised: 03/2015 Form: D-5461
What is healthy heart eating? Healthy heart eating is part of a healthy lifestyle. Eating foods from the different food groups and including more plant based foods can improve your heart health. This includes eating foods that are high in fibre, low in sodium (salt) and healthy fats.
How can a registered dietitian help? Registered dietitians can provide you with reliable information about healthy heart eating. University Health Network (UHN) dietitians can meet with you to talk about your nutrition whether you are staying in the hospital or at an appointment. Talk with a dietitian if: • your doctor has prescribed a 1.5 gram (1500 milligrams) to 2 gram (2000 milligrams) diet • you have lost your appetite • you have lost weight because of your illness • you have high cholesterol, high blood pressure or high blood sugar Your registered dietitian (RD) at UHN: Name: Date: Dietitian: Phone number: To find a registered dietitian in your community, you can contact: Dietitians of Canada Phone: 416 596 0857 Website: www.dietitians.ca Eat Right Ontario Website: www.eatrightontario.ca 2
Follow this guide for healthy heart eating: Use the information in Eating Well with Canada’s Food Guide to help you plan your meals. You can find this information at: Website: www.healthcanada.gc.ca/foodguide Enjoy different foods from the 4 food groups: • • • •
Vegetables and Fruit Grain Products Milk and Alternatives Meats and Alternatives
Include at least 3 of the 4 food groups at each meal
Eat healthy fats that come from plants. • Choose unsaturated fats such as olive, canola, corn and sunflower oils. • Limit the amount of saturated fat you eat. This fat is in all animal products (meats) and most dairy products. The exceptions are palm and coconut oils. These fats come from plants but are high in saturated fat. • Limit the amount of trans fat you eat. This fat is in shortening or baked goods you buy from the store, and deep fried foods. Choose milk products that are low fat. Choose skim or 1% milk, low fat yogurt and lower fat cheeses. Choose high fibre foods more often. • Choose whole grain breads and cereals. • Eat more legumes and lentils (for example kidney beans, chick peas, red and green lentils) • Eat more vegetables and fruits. Reduce foods that are high in cholesterol. • Limit to no more than 2 egg yolks each week. • Limit the amount of shrimp, squid, and organ meats you eat. 3
Avoid foods that are high in sodium (salt). All types of salt have sodium. This includes table salt, sea salt, kosher salt, garlic salt, celery salt and other types of salt. • Try to have no more than 1500 milligrams to 2300 milligrams of sodium a day. Check the Nutrition Facts food label on foods. Choose foods that have less than 10% or 250 milligrams of sodium per serving. • Try to read food labels because some foods that you may not expect can be high in sodium. • Replace your salt shaker with pepper or other herbs and spices. • Reduce the amount of salt you use in cooking and baking. • Limit salty foods such as bacon, canned foods, and salty snack foods (potato chips, French fries, popcorn, pretzels). • Sauces and condiments such as soy sauce, chili sauce, ketchup and mustard are high in sodium. Use herb mixes with no salt added (such as Mrs. Dash®, McCormick's®, David's® blend of herbs and spices), fresh or dried herbs, spices, vinegars or lemon juice for flavour instead. • Avoid foods that list monosodium glutamate (MSG) in the ingredient list. • Avoid foods that are pickled or smoked such as dill pickles, relishes, or smoked or pickled fish. • Avoid herb mixes that have potassium chloride, a salt substitute. • Restaurant meals are often higher in salt. Choose carefully from the menu! Try to eat at home more often.
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Choose proteins like fish, poultry (chicken or turkey) and lean cuts of meat. • Bake, broil, BBQ, roast or microwave your meats on a rack so fat drips off. • Trim any fat from meat and remove skin from poultry before cooking. Eat fish twice a week. • Fish is a source of Omega 3 fatty acids, which lowers your risk of heart disease. • Fish such as salmon, haddock, sardines, herring and lake trout are good sources of omega 3. Eat other high protein foods such as beans, lentils and tofu more often. These are excellent sources of fibre and are low in saturated fat and sodium. Eat less sugar and other sweets. Reduce how much sugar, honey, jam or syrup you eat. Save cakes, desserts, and baked goods for special occasions. Talk to your doctor about how much alcohol is safe for you. Drinking alcohol can: • affect how well certain medicines (like warfarin) work • increase triglyceride levels (fats in your blood). Avoid drinking alcohol if your triglyceride levels are already high. • raise blood pressure • cause damage to your liver and nerves • affect your blood sugar control • cause irregular heart beat
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How do I include a balanced meal? Start with 1/2 a plate of vegetables. They can be: • fresh or cooked from frozen • stir-frys or salads • homemade vegetable soups
Add 1/4 plate of grain products or starchy vegetables. They can include: • rice, potato or corn • whole-wheat pasta, noodles or couscous kasha, quinoa, bulgur, or barley • whole-grain bread or flatbread
Add 1/4 plate of meat or other high protein foods. These may include: • fish • skinless chicken and lean meats • legumes or lentils • soy products (tofu, low sodium versions of soy-based vegetarian products, tempeh)
To complete your meal, add fruit and low fat milk or yogurt.
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How much and which types of foods should I choose? The amount of food you need depends on: • whether you are male or female • your age • body size • how active you are
Use the guide starting on the next page to help you pick foods that are low in saturated and trans fat, high in fibre and low in salt. This symbol means a food is high in salt.
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Vegetables and fruits – 7 to 10 servings each day Vegetables and fruit are an excellent source of vitamins and minerals. They are also low in fat. A half plate of vegetables is a good source of fibre and will help to keep you full. Fruit is a great dessert choice, and it’s a snack that’s easy to take anywhere you go. Best choices Examples of 1 serving:
Choose less often
• 125 millilitres (1/2 cup) fresh or frozen vegetables • 250 millilitres (1 cup) salad
• buttered, creamed or deep fried vegetables • canned vegetables (except low sodium)
• • • •
• all fruit juice or fruit drinks • V8® juice, tomato juice, Clamato® juice • canned fruits in heavy syrup • coconut, coconut milk
1 piece of fresh fruit (small) 125 millilitres (1/2 cup) mixed fruit 250 millilitres (1 cup) berries 125 millilitres (1/2 cup) canned unsweetened fruit
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Grain products and starchy vegetables – 6 to 8 servings each day Grain products and starchy vegetables provide your body with energy. They are also a good source of fibre. At least half of the grain products you eat each day should be whole grain. Eat a variety of whole grains such as barley, brown rice, oats and whole-grain breads. Best choices Examples of 1 serving:
Choose less often
• 1 slice of whole grain, rye or pumpernickel bread • 1/2 whole wheat pita • 1/4 whole wheat bagel • 1/2 whole wheat chapati or roti • 1/2 whole wheat matza • 1/2 whole wheat tortilla • 1/2 whole wheat hamburger bun or kaiser • 1/2 whole wheat English muffin
• white bread • salted crackers, egg bread, cheese rolls, croissants • store bought cakes, muffins, doughnuts, danishes, waffles, or pancakes • store bought breading products (for example Shake'N Bake®) • potato chips, corn chips, tortilla chips
• 250 millilitres (1 cup) of homemade soup made with beans, lentils, barley and vegetables
• canned, packaged or dried soups
• 2 to 4 whole wheat, low fat crackers such as Ryvita, Wasa or high fibre flat breads
• store bought cookies, high fat crackers
• 125 millilitres (1/2 cup) of starchy vegetables such as corn, sweet potato, yam, cassava • 1 small or 1/2 a medium potato
• creamed corn • frozen French fries
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Grain products and starchy vegetables – 6 to 8 servings each day (continued) Best choices Examples of 1 serving:
Choose less often
Cereals: Check the Nutrition Facts label and choose cereals with 4 grams of fibre or more.
• corn flakes, Rice Krispies®, high sugar cereals (for example, Fruit Loops )
For example: • 75 millilitres (1/3 cup) Kellogg’s Bran Buds with Psyllium® or All Bran • 190 millilitres (3/4 cup) cooked oatmeal or Red River® • 175 millilitres (2/3 cup) Post Shredded Wheat® 125 millilitres (1/2 cup) cooked grains and pasta, for example: • brown or wild rice • whole-wheat pasta • kasha • barley • bulgur • quinoa
• pre-seasoned rice and pasta products such as Uncle Ben’s Ready Rice® or Knorr Pasta Sides® • egg pasta, fried noodles • dried soup noodles (for example Mr. Noodles®)
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Milk products – 2 to 3 low fat servings each day Milk products are an excellent source of calcium and vitamin D. If you do not drink milk, choose unflavoured soy drinks with added calcium and vitamin D. Best choices Examples of 1 serving:
1%
Choose less often
• 250 millilitres (1 cup) skim or 1% milk • 250 millilitres (1 cup) calcium-fortified plain soy beverage • 75 millilitres (1/3 cup) skim milk powder • 125 millilitres (1/2 cup) evaporated skim milk
• whole milk, 2% milk, chocolate milk • goat milk • regular cream, light cream, sour cream, whipping cream • evaporated whole milk, condensed milk
• 175 millilitres (3/4 cup) yogurt (1% milk fat or less)
• yogurt with more than 1% milk fat
• 1 ounce (30 grams) of skim milk cheese (less than 8% milk fat) • 125 millilitres (1/2 cup) low fat cottage cheese • 125 millilitres (1/2 cup) low fat ricotta cheese
• processed cheese, full-fat cheese, cheese spreads
• 125 millilitres (1/2 cup) frozen yogurt
• regular ice cream, 1% ice milk • no sugar added ice-cream • coffee whitener, dessert topping
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Meat and other high protein foods – 2 to 3 servings each day These foods are a good source of iron and protein. Choose beans, lentils and tofu more often. Fish is an excellent source of Omega-3 fatty acids. Choose fish at least twice each week. Best choices Examples of 1 serving:
Choose less often
• 75 grams cooked weight or 125 millilitres (1/2 cup) fresh or frozen fish such as char, herring, mackerel, salmon, sardines and trout • 75 grams cooked weight or 125 millilitres (1/2 cup) shellfish such as crab, mussels, oysters and scallops • 50 millilitres (1/4 cup) canned salmon or tuna (packed in water).
• shrimp, squid, canned fish packed in oil • battered, fried or creamed fish or squid • smoked/salted or pickled fish and canned sardines
• 75 grams cooked weight (or size of a deck of cards) poultry like chicken, lean ground chicken, turkey or Cornish hen
• duck, goose, poultry skin • prebasted poultry
• 75 grams cooked weight (or size of a deck of cards) lean cuts of beef, extra-lean ground beef, veal, lamb, pork, rabbit, or venison.
• sandwich meat, back bacon, ham, sausages, hotdogs, or salami • organ meats, spareribs
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Meat and other high protein foods – 2 to 3 servings each day (continued) Best choices Examples of 1 serving:
Choose less often
• 2 eggs (maximum of 2 yolks per week) • egg whites • 100 millilitres (1/2 cup) of egg substitute (equals 2 eggs) • 150 grams (or 1/4 to 1/3 block) of firm tofu • 150 grams of "lower-sodium versions" of soy-based products like veggie burgers, soy ground round • 150 grams soy cheese or tempeh • 175 millilitres (3/4 cup) cooked lentils, soy beans, chick peas, navy beans or kidney beans
• canned beans (unless rinsed well)
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Fats and oils – no more than 2 to 3 tablespoons (30 to 45 millilitres) a day Unsaturated fats are a good source of essential fatty acids and vitamins. Limiting saturated fat and trans fat reduces your risk of heart disease. Use the Nutrition Facts food label to choose items that have less than 10% Daily Value from saturated and trans fat. Many processed and deep fried foods are high in fat. Choose these foods less often.
Best choices Examples of 1 serving:
Choose less often
• 5 millilitres (1 teaspoon) canola, olive, corn, safflower, soybean, and sunflower oils
• lard, suet, shortening, hydrogenated vegetable oils • tropical oils such as palm oil or coconut oil
• 5 millilitres (1 teaspoon) non-hydrogenated and low in saturated fat margarine • 10 millilitres (2 teaspoons) light margarine
• butter, partially hydrogenated margarine or hydrogenated margarine
• 15 millilitres (1 tablespoon) homemade salad dressing made with best choice oils or store bought regular salad dressings
• more than 1 tablespoon of regular salad dressing • full fat salad dressing that has cream, cheese, or bacon in the ingredients
• 30 millilitres (2 tablespoons) calorie reduced or low fat salad dressings
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Fats and oils – no more than 2 to 3 tablespoons (30 to 45 millilitres) a day (continued)
Best choices Examples of 1 serving: • 7 millilitres (1/2 tablespoon) peanut butter, almond butter • 15 millilitres (1 tablespoon) light peanut butter
Choose less often
• peanut butter made with hydrogenated oil
• unsalted nuts and seeds: 8 almonds, • chocolate coated nuts, nuts roasted 4 walnut halves, 10 peanuts (choose in hydrogenated oils, salted nuts dry roasted or in the shell) • 1 tablespoon shelled or 3 tablespoons unshelled sunflower seeds • 7 millilitres (1/2 tablespoon) regular mayonnaise and mayonnaise type dressings • 15 millilitres (1 tablespoon) light regular mayonnaise and light mayonnaise type dressings • 1/6 of a medium avocado
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