Transcript Healthy Eating

Preventing Strokes
One at a Time
Healthy Eating
2009
Managing Stroke Risk Factors
LEARNING OBJECTIVES
Upon completion, participants will be able to:
 Counsel patients about a healthy balanced diet
according to the Canadian Best Practice
Recommendations for Stroke Care, 2008.
 Partner with patients & families to develop an
individualized plan for cooking and eating healthier.
2.1 Lifestyle and Risk Factor
Management
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Persons at risk of stroke and patients who have
had a stroke should be assessed for vascular
disease risk factors and lifestyle management
issues:
 Diet, Sodium intake, Exercise, Weight, Smoking,
Alcohol intake
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They should receive information and counseling
about possible strategies to modify their lifestyle
and risk factors.
CMAJ 2008;179(12 Suppl):E1-E93. #2.1
Healthy Balanced Diet
Fat
 Cholesterol
 Fibre
 Canada’s Food Guide
 Other tips
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 How to balance a meal
BMI and Waist Circumference
 Resources
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Canadian Best Practice Recommendations for
Stroke Care, 2008 #2.1i)
Healthy balanced diet
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High in fresh fruits, vegetables, low fat
dairy products, dietary and soluble fibre,
whole grains, proteins from plant sources,
and low in saturated fat, cholesterol and
sodium, in accordance with Canada’s Food
Guide to Healthy Eating
CMAJ 2008;179(12 Suppl):E1-E93 #2.1
Canadian Best Practice Recommendations for
Stroke Care, 2008 #2.1 ii)
Sodium
The recommended daily sodium intake from all
sources is the Adequate Intake by age.
 For persons 9 – 50 years, the Adequate Daily
Intake is 1500 mg. Adequate Intake decreases to
1300 mg for persons 50 – 70 years and to 1200
mg for persons > 70 years.
 A daily upper consumption limit of 2300mg
should not be exceeded by any age group
 See www.sodium101.ca for sodium intake
CMAJ guidelines.
2008;179(12 Suppl):E1-E93 #2.1
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Recommendations for Adequate
Sodium Intake by Age
Age
Sodium Intake per Day
(mg)
0-6 months
120
7-12 months
370
1-3 years
1000
4-8 years
1,200
9-50 years
1,500
50-70 years
1,300
> 70 years
1,200
CMAJ 2008;179(12 Suppl):E1-E93 #2.1
Equivalent Measurements of Sodium
and Salt
Sodium
(mg)
Sodium
(mmol)
Salt (g)
500
1,500
22
65
1.25
3.75
2,000
87
5.0
For example:
•Two slices (292 grams total) of
a Pepperoni Lover's large
stuffed crust pizza at Pizza Hut
contain 3,000 mg of sodium,
double the recommended intake
for a full day.
2,300
2,400
100
104
5.8
6.0
.
http://www.marketwire.com/pressrelease/Canadian-Stroke-Network944176.html
3,000
4,000
130
174
7.5
10
CMAJ 2008;179(12 Suppl):E1-E93 #2.1
Types of Salt
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Table salt =fine-grained, we get it from salt
mines. In 1920 iodine was added.
Sea salt =evaporated seawater
Kosher salt =table salt but with no additives,
made to prepare meat according to Jewish dietary
regulations
Pickling salt= fine grained like table salt but
doesn’t contain iodine, used to pickle food.
•
1 teaspoon contains 2300 mg sodium
Dietary Fat
Overall…choose low fat
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Use less butter and margarine.
Use skim, 1% or 2% milk.
Choose low fat yogurt (<2%) and cheese (<20% MF)
Choose lean meat/poultry and trim fat before cooking
Items to limit: bacon, cold cuts, sausages, gravy,
chips, fried food, pastries
Use small amounts of canola (cooking) or olive oil.
Eat more vegetables and fruit.
GOOD versus BAD fat
Good Fats/Healthy
Bad fats/Unhealthy
(mono & polyunsaturated)
(trans and saturated fats)
 Non-hydrogenated margarine  Red meat, poultry
 Oils: canola, olive, corn,
 Whole milk, cheese, cream
avocado, olives
 Butter, cream cheese
 Nuts: almonds, peanuts,
 Ice cream, sour cream
pecans, walnuts
 Palm oil, coconut oil,
 Seeds: flax, sunflowers,
hydrogenated vegetable
sesame
oil, shortening
 Fish: salmon, trout, tuna,
 Fried foods
sardines
 Processed food
 Eggs: Omega-3
Fibre
(25-35 g a day)
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Eat a variety of soluble and insoluble
 Insoluble Fibre: Bran Cereals, Whole Grains
 Soluble Fibre: Dried Beans, Peas, Lentils, Rolled Oats,
Oat Bran, Barley, Psyllium
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Soluble fibre can lower LDL cholesterol
Provides a feeling of fullness (↓ intake)
Help control blood glucose levels (diabetes)
(up to 50g fibre with diabetes)
Grains
Grain Products (1/4 Plate):
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Whole Grain Breads
Brown Rice, Whole Wheat Pasta, Barley
1-2 Tbsp Ground Flaxseed
High Fibre Cereals – Shredded Wheat,
Oatmeal, All Bran Buds with Psyllium
Cholesterol
(300mg or less a day)
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Little effect on blood cholesterol
Genetics, diabetes, physical activity
Found only in animal products
Focus on decreasing unhealthy fats in the diet
instead of decreasing cholesterol intake
Increase fibre intake
Canada’s Food Guide
Food Group
19-50
51+
F
M
F
M
Vegetables & Fruit
7-8
8-10
7
7
Grain Products
6-7
8
6
7
2
2
3
3
2
3
2
3
Milk & Alternatives
Meat & Alternatives
Other Tips to a Healthy Balanced Diet
Vegetables (1/2 Plate):
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7-8 servings daily
(Fresh/Frozen) vegetables vs juice
Brighter is better
Choose one green and one orange daily
(Broccoli, Spinach, Peppers, Squash,
Sweet Potatoes, Carrots)
Healthy Eating
Include 3 of 4 food groups at each meal
 Choose fruits vs juices
 Low fat dairy
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Meal planning : Breakfast
1 fruit
1 milk
Meat and alternatives
2-3 grain products
Meal Planning: Lunch & Dinner
1 fruit
2-3 vegetables
(fibres)
1 Milk
Meat and alternatives
2-3 grain products
Portion Sizes and Tableware
Dinner plate 23cm/9inches
 Soup bowl 250 ml /1cup
 Cereal Bowl 250ml /1 cup
 Drinking glass150 ml /2/3 cup
 Dessert Bowl 150 ml /2/3 cup
 Wine glass 125ml /1/2 cup
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Eat Smart When Eating Out
Better choices:
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Condiments on the Side
Salad vs Fries (caution: Caesar Salad)
Tomato vs Cream Sauce for Pasta
Plainer Burger vs. “House” Specialty
Smaller / Share / Take Home Portions
Resources
www.sodium101.ca
 www.heartandstroke.ca
 www.dietitians.ca
 www.hc-sc.gc.ca
 www.dairygoodness.ca
 www.hypertension.ca
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Healthy Eating “Station”
The following slides will be referred to
at “healthy eating” station with a
chance to read labels.
Label reading
Learn how to read a label at Health
Canada website
www.hc-sc.gc.ca/fn-an/labeletiquet/nutrition/cons/interactive-eng.php
 Label reading specific to sodium at
Canadian Stroke Networks sodium 101
website
www.sodium101.ca/en/takecontrol/reading
labels.html
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Shop Smart
Plan Meals Using Canada’s Food Guide
 Use a shopping list
 Don’t shop hungry
 Periphery of the store
 Read labels
 Health Check Symbol on food
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Shop Smart
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Snacks, Cereals, Cookies
 < 3 g Total Fat, <2 g Saturated & Trans Fat
 < 200 mg Sodium (10% DV)
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Cereals, Grains
 > 3 g Fibre; Whole Grain 1st Ingredient
 < 4 g Sugar (For TG)
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Frozen Dinners
 < 600 mg Sodium
Shop Smart
Ingredient List – watch out for:
 Saturated and Trans Fat
 Hydrogenated or Partially Hydrogenated Shortening
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Saturated fats
 Palm, Palm Kernel, Coconut, Tropical Oils
 Lard, Tallow, Butter
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Sodium
 Salt, Flavoured Salts, Sea Salt, Sodium, MSG, Brine, Soy
Sauce, Baking Soda, Baking Powder
Canadian Best Practice Recommendations for Stroke Care, updated 2008
www.canadianstrokestrategy.ca