Transcript PRESENTATION NAME - Helderberg Cardiac

Nutrition Intervention of CHD
Amanda I’Ons Registered
Dietitian
Water
• Drink 2 litres or less of water per day
• (if you on fluid restriction, adhère to doctors
recommandations)
• Water is the most important nutrient
• Restrict your intake of sodium to 1.5 g per
day. Non CHD adults restrict to 2.3g/day
• Eat potassium rich foods each day such as
banana, pawpaw, potatoes, tomatoes,
strawberries
Water- our most important
nutrient
The Importance of Drinking Water
Salt
• Is often ‘HIDDEN’ in food
• Names: mono sodium glutamine
or glutamate
• Powders- sauces, soups, biltong
• Pies, chips, fizzy colddrinks,
processed/instant foods
• Be careful with potassium salt or
salt replacements
• Use herbs and spices
6-8 glasses per day
high salt intake and high fluid intake may lead to fluid
retention and high blood pressure
Vitamins and Minerals
Vitamin D- deficiency may cause
Rickets
Hypertension
CVD
Heart Failure
Peripheral arterial disease
Sources: sunlight 20minutes/day
Dairy products, oily fish, egg yolk and
cod liver oil or fish oils, supplement
Vitamin C
Vitamin E
B-vitamins
Magnesium and Potassium
Zinc, Selenium
Fruit and Vegetables
Two main functions:
•Soluble fibre
• Plant sterols , sterolins and other
phytontutrients
•Vitamins and minerals
•Also a source of CHO
•* apple – pectin and phytonutrients
•“An apple a day keeps the doctor
away”.
Berries (mixed)
All Berries are a very nutritious food
source.
They are one of fruit and foods with
the most alkalising effect on the body.
A poor diet, high in alcohol, coffee,
sugar, smoke and unhealthy red meat
will cause the body to become more
acidic. Often manifesting as gout
(purines) or other inflammatory
diseases.
Very high vitamin C
Phyto chemicals in skin and fruit
Eat as desert or smoothie.
Fibre
We need a total of 25-35g fibre (both soluble and insoluble) daily
or 14g fibre per 1000kcal AI.
Whole grains (insoluble fibre)
Fruit and Veg (soluble fibre)
Fibre
Need 25-35g fibre per day
• Fibre is very important for gut health and to
lower serum cholesterol levels.
• Gut
micro-flora
• Bile secretion- reduce serum cholesterol
• Satiety effect, consequently reduce fat intake
• Get soluble fibre: fruit, vegetables, oats, oat
bran, legumes- most important fibre.
• Insoluble fibre: wheat, bran, whole grainsstool bulking effect
How to increase your fibre intake
• Eat high fibre cereals, whole wheat breads,
pasta and brown rice. And Legumes.
• Eat 5-6 servings fruit and vegetables per day
and try to leave skins on.
• Eat high fibre low fat snacks e.g. Raw
vegetables, fresh fruit and popcorn.
• Check labels for fibre facts- list the amount of
fibre per serving or the words bran, whole
wheat flour listed as one of the 1st five
ingredients.
Fibre Content of Various Foods
Food
Amount
Soluble
Fiber, g
Total Fiber, g
Kidney beans 1/2 cup
2.0
6.7
Pinto beans
1/2 cup
2.0
6.7
Brussels
sprouts
1/2 cup
2.0
3.8
Broccoli
1/2 cup
1.1
2.6
Spinach
1/2 cup
0.5
2.1
Zucchini
1/2 cup
0.2
1.6
Apple
1 medium
1.2
3.6
Orange
1 medium
1.8
2.9
Grapefruit
1/2 medium
1.1
1.8
Grapes
1 cup
0.3
1.1
Prunes
6 medium
3.0
8.0
Oatmeal
(dry)
1/3 cup
1.3
2.8
Oat bran
(dry)
1/3 cup
2.0
4.4
Corn flakes
1 ounce
0.1
0.3
Brown rice
(cooked)
1/2 cup
0.4
5.3
Wholewheat bread
1 slice
0.4
2.1
White bread
1 slice
0.2
0.4
Legumes
(cooked)
Vegetables
(cooked)
Fruits (raw)
Grains
Legumes
•Hydro ½ cup cooked dried beans,
lentils per day.
•Include in meat/salads/rice/veg
•? Glycaemic Index
•Insulin- explained
•Contribute to euglycaemia
•Tolerance- bacterial overgrowth
•Vegetarian meals approximately 3
times a week.
Insulin/Glucose Peak
Glycaemic Index Chart
Glycaemic Load
Sugars and Sweeteners
• Sugar- sucrose has medium glycaemic index
• Honey- health properties, but high glycaemic
index
• Insulin-peak, dip (revisited)
• Artificial sweeteners
• www.gifoundation.com
Confectionary
•
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Limit
low GI (avoid insulin peak)
Look for healthy recipes and alternatives
Eating for Sustained Energy by Liesbet Delport
and Gabbi Steenkamp
• Chocolate- limit, black chocolate, 70% and
more cocoa. Or cocoa drink with low fat milk,
limit sweetener.
Dairy Products
•Very important source calcium, Bvitamins, vitamin A ,D and protein.
•Not essential in adult diet- easily
replaced
•Vitamin D- deficiency may cause
hypertension, CVD, Heart Failure,
Peripheral Arterial Disease
•Calcium supplement
•For cholesterol lowering purposes and
weight management, low fat is best.
•Nutritious, Organic vs non-organic
•rBST free, free antibiotics, free range
Healthy cows in natural
environment
Beef
Not all beef is unhealthy
Always remove visible fat from meat
Always eat lean meat e.g. Lean mince
Free range beef- during winter months
reduced saturated fat and omega 6
fatty acids from grass diet.
High corn diet, high hormone rich
meat, usually with antibiotics.
Meat bought may or may not be grass
fed beef.
Lean meat cuts
Lean cuts
Avoid organ meats- high in saturated
fat and cholesterol
Avoid shell fish- high cholesterol
Eggs- err on caution- use 3/ week
No evidence increase cholesterol
Serum cholesterol levels more affected
by types and amount of fats we eat,
fibre content diet, exercise and water
than the amount of cholesterol eaten.
All animal products contain cholesterol
No plant product contains cholesterol
Ostrich meat, considered healthy
alternative
• Chickens on natural diet
Free range chickens
Health benefits of diet free of
antibiotics and hormones
The chicken meat has lower fat
content, fowl eats natural diet.
Tunnel Produced Chickens
Free Range Chickens
Cholesterol:
Less than 300mg/ day for healthy
adults
Less 200mg/day for adults with high
levels of LDL (BAD) cholesterol or who
taking cholesterol lowering
medication.
Eggs- fatty acid content and
cholesterol content
1 egg on average has 200mg
cholesterol and 5g fat
Benefits; protein, vit D, riboflavinfolate
folate
Nuts
Contain fibre, calcium, protein and
essential fatty acids.
Most nutritious nut to eat is the raw,
unsalted almond.
Concentrated energy source, eat it in
limited quantities ¼ cup or 7-14 nuts.
Natural energy from the sun- we can’t
measure it in calories.
Nuts
Omega 3 fatty acid :
Walnuts
Omega 6 Fatty acid:
Soy nuts
Monounsaturated fat:
Almonds, cashews, peanuts, pecans,
and butters made from these nuts.
Fats and Oils
All Seeds are important
They contain essential poliunsaturated
fatty acids.
Fats and fatty acids are a very
important part of management of
Heart disease.
Saturated fat- animal fats, must be
reduced to 7% or less than 14g if you
follow a 2000 calories diet.
Poliunsaturated fats 10% of total fat
intake e.g. Omega 3 and 6 fatty acids.
Trans fats- dangerous, rancid fats,
found in brick margarine and damaged
sunflower oil. Try and have none- must
be less 1% of your total calories.
Read labels
Oils
* Olive oil mono-unsaturated oil
(only one unbound carbon)
•Canola mix
•Avocado pear oil
•Grape seed- polyunsaturated oil with
highest smoking temperature
•Fry food- avoid, only occasionally,
•All oils are damaged when heated
• look for cold pressed oils
Comparison of Dietary Fats
Fish-wild salmon, pilchards
Fatty acid supplements
Dosage: 1000mg ( EPA and DHA)
omega 3 fatty acid for CHD patients.
2-4g EPA and DHA per day for
triglyceride lowering effect.
Non cardiac patients 1000mg/day of
EPA and DHA. OR eat oily fish 2 x per
week (rich in linolenic acid) also
include flaxseed, canola oil, soybean
oil, flaxseeds and walnuts.
Caution: contraindicated if on blood
thinners
Cholesterol lowering properties higher
in fish source of oil than plant (more
active molecules and body just absorb)
Omega 6 fatty acids: 1000mg / day
Star flower, flax seed oil, evening
primrose oil.
The Benefits of Omega 3 fatty acids
Flaxseed oil vs. Salmon oil
Flaxseed Oil
Salmon or fish oil
Conclusion
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Watch your:
Water
Fibre
Fats and oils
Sufficient plant phytonutrients and vitamins
and minerals
• Exercise/relaxation/Sunshine
Laughter is good for the heart
and strength to the bones.
Contact Details
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Amanda I’Ons
Cellphone number 0792973936
Email address: [email protected]
High Rustenberg Hydro: 021-8093800
Stellenbosch