Transcript Nutrition and Diet Recommendations for CR

NUTRITIONAL MANAGEMENT OF
CARDIOVASCULAR DISEASE
(PUTTING KNOWLEDGE INTO PRACTICE)
Erin Spenner, MS, RD, LDN
Memorial Weight Loss & Wellness Center
Springfield, Illinois
DIETARY CHANGES ARE VITAL TO
CARDIAC RISK REDUCTION!!!
THE BROAD STROKES:
Foods to Increase

Fiber





Fruits
Vegetables
Whole Grains
Legumes
“Good” fats



Non-tropical vegetable oils
Nuts
Omega-3
Nutrients to Decrease

Salt

“Bad” fats


Saturated
Trans

Sugar

Red Meats
“I KNOW WHAT I SHOULD DO, I JUST DON’T DO IT”

People eat food, NOT nutrients

Food choices driven by many factors
Culture/Religion
 Past Experiences






Food Supply


Celebrations
Comfort
Reward
Entertainment
SES
Taste
GOING FROM “SHOULD” TO “COULD”
We
should emphasize overall
dietary patterns rather than get
caught up in specific nutrients





Less likely to demonize foods
More likely to encourage diet variety
More likely to improve overall diet quality
Reduce confusion
Increase compliance
UNDERSTANDING YOUR PATIENTS’ DIET: DIET ASSESSMENT

Diet recall/Diet history/Food log

Most useful for evaluating intake of a specific nutrient


Fat, sodium, etc
Food Frequency Questionnaires

Good for evaluating overall patterns of intake

If self-guided, ensure appropriate literacy level

***All tools should be administered or evaluated by
Nutrition professional***

And remember, friends: Humans make terrible lab rats.
EVIDENCED-BASED NUTRITION
RECOMMENDATIONS FOR
CARDIOVASCULAR DISEASE
VEGETARIAN/VEGAN



The China Study
The “Blue” Zones
Dean Ornish

Often seen as extreme measures
Limited compliance

Long story short:



Diet Rx should be individualized.
“One Size Fits All” doesn’t exist.
EVIDENCED-BASED NUTRITION
RECOMMENDATIONS FOR DYSLIPIDEMIA
FAT

Reducing total fat intake lowers calorie intake, which
can lead to weight loss, which leads to lower LDL,
VLDL, TG.


Benefits seen from the weight loss, not necessarily the
reduced fat
Many kinds of fat
Trans
 Saturated
 Unsaturated



Mono
Poly
SATURATED FAT


Comes mostly from animal sources and tropical
vegetable oils (coconut, palm)
Ideally, intake would be 5-6% total calories

On 2000 calories per day, that equals 11 grams


Reducing Saturated fat intake lowers both LDL-C
and HDL-C


Equivalent of 1 TB butter
Greater effect seen on the LDL
What about Coconut?!?
UNSATURATED FATS: PUFA
Omega-3

Alpha-Linoleic Acid
(ALA)
Omega-6

Linoleic Acid (LA)
MAY reduce
inflammation
 Lower LDL/VLDL
 Higher HDL


Ratio of 3:6 influences
inflammatory state of
human body
UNSATURATED FATS: MUFA

Oleic Acid





Olive Oil, Canola Oil
Lowers LDL, TG, TC?HDL
Raises HDL
***When MUFA’s REPLACE saturated fats they
demonstrate a positive influence on the lipid profile
and may improve insulin resistance.
***PUFA’s had a greater benefit
MEDITERRANEAN DIET
Associated with southern Europeans
 Has demonstrated reduction in heart disease
mortality in studies from around the workld
 Multiple versions exist with significantly
differing macronutrient distributions
 Everyone’s favorite part: WINE

EVIDENCED-BASED NUTRITION
RECOMMENDATIONS FOR HYPERTENSION
THE DASH DIET
Main consideration of this diet is reducing
sodium intake
 Plant-based
 Focused on minimally processed foods
 Multiple versions of this diet exist


2300mg vs 1500mg
EVIDENCED-BASED NUTRITION
RECOMMENDATIONS FOR OBESITY
We are all Special
Snowflakes…


It’s important to adapt the
recommendations above,
keeping in mind calorie
requirements, to personal and
cultural food preferences.
Nutrition therapy for other
conditions like diabetes should
also be considered. Doing so
helps create healthy eating
patterns that are realistic and
sustainable.
STAGES OF CHANGE:
WRAP-UP AND QUESTIONS