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Eating Well for Disease Prevention

Eating Well for Disease Prevention. Rita P. Smith, MS, RD, CDE Registered Dietitian Certified Diabetes Educator rita.smith@mjh.org. “If you don’t take care of your body, Where are you going to live?” Anonymous. Menu of Topics. A Healthy Weight Caloric Balance USDA Guidelines:

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Eating Well for Disease Prevention

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  1. Eating Well for Disease Prevention Rita P. Smith, MS, RD, CDE Registered Dietitian Certified Diabetes Educator rita.smith@mjh.org

  2. “If you don’t take care of your body,Where are you going to live?”Anonymous

  3. Menu of Topics A Healthy Weight Caloric Balance USDA Guidelines: Fats, Carbohydrates & Protein Soy Good Homocysteine Phytonutrients Calcium and Sodium

  4. Average Intake Each Year!! • 764 donuts • 60 pounds of cake and cookies • 23 gallons ice cream • 7 pounds potato chips • 22 pounds candy • 365 servings soda

  5. Daily Food Intake of Kids Percentage of infants and toddlers who consume daily: 9 – 11 19 – 24 Food month-oldsmonth-olds Candy 3% 10% Pizza 2% 11% Soft drink 4% 23% French Fries 9% 21% Hot dogs, bacon 7% 25% Reference: Archives of Pediatric and Adolescent Medicine 2003; 157: 789-896.

  6. We EatFAST !! $6 billion spent on fast food in 1970 $110 billion spent on fast food in 2000 $240 billion estimated annual health-care costs in the U.S. from obesitySource: Fast Food Nation, Houghton Mifflin, 2001.

  7. On-the-Go Fare:The Good and Not-So-Good ItemCalories McDonalds grilled chicken w/ nonfat dressing 130 Taco Bell chicken soft taco 190 Auntie Anne’s glazing raisin pretzel 510 BK whopper w/ cheese 780 Sbarro’s sausage & pepperoni stuffed 880

  8. On-the-Go Fare:The Good and Not-So-Good ItemCalories Onion rings, 1 side order 900 BK double whopper w/ cheese 1,020 Taco Bell mucho grande nachos 1,320 Cheesecake Factory carrot cake, 1 sl 1,560 Beef burrito w/ beans & guacamole 1,640

  9. Excess Calorie Intake • From sugar: more than 150 lb./year • From fat: more than 80 g/day • From carbs: mostly refined and processed Fiber intake: less than 15 g/day • From beverages: sodas, fruit drinks, alcohol

  10. Portion Distortion • Portions are LARGER than ever • We SUPERSIZE meals • We order JUMBO size drinks

  11. The Weight Facts: 65% of adults are overweight and obese 39% of children and adolescents are overweight and obese

  12. Excess Weight Increases Disease Risk • High blood pressure • Coronary artery disease • Stroke • Type 2 diabetes (adult onset) • Asthma • Gallbladder disease • Arthritis • Sleep apnea • Disorders of reproduction • Certain cancers, including colon, endometrial and post- menopausal breast cancer

  13. An Extra 100 Calories 1 granola or cereal bar or 1 tablespoon margarine adds up to 36,500 calories in 1 year.   That’s 10 pounds gained!

  14. Exercise Makes a Difference Walking 30 minutes each day will use 210 calories.  That is 76,650 calories in 1 year or 22 pounds lost.

  15. Many Weight Loss Options(Calorie-saving options) High-Protein, Low-Carb: Mod-Carb, Mod-Fat Dr. Atkins Mediterranean Protein Power Weight Watcher’s The DASH High Carb, Low-Fat: The Zone Ornish Vegetarian South Beach Pritikin

  16. Lifestyle Changes Can Make A Differencein a matter of weeks Feb. 3Feb. 2623 days Weight 208 lbs 197 lbs -11 lbs Total Cholesterol 280 mg 224 mg -56 mg HDL-Cholesterol 45 mg 49 mg +4 mg LDL-Cholesterol 182 mg 150 mg -32 mg Triglycerides 265 mg 123 mg -142 mg

  17. Healthy Changes An early morning walk Grilled chicken sandwiches and wraps Tossed salads Calorie - free beverages

  18. Lifestyle Changes Can Make A Differencein a matter of months AprilJune3 months Weight 266 lbs 205 lbs -61 lbs Total Cholesterol 236 mg 146 mg -90 mg HDL-Cholesterol 34 mg 28 mg -6 mg LDL-Cholesterol 167 mg 94 mg -73 mg

  19. Healthy Changes Breakfast: Decaf coffee and a fresh bagel Snack: Fresh fruit Lunch: Pasta with marinara sauce Grilled chicken salad Vegetable soup Vegetarian stirfry Exercise with wife after work Dinner: Vegetarian entrees Shared entrée with wife

  20. A Great Resource: MyPyramid Source: www.usda.gov

  21. USDA Dietary Guidelines:Control Calorie Intake Calories DO count for weight control, not the proportions of protein, fat, and carbohydrates. The healthiest way to reduce calories is to lower: Saturated fats Added sugar Alcohol Source:www.usda.gov

  22. USDA Dietary Guidelines:Energy Balance Eating 500 calories less/day = 1 lb. weight loss/week. Control portion sizes to reduce calories, especially from calorie dense foods.

  23. USDA Dietary Guidelines:ChooseFats Wisely Total fats:20% - 35% of total daily calories (Example: 30-55 grams for a 1500-calorie diet) Saturated fats:less than 20% of total daily calories (Example: < 16 grams for a 1500-calorie diet) Trans fats: Less than 1% of total daily calories (Example: < 2 grams for a 1500-calorie diet)

  24. Nutrition Facts Label

  25. Effects of Dietary Fat on Blood Lipids Food SourceEffect on Lipids Saturated: Increases total cholesterol dairy fat, animal fat, Increases LDL-cholesterol chicken skin Little effect on HDL-cholesterol Polyunsaturated: Decreases total cholesterol corn, safflower, sunflower, Decreases LDL-cholesterol cottonseed, soybean Decreases HDL-cholesterol Monounsaturated: Decreases total cholesterol olive, canola & peanut oils; Decreases LDL-cholesterol nuts: walnuts, peanuts, Little effect on HDL-cholesterol almonds, pecans, etc. Omega-3 fatty acids: Decreases total cholesterol fish, especially salmon, Decreases LDL-cholesterol tuna, trout, sardines May increase HDL-cholesterol; flaxseed; walnuts Trans fatty acids & Increases total cholesterol hydrogenated fats: Increases LDL-cholesterol stick margarine, shortening May decrease HDL-cholesterol

  26. Healthy Fats: Nuts Daily consumption of nuts can lower blood cholesterol levels and high blood pressure. (1/4 cup serving per day) Peanuts Walnuts Almonds Pecans Reference: American Journal of Clinical Nutrition, 2003.

  27. Healthy Fats: Fish Oils Benefits: • Reduces sudden death • Anti-inflammatory • Lowers triglycerides How Often?(from AHA) • 2 servings of fish per week Best Sources: • Salmon, tuna, mackerel, sardines, herring

  28. Mercury Warning Mercury is highest in Shark King mackerel Swordfish Tilefish Pregnant or nursing women: avoid these fish completely < 12 ounces fish/week if purchased in stores or restaurants Source: Food and Drug Administration

  29. Healthy Fats: Flaxseed Oil Benefits: • Source of omega – 3 fatty acids and fiber • Reduces heart disease risk • Contains cancer-fighting lignans Hints: • Grind the seeds just before using • Store the seeds in the refrigerator • Sprinkle on cereal, salads, baked potatoes, cottage cheese and yogurt • Add to muffin and bread recipes

  30. Healthy Fats:Plant Stanols & Sterols Benefits: Interferes with dietary cholesterol absorption in the gut Decreases LDL-cholesterol by 10-15% in 2 weeks How Much? Take Control or Benecol margarine - 2 Tbsp/day Benecol Smart chews - 4/day Minute Maid Heartwise orange juice – 2 cups/day

  31. USDA Dietary Guidelines:Healthy Carbohydrates Total carbohydrate intake: 45-65% of total daily calorie (Example: 190-245 grams for a 1500-calorie diet) Fiber intake: 14 grams per 1000 calories Include healthy carbohydrate foods daily: Fruits, vegetables, whole grains, legumes, and low-fat milk products.

  32. Grains Group: 6+ servings per day whole grain breads, cereals, rice, pasta, crackers, pretzels, etc. Healthy Carbs

  33. Fruit Group: 4 servings per day fresh, frozen, light-packed canned, dried or juices Vegetable Group: 5 servings per day raw, cooked or juice Healthy Carbs

  34. Healthy Protein Protein Group: • 2 small servings per day (5 ounces total) • fish, poultry, red meat, nuts, nut butters, cheese, eggs, dried beans and peas, veggie burgers

  35. Soy Protein Action: Reduces Total and LDL-cholesterol Reduces triglyceride levels  Improves elasticity of arteries How Much Per Day? FDA suggests 25 grams per day for heart health (2-3 servings of soy products) More information: www.soyfoods.com; www.talksoy.com

  36. Dietary Soy Additions Breakfast: Soy milk on cereal Soy milk fruit smoothie Snacks: Soy milk yogurt (SILK) Roasted soy nuts Lunch: Soy milk cheese added to sandwich or salad Dinner: Marinated tofu – ricotta cheese stuffed shells Soy ground beef chili Soy burger on whole grain bun

  37. Homocysteine High levels of this amino acid in the blood may increase heart disease risk. Higher homocysteine levels are found in … Men Advanced age Excess weight Excess alcohol Smoking High blood pressure Without multivitamin - mineral supplement

  38. Folic Acid dried beans and peas, spinach, orange juice Vitamin B6 bananas, avocados, spinach and other greens Vitamin B12 beef liver and fish B-Vitamins To Reduce Homocysteine

  39. Shop By Color BLUE blueberries RED cherries, raspberries, grapes strawberries, tomatoes, peppers PURPLE grapes, cabbage GREEN spinach, broccoli, collard greens, peppers, kiwi ORANGE oranges, tangerines, cantaloupe, carrots, sweet potatoes

  40. Vitamin A (Beta Carotene)RDA=5,000 IU IU Carrots, 1 large, raw 11,000 Sweet Potato, 1 small 8,100 Carrots, ½ cup cooked 7,600 Spinach, ½ cup cooked 7,200 Winter Squash, ½ cup 4,300 Cantaloupe, half 3,300 Broccoli, 1 large stalk 2,500 Apricots, 2 dried 1, 600 Tomato sauce, ½ cup 1,100

  41. Polyphenols Don’t forget the dark chocolate for protective polyphenols!Reference: Journal of the American Medical Association, 2003.

  42. Calcium-Rich Foods May… • Prevent high blood pressure • Protect bones and prevent osteoporosis • Help with weight loss • Prevent colon cancer

  43. Bone Up on Calcium Calcium Recommendations Teens 1,200 mg/day Adults (over 22 years) 1,000 mg/day Postmenopausal women 1,500 mg/day Men over age 65 years 1,500 mg/day Source: NIH Consensus Conference on Calcium

  44. Calcium Food Sources Yogurt, 1 cup 400 mg Milk, 1 cup 300 mg Calcium-fortified soy milk, 1 cup 300 mg orange juice, 1 cup 300 mg Cheese, 1 oz 200-250 mg Tofu, ½ cup 260 mg Salmon, 3 oz. 200 mg Turnip greens, ½ cup 100 mg

  45. DASH to Better Health(Dietary Approaches to Stop Hypertension) Daily Recommendations from the DASH Study: Lots of Fruits and Veggies 8 – 10 servings Low-fat Dairy Products 2 – 3 servings Fish, Poultry, Lean Meat 1 – 2 small servings Nuts, Seeds, Legumes 4 – 5 servings per week Reference: www.nhlbi.nih.gov/health

  46. Sodium Guidelines Adequate Intake Per Day Young and middle aged adults 1,500 milligrams 50 years and older 1,300 milligrams 70 years and older 1,200 milligrams Reference: The Institute of Medicine Safe upper limit: 2,500 milligrams Note: 1 teaspoon salt = 2,300 mg sodium

  47. Menu Ideas Breakfast Old-fashioned oatmeal w/ fresh blueberries Skim or soy milk Snack Seasonal fresh fruit

  48. Menu Ideas Lunch Soup w/ beans, barley, and vegetables Rye Krisp or whole grain crackers Low-fat yogurt w/ fresh fruit Snack Seasonal fresh fruit

  49. Menu Ideas Pre-Dinner Grape juice, 1 cup + Handful of nuts Dinner Fresh salmon, brushed w/ olive oil Baked sweet potato Steamed spinach tossed w/ olive oil & garlic Snack Seasonal fresh fruit cup

  50. Eat Well to Be Well Rita Smith, MS, RD, CDE Registered Dietitian Certified Diabetes Educator rita.smith@mjh.org

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