Patient Education & Resources

Patient Education Module 6 - Nutrition 1

Following a lower fat diet may actually allow you to eat more food than before because fat has twice the calories of protein or carbohydrates. So you don't have to starve yourself or deprive yourself of delicious meals to keep healthy. You can't change your heredity, but you can change your lifestyle.

Canada's food guide recommends an increased intake of grains, fruits and vegetables and less fat and alcohol.

Good nutrition is often an effective treatment for increased cholesterol.

Guidelines to a Heart Healthy Diet

A heart healthy diet is:

• Low in fat (saturated & trans fats)
• High in fibre
• Low in salt
• Low in sugar

The easiest way to reduce the total fat is to cut back on the foods that contribute the most total and saturated fats to your diet (animal products, and the fat and oil group). Some foods contain a surprising amount of fat, so the best way to know for sure is to consult a detailed guide to fat content. Published guides include:

• T-Factor Diet
• The Heart and Stroke Foundation Cookbook (Light Hearted Cooking)
• Any of the books by Dean Ornish

All of these are excellent information sources on fat content. (Some or all of them may be available for purchase in the Rehabilitation/Risk Factor Management Clinic.)

Try to end up with a system to apply to your lifestyle on a daily basis. Buy a low fat cookbook to help you out, many are available (ask your health care worker for guidance). Remember, this is not a short term diet, but a new and permanent lifestyle.

Fruits and Vegetables

• Try all kinds of fruits and vegetables.
• Eat them fresh, raw, in juices or canned in unsweetened juice. Cook your vegetables and potatoes lightly: steam, pressure cook, bake or micro­wave
• Eliminate deep frying
• Savour your vegetables and potatoes without adding fats (butter or margarine) or creamy sauces. Try a squeeze of fresh lemon or lime on carrots, beans, broccoli etc.
• Avoid coconuts
• The recommended serving per day is 5. One serving would equal a medium size vegetable or fruit, or 1 cup of salad, or 1/2 cup of juice. Remember that grapefruit juice should not be taken with certain medications, such as some statins. Check with your pharmacist.

Breads and Cereals

• Try different kinds of breads and cereals (brown rice, bulgar). Pitas, pasta and low fat muffins are all good choices
• Choose whole wheat products
• Limit the amount of fat you use on your bread, muffins
• For pasta choose tomato sauce instead of cream based sauces
• While you are getting on track, try to increase fibre in your diet by eating whole wheat bread, and perhaps try legumes weekly as a meat alternative
• The recommended serving is 5 per day. One serving of bread would be equal to the size of the palm of your hand. One serving of cereal would be equal to the size of a tennis ball.

Meats, Fish and Poultry

You may have heard that you should avoid red meat completely. This is because the fat that surrounds red meat and the white streaks or marbling in the meat contain a lot of saturated fat and cholesterol.

• Look for beef with only a small amount of marbling
• Try to buy cuts of meat with round or lean in their names
• Trim fats from all meats and remove skin from poultry before cooking
• Most important of all, cut down on portions; if you want a steak, eat a 3 or 4 oz steak instead of a 6 or 8 oz portion
• Pork is acceptable if it's a lean cut such as tenderloin, or chops with the fat cut off, but again, eat smaller portions
• Avoid cold cuts high in fat such as bologna, salami,and other processed meats such as sausages, bacon and wieners. A better choice would be lean cold cuts such as smoked turkey, low fat ham slices, fresh turkey, black forest ham or beef slices
• If you like fish, try to eat it twice a week but avoid fish canned in oil or preparation methods that include frying. Be aware that what you put on your seafood dish may contain more fat than the food itself - don't put butter sauce on your shrimp or lobster!
• Skim fat from stews and soups (refrigerate and fat will harden quicker)
• A recommended serving per day is 2-3 servings. One serving would be equal to 3oz of cooked meat. Your meat portion should be about the size of a deck of playing cards and should make up no more than 1/4 of your meal

Dairy Products

When making choices from dairy products, you will see M.F. or B.F. on the packaging, which means milk or butter fat.

• Aim for M.F. or B.F. less then 1% with milks and yogurts, and cheeses less than 7%
• try to reduce the amounts you eat as well

Avoid:

• creams such as half and half, whipping cream and sour cream.
• non-dairy creamers (because they contain coconut and palm oil, which are high in saturated fats), butter, cream and ice cream -- they have even more saturated fat in them than whole milk

Beware of butter and cream hidden in casseroles and other mixed dishes, baked goods and desserts. In some recipes, margarine or vegetable oil can be substituted for butter. Use low fat yogurt in sauces. A recommended serving per day is 2-4 servings. One serving would be equal to 1 cup of milk or 3/4 cup of yogurt, or a one-inch cube of low-fat cheese.

Eggs

Egg yolk is high in cholesterol. Limit yolk to two per week. This includes eggs used in baking. Two egg whites can replace one whole egg in baking. Egg substitutes and egg whites are a good choice.

Fats and Oils

If a fat is hard or solid at room temperature, it is saturated (for instance, butter and lard). If it is liquid at room temperature, it is unsaturated, such as:

1. monounsaturated (found in olive or canola oil)
2. polyunsaturated such as corn oil sunflower and safflower oils

Polyunsaturated or monounsaturated oils can be used in baking, frying and in salad dressings and can help lower the cholesterol in your blood. Don't go overboard though, as all fats are a rich source of calories. Each tablespoon of oil contains about 13 grams of fat or 120 calories.

• Choose soft non-hydrogenated margarine, which is high in polyunsaturates and monounsaturates. Look for the saturated fat content to be at least half of the poly­unsaturated fat content, in not only margarines but in all products
• Avoid palm oil, coconut oil (tropical oils), which are found in prepackaged foods
• Look out for the word hydrogenated, because it turns into saturated fats in the body
• The recommended intake of oils per day is 3-6 servings per day. One serving is a teaspoon of oil or margarine (about the size of your thumbnail). For weight loss, consume even less.