CARDIAC REHAB THERAPEUTIC LIFESTYLE CHANGES DIET T.L.C. WHAT ARE THERAPEUTIC LIFESTYLE CHANGES? Diet Exercise Habits Smoking Habits Weight Blood Pressure Control WHY DO WE NEED TLC? For those with Cardiac Disease or at high risk for Cardiac Disease Helps to lower the Bad Cholesterol (LDL), raise the good Cholesterol (HDL), improve Total Cholesterol levels, and improve Triglyceride levels. Prevent future heart attacks. THE TLC DIET Cholesterol: < 200 mg/day Total Fat: 25-35% of total calories Saturated Fats: < 7% of total calories Monounsaturated Fats: Up to 20% of total calories. Polyunsaturated Fats: Up to 10% total calories. Trans Fatty Acids: No established amount Total Calories: Balance calorie intake with calories burned to achieve desirable body weight and prevent weight gain. THE TLC DIET Plant Phytosterols Increased Soluble Fiber Soy Products Omega 3 Fatty Acids CHOLESTEROL A Fat-like substance found in animal products. Raises cholesterol levels in the blood. Sources of cholesterol: Egg yolks, meats, dairy, etc. Less than 200 mg cholesterol/day TOTAL FAT: There is a range of total fat recommended – 25-35% of calories. Usually with diabetes or metabolic syndrome, the level of total fat is higher. Saturated fats should still be very low, polyunsaturated and monounsaturated fats moderate. GRAMS OF TOTAL FAT Fatis measured in grams. Each gram of fat has nine calories. Some examples of total fat intake and calorie levels: 1200 calories - 25% fat - 33 grams 1500 calories - 25% fat - 42 grams 1800 calories - 25% fat - 50 grams SATURATED FATS: These fats are usually found in animal products, but can be in some vegetables. Usually solid or hard at room temperature. Raises blood cholesterol more than any other fat in the diet Foods high in “sat fat” – coconut, bacon, sausage, cream, sour cream, hotdogs, bologna, cheeses, etc. These fats should be a small part of your diet. POLYUNSATURATED FATS: These fats are usually from a plant source. When polyunsaturated fats replace saturated fats, the LDL levels decrease. Sources are: Soybean, sunflower, cottonseed oils; margarines made from these oils. MONOUNSATURATED FATS: These fats are usually found in plant sources. These fats can be substituted for carbohydrates with metabolic syndrome or diabetes Sources: Many nuts, olive, peanut and canola oils. TRANS FATTY ACIDS: These fats come from plant sources, but are liquid oils that have been processed and are made hard like saturated fats. These fats raise the cholesterol and LDL levels in the blood. Sources of these fats are: Stick margarine, Crisco-type fats, baked goods, breads, snack foods, donuts, etc. TOTAL CALORIES: How many calories do we need? Multiply your weight by 10-12 and that is your calorie level for weight maintenance. Subtract 500 calories/day for each pound weight loss/week. Balance calories by eating a little less and exercising a little more. PLANT PHYTOSTEROLS: These foods are found in plants and are thought to help lower cholesterol. Phytosterols are also added to foods, like margarine, spreads, cereals and cereal bars.. Natural sources are: vegetables, nuts and seeds. SOLUBLE FIBER: These foods have a “gel- like” substance that may help to lower cholesterol and LDL levels. Sources of soluble fiber: Oats, whole grain breads, dried beans and peas, apples, oranges, green beans, sweet potatoes, almonds, etc. We need 10-25 grams/ day. SOY PRODUCTS: Soy foods can be substituted in the diet, in place of animal proteins to help lower LDL levels. Studies show that soy protein may improve cholesterol, improve hypertension, and improve blood vessel health. Sources of soy are: tofu, edamame, meat replacements, soy milk, roasted soy nuts and more. Substitute 25-50 gm of soy protein for animal protein each day to lower LDL. OMEGA 3 FATTY ACIDS: These fats can be found in fish as well as some plant sources. Studies show that these fatty acids have potential benefits for preventing heart disease. Sources of these fats are: salmon, mackerel, sardines, herring, trout and plant sources, flax, canola, walnuts and soy products. It is recommended to add 2 servings of fish weekly to increase omega 3 fatty acids. EATING WELL WITH THE TLC DIET The TLC diet calls for a variety of foods. It is a mixture of foods that are low in saturated fats, trans fats and high in fiber and taste! It will satisfy your tastes and your heart! EATING WELL WITH TLC: BREADS/CEREALS/GRAINS We need 6 or more servings/day A serving is 1 ounce or 1 cup These foods can be higher in fiber, vitamin B complex, calcium, and iron. These foods are usually low in saturated fats, cholesterol, and total fat. Use whole grains breads, cereals, rice, crackers and low fat cookies and desserts. EATING WELL WITH TLC: VEGEGABLES, BEANS, PEAS We need 3-5 servings each day. A serving size is ½ cup cooked and 1 cup raw. These foods are good sources of vitamins, fiber, minerals, protein and other nutrients. Use fresh or frozen to reduce sodium and get plenty of fiber. All are great for you! EATING WELL WITH T L C: FRUITS We need 2-4 servings each day. A serving is one piece or ¾ cup. Good sources of vitamins, fiber and sweet flavor. Use fresh or frozen or “light” canned fruits. All are great for you! EATING WELL WITH T L C: DAIRY FOODS We need 2-3 servings each day. A serving size is 8 oz. or 1 cup These foods provide Calcium, Vitamin D, protein, and carbohydrates. The best sources are fat-free, skim or low fat milk, cheeses, cream cheese, sour cream, non-dairy creamer and frozen products. EATING WELL WITH T L C: PROTEIN FOODS: MEATS We need 5 ounces each day or less. A serving = 1 ounce Choose lean red meats: sirloin, round, rump, tenderloin, loin, etc. Limit organ meats. Choose red meats less often. All meats, even fish and chicken, have fats and cholesterol. EATING WELL WITH T L C: POULTRY, FISH AND EGGS Choose skinless poultry. Choose any fish product. Bake, broil, stew, grill, poach – DO NOT FRY! Try to eat 2 servings of fish/week. Choose egg whites any time – only 2 egg yolks each week. EATING WELL WITH T L C: FATS AND OILS We need about 3-6 servings of added fats/day. A serving is 1 teaspoon. Choose canola, olive or peanut oils. Choose margarines with “No Trans Fats”, liquid oil or water as the first ingredient. EATING WELL WITH T L C: EATING A BALANCED DIET Eating a variety of foods is key to staying healthy. Watching portion sizes, on the labels and by using your “eyeballs” help with weight management. Include plenty of fruits, vegetables, whole grains, lean meats and dairy and a little fat and you are set!! A WORD ABOUT CARB FOODS Good, Bad, or What? We need carbs, even with diabetes. Try to choose the more complex carbs: whole grain breads, cereals, pastas, fruits, etc. Avoid the sugars: cokes, candy, cakes, pies, etc. EATING OUT WITH T L C Choose carefully, but always ENJOY! Ask for double side veggies or salads. Ask for dressing, sauces, and butter on the side. Choose grilled, steamed, garden fresh, stir fried, blackened, etc. Ask a lot of questions and request yours prepared the way you want it. COOKING WITH T L C Use non-stick cookware with spray oil or very little (1 tsp.) oil. Start off with 90% or leaner meats. Allow soups, stew, gravies, broths, etc. to cool for several hours and remove visible fat. Use non fat milk/skim evaporated milks for creamed items. Use fat free seasonings: bouillon, fat free soups, herbs, spices, non fat sour cream, etc. HEART HEALTHY LIVING Learn to enjoy cooking and eating low fat and with less salt. It takes a little time and effort, but the rewards in taste and health will be worth it.