Start with a Healthy Heart!

healthy heartIt seems appropriate that February would be National Heart Month.  After all, it brings us the Valentine’s Day holiday.  That gets us thinking of  hearts in a happy way.  However, we need to be serious when thinking about keeping our hearts and blood vessels healthy.   Did you know that heart disease kills one in three women while breast cancer kills one in twenty-nine?  It also takes the lives of thousands of men.  One thing that really stands out to me with heart disease is we absolutely can make changes in our lifestyles that can reduce our risk of getting it or at least delay its progression.  Diet, exercise, medication and stress control can significantly impact your  heart health.   If you have a family history of cardiovascular disease – you really need to pay attention and be proactive with regards to cardiovascular care  It’s never too early to start heart healthy eating.  Include plenty of fruits, vegetables and whole grains as a daily part of your children’s diet, starting  in toddlerhood so they develop a taste for those foods and develop lifelong good eating habits.

What are some changes you can make that can significantly reduce your risk of a heart attack or stroke?  Primarily keeping your cholesterol (LDL and HDL) and triglycerides in check and maintaining a normal blood pressure.   How can we do that?  Start by knowing your baseline lipid  laboratory values (cholesterol, LDL, HDL, triglycerides).  I am a firm believer that teens need to get their lipids checked to make sure there is no early indication of  plaque formation.   Now you will not get a recommendation for this from your physician or pediatrician but I think it’s important to have a starting point – especially if you have a family history.  Prevention is the key!  Keeping those arteries clear at a young age is vital!  Cholesterol numbers should be checked every five years if results are within normal limits.   If you have abnormal values,  labs need to be drawn more frequently.  Normal values are:

  • Blood Pressure – 120/80 or below
  • LDL cholesterol – Optimal is considered to be below 100.  Above optimal – 100-129.  Borderline high – 130-159.  High 160-189.
  • HDL cholesterol – Optimal is considered 60 and above.  Less than 40 in men and less than 50 in women is considered low – higher risk of heart disease.
  • Triglycerides – 150 or below is considered normal.  150-199 is mildly high.  200-499 is high.  500 or higher is very high.
  • Cholesterol – Less than 200 is desirable.  200-239 is borderline.  240 and above is high.

Please note also that if you have heart disease or blood vessel disease, some experts recommend your LDL cholesterol be below 70.  This you would need to discuss with your physician.

LDL cholesterol (low density lipoproteins) are the “bad” guys.  They carry cholesterol to the cells and cause plaque to form on the artery walls.  Genetics, smoking, obesity, a high saturated fat diet and a sedentary lifestyle all contribute to higher levels of LDL’s.  HDL cholesterol (high density lipoproteins) are the “good” guys.  They carry cholesterol away from the cells where it goes to the liver for reprocessing.  Recent studies have also shown that the antioxidant and anti-inflammatory properties of HDL may inhibit the buildup of plaque on artery walls.  For every one point increase in HDL, there is a three percent decrease in a person’s risk of suffering a fatal heart attack.  That’s motivating to get your HDL number up!  How can we increase HDL?  Exercise, weight loss, increasing dietary fiber, consuming omega-3 fatty acids, limiting intake of simple carbohydrates (yup), and choosing mono- and polyunsaturated fats over saturated fats can all help increase HDL levels.

One of the most important dietary considerations for keeping your heart healthy is making sure you get enough fiber.  Fiber has been proven to help lower LDL cholesterol.  Haven’t you seen those Cheerios commercials?  Do you know you would have to eat 28 bowls of cereal to meet your needs for the day?  They boast about all the fiber in Cheerios but there is really only 1 gram/serving.  Ok – back to business.  Incorporate fiber into your diet as often as possible.  The recommended amount of fiber for children and adults is 14 grams per 1000 calories.  That pretty much means about 14-21 grams for children and 28 grams for adults per day.  Good sources of fiber include oat cereal, lentils, beans, fruits/vegetables, whole wheat and whole grains.  You really have to make an effort to get your fiber.  Some foods with the highest amounts of fiber are  black beans (15 grams/cup), raspberries (8 grams/cup), pears (5.1 grams), oatmeal (4 grams/cup).  To see a list of high fiber foods go to www.todaysdietitian.com/newarchives/063008p28.shtml.

Next, you want to make sure you are getting a healthy dose of omega-3’s.   Omega-3 fatty acids from fish and flaxseed are found to help protect against heart disease, specifically they help lower triglyceride levels.  Elevated triglycerides are associated with an increased risk of coronary artery disease which increases your chance of heart attack or stroke.  Foods high in omega-3s include salmon, sardines, walnuts, and flaxseed.image11

Plant sterols and stanols have been linked with a reduction in LDL cholesterol.  Foods that are high in these compounds include brussel sprouts, beets, oranges, cauliflower and whole grains.  You can also find some products fortified with these such as margarine spreads.

Bottom line is that you need to know your  blood lipid numbers.  Follow a diet high in fiber, omega-3’s and plant sterols and stanols.   That pretty  much covers fruits, vegetables and whole grains – things we all should be including in our diets anyway.  Don’t smoke.  Keep stress under control.  Exercise!   If you have a family history of heart disease, see your doctor or a cardiologist prior to age 40.  Don’t wait until something happens.  Our genes are very powerful predictors of our future health.   Some people find that their weight is within normal limits, they don’t smoke, they work out regularly, and eat well but still have elevated cholesterol.   It is possible.  If all of those things don’t keep your numbers in a healthy range, do what you need to do.  It you need to be on medication for your cholesterol and/or blood pressure, do it!  The Mayo Clinic has a heart disease risk calculator tool www.mayoclinic.com/health/heart-disease-risk/HB00047.  Try it and see where you fall.  Be proactive and be heart smart!

“An ounce of prevention is worth a pound of cure.”  Benjamin Franklin

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Label Reading for Kids

One of the best things we can do for our kids is to provide them with knowledge to help them make good choices.  We do this with many aspects of their life.  We educate them so they can make smart decisions when they are with their friends, doing school work, perhaps with a job if they have one.  Providing them with the information and resources needed to make good nutritional choices is also important.  We can tell them what we think they should and shouldn’t be eating, how much, how often.  Kids often respond better if they feel they have more control.  If they know how many calories or how much fat or sodium they should be consuming in a day, they can utilize this knowledge to help them make better choices.  For many adults, label reading is confusing but this skill is one way to obtain the facts needed to help make educated food selections.  Hopefully, this blog will help to clarify some things.

The first thing on a food label kids should be wary of is serving size.  Often they are not thinking in these terms when pouring a bowl of cereal and milk.  For instance, if they are having a bowl of Honey Nut Cheerios (serving size 3/4 cup) with 1/2 cup of skim milk they may look at the label thinking they are consuming 150 calories.  However, they could easily be doubling that serving size of cereal (220 calories) and maybe using either using more milk or whole milk.   Their 150 calorie bowl of cereal could easily end up being 350 calories or more.  That may be absolutely fine but the important thing is they are not mislead.  You can even take out some measuring cups and help them learn what different portion sizes look like.  Soon they will be able to eyeball it.  Also, sometimes so-called “individual” packages of things often mislead us into thinking there is only one serving inside.  Double check labels to make sure it is a single serving especially with potato chips, ranch or other individually packaged dips, cookies, popcorn, and many other snack foods.

Next on the labels are the total calories.  This tells you how much “energy” you will get from one serving of food.  Remind your young one to watch foods high in calories as energy that doesn’t get used will get stored as fat.

Calories from fat tell you how many calories come from fat in a particular food.    As a general guideline, try to select foods with 5 grams or less per serving.  Also, avoid foods that contain trans fat (raises LDL (bad) cholesterol, lowers HDL (good) cholesterol) and foods that are high in saturated fat.   Total daily saturated fat intake, on average for a child, should be about 20 grams.  Overall fat intake should not exceed 30% of total caloric intake per day.

Cholesterol should not exceed 300 mg a day for adults.   If your child has risk factors for a tendency to have elevated cholesterol, it would be wise to try to limit total intake to 200 mg/day.   Cholesterol is only found in foods that come from animals so pay special attention to meat, eggs, and dairy products.

Dietary fiber is an important part of all of our diets.  It has been shown to significantly reduce your risk of developing heart disease, diabetes, obesity, and certain gastrointestinal diseases.  It helps in reducing blood pressure and cholesterol.  Increased intake of soluble fiber improves insulin sensitivity not only in diabetics but also non-diabetics.  Clearly you can tell I am a fiber fan!  Getting our kids to incorporate foods that contain fiber in their diets and retain this as a lifelong habit can help maintain good overall health.  That being said they should consume 10-20 grams of fiber per day (or 5 grams plus your child’s age).  Fiber is found in many foods that come from plants.  Of course, awesome sources are fruits, vegetables, and whole grains.

Sodium is another nutrient that we sometimes don’t get concerned about until adulthood.   Although there is no set recommendation for kids, adults should be consuming no more than 2,400 mg/sodium per day.   Those with heart, kidney, and other diseases should consume much less.  For reference, one teaspoon of salt contains 2,300 mg/sodium.  Teach your child to take note of how much sodium is in foods.  Check out the sodium in processed or convenience foods with your son or daughter – this  may really surprise them.  Also, be aware that restaurant foods tend to really overdo the sodium.

Sugar!!  How much is too much?   There has been a lot of talk regarding sugar lately.  The American Heart Association recommends children consume no more than 12 gms/day (3 teaspoons).  Realistic?  I think not.  I have seen suggested limits of 40 gms per day.  I think the key here is to check the label and BE AWARE!  For example, one half cup serving of Edy’s Cookies and Cream ice cream has 15 gms of sugar.  This already exceeds the AHA’s recommendation for the day!!!  There will be more to come on this topic…

FYI, the percent daily value on a label gives the percentage of certain nutrients that a person will eat in one serving based on a 2,000 calorie diet.   Based on this amount, 600 calories should be coming from fat.  When reading your label, if food contains 110 fat calories, you would have 490 left for the day.  Remember your child’s caloric needs may be higher or lower than 2000 per day, so just use this as a general guideline.

Finally,  when checking the ingredient list, remember items are listed in greatest quantities first.  Watch out for words such as high-fructose corn syrup, corn syrup, sugar, and dextrose especially when listed as one of the first few ingredients.  Also, try to avoid foods that contain hydrogenated or partially hydrogenated vegetable oil, lard,  and coconut and/or palm oils.

My basic philosophy is everything in moderation.  However, learning to read food labels provides us with information to make choices.  The earlier our kids learn this, the more likely it is to become a lifelong practice.   Remember…

“Knowledge is power.”  – Sir Francis Bacon