Title: Nutrition Intervention of CHD
1Nutrition Intervention of CHD
- Amanda IOns Registered Dietitian
2 Water
- Drink 2 litres or less of water per day
- (if you on fluid restriction, adhère to doctors
recommandations) - Water is the most important nutrient
- Restrict your intake of sodium to 1.5 g per day.
Non CHD adults restrict to 2.3g/day - Eat potassium rich foods each day such as banana,
pawpaw, potatoes, tomatoes, strawberries
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5Water- our most important nutrient
6The Importance of Drinking Water
7Salt
- Is often HIDDEN in food
- Names mono sodium glutamine or glutamate
- Powders- sauces, soups, biltong
- Pies, chips, fizzy colddrinks, processed/instant
foods - Be careful with potassium salt or salt
replacements - Use herbs and spices
86-8 glasses per dayhigh salt intake and high
fluid intake may lead to fluid retention and high
blood pressure
9Vitamins and Minerals
- Vitamin D- deficiency may cause
- Rickets
- Hypertension
- CVD
- Heart Failure
- Peripheral arterial disease
- Sources sunlight 20minutes/day
- Dairy products, oily fish, egg yolk and cod liver
oil or fish oils, supplement - Vitamin C
- Vitamin E
- B-vitamins
- Magnesium and Potassium
- Zinc, Selenium
10Fruit and Vegetables
- Two main functions
- Soluble fibre
- Plant sterols , sterolins and other
phytontutrients - Vitamins and minerals
- Also a source of CHO
- apple pectin and phytonutrients
- An apple a day keeps the doctor away.
11Berries (mixed)
- All Berries are a very nutritious food source.
- They are one of fruit and foods with the most
alkalising effect on the body. - A poor diet, high in alcohol, coffee, sugar,
smoke and unhealthy red meat will cause the body
to become more acidic. Often manifesting as gout
(purines) or other inflammatory diseases. - Very high vitamin C
- Phyto chemicals in skin and fruit
- Eat as desert or smoothie.
12FibreWe need a total of 25-35g fibre (both
soluble and insoluble) dailyor 14g fibre per
1000kcal AI.
- Whole grains (insoluble fibre)
- Fruit and Veg (soluble fibre)
13FibreNeed 25-35g fibre per day
- Fibre is very important for gut health and to
lower serum cholesterol levels. - Gut micro-flora
- Bile secretion- reduce serum cholesterol
- Satiety effect, consequently reduce fat intake
- Get soluble fibre fruit, vegetables, oats, oat
bran, legumes- most important fibre. - Insoluble fibre wheat, bran, whole grains- stool
bulking effect
14How to increase your fibre intake
- Eat high fibre cereals, whole wheat breads, pasta
and brown rice. And Legumes. - Eat 5-6 servings fruit and vegetables per day and
try to leave skins on. - Eat high fibre low fat snacks e.g. Raw
vegetables, fresh fruit and popcorn. - Check labels for fibre facts- list the amount of
fibre per serving or the words bran, whole wheat
flour listed as one of the 1st five ingredients.
15Fibre Content of Various Foods
Selected Sources and Amounts of Dietary Fiber
Food Amount Soluble Fiber, g Total Fiber, g
Legumes (cooked)
Kidney beans 1/2 cup 2.0 6.7
Pinto beans 1/2 cup 2.0 6.7
Vegetables (cooked)
Brussels sprouts 1/2 cup 2.0 3.8
Broccoli 1/2 cup 1.1 2.6
Spinach 1/2 cup 0.5 2.1
Zucchini 1/2 cup 0.2 1.6
Fruits (raw)
Apple 1 medium 1.2 3.6
Orange 1 medium 1.8 2.9
Grapefruit 1/2 medium 1.1 1.8
Grapes 1 cup 0.3 1.1
Prunes 6 medium 3.0 8.0
Grains
Oatmeal (dry) 1/3 cup 1.3 2.8
Oat bran (dry) 1/3 cup 2.0 4.4
Corn flakes 1 ounce 0.1 0.3
Brown rice (cooked) 1/2 cup 0.4 5.3
Whole-wheat bread 1 slice 0.4 2.1
White bread 1 slice 0.2 0.4
16Legumes
- Hydro ½ cup cooked dried beans, lentils per day.
- Include in meat/salads/rice/veg
- ? Glycaemic Index
- Insulin- explained
- Contribute to euglycaemia
- Tolerance- bacterial overgrowth
- Vegetarian meals approximately 3 times a week.
17Insulin/Glucose Peak
18Glycaemic Index Chart
19Glycaemic Load
20Sugars and Sweeteners
- Sugar- sucrose has medium glycaemic index
- Honey- health properties, but high glycaemic
index - Insulin-peak, dip (revisited)
- Artificial sweeteners
- www.gifoundation.com
21Confectionary
- Limit
- low GI (avoid insulin peak)
- Look for healthy recipes and alternatives
- Eating for Sustained Energy by Liesbet Delport
and Gabbi Steenkamp - Chocolate- limit, black chocolate, 70 and more
cocoa. Or cocoa drink with low fat milk, limit
sweetener.
22Dairy Products
- Very important source calcium, B-vitamins,
vitamin A ,D and protein. - Not essential in adult diet- easily replaced
- Vitamin D- deficiency may cause hypertension,
CVD, Heart Failure, Peripheral Arterial Disease - Calcium supplement
- For cholesterol lowering purposes and weight
management, low fat is best. - Nutritious, Organic vs non-organic
- rBST free, free antibiotics, free range
23Healthy cows in natural environment
24Beef
- Not all beef is unhealthy
- Always remove visible fat from meat
- Always eat lean meat e.g. Lean mince
- Free range beef- during winter months reduced
saturated fat and omega 6 fatty acids from grass
diet. - High corn diet, high hormone rich meat, usually
with antibiotics. - Meat bought may or may not be grass fed beef.
25Lean meat cuts
- Lean cuts
- Avoid organ meats- high in saturated fat and
cholesterol - Avoid shell fish- high cholesterol
- Eggs- err on caution- use 3/ week
- No evidence increase cholesterol
- Serum cholesterol levels more affected by types
and amount of fats we eat, fibre content diet,
exercise and water than the amount of cholesterol
eaten. - All animal products contain cholesterol
- No plant product contains cholesterol
26Ostrich meat, considered healthy alternative
27Free range chickens
- Health benefits of diet free of antibiotics and
hormones - The chicken meat has lower fat content, fowl eats
natural diet.
28Tunnel Produced Chickens
29Free Range Chickens
- Cholesterol
- Less than 300mg/ day for healthy adults
- Less 200mg/day for adults with high levels of LDL
(BAD) cholesterol or who taking cholesterol
lowering medication. - Eggs- fatty acid content and cholesterol content
- 1 egg on average has 200mg cholesterol and 5g fat
- Benefits protein, vit D, riboflavinfolate folate
30Nuts
- Contain fibre, calcium, protein and essential
fatty acids. - Most nutritious nut to eat is the raw, unsalted
almond. - Concentrated energy source, eat it in limited
quantities ¼ cup or 7-14 nuts. - Natural energy from the sun- we cant measure it
in calories.
31Nuts
- Omega 3 fatty acid
- Walnuts
- Omega 6 Fatty acid
- Soy nuts
- Monounsaturated fat
- Almonds, cashews, peanuts, pecans, and butters
made from these nuts.
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33Fats and Oils
- All Seeds are important
- They contain essential poliunsaturated fatty
acids. - Fats and fatty acids are a very important part of
management of Heart disease. - Saturated fat- animal fats, must be reduced to 7
or less than 14g if you follow a 2000 calories
diet. - Poliunsaturated fats 10 of total fat intake e.g.
Omega 3 and 6 fatty acids. - Trans fats- dangerous, rancid fats, found in
brick margarine and damaged sunflower oil. Try
and have none- must be less 1 of your total
calories. - Read labels
34Oils
- Olive oil mono-unsaturated oil
- (only one unbound carbon)
- Canola mix
- Avocado pear oil
- Grape seed- polyunsaturated oil with highest
smoking temperature - Fry food- avoid, only occasionally,
- All oils are damaged when heated
- look for cold pressed oils
35Comparison of Dietary Fats
36Fish-wild salmon, pilchards
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38Fatty acid supplements
- Dosage 1000mg ( EPA and DHA) omega 3 fatty acid
for CHD patients. - 2-4g EPA and DHA per day for triglyceride
lowering effect. - Non cardiac patients 1000mg/day of EPA and DHA.
OR eat oily fish 2 x per week (rich in linolenic
acid) also include flaxseed, canola oil, soybean
oil, flaxseeds and walnuts. - Caution contraindicated if on blood thinners
- Cholesterol lowering properties higher in fish
source of oil than plant (more active molecules
and body just absorb) - Omega 6 fatty acids 1000mg / day
- Star flower, flax seed oil, evening primrose oil.
39The Benefits of Omega 3 fatty acids
40Flaxseed oil vs. Salmon oil
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42Conclusion
- Watch your
- Water
- Fibre
- Fats and oils
- Sufficient plant phytonutrients and vitamins and
minerals - Exercise/relaxation/Sunshine
43Laughter is good for the heartand strength to
the bones.
44Contact Details
- Amanda IOns
- Cellphone number 0792973936
- Email address avions.burg_at_gmail.com
- High Rustenberg Hydro 021-8093800
- Stellenbosch