Eating right: We know how complex it can be. What you eat can have emotional and health impacts and can affect your family and lifestyle.
The American Heart Association offers seven simple steps to help avoid cardiovascular disease.
Some common questions about heart healthy eating are how much of an impact does sugar have on the cardiovascular system? What are the key foods to incorporate into a heart-healthy diet?
Listen in to hear answers to these questions and to learn about key components of a heart-healthy diet from Mary Lou Perry, MS, RD, a UVA registered dietitian.
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How to Maintain a Heart-Healthy Diet: It's Easier Than You Think!
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Learn more about Mary Lou Perry, MS, RD
Mary Lou Perry, MS, RD, CDE
Mary Lou Perry, MS, RD is a registered dietitian and a certified diabetes educator.Learn more about Mary Lou Perry, MS, RD
Transcription:
How to Maintain a Heart-Healthy Diet: It's Easier Than You Think!
Melanie Cole (Host): Do you know what the key components of a heart healthy diet really are? My guest today is Mary Lou Perry. She’s a Registered Dietician Nutritionist and a Certified Diabetes Educator at UVA Health System. Welcome to the show, Mary Lou. What are the seven simple steps outlined by the American Heart Association to avoid cardiovascular disease?
Mary Lou Perry (Guest): Well, thanks, Melanie. I appreciate being on. The Life’s Simple 7, actually, Seven Small Steps to Big Changes, is the American Heart Association’s call to action for the population to decrease cardiovascular risk and there are seven small steps that people are encouraged to do. One is to manage blood pressure; secondly, to keep blood cholesterol at or near normal; manage blood glucose, not smoking, and if you do to quit smoking; increasing your physical activity to at least 150 minutes a week; losing weight if you are overweight or obese; and then, finally, the one that’s near and dear to my heart, eating well. So, those are all those things that can go into a heart-healthy lifestyle and reducing the risk of cardiovascular disease or cardiovascular death.
Melanie: What’s involved in eating healthy? People see so much Mary Lou in the media and all around and it can be a bit confusing when they’re hearing about carbohydrates are not good for you or fats are not good. You should eat more protein, less protein, clear some of this heart-healthy eating up for us.
Mary Lou: There’s no doubt about it, there are lots of mixed messages out there and depending on someone’s ability to communicate, you might hear one louder than the other. But, here’s what we do know. People do not eat in nutrients. People don’t think about, “Well, I’m going to have two carbohydrates today and one fat today.” People think in terms of food and so we have to start talking to people about eating healthy, not with nutrients but eating healthy with real food. So, what does that actually look like? The big players here for heart healthy eating are always going to be fruit and vegetables. Across the board, no matter what study that you read, no matter what study population or what kind of conditions, what seems to really get filtered through one time and time again is the benefit of consuming lots of fruit and lots of vegetables. So, I would just say to somebody I’m working with, if they’re only eating, and most of us or very few of us are getting the recommended amount of fruits and vegetables. So, first, just start with that, by adding more fruits and vegetables to the way that you eat. Now, what that will mean is that you’re actually increasing healthy carbohydrates and, in doing so, you’re decreasing saturated fat, cholesterol, and total fat. But, the patient hears it or the person hears it as something that they can do--an actionable step that’s relatively simple. I can eat more fruit and vegetables. So, I get why there’s a lot of confusion but we can clear that up by just some basic, simple steps. I already talked about the benefits of fruit and vegetables and we also know that fish and regular consumption of fish is associated with decreasing cardiovascular risk and having real benefit. What’s now recommended for the population is at least two fish meals a week and, if that fish could be some kind of Omega-3 rich or rich in Omega-3 fatty acid, all the better. So, something like salmon, mackerel, or tuna, but even if it isn’t, the fact that you’re consuming seafood or fish means that you’re getting significantly less fat and significantly less saturated fat. So, we know fruits and vegetables are good; we know that consuming more fish, especially about two servings per week; we also know that there are certain kinds of fat, not so much the how much but it’s really about the what kind when it comes to fat. And, this is also where a lot of the confusion comes from. Many people have probably heard the Mediterranean diet or heard of the Mediterranean style of eating. That is what we think about when we think about a heart-healthy diets because one of the things that they do really well in the Mediterranean is eat well because they eat locally and they don’t eat processed foods. They also use lots and lots of olive oil for flavoring and for cooking. So, that’s a real important component of eating healthy and decreasing the amount of saturated fat and increasing the amount of healthy fat. That would be in the form of using olive oil when you can. Additionally, it is important to decrease saturated fat as well as cholesterol. Now, what does that look like? What’s the real food recommendation? That would be increase the amount of chicken, turkey, and lean cuts of beef that you’re eating. Decrease the amount that you’re eating and then, finally, keep the style of cooking bake, broiled or grilled so that you’re decreasing total fat, not only in the cooking but total fat in the type of meat, as well as the amount of meat. Generally, what we tell patients as a good rule of thumb is to use a deck of cards. A deck of cards is the perfect portion for a serving size of meat. So, far you’ve got eating more fruits and vegetables, consuming healthy fats such as olive oil, eating more fish, and using leaner cuts of meat or types of meat. And then, what we also know is that decreasing fried foods becomes important. That will decrease the total fat and the amount of saturated fat, and finally the calories. One of the things that we also know is that two thirds of our population is struggling with weight issues and that means that the majority of the people that we come across probably could lose some weight. To lose some weight, you want to do that slowly and you want to cut back on calories. The way to do that is to decrease high calorie foods like fried foods and snack foods. Another thing that has come about, Melanie, quite interestingly or more recently in the last couple of years, is the whole area of sugar. It used to be that sugar wasn’t recommended because of the extra calories or the impact it has on dental cavities, but now we know that sugar is probably a bigger culprit in cardiovascular disease, diabetes, and other kinds of metabolic type syndromes. If we look at population studies, we know that Americans across the board are consuming too much sugar. In fact, the average sugar consumption in a teaspoon a day, now this just isn’t added sugar but what’s contained in food, average sugar consumption for most Americans is 22 teaspoons of sugar. What the American Heart Association is saying, as well as the US Dietary Guidelines says, “Let’s cut that in half.” Cut that down to about ten teaspoons a day or approximately 100 calories coming from simple sugars or added sugars. So, that’s a very interesting thesis, something people can start thinking about. I think that the way that that would work in a meal plan is look at the beverages that you’re consuming and are you consuming regular soda pop? Are you consuming sugar-containing beverages? Cut back on those and even cut back on fruit drinks that aren’t always 100% fruit but they do contain added sugar. So, watch the beverage intake and try to limit your beverage intake to mostly water, coffee, and tea that’s unsweetened. But, again, I think we can sometimes make it more complicated than it needs to be by focusing on a micronutrient or a macronutrient. By picking on B12 or B6 or picking on carbohydrate, protein, and fat, but it really makes sense to take a couple steps back and look at it in terms of, how to I make sense of this and what do I put on my plate and how do I do this day after day? So, using those general guidelines will help people navigate a confusing world around food and nutrition when it comes to cardiovascular health. Melanie, does that answer your question?
Melanie: It certainly does Mary Lou. What an amazing guest you are. I have one last question for you, what do you want people to do? Give us your best advice when they dine out to follow these bits of information that you’ve given us today, and they were such great bits of information, but when they dine out, they look at that menu and they don’t know whether one thing is healthy or not. They see avocados. They think that’s going to be healthy but some people say that’s very high calorie, high fat food. What do you want them to know about dining out?
Mary Lou: Great question and I do want to just, as a side bar, when it comes to avocados, avocados are very healthy foods and so very high in these monounsaturated fats. Avocados, though, high in calories, they also pack a punch. So, I would say avocados on the whole are healthy because of their healthy fats. But, let me get to the real question was, what do we do when we go out to eat? How do we know how to maneuver these dietary guidelines or these dietary recommendations when we eat out? I think first and foremost, just remember, when you eat out, most serving sizes are much too large or way too big for most people. So, ask for a doggy bag, even before you order just say I want to get a doggy bag or simply split the entrée with a friend. That way you’re cutting back on literally half the calories and half the fat. Additionally, with that you want to watch out for fancified types of foods, if you will. Those are things with heavy sauces and gravies and stick with plain things. So, like a plain steak, not a sixteen ounce rib eye, but maybe a four ounce sirloin which is not covered in bleu cheese or not covered in some kind of special sauce. So, the things you want to look for words like “plain” or not fried. And then, another thing is just ask questions. Many times in a restaurant you can make wonderful substitutions that aren’t always listed or clear in the menu. So, if you’re looking at decreasing total calories or decreasing total fat, and on the menu French fries are served, ask your server if you can substitute a steamed vegetable in place of those French fries. You’re going to get healthy carbohydrate, you’re going to get a lot less calories, and you’re going to get a lot more fiber, all of which are heart-healthy. So, I would say just kind of go armed with a healthy curiosity, ask questions of your server and some restaurants are now partnering with the American Heart Association for heart-healthy entrees. So, sometimes you can even look for that as a shortcut to making healthier choices. The one piece of advice that I would give people when they’re getting fast food is to think small. So, when I say that, think like a kid. Get the kid’s meal. Most times, you can ask the fast food restaurant for the kid’s meal. That way, you’re getting much smaller portions of what’s being offered. So, I think, as a rule of thumb, when you go for fast food, think small and also ask the same questions about making some of those healthy substitutions.
Melanie: Thank you so much for being with us today, Mary Lou. It’s really great information. You’re listening to UVA Health Systems Radio and for more information you can go to UVAHealth.com. That’s UVAHealth.com. This is Melanie Cole. Thanks so much for listening.
How to Maintain a Heart-Healthy Diet: It's Easier Than You Think!
Melanie Cole (Host): Do you know what the key components of a heart healthy diet really are? My guest today is Mary Lou Perry. She’s a Registered Dietician Nutritionist and a Certified Diabetes Educator at UVA Health System. Welcome to the show, Mary Lou. What are the seven simple steps outlined by the American Heart Association to avoid cardiovascular disease?
Mary Lou Perry (Guest): Well, thanks, Melanie. I appreciate being on. The Life’s Simple 7, actually, Seven Small Steps to Big Changes, is the American Heart Association’s call to action for the population to decrease cardiovascular risk and there are seven small steps that people are encouraged to do. One is to manage blood pressure; secondly, to keep blood cholesterol at or near normal; manage blood glucose, not smoking, and if you do to quit smoking; increasing your physical activity to at least 150 minutes a week; losing weight if you are overweight or obese; and then, finally, the one that’s near and dear to my heart, eating well. So, those are all those things that can go into a heart-healthy lifestyle and reducing the risk of cardiovascular disease or cardiovascular death.
Melanie: What’s involved in eating healthy? People see so much Mary Lou in the media and all around and it can be a bit confusing when they’re hearing about carbohydrates are not good for you or fats are not good. You should eat more protein, less protein, clear some of this heart-healthy eating up for us.
Mary Lou: There’s no doubt about it, there are lots of mixed messages out there and depending on someone’s ability to communicate, you might hear one louder than the other. But, here’s what we do know. People do not eat in nutrients. People don’t think about, “Well, I’m going to have two carbohydrates today and one fat today.” People think in terms of food and so we have to start talking to people about eating healthy, not with nutrients but eating healthy with real food. So, what does that actually look like? The big players here for heart healthy eating are always going to be fruit and vegetables. Across the board, no matter what study that you read, no matter what study population or what kind of conditions, what seems to really get filtered through one time and time again is the benefit of consuming lots of fruit and lots of vegetables. So, I would just say to somebody I’m working with, if they’re only eating, and most of us or very few of us are getting the recommended amount of fruits and vegetables. So, first, just start with that, by adding more fruits and vegetables to the way that you eat. Now, what that will mean is that you’re actually increasing healthy carbohydrates and, in doing so, you’re decreasing saturated fat, cholesterol, and total fat. But, the patient hears it or the person hears it as something that they can do--an actionable step that’s relatively simple. I can eat more fruit and vegetables. So, I get why there’s a lot of confusion but we can clear that up by just some basic, simple steps. I already talked about the benefits of fruit and vegetables and we also know that fish and regular consumption of fish is associated with decreasing cardiovascular risk and having real benefit. What’s now recommended for the population is at least two fish meals a week and, if that fish could be some kind of Omega-3 rich or rich in Omega-3 fatty acid, all the better. So, something like salmon, mackerel, or tuna, but even if it isn’t, the fact that you’re consuming seafood or fish means that you’re getting significantly less fat and significantly less saturated fat. So, we know fruits and vegetables are good; we know that consuming more fish, especially about two servings per week; we also know that there are certain kinds of fat, not so much the how much but it’s really about the what kind when it comes to fat. And, this is also where a lot of the confusion comes from. Many people have probably heard the Mediterranean diet or heard of the Mediterranean style of eating. That is what we think about when we think about a heart-healthy diets because one of the things that they do really well in the Mediterranean is eat well because they eat locally and they don’t eat processed foods. They also use lots and lots of olive oil for flavoring and for cooking. So, that’s a real important component of eating healthy and decreasing the amount of saturated fat and increasing the amount of healthy fat. That would be in the form of using olive oil when you can. Additionally, it is important to decrease saturated fat as well as cholesterol. Now, what does that look like? What’s the real food recommendation? That would be increase the amount of chicken, turkey, and lean cuts of beef that you’re eating. Decrease the amount that you’re eating and then, finally, keep the style of cooking bake, broiled or grilled so that you’re decreasing total fat, not only in the cooking but total fat in the type of meat, as well as the amount of meat. Generally, what we tell patients as a good rule of thumb is to use a deck of cards. A deck of cards is the perfect portion for a serving size of meat. So, far you’ve got eating more fruits and vegetables, consuming healthy fats such as olive oil, eating more fish, and using leaner cuts of meat or types of meat. And then, what we also know is that decreasing fried foods becomes important. That will decrease the total fat and the amount of saturated fat, and finally the calories. One of the things that we also know is that two thirds of our population is struggling with weight issues and that means that the majority of the people that we come across probably could lose some weight. To lose some weight, you want to do that slowly and you want to cut back on calories. The way to do that is to decrease high calorie foods like fried foods and snack foods. Another thing that has come about, Melanie, quite interestingly or more recently in the last couple of years, is the whole area of sugar. It used to be that sugar wasn’t recommended because of the extra calories or the impact it has on dental cavities, but now we know that sugar is probably a bigger culprit in cardiovascular disease, diabetes, and other kinds of metabolic type syndromes. If we look at population studies, we know that Americans across the board are consuming too much sugar. In fact, the average sugar consumption in a teaspoon a day, now this just isn’t added sugar but what’s contained in food, average sugar consumption for most Americans is 22 teaspoons of sugar. What the American Heart Association is saying, as well as the US Dietary Guidelines says, “Let’s cut that in half.” Cut that down to about ten teaspoons a day or approximately 100 calories coming from simple sugars or added sugars. So, that’s a very interesting thesis, something people can start thinking about. I think that the way that that would work in a meal plan is look at the beverages that you’re consuming and are you consuming regular soda pop? Are you consuming sugar-containing beverages? Cut back on those and even cut back on fruit drinks that aren’t always 100% fruit but they do contain added sugar. So, watch the beverage intake and try to limit your beverage intake to mostly water, coffee, and tea that’s unsweetened. But, again, I think we can sometimes make it more complicated than it needs to be by focusing on a micronutrient or a macronutrient. By picking on B12 or B6 or picking on carbohydrate, protein, and fat, but it really makes sense to take a couple steps back and look at it in terms of, how to I make sense of this and what do I put on my plate and how do I do this day after day? So, using those general guidelines will help people navigate a confusing world around food and nutrition when it comes to cardiovascular health. Melanie, does that answer your question?
Melanie: It certainly does Mary Lou. What an amazing guest you are. I have one last question for you, what do you want people to do? Give us your best advice when they dine out to follow these bits of information that you’ve given us today, and they were such great bits of information, but when they dine out, they look at that menu and they don’t know whether one thing is healthy or not. They see avocados. They think that’s going to be healthy but some people say that’s very high calorie, high fat food. What do you want them to know about dining out?
Mary Lou: Great question and I do want to just, as a side bar, when it comes to avocados, avocados are very healthy foods and so very high in these monounsaturated fats. Avocados, though, high in calories, they also pack a punch. So, I would say avocados on the whole are healthy because of their healthy fats. But, let me get to the real question was, what do we do when we go out to eat? How do we know how to maneuver these dietary guidelines or these dietary recommendations when we eat out? I think first and foremost, just remember, when you eat out, most serving sizes are much too large or way too big for most people. So, ask for a doggy bag, even before you order just say I want to get a doggy bag or simply split the entrée with a friend. That way you’re cutting back on literally half the calories and half the fat. Additionally, with that you want to watch out for fancified types of foods, if you will. Those are things with heavy sauces and gravies and stick with plain things. So, like a plain steak, not a sixteen ounce rib eye, but maybe a four ounce sirloin which is not covered in bleu cheese or not covered in some kind of special sauce. So, the things you want to look for words like “plain” or not fried. And then, another thing is just ask questions. Many times in a restaurant you can make wonderful substitutions that aren’t always listed or clear in the menu. So, if you’re looking at decreasing total calories or decreasing total fat, and on the menu French fries are served, ask your server if you can substitute a steamed vegetable in place of those French fries. You’re going to get healthy carbohydrate, you’re going to get a lot less calories, and you’re going to get a lot more fiber, all of which are heart-healthy. So, I would say just kind of go armed with a healthy curiosity, ask questions of your server and some restaurants are now partnering with the American Heart Association for heart-healthy entrees. So, sometimes you can even look for that as a shortcut to making healthier choices. The one piece of advice that I would give people when they’re getting fast food is to think small. So, when I say that, think like a kid. Get the kid’s meal. Most times, you can ask the fast food restaurant for the kid’s meal. That way, you’re getting much smaller portions of what’s being offered. So, I think, as a rule of thumb, when you go for fast food, think small and also ask the same questions about making some of those healthy substitutions.
Melanie: Thank you so much for being with us today, Mary Lou. It’s really great information. You’re listening to UVA Health Systems Radio and for more information you can go to UVAHealth.com. That’s UVAHealth.com. This is Melanie Cole. Thanks so much for listening.