RISK FACTORS FOR HEART DISEASE

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2 RISK FACTORS FOR HEART DISEASE Non-modifiable Family history Gender Age Modifiable A pack a day smoker spends over Smoking $5,000 a year on cigarettes Inactivity Obesity Diabetes High Cholesterol High blood pressure Stress Good News! PCN has smoking cessation counseling. Book with our pharmacist today!

3 PLAQUE

4 RUPTURE

5

6 STENT/ANGIOPLASTY

7 Type Description High Risk Target Average Risk Target Total Cholesterol Combination of LDL + HDL + VLDL + other?? LDL Needed for cell growth and repair. Too much may increase plaque buildup Why it may be high: heredity; diet high in fat <2.0 <3.5 HDL Acts like a cleaner To increase: stop smoking; physical activity; maintain healthy weight; healthy oils >1.0 Men >1.3 Women Same Triglycerides A fat found in the body and is like a thick cream Why it may be high: high fat diet; heredity; excess sweets; diabetes; alcohol <1.7 Same TC/HDL Total Cholesterol/ HDL Ratio <4.0 <5.0

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9 TWO TYPES OF CHOLESTEROL 1. Dietary Cholesterol: found in foods of animal origin like meat, liver, milk products, egg yolks and seafood 2. Blood Cholesterol: Produced in our bodies by our liver Our bodies need some cholesterol to function Too much of it can be harmful Mainly influenced by our total fat intake, especially saturated and trans fats.

10 DIETARY FATS How much fat should an average person consume? Average women = approximately grams per day Average man = approximately grams per day Provides approx 30 % of total daily energy

11 FAT SCOREBOARD 3 oz White meat chicken 2 grams fat 3 oz White meat with skin- 9 grams fat Croissant- 12 grams fat 1 Tbsp Oil/Butter/Margarine -15 grams fat ½ cup Mixed Nuts 37 grams fat Milk/Cheese - % Milk Fat (M.F.) Milk and Yoghurt tend to be low fat products Cheese- aim for < 22% M.F. Veggies and Fruit- very little - EXCEPT ½ Avocado 14 grams fat olives; coconut

12 Types of Fat Saturated Trans Unsaturated Monounsaturated Polyunsaturated Omega 6 Omega3

13 General Rule: solid at room temperature Elevate bad (LDL) cholesterol and hence total cholesterol in blood A high intake is associated with enhanced plaque build up in arteries and increases risk of heart disease Animal Sources (main sources in diet): - Fatty meats - Lard - Processed meat: bologna, salami, hot dogs - Butter - Milk - Cream

14 SATURATED FATS Plant sources: - Palm oil - Coconut oil - Vegetable shortenings Saturated fats found in: - Many pre-packaged foods (cookies, crackers, potato chips) - Whipped toppings - Many baked goods (croissants, cakes, Danishes) - Processed foods made with lard, palm oil or coconut oil

15 MONOUNSATURATED FATS Liquid at room temperature Tend to lower LDL cholesterol when they replace saturated fat without lowering HDL (good) cholesterol Plant sources: - Olives and olive oil - Rapeseed oil - Canola oil - Almonds - Non-hydrogenated margarines made from these oils - Peanuts and peanut oil - Avocados

16 POLYUNSATURATED FATS 2 types: Omega-6 and Omega-3 Essential Fatty Acids: must be obtained from diet General Rule: Liquid at room temperature Converted in body to long chain fatty acids e.g. EPA, DHA, which plays a role in fetal and early life neural development

17 OMEGA-6 FATS Do lower LDL cholesterol when they replace SF but can also lower HDL (good) cholesterol needed for lowering risk of heart disease Plant sources: - Liquid oils: Sunflower, Safflower, Corn, Groundnut, Soy, Sesame - Non-hydrogenated margarines made from these oils - Nuts and Seeds: Flax seeds - Tofu

18 OMEGA-3 FATS Heart Healthy Fats : reduce risk of heart disease by reducing stickiness and clotting of blood Also involved in immune responses and inflammatory processes Potential benefit from 1gram/day Best sources: Fatty fish 2.5 oz Salmon grams 3 oz Mackerel 1 gram 3 oz Trout -1.1 gram Ground flaxseed -1 Tbsp = 1.6 grams Flaxseed Oil 2.5 grams Walnuts - ¼ cup = 2.3 mg Omega 3 Eggs 1 egg =0.4 grams Supplements: Omega 3,6, 9 is NOT better

19 TRANS FATS Found naturally in small quantities in milk, cheese, beef and lamb Mainly created during manufacturing when polyunsaturated liquid fats are hydrogenated to form solid fats Are similar to SF, can elevate LDL cholesterol and increase heart disease risk Found in: - Hard and soft margarines (hydrogenated) - Baked goods (pastry, shortening) - Packaged snack foods - Deep fried foods

20 DIETARY FATS CONCLUSIONS Use monounsaturated fats primarily Have an adequate and not excessive amount of polyunsaturated Omega 6 fats Enjoy Omega-3 fatty fish 2 times per week Limit SF and Trans fats in diet Limit high cholesterol foods Use low fat products and Omega-3 fortified products Regardless of type of fat (SF/MF) or product (low fat) fats are all fats so must be consumed sparingly CFGHE ml/2-3 tbsp unsaturated fat per day includes oils, salad dressings, mayonnaise and margarine

21 SALT! Increases blood pressure Salt=Sodium Most of it comes from processed foods. Only 15% comes from our cooking. Aim for between 1500 and 2300 mg of sodium per day 1 tsp of Salt = 2300mg of Sodium!

22 TYPES OF SALT Table salt is a fine-grained salt that we get from salt mines. Table salt is 99% sodium chloride Sea salt is made by the evaporation of seawater. Unrefined sea salt contains 95-98% sodium chloride and 2-5% trace minerals Kosher salt is basically table salt but contains no additives and has a coarse grain. It is used to prepare meat according to Jewish regulations Pickling salt is used for brines to make pickled foods All the above salts contain about 2300 mg of sodium per teaspoon

23 TYPES OF SALT Salt-free seasoning blends: can be used instead of salt to flavor food. They are a mixture of dried herbs and spices that don t contain sodium chloride such as Mrs Dash or Mccormick s blend Salt substitutes: replace some or all of the sodium in salt with another mineral such as potassium or magnesium. Potassium chloride is a common salt substitute. Check with Physician before using

24 TIPS TO REDUCE SALT AND SODIUM Choose low or reduced sodium versions of foods when available Choose fresh, frozen, or canned low-sodium vegetables Use fresh poultry, fish, and lean meat, rather than canned or processed Limit cured foods (such as bacon and ham); foods packed in brine (such as pickles, pickled vegetables, olives) Limit even lower sodium versions of soy sauce and teriyaki sauce Limit cheese consumption, particularly processed cheese Choose "convenience" foods that are lower in sodium (such as canned soup). Cut back on frozen dinners Rinse canned foods, such as tuna and canned beans, to remove some of the sodium or buy canned in spring water Use spices instead of salt. In cooking and at the table, flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends

25 SALT GAME atic/health/salt/game.swf?=6

26 Any Questions?

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