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Transcript
HEARTWISE
NUTRITION EDUCATION
PROGRAM
TABLE OF CONTENTS
Contributors:
Caroline Bohl, M.S., R.D.
Leila Bruno, M.S., R.D.
Paul Cannon, M.D.
Laura Cipullo, R.D.
Sonia Cruz, R.D.
Andrea Dmitruk, M.A., R.D.
Judy Fogel, M.S., R.D.
Stacey Freis, M.S., R.D. C.N.S.D.
Ann Gaba, EdD, R.D., C.D.E.
Henry Ginsberg, M.D.
Kristin Greenspan, M.S., R.D.
O. Wayne Isom, M.D.
Soon Juhng, M.S,, R.D.
Wahida Karmally, DrPH, R.D., C.D.E.
June Levine, R.D.
Lisa Mainieri, MPH, MSW
Martha McKittrick, R.D.
Louise Merriman, M.S., R.D.
Jennifer Nelson, R.D.
Gerald Neuberg, M.D.
Renee Radenberg, R.D.
Elaine Rosenthal, M.S., R.D.
Mehmet Oz, M.D.
Milton Packer, M.D.
Richard S. Rivlin, M.D.
Myron Weisfeldt, M.D.
Introduction ...............................................................................
1
NewYork-Presbyterian
The University Hospitals of Columbia and Cornell
HeartWise Snacks ......................................................................
26
NewYork Weill Cornell Medical Center
Department of Food and Nutrition
525 East 68th Street
New York, NY 10021
(212) 746-0838
How Much Fat Should You Eat? ................................................
29
Columbia University Medical Center
Department of Food and Nutrition
622 West 168th Street
New York, NY 10032
(212) 305-9969
Dining Out ...............................................................................34
www.nyp.org/nutrition
Definitions ...............................................................................3
The Food Guide Pyramid .........................................................9
Choosing HeartWise Foods .......................................................
10
Breads, Cereals, Rice and Pasta ..........................................
11
Vegetables ............................................................................
12
Fruits ..................................................................................
13
Milk, Yogurt and Cheeses ....................................................
13
Dried Beans, Fish, Poultry, Meat and Eggs ..........................
14
Fats and Oils ......................................................................
17
Sweets .................................................................................
19
Beverages and Miscellaneous Foods ...................................
21
High Sodium Foods ................................................................22
In Your Grocery Store .................................................................
23
HeartWise Meal Planning ............................................................
25
Portion Sizes ...............................................................................
27
Reading Food Labels ...................................................................
30
HeartWise Cooking Tips ............................................................
32
HeartWise References ...............................................................35
Notes
HeartWise Resources
© 2004 NewYork-Presbyterian, The University Hospitals of Columbia and Cornell
ID 510:0204
INTRODUCTION
Welcome to the NewYork-Presbyterian Hospital HeartWise Cardiac
Nutrition Rehabilitation Program. This Program is designed to help you
understand the dietary prescription recommended by your Physician.
This HeartWise Booklet was written to recommend food choices that will
help you to modify and reduce your intake of sodium, total fat, saturated
fat, trans fatty acids and cholesterol. You and your family will meet with a
Registered Dietitian to learn about the information provided in the
HeartWise Booklet.
♥ Prepare HeartWise food items at home using recommended foods.
♥ Be HeartWise while using the Food Guide Pyramid as a plan to help
you select a variety of foods daily.
♥ Maintain energy balance by limiting Calorie/energy intake, and
increasing daily physical activity for energy expenditure.
The purpose of the HeartWise Cardiac Nutrition Rehabilitation Program
is to teach you how to:
♥ Reduce your daily fat intake to 30 percent or less of total Calories by
making informed food choices and controlling portion sizes of high
fat foods.
♥ Reduce your daily intake of foods containing saturated fats to 10
percent or less of total Calories, cholesterol to less than 300
milligrams, and to substitute polyunsaturated and particularly
monounsaturated fats for saturated fats.
♥ Reduce your sodium intake by selecting foods lower in salt or
sodium. The general recommendation for sodium intake is 2400
milligrams per day. Some people do not need to restrict their sodium
intake and can use the list on page 22 for greater variety in their diet.
Consult with your Dietitian or Physician.
♥ Increase your intake of complex carbohydrates found in whole grain
products, fruits and vegetables aiming to achieve an intake of 25-30
grams of dietary fiber per day.
♥ Increase your intake of Omega-3 fatty acids. The current
recommendations for omega-3 fatty acid is 1.6 grams per day for
men, and 1.1 grams per day for women.
♥ Evaluate specific food items according to HeartWise guidelines as all
foods (especially commercial products) cannot be listed in this
booklet and manufacturers may alter ingredients or develop new
products.
1♥
2
DEFINITIONS
SOME DEFINITIONS YOU WILL FIND HELPFUL IN
UNDERSTANDING YOUR DIET:
Atherosclerosis – A disease in which plaque containing cholesterol and
inflammatory cells builds up on the inner lining of arteries. As atherosclerosis progresses, arteries may narrow so that oxygen-rich blood and
other nutrients may have difficulty reaching the heart, limbs and other
vital organs. High blood pressure and inflammation may cause plaques to
rupture, with blood clotting on the inner surfaces of arteries, leading to a
heart attack or stroke. Atherosclerosis can be prevented by lifestyle
changes (including diet, aerobic exercise, smoking cessation and stress
reduction) and by treatment of cardiovascular risk factors (including
diabetes, high blood pressure, high cholesterol and blood clotting).
• Dietary Cholesterol – Cholesterol that is in the food you eat. It is
present only in foods of animal origin including whole milk, whole
milk dairy products, egg yolks, meats, poultry and seafood. Dietary
cholesterol and saturated fat tend to raise blood cholesterol, which
increases the risk for heart disease. Plants do not contain
cholesterol; however, some plant products do contain saturated fat,
such as coconut and palm oil. Saturated fat will raise the blood
cholesterol level as noted below.
Carbohydrates – Carbohydrates (sugars and starches) are the body’s
main source of fuel. They are mainly found in plant foods like grains,
fruits, vegetables, legumes, milk and yogurt. All carbohydrates are sugar.
The shorter chains of sugar molecules like table sugar are termed
“sugars” and the longer chains are called “starches.” Starches with fiber
like whole wheat, oats, legumes, fruits and vegetables have more health
benefits, because in addition to fiber, they provide antioxidants and
phytochemicals. The National Academy of Sciences recommends at least
130 grams (more in pregnancy) of carbohydrates a day.
Coronary Artery Disease (CAD) – Atherosclerosis affecting the arteries
that provide blood to heart muscle. When coronary arteries become
partially blocked, exercise, eating or stress may provoke chest pains
called angina pectoris. Severe and prolonged chest pain (along with
shortness of breath, vomiting or sweating) may indicate a heart attack, in
which a blood clot completely blocks an artery, causing permanent
damage to heart muscle. Coronary artery disease is treated with lifestyle
changes and medication and sometimes with surgical interventions, such
as stents intended to keep arteries open.
Dietary Fiber – A type of carbohydrate that your body cannot digest or
absorb. Because dietary fiber is excreted, it does not provide Calories in
the diet. There are two types of dietary fiber: insoluble and soluble.
Insoluble fiber functions to provide bulk to stool and passes through the
digestive tract largely intact. It is found mainly in wheat and corn brans,
nuts, and most fruits and vegetables. Soluble fiber also aids in
maintaining bowel regularity but may also lower blood sugar and
blood cholesterol levels, which may help reduce the risk of heart disease.
Soluble fiber is found primarily in dried beans, apples, oranges, pears
and oats.
Vitamins and Minerals – Substances your body needs in small amounts
for normal growth, function and health. Together, vitamins and minerals
are called micronutrients. Your body can’t make most micronutrients, so
you must get them from the foods you eat or, in some cases, from
supplements. For most people, healthy balanced diet (including at least 5
servings of fruits and vegetables per day) provides adequate amounts of
vitamins and minerals. However, a daily multivitamin supplement may
be recommended for the elderly, and for others with nutritional
problems. Folate (folic acid) and other B vitamins help to break down
the amino acid homocysteine. High levels of homocysteine in the blood
may be a risk factor for cardiovascular disease, but so far there is no
proof that treating a mildly elevated homocysteine level improves heart
health. Vitamin E supplements are very popular but, unfortunately,
recent studies have shown that they do not prevent heart attacks, and
they actually may interfere with cholesterol medication. Please inform
your physician if you take any herbs or nutritional supplements, since
there may be drug interactions.
Cholesterol – A soft, waxy, fat-like substance. Cholesterol is found in
foods of animal origin. Cholesterol is also made by the body. It is
necessary for the manufacture of hormones, bile acids and vitamin D.
Cholesterol is present in all cells of the body including the nervous
system, muscle, skin, liver, intestines and heart.
3
• Blood Cholesterol – Cholesterol that is manufactured by the liver
and absorbed from the food you eat. It is carried in the blood for
use by all parts of the body. A high level of blood cholesterol may
lead to atherosclerosis and coronary heart disease.
4
Obesity – It is defined as an excessive accumulation of fat in the body
and is associated with numerous health problems including coronary
heart disease, insulin resistance, type 2 diabetes, hypertension and
certain types of cancer. We have an epidemic of obesity, diabetes and
cardiovascular diseases, largely because we eat too much and move too
little. 60% of Americans are overweight. To avoid weight gain, we cannot
consume more energy than our bodies actually need. We should also
increase energy expenditure via moderate physical activity for 30-60
minutes a day (if approved by your physician). People on low-fat diets
often make the mistake of overeating refined starches (bread, pasta, rice,
potatoes) and sweets (including sugar-containing beverages). Since they
are rapidly absorbed into the bloodstream, they cause insulin release,
which can increase hunger. Fruits, vegetables and whole grains are
preferred.
Body mass index (BMI) is a measure of body fat based on height and
weight that applies to both adult men and women. According to
World Health Organization guidelines, individuals with a BMI of
25.0-29.9 are considered overweight and those with a BMI of >30
are obese (see graph).
Height
6’6”
6’5”
6’4”
6’3”
6’2”
6’1”
6’0”
5’11”
5’10”
5’9”
5’8”
5’7”
5’6”
5’5”
5’4”
5’3”
5’2”
5’1”
5’0”
4’11”
BMI (Body Mass Index)
25
30
5
ht
yW
eig
Ob
ese
Ov
erw
eig
alth
He
75
100
125
150
Pounds**
175
200
• Saturated Fat – A type of fat found in greatest amounts in foods
from animals such as meat, poultry and whole-milk dairy products
like butter, cream, milk, ice cream and cheese. Saturated fats are
generally solid at room temperature. The saturated fat content is
high in some vegetable oils – such as coconut, palm kernel and
palm oils – which remain liquid at room temperature. Saturated fat
raises blood cholesterol more than anything else in the diet. When
excess amounts of saturated fat are consumed, this fat is broken
down and converted to body fat. In this process, compounds are
formed which cause the body to make cholesterol.
– Monounsaturated Fat – An unsaturated fat that is found in
greatest amounts in foods from plant origin. Examples are olive
oil, canola (rapeseed) oil, peanut oil and most nuts. When
substituted for saturated fat (refer to page 17), monounsaturated
fat helps reduce total blood cholesterol without lowering
HDL levels.
– Polyunsaturated Fat – An unsaturated fat that is found in
greatest amounts in foods from plant origin and fatty fish. When
substituted for saturated fat, polyunsaturated fat helps reduce
blood cholesterol. There are two types of polyunsaturated fat:
4’10”
50
• Total Fat – The sum of the saturated, monounsaturated and
polyunsaturated fats that are present in food. A mixture of all three
types of fat is found in most foods, including oils.
• Unsaturated Fat – A type of fat that is usually liquid at room
temperature. There are two kinds of unsaturated fat:
ht
18.5
Fats – One of the three nutrients that supply Calories to the body. Fats
provide nine calories per gram – more than twice the number of Calories
than are provided by carbohydrates or protein. In addition to providing
Calories, fat helps in the absorption of certain vitamins and other
important compounds found in food. Small amounts of fat in your diet
are necessary for normal body function.
225
250
275
Omega–6 Fatty Acid – A polyunsaturated fat found in greatest
amounts in oils from plants. Examples are corn, cottonseed,
safflower, soybean and sunflower oils.
6
Omega–3 Fatty Acid – A polyunsaturated fat found mostly in
fatty fish, such as tuna, salmon, sardines, bluefish and
mackerel as well as soy beans, flaxseed/linseed oil, canola
(rapeseed oil), walnuts and pumpkin seeds. Omega-3
fatty acids are natural blood thinners and may reduce the risk
of blood clots and stroke. Eating fatty fish at least 2 times per
week is recommended, but the benefit, if any, of taking fish oil
supplements has not been established and is, therefore, not
recommended at this time.
Trans Fatty Acids (or Trans Fats) – Trans fatty acids are formed when
unsaturated fats go through a process called hydrogenation which changes
liquid vegetable oils into a more solid fat product. Studies have shown
that trans fatty acids may raise total blood cholesterol levels and increase
the risk of heart disease. Foods that contain high amounts of trans fatty
acids include stick margarines, shortenings, fried foods, commercial
cakes, cookies and crackers. Read labels and look for “partially
hydrogenated vegetable oils” as an indication that trans fatty acids
may be present.
Sodium – A mineral contained naturally in many food items which may
be added to foods as “table salt” or during processing. Almost 50 percent
of “table salt” is sodium. Decreasing consumption of salt or foods with
a high sodium content, such as many processed foods, may be
recommended for some patients in the management of hypertension,
cardiovascular disease and congestive heart failure.
Triglyceride – A fat in the blood which comes from the body’s fat stores
or from the food we eat. Elevated levels of serum triglycerides can result
from consuming too much sugar, alcohol or fat. High levels can also
result from being overweight or from certain diseases, such as diabetes.
Lipoproteins – Protein-coated packages that carry fat and cholesterol
through the blood. Lipoproteins are classified according to their density:
• High Density Lipoproteins (HDL) – Lipoproteins that contain a
small amount of cholesterol and carry cholesterol away from body
cells and tissues to the liver for excretion from the body. Low levels
of HDL are associated with an increased risk of coronary heart
disease; therefore, the higher the HDL level, the better.
• Low Density Lipoproteins (LDL) – Lipoproteins that contain the
largest amount of cholesterol in the blood. LDL are responsible for
depositing cholesterol in the artery walls. Low levels of LDL are
associated with a decreased risk of coronary heart disease; therefore,
the lower the LDL level, the better.
7
8
THE FOOD GUIDE PYRAMID
CHOOSING HEARTWISE FOODS
HeartWise Guide To Daily Food Choices
The food lists on the following pages will help you make more healthful
food choices. There are no “good” or “bad” foods, only “good” or “bad”
diets. Selecting most of your foods from the “CHOOSE” column will help
you to achieve a HeartWise Diet. This program:
• Eat a variety of foods from each food group every day.
• Follow the recommended number of servings and suggested
serving sizes.
•
Means a good choice for increased fiber content.
• Substitute unsaturated fats like nuts, seeds and liquid vegetable oils
for saturated fats like butter, shortenings, stick margarine
• Substitute reduced fat/Calorie salad dressing, for higher fat/Calorie
versions
FATS, OILS & SWEETS
(USE SPARINGLY)
Serving Examples
1 teaspoon tub margarine
1 teaspoon oil
1 tablespoon salad dressing
1 tablespoon nuts/seeds
Note: Nuts now have a health claim
and seeds such as ground flax seeds
are high in omega-3 fatty acids.
MILK, YOGURT & CHEESES
DRIED BEANS, FISH,
2–3 SERVINGS
POULTRY, MEAT & EGGS
Serving Examples
2–3 SERVINGS
1 cup skim milk or
Serving Examples
soy milk
1 cup cooked beans
1 cup fat free yogurt or
1/2 cup tofu
soy yogurt
2-3 oz. cooked fish, lean
1-1/2 oz. low fat cheese or
meat or poultry
soy cheese
1/2 cup egg substitute
VEGETABLES
3–5 SERVINGS
Serving Examples
1 cup raw leafy greens
1/2 cup any other vegetable
1/2 cup vegetable juice
FRUITS
2–4 SERVINGS
Serving Examples
1 medium raw fruit
1/2 cup raw, cooked or canned fruit
1/2 cup fruit juice
BREAD, CEREALS, RICE & PASTA
6-11 SERVINGS
Serving Examples
1 slice whole grain bread
3/4 cup unsweetened, whole grain, cold cereal
1/2 cup cooked brown rice or pasta or cooked whole grain cereal
9
♥ Defines low fat foods (commercial or homemade) as those foods
containing no more than 3 grams of fat per 100 calories.
♥ Recommends substituting unsaturated fats for saturated fats in
your diet.
♥ Recommends selecting a variety of foods from the “choose” column.
Some items in these lists contain more than 3 grams fat per 100
calories; however, they are high in polyunsaturated and/or
monounsaturated fats. Examples include salmon and peanuts.
♥ Recommends limiting beef, lamb and veal (red meats) to a 3-ounce
cooked lean portion no more that 3 times per week.
♥ Recommends that you consume at least 5 servings of fruits and
vegetables per day.
♥ Defines foods to choose as being less than 300 milligrams of sodium
per serving.
♥ Recommends that you increase the variety of foods in your diet.
♥ Recommends that you increase your fiber intake. Follow the wheat
symbol to select foods high in dietary fiber (2 grams or more per
serving), in order to meet a daily goal of 25-30 grams of fiber, both
soluble and insoluble.
♥ Recommends that you increase your fluid intake. A guideline to use
is 8 glasses of water or other low Calorie, sodium- caffeine- and
alcohol-free beverages. Remember that caffeine and alcohol
containing beverages may be dehydrating, and do not count as part
of your total fluid intake.
Source: Adapted from U.S. Department of Agriculture.
10
CRACKERS AND
SNACKS:
BREAD, CEREALS, RICE AND PASTA
(Eat 6-11 servings a day.)
BREADS AND BAKED
PRODUCTS:
CHOOSE
DECREASE
White,
whole
wheat, pumpernickel, rye, raisin,
Italian, French, pita,
bagels,
English
muffins, fat free
tortillas, hard rolls,
hamburger and hot
dog buns,
Low fat or fat free:
coffee cake,
pancakes, waffles,
French toast,
cornbread,
muffins, biscuits.
Cheese or egg breads
(challah), egg bagels,
sweet rolls, fried
tortillas, taco shells,
Matzo balls, salted
bagels, croissants,
Danish pastry, donuts,
biscuits, nut breads,
breakfast bars, toaster
products, fritters,
popovers, hush
puppies, other coffee
cakes, muffins,
pancakes, waffles and
French toast.
CEREALS:
CHOOSE
DECREASE
3/4 cup
Hot or cold
whole grain cereals;
choose those that
are less than 300
milligrams sodium
and less than 3
grams of fat per
serving.
Granola, hot or cold
cereals containing
coconut or other high
fat ingredients, any
cereal with more than
3 grams of fat and/or
300 milligrams of
sodium per serving.
PASTA, RICE AND
GRAINS:
CHOOSE
DECREASE
Pasta, noodles,
whole wheat pasta,
bulgur,
kasha,
millet,
quinoa, white
brown rice,
rice,
wild rice,
barley,
cous
cous,
cornmeal,
kamut,
spelt.
Egg pasta, egg
noodles, chow mein
noodles, pasta dishes
with cheese or cream
sauce; commercial
mixes for pasta, rice,
casserole or stuffing.
1 slice bread
1/2 English muffin,
bagel, bun, 1 ounce
baked product
1/2 cup cooked pasta
1/2 cup cooked rice
11
1 ounce serving (about
3-4 crackers) with no
more that 3 grams of fat
and 300 milligrams
sodium per serving
CHOOSE
DECREASE
Graham and oyster
crackers; bread
sticks, flatbread,
lavasch, matzoh,
melba toast, rice
wafers or cakes,
rusk, low fat or fat
free croutons,
unsalted: pretzels,
fat free snack
crackers,
airpopped popcorn,
baked or low fat
potato/tortilla chips.
Butter, cheese or
peanut butter sandwich
crackers; salted pretzels,
crackers with salted
tops, bread crumbs, all
other fried chips.
VEGETABLES
(Eat or drink at least 3-5 servings a day.)
VEGETABLES:
CHOOSE
DECREASE
1 cup raw
1/2 cup cooked
1/2 cup juice
Plain: fresh, frozen
(without added salt)
and canned that has
been drained and
rinsed; mashed
potatoes made
without salt or fat;
vegetable salads
made with fat free
dressings; low
sodium vegetable
juices (limit regular
tomato and
vegetable juice to
1/2 cup per day).
Vegetables that are
creamed, scalloped or
made with cheese sauce
or hollandaise sauce;
vegetable salads made
with regular mayonnaise,
sour cream or oil-based
dressings; instant mashed
potatoes, sauerkraut,
pickles.
12
FRUITS
(Eat or drink at least 2-4 servings a day.)
FRUITS:
CHOOSE
Fresh, frozen,
1 medium piece fresh
canned or dried;
fruit
1/2 cup cooked or canned juices and nectars.
1/2 cup juice
CHEESES:
CHOOSE
DECREASE
1-1/2 ounces
Fat free or low fat
and low sodium
cheeses, including
ricotta cheese and
mozzarella
cheese; 1% or fat
free farmer or pot
cheese; any other
low fat, low sodium
or fat free, low
sodium cheese (low
fat should be less
than 3 grams per
serving and low
sodium should be
less than 140
milligrams per
serving); no salt
added, 1% or fat
free cottage cheese.
All other high fat and
high sodium cheeses.
DECREASE
Dried fruit or fruit
juice where sodium
has been added as a
preservative.
MILK, YOGURT AND CHEESES
(Eat or drink 2-3 servings a day.)
MILK:
1 cup
CHOOSE
DECREASE
Skim milk, 1% milk 2% milk, whole milk
(chocolate,
(chocolate,
evaporated,
evaporated,
condensed, fluid or condensed, fluid,
powdered), malted
powdered),
buttermilk (no more milk, coconut milk.
than 1 cup per day),
low fat or skim lactose
reduced milk, low fat
chocolate milk; fat
free or 1% calcium
enriched soy and rice
milk.
YOGURT:
CHOOSE
DECREASE
1 cup
Low fat or fat free:
yogurt, frozen
yogurt and soy
yogurt.
Whole milk yogurt.
13
DRIED BEANS, FISH, POULTRY, MEAT AND EGGS
(Eat 2-3 servings a day; eat no more than 3 servings a week of lean red
meat and no more than 4 egg yolks a week.)
FISH:
CHOOSE
DECREASE
2-3 ounces cooked
Plain: fresh or
frozen; low sodium,
water-packed tuna
or salmon; herring
without cream
sauce or pickling.
Roe, caviar, anchovies,
gefilte fish, smoked
fish; fish battered and
fried; fish cooked in
butter, stick margarine
or oil; fish canned in
oil.
14
SHELLFISH:
CHOOSE
DECREASE
LAMB:
CHOOSE
DECREASE
2-3 ounces cooked
Plain: fresh or
frozen such as
shrimp, mussels,
clams, oysters,
lobster, crab,
scallops.
Fried or batter-baked
shellfish, shellfish
salads made with
mayonnaise, canned
shellfish.
2-3 ounces cooked
Plain: fresh or
frozen – trimmed
foreshank, leg
(shank half or top
round), loin chops.
Leg (sirloin half), loin
roast, rib chops or
roast, shoulder arm or
blade chops, shoulder
roast, ground lamb.
POULTRY:
CHOOSE
DECREASE
VEAL:
CHOOSE
DECREASE
2–3 ounces cooked
Plain and skinless:
fresh or frozen
white meat – lean
ground chicken or
turkey (99% fat
free).
Poultry skin, ground
chicken and turkey
(less than 99% fat
free), chicken or
turkey wings, turkey
or chicken giblets;
goose, duck or
poultry cooked with
butter, breaded
poultry cutlets, turkey
or chicken roll,
canned poultry, other
poultry, lunch meats,
chicken or turkey
bacon or sausage.
2-3 ounces cooked
Plain: fresh or
frozen – arm steak,
loin chops, cutlets,
shank cross cuts.
Breast, rib roast or
chops, riblets, ground
veal, lunch meats.
PORK:
CHOOSE
DECREASE
2-3 ounces cooked
Plain: fresh or
frozen – tenderloin,
boneless loin roast,
boneless sirloin
chops, boneless top
loin chops, loin
chops.
BEEF:
CHOOSE
DECREASE
2–3 ounces cooked
Plain and lean: fresh
or frozen choice or
select grade – chuck
arm pot roast, top
loin steak, tenderloin
steak (filet mignon),
wedge bone sirloin
steak, porterhouse
steak, t-bone steak,
top sirloin steak, eye
round, top round
steak, bottom round
roast, round tip
roast, shank cross
cuts, flank steak,
95% lean ground
beef.
All prime grade
meats, chuck blade
roast, short ribs, rib
roast or steak, rib-eye
roast or steak, cubed
steak, fresh brisket,
corned beef, skirt
steak, organ meats,
beef lunch meats,
chipped beef, kosher
meats, frankfurters;
canned, smoked or
salt cured meats.
Note: Due to
koshering process,
kosher meats have a
higher sodium content.
Blade chops, fresh or
smoked Boston
shoulder cuts, fresh or
smoked arm roast or
steak, fresh or smoked
arm picnic, smoked
ham–butt or shank
portion, ground pork,
sausage, bacon,
spareribs, fresh or
smoked hock, pigs feet,
salt pork, fat back,
scrapple, chitterlings,
luncheon meats,
frankfurters.
15
16
MEAT SUBSTITUTES:
CHOOSE
1 cup cooked beans
1/2 cup tofu
1/2 cup egg substitute
2 eggs
Texturized Vegetable
Protein (TVP)–
1/2 cup dry chunks,
1/4 cup dry granules
Whole eggs (no
Egg yolks exceeding 4
more than 4 per
per week, canned
week), egg whites,
pork and beans.
fat and cholesterol
free egg substitutes;
tempeh, TVP, tofu,
peanut butter
(no more than 4
tablespoons per
serving and no more
than twice per
week),
all dried
peas and beans.
DECREASE
FROZEN DINNERS:
CHOOSE
DECREASE
1 boxed meal
Those that are less
than 3 grams of fat
per 100 calories
and less than 600
milligrams sodium
per dinner.
All other frozen
dinners.
OILS:
CHOOSE
DECREASE
1 teaspoon
Monounsaturated
oils: olive, canola,
peanut.
SALAD DRESSINGS:
CHOOSE
DECREASE
1 tablespoon
Fat free mayonnaise
and mayonnaisetype dressing; fat
free commercial
salad dressing, low
fat mayonnaise,
and low fat salad
dressing.
Regular mayonnaise
and mayonnaise-type
dressing; regular salad
dressing.
MARGARINE:
CHOOSE
DECREASE
1 teaspoon
Soft margarine or
spreads made from
monounsaturated
oils, polyunsaturated oils or as
listed previously,
diet margarine.
Margarine or shortening
made from fats listed
previously under
“Decrease,” partially
hydrogenated or
hydrogenated stick
margarine.
CREAM CHEESE:
CHOOSE
DECREASE
2 tablespoons
Fat free, low fat,
reduced fat, or light
cream cheeses.
Regular cream cheese.
FATS AND OILS
(Use sparingly.)
17
VEGETABLE SPRAYS:
Saturated fats:
coconut, palm and
palm kernel oil, butter,
lard, cocoa butter,
bacon, chicken fat,
Polyunsaturated
oils: safflower, corn, solid shortenings made
from partially
soybean, cottonhydrogenated or
seed, sesame,
hydrogenated oils
sunflower.
(may contain
trans fats).
CHOOSE
All
NUTS AND SEEDS:
CHOOSE
1 tablespoon seeds,
1 ounce nuts
Unsalted: almonds, Brazil nuts, cashews,
beechnuts, buttercoconut, macadamia
nuts, chestnuts,
nuts, pine nuts.
filberts, hickory
nuts, peanuts,
pecans, pistachios,
walnuts, sunflower
seeds, soy nuts.
DECREASE
18
OTHER:
CHOOSE
DECREASE
Au jus gravy, fat free
or low fat sour
cream and coffee
creamers.
Regular non-dairy
creamer, cream,
regular sour cream,
imitation sour cream,
whipped cream, gravy
mixes, gravy prepared
with meat drippings,
added salt or added
fat, snack chips made
with processed
cheese, dips made
with instant soup
mixes.
CHOOSE
DECREASE
DESSERTS AND
SNACKS:
CHOOSE
DECREASE
Gelatin (all kinds),
fig bars, ginger
snaps, angel food
cake, low fat or fat
free: ginger bread,
cakes, pies, tapioca,
vanilla or chocolate
pudding (made with
skim milk), frozen
yogurt, ice cream,
sherbet, fruit ice,
popsicles, sorbet.
All other desserts
including: commercially
baked cookies, cakes,
pies, pastries, ice cream;
pudding made with
whole milk, salt, baking
soda, baking powder;
nuts, candy containing
nuts, salted nuts or milk
chocolate.
SWEETS
(Use sparingly.)
SWEETS AND
CANDY:
19
Milk chocolate,
Sugar, cocoa,
chocolate baking
chocolate syrup,
squares; chocolate
fruit and
fudge topping, custard
butterscotch
and hard sauce, carob,
toppings, maple
other candy.
syrup, honey,
marshmallow sauce,
molasses, sorghum,
jam, jelly, marmalade,
fruit spreads, fruit
butters, preserves,
hard candy, jelly
beans, gumdrops,
marshmallows,
peppermint, gummy
bears, lollipops.
20
BEVERAGES AND MISCELLANEOUS FOODS
(Drink at least 8 servings of decaffeinated non–alcoholic beverages
a day.)
BEVERAGES:
CHOOSE
DECREASE
8 ounces (1 cup)
Water, seltzer,
caffeine free
carbonated drinks,
decaffeinated coffee,
decaffeinated tea,
herbal tea, fruit–
flavored drinks,
instant breakfast–
type milk beverage
mixes (mixed with
skim milk),
chocolate malted
mix, hot cocoa
flavored mix (mixed
with skim milk or
water).
Flavored instant–
coffee beverages,
commercially
prepared milk–based
drinks, milkshakes,
eggnog, commercially
softened water.
SAUCES:
CHOOSE
DECREASE
1/4 cup
Low sodium or
homemade:
marinara, tomato,
clam, spaghetti,
barbecue, sweet and
sour, chili, salsa.
White sauce, cheese
sauce, sour cream–
based sauce,
hollandaise, Bearnaise,
Alfredo, pesto,
bechamel, curry,
mushroom, tartar
sauce.
CHOOSE
DECREASE
Aromatic bitters,
fresh horseradish,
lemon and lime
juice, vinegar,
herbs, spices, flavor
extracts, tabasco
sauce.
Salt*: onion salt, celery
salt, seasoned salt, garlic
salt, rock salt, sea salt,
kosher salt, MSG
(Monosodiumglutamate),
soy sauce, meat
tenderizers containing
MSG.
*NOTE:
Salt substitutes may be
used with your
physician’s approval.
NOTE:
Consumption of
caffeinated and
alcoholic beverages is
upon the advice of
your physician.
SOUPS:
CHOOSE
DECREASE
1 cup
Commercial low
sodium and
reduced fat, low fat
or fat free soups.
All others.
21
CONDIMENTS AND
SPICES:
HIGH SODIUM FOODS
Each of the following items contains about 300-400 milligrams of
sodium. Only two of these items may be eaten each day:
Miscellaneous
Breads/Desserts
1/4 teaspoon salt (added at the
table or in cooking)
4 tablespoons Worcestershire sauce
4 tablespoons low fat salad dressing
2 tablespoons chili sauce or
barbecue sauce
4 medium, 3 extra large, or 2 giant
olives
1 tablespoon imitation butter
granules
1 teaspoon soy or teriyaki sauce
2 tablespoons mustard
4 tablespoons sweet pickle relish
2 tablespoons catsup
Salted pretzels: 20 small, 3 medium
twisted, 1 Dutch or 1 soft
Soups
1/2 cup reconstituted, canned or
dehydrated regular soups
Vegetables
2 servings (1/2 cup each) regular
canned vegetable from Choose list
(not rinsed and drained)
1/3 canned regular sauerkraut, drained
1/2 large dill pickle
Meat or meat substitutes
1-1/2 ounce regular canned tuna
3 ounces regular canned salmon
1-1/2 ounce regular canned crab
1 ounce Canadian bacon
3/4 cup 1% or fat free cottage cheese
2 ounces low fat cheese
1 ounce herring
22
IN YOUR GROCERY STORE
Here are some food products that you may be wondering about...
Flaxseed: A growing body of research suggests that diets high in
omega-3 fatty acids may offer some degree of protection against heart
disease. Omega-3 fatty acids may lower total blood cholesterol as well as
LDL cholesterol. Flaxseeds and their oil are sources of omega-3 fatty
acids. Flaxseeds must be ground for the omega-3 fatty acids to be
absorbed by the body. This can be done with a coffee grinder or ground
flaxseeds may be purchased. The fiber in flaxseeds may also lower
cholesterol as it is considered a soluble fiber. Flaxseeds can be a healthful
addition to an overall balanced, low fat diet. Flaxseeds have a pleasant
nutty flavor and can be sprinkled on salads, cooked vegetables and
cereals. Flaxseeds can be stored in the refrigerator for no more than a
month. Flaxseed oil cannot be used for frying or sautéing as other oils
can. One tablespoon of ground flaxseed will provide 1.29 grams of
omega-3 fatty acid and 1 tablespoon of flaxseed oil will provide 6.39
grams of omega-3 fatty acid.
Tips for including flaxseed in the diet:
• Add a tablespoon of ground flaxseeds to breakfast cereal.
• Mix a tablespoon of ground flaxseeds or flaxseed oil into an 8
ounce container of yogurt as a snack.
• Add a teaspoon of flaxseed oil to your low fat mayo or mustard as
you spread it onto bread.
• Add a tablespoon of ground flaxseeds or flaxseed oil to your sauce,
rice, pasta, or mixed dish.
• Bake ground flaxseed into cookies, muffins, and other baked goods.
• Ready-made flaxseed products are available on the market as well
(breads, muffins, cereals).
Note: Skip flaxseed supplements
Simple ways to add soy to your diet:
• Include 2 tablespoons of soy flour to each cup of bread flour when
making bread to make a dense, moist, bread with a nutty flavor.
• Replace milk with soy milk in cereal, cream soup and sauce.
• Add tofu to recipes such as stir-fry, chili, kabobs and vegetable
lasagna; tofu takes on the flavor of other ingredients.
• Add toasted soy nuts to salads, or enjoy as a snack.
• Try a variety of tasty “veggie” burgers containing soy.
• Use boiled green soybeans (edamame) as a great side dish or
replacement for other beans in many dishes.
Plant Stanols and Sterols: Plant stanols and sterols are structurally
similar to cholesterol. Because of this similarity, they can compete with
cholesterol for absorption, even in people already eating low cholesterol
diets. Consumption of plant stanols and sterols significantly lowers
cholesterol absorption. The amount needed for this competition to take
place is at least 1 gram per day and is maximal at 2 grams to 3 grams per
day. Usual daily intake of plant stanols and sterols from plant-based
foods is about 300 mg/day, not enough to interfere with cholesterol
absorption. Research has determined that fat-based foods serve as the
most effective way to deliver plant stanols/sterols to the body and they
have been incorporated into some soft margarines. In the commercial
products available, 1 serving of the product is formulated to contain ~ 1
gram of plant stanols (Benecol*) or plant sterols (Take Control*). To
obtain maximal effect, 2 to 3 servings of these products should be
consumed daily. Currently, only margarine spreads fortified with plant
stanols/sterols are available in the United States for purchase in stores.
*Use of brand names does not constitute an endorsement.
Soy: Recent evidence has shown that consumption of soy protein as part
of a low fat diet may help reduce the risk of heart disease. In addition to
being a good source of protein, omega-3 fatty acids, calcium and fiber,
soy contains a variety of plant estrogens (phytoestrogens) known as
isoflavones, which may have an effect on total cholesterol, LDL
cholesterol and triglycerides. While the optimal level of soy needed to
achieve a significant effect remains unknown, soy products may be a
heart-healthy addition to a balanced diet.
23
24
HEARTWISE MEAL PLANNING
This sample meal plan is low in fat, high in fiber, moderate in sodium
and follows the recommendations of the Food Guide Pyramid.
HEARTWISE SNACKS
Consider these heart healthy options:
♥
Fresh fruits and raw vegetables are low Calorie and chock-full
of nutrients.
♥
Air-popped plain popcorn flavored with a small amount of
imitation butter granules or spiced with chili or garlic powder.
♥
Whole grain breads, matzoh, breadsticks or low sodium crackers
spread with low-fat
bean dip or fat free yogurt dip.
♥
Rice cakes, whole wheat crackers or English muffins topped with
apple butter or fruit spread.
♥
Bite-size,
whole grain cereals and
nuts and soy nuts mixed together.
♥
Graham crackers topped with no-salt-added fat free cottage or
fresh fruit slices.
ricotta cheese and
♥
Equal parts fat free yogurt, skim milk and
fresh or frozen fruit
whipped in a blender and frozen in paper cups.
♥
Skim milk or fortified soy milk whipped in a blender with ice
fresh banana,
strawberries or
cubes and fresh fruit such as a
peaches.
♥
Fat free yogurt with 1/4 cup
berries.
♥
Frozen sliced
♥
Unsalted nuts and soy nuts (watch portion sizes as nuts are high
in Calories).
BREAKFAST
1/2 medium banana
1/2 cup whole grain cereal, cooked
1 slice whole grain bread
1 teaspoon soft tub margarine
8 ounces skim milk or soy milk
Coffee/tea
1 fruit serving
1 bread serving
1 bread serving
1 fat serving
1 milk serving
1 beverage serving
LUNCH
3 ounces sliced turkey breast on
2 slices whole grain bread with
lettuce, tomato, fat free mayonnaise
1/2 cup carrot sticks
fresh apple
8 ounces skim milk or soy milk
Water or seltzer water
1 meat serving
2 bread serving
1/2 vegetable serving
1 vegetable serving
1 fruit serving
1 milk serving
1 cup or more
DINNER
3 ounces baked salmon with lemon
1/2 cup steamed brown rice
1/2 cup steamed broccoli
1 cup mixed greens
1 tablespoon oil and vinegar
1 whole grain roll
1 teaspoon soft tub margarine
1/2 cup fat free frozen yogurt
water or seltzer water
1 meat serving
1 bread serving
1 vegetable serving
1 vegetable serving
1 fat serving
1 bread serving
1 fat serving
1 milk serving
1 cup or more
SNACKS
10 almonds
3 cups plain popcorn
1 medium orange
4 ounces, low sodium vegetable juice
1 cup fat free yogurt
water or flavored seltzer
25
2 fats serving
1 bread serving
1 fruit serving
1 vegetable serving
1 milk serving
1 cup or more
bananas and
dried fruits and unsalted
whole grain cereal and 1/2 cup
grapes.
26
PORTION SIZES
These drawings represent portion sizes for cooked animal protein (lean
steak, lean roast beef, skinless chicken breast or fish), and low fat or fat
free cheeses.
For a serving of cooked animal protein, your slice should be as big as the
large drawing and as thick as the 2–or 3–ounce rectangle. For a 1–ounce
serving of cheese, your slice should be as big as the square and as thick
as the 1–ounce rectangle.
For animal protein products that are more round in shape (lean burgers
and trimmed chops), use these drawings. For a 2-ounce cooked serving,
your slice should be as big as the circle drawing and as thick as the 2ounce rectangle. For a 3-ounce cooked serving, your slice should be as
big as the circle and as thick as the 3-ounce rectangle.
dimensions for low fat
or fat free cheeses
dimensions for
cooked animal protein
1-ounce thickness
2-ounce thickness
2-ounce thickness
3-ounce thickness
3-ounce thickness
27
28
HOW MUCH FAT SHOULD YOU EAT?
READING FOOD LABELS
Your fat intake should be controlled, but not eliminated from your diet.
The following Guidelines and Definitions from the Department of Health
and Human Services will help you to better understand food labels:
1. How many Calories should you consume each day?
13 Calories per pound body weight if you are not active (office
work only).
15 Calories per pound body weight if you are moderately active
(you walk or bike 30 to 45 minutes 3 times per week).
17 Calories per pound body weight if you are very active (you jog,
run, do aerobics 45 to 60 minutes 5-7 times per week).
20 Calories per pound body weight if you are extremely active
(you are a professional athlete).
If you are overweight, multiply your desired weight, in pounds, by
the number of Calories which matches your level of physical activity.
2. How many grams of fat should you consume per day? Your total fat
intake each day should not exceed 30% of your daily caloric intake
or a minimum of 15%, with saturated fat providing no more than
10% of total Calories.
To calculate your daily fat allowance:
Example:
Estimate daily Calorie requirement
Drop the last digit
Divide by 3
Multiply by 9(Cal/g)
♥ “Low fat” is less than or equal to 3 grams of fat per serving.
♥ “Low in Saturated Fat” is less than or equal to 1 gram of saturated fat
per serving.
♥ “Low Cholesterol” is less than or equal to 20 milligrams of cholesterol
per serving. Note: Low cholesterol or cholesterol free does not mean
Calorie or fat free.
♥ “Fat free” or “Non Fat” is less than or equal to 0.5 grams of fat per
serving.
♥ “Reduced Fat” or “Lower Fat” is at least 25% less fat per serving than
the original item.
♥ “Light” is at least 33% fewer Calories or 50% less fat per serving than
the original item.
♥ Remove skin from cuts of chicken and turkey; choose cuts of beef
labeled “lean.” Read labels to determine the percentage of fat.
♥ Read labels on snack foods for hydrogenated oils as these foods may
contain trans fats.
2100
210
70 = fat grams/day
630 = total Calories from fat per day
In this example, the daily fat allowance is 70 grams which represents 30%
of the Caloric intake. This means that, over several days, fat intake should
average no more than 70 grams a day.
Although this booklet does not give you the specific fat content of foods,
you can review the Reference List for recommended books that do provide
this information.
29
Nutrition information is based on one serving and standard serving
sizes. If you consume greater than this amount, be sure to adjust the
nutrient calculations.
♥ Look for food products which have a maximum of 3 grams of fat per 100
Calories, which translates into a maximum of 30 percent Calories as fat.
The percentage of Calories coming from fat can be calculated by using
the following method:
Fat Calories = grams of fat per serving X 9 Calories per gram of fat.
Fat Calories X 100 = % of Calories coming from fat per serving
Total Calories
Example:
Food
Amount
8 ounces
Skim milk
8 ounces
1% milk
8 ounces
2% milk
8 ounces
Whole milk
1% cottage cheese 1/2 cup
2% cottage cheese 1/2 cup
4% cottage cheese 1/2 cup
Total Calories % of Calories
Fat
Grams of Fat
As Fat
Per Serving Calories Per Serving
86
0%
0
0
102
23%
23
2.5
125
36%
45
5
150
72
48%
8
82
9
11%
1
100
18
18%
2
117
39%
45
5
30
READING FOOD LABELS
HEARTWISE COOKING TIPS
Don’t be fooled by food
products that are labeled by
weight such as 85% lean or
85% fat free. These foods
may be only 15% fat by
weight, but can provide
over 50% of their calories
from fat. It is better to
evaluate foods based on
grams of fat per serving.
high fiber cereal
Packaged foods have
standard nutrition label
format. An example of this
labeling format is presented
on the following page.
Total Fat 1g*
Saturated Fat 0g
Cholesterol 0mg
Sodium 90mg
Total Carbohydrate 43g
Dietary Fiber 5g
Soluble Fiber 2g
Insoluble Fiber 3g
Sugars 10g
Protein 5g
MEATS
Nutrition Facts
Serving Size 2/3cup (55g)
Servings Per Container about 6
Amount per Serving
Cereal
Cereal with
1/2 cup
Skim milk
Calories
Calories from Fat
190
10
230
10
% Daily Value**
Example:
Ingredients: oats, dates,
cane juice, brown rice flour,
sprouted barley malt,
concentrated grape juice,
natural vanilla flavor, rice
bran, natural almond flavor,
baking soda, sea salt,
natural beta carotene,
natural vitamin E
(D-alpha tocopherol),
niacin, vitamin B6
(pyridoxine hydrochloride),
riboflavin, vitamin
B1(thiamin hydrochloride),
folic acid, vitamin B12
(cyanocobalamine).
Vitamin A
Vitamin C
Calcium
Iron
Thiamine
Riboflavin
Niacin
Vitamin B6
Folate
Vitamin B12
2%
0%
7%
16%
24%
Calories per gram:
Fat 9
•
Carbohydrate 4
Exchanges: 1-1/2 Starch, 1 Fruit
2,000
65g
20g
300mg
2,400mg
3,500mg
300g
25g
•
Drain fat from browned meats before adding other ingredients. Vegetables
and starches absorb fat.
Cook stews, soups and boiled meats a day ahead and then refrigerate.
Skim off the hardened fat at the top, reheat and serve.
VEGETABLES
SENSATIONAL SUBSTITUTIONS
2%
4%
2%
8%
10%
10%
10%
10%
10%
10%
Calories
Less than
Less than
Less than
Less than
Trim visible fat from meat before cooking. Use a rack to broil, roast or
bake meat so that fat will drip away. Baste with fat free salad dressing, fruit
or vegetable juice, wine or bouillon.
Steam, microwave or stir-fry in non-stick cookware with a small amount of
vegetable spray or liquid vegetable oil from allowed oils. Season with herbs,
spices, seasoned vinegar or imitation butter granules.
8%
6%
15%
8%
10%
10%
10%
10%
10%
20%
* Amount in cereal. One half cup of skim milk contributes an
additional 40 calories, 65 mg sodium, 6g total carbohydrate
(6g sugars) and 4g protein.
**Percent Daily Values are based on a 2,000 calorie diet. Your daily
values may be higher or lower depending on your calorie needs:
Total Fat
Sat. Fat
Cholesterol
Sodium
Potassium
Total Carbohydrate
Dietary Fiber
31
2%
0%
4%
14%
24%
Alter your thinking about meat. Make it an addition to grains and
vegetables rather than the main item.
Protein 4
2,500
80g
25g
300mg
2,400mg
3,500mg
375mg
30g
You can easily increase nutrition and trim the fat in many of your favorite
recipes by using the healthier alternatives listed below.
COOKING
Instead of ...
1 cup cream
Cream to thicken soups
Oil base for marinade
Stick margarine/butter
2 oz. Mild cheddar cheese
High-fat sauces over meat/poultry
White rice
Bread crumbs
Meat/poultry for stir-fry
Ground meat
Try this ...
1 cup evaporated skim milk
Pureed potatoes or vegetables
Small amount of olive or canola oil
Liquid margarine
1 oz. Reduced-fat sharp or
extra- sharp cheddar cheese
Vegetable purees (blend steamed
broccoli, sauteed onion, garlic, salt
and pepper), fruit salsa
Brown rice, Bulgur, Kasha, Quinoa,
whole wheat couscous
Toasted wheat germ, whole wheat
bread crumbs
Extra-firm tofu, cubed; more vegetables
Ground turkey breast, plus finely
chopped vegetables; crumbled
tofu, tempeh or TVP;
32
cooked beans
DINING OUT
BAKING
Instead of…
1/2 cup butter /margarine
1 egg
sweetened condensed milk
Evaporated milk
1 cup all-purpose flour
Pastry pie crust
1 oz. baking chocolate
1 cup chocolate chips
Fudge sauce
Frosting
Try…
1/2 cup canola oil, or soft margarine
2 egg whites or 1/2 cup liquid egg
substitute
Fat free sweetened condensed milk
Evaporated skim milk
1 cup finely milled whole wheat flour.
1 cup “white” whole wheat flour.
7/8 cup all-purpose flour + 2
tablespoon soy flour
Phyllo crust (use cooking spray
between layers); graham cracker
crust
3-4 tablespoon cocoa powder + 1
tablespoon oil + 1 tablespoon
sugar(for frosting or sauces).
1/4 cup cocoa (for cakes or cookies)
1/2 cup mini chocolate chips; chopped
dried fruit such as cranberries,raisins,
apricots, cherries; chopped nuts
Chocolate syrup
Sliced fresh fruit; pureed fruit; light
dusting of powdered sugar
Experiment with new spices, which can add flavor to foods without
adding fat or Calories. Read labels to be sure that seasonings do not
contain sodium (salt).
Before you go out to eat, review your recommended food lists. At
breakfast time, fresh fruit is always a good choice. Order whole grain
bread, a bagel or English muffin with soft margarine or low fat cottage
cheese served on the side. Cereals are good choices with skim milk. Some
restaurants offer egg substitutes or egg whites. Ask for Omelettes to be
prepared without butter or oil. Low fat yogurt may also be available.
For lunch or dinner, poached seafood and raw vegetables are fine, but
check the sauces for fat content. Melon or other fruits or juices are also
good choices. Breadsticks or bread can be a healthful starter if you
skip the spreads. Beverages can include sparkling water with lemon or
lime. Ask that salted nuts, buttery crackers and chips be removed from
your table.
Salads can be lean and flavorful. Choose fresh greens and other
vegetables but avoid cheese, eggs, high-fat meat, bacon, croutons and
creamy dressings. Request your dressing on the side so you can control
the amount added. Lemon juice can be used instead of a higher
Calorie dressing.
As you choose your entree, look for poultry, fish, shellfish or vegetable
dishes that are simply prepared without added salt or fat. If lean red
meats are trimmed and prepared by a lower fat method, they are also
acceptable. Choose small serving sizes (about 4 ounces cooked) instead
of large portions.
Accompaniments of vegetables or starches should be cooked by fat free
methods. Request yogurt in place of sour cream for baked potatoes.
Lemon is also good on vegetables.
When it’s time for dessert, remember fresh fruit, fruit ices, sherbets,
gelatin and angel food cake ... or have decaf espresso or herbal tea with
a lemon or orange twist.
Use the 50 percent rule. You can still enjoy your favorite foods, but ask
that half of the usual portion be served. Take the other half home.
Do not be afraid to ask questions. Restaurants are often willing to
accommodate customer requests regarding preparation of dishes.
33
34
HEARTWISE REFERENCES
HEARTWISE RESOURCES
The American Dietetic Association, Cut the Fat. New York, NY: 1996
American Dietetic Association
120 South Riverside Plaza,
Suite 2000
Chicago, IL 60606
(800)877-1600
www.eatright.org
The American Heart Association One-Dish Meals. New York, NY: 2003
The American Heart Association Low-Calorie CookBook. New York,
NY: 2003
The American Heart Association Quick & Easy Cookbook. New York,
NY: 2001
The American Heart Association Low-Salt Cookbook. New York, NY: 2001
The American Heart Association Low-Fat & Luscious Desserts. New York,
NY: 2000
The American Heart Association Meals in minutes Cookbook. New York,
NY: 2000
The American Heart Association Cookbook. New York, NY: 1999
The American Heart Association Low- fat, Low-Cholesterol Cookbook.
New York, NY: 1997
DeBakey, M.E., Gotto, Jr., A.M., and Scott, L.W. The Living Heart Guide to
Eating Out, New York, NY: MasterMedia; 1993
DeBakey, M.E., Foreyt. J.P., Gotto, Jr., A.M., Scott, L.W. The New Living
Heart Diet. New York, NY: Fireside; 1996
The Moosewood Collective. Moosewood Restaurant Low Fat Favorites.
New York, NY: Clarkson Potter Publishers; 1996
Natow, A.B., Heslin, J. The Fat Counter. New York, NY: Pocket Books; 1993
Piscatella, J.C. Don’t Eat Your Heart Out Cookbook. New York, NY:
Workman Publishing; 1991
Shaw, D. The Essential Vegetarian Cookbook. New York, NY: Clarkson
Potter Publishers; 1997
NewYork-Presbyterian Hospital
Department of Food and Nutrition Website:
www.nyp.org/nutrition
35
National Center for Nutrition
and Dietetics
Consumer Hot Line:
(800)366-1655
(Available 10 a.m.-5 p.m.
Eastern Standard Time)
American Heart Association (AHA)
National Center
7320 Greenville Avenue
Dallas, TX 75231
(800)AHA-USA-1
www.americanheart.org
American Heart Association
New York City Affiliate
122 East 42nd Street
New York, NY 10168
(212)661-5335
American Institute for
Cancer Research
1759 R Street, NW
Washington, DC 20009
(800)843-8114
www.aicr.org
Nutrition Consultation Service
Department of Food and Nutrition
NewYork Weill Cornell Medical Center
Greenberg Pavilion
525 East 68th Street
New York, NY 10021
(212)746-0838
Columbia University Medical Center
177 Fort Washington Avenue
New York, NY 10032
(212)305-9969
Fauth Cardiopulmonary
Rehabilitation Center
Columbia University Medical Center
622 W 168th Street
Vanderbilt Clinic, Rm 3-363
New York, NY 10032
(212)305-4695
The Coronary Risk Reduction Program
Lectures and Support Groups Available
(212)746-2150
Cardiac Health Center
NewYork Weill Cornell Medical Center
1153 York Avenue
New York, NY 10021
(212)746-1200
Special Surgery – Sports Medicine
at Chelsea Piers
23rd Street and the Hudson River
(Pier 60)
New York, NY 10011
(212)366-5100
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For referral call 1-877-NYPWELL
NewYork Weill Cornell Medical Center
525 East 68th Street, New York, NY 10021
Columbia University Medical Center
622 West 168th Street, New York, NY 10032