Download AVERAGE INTAKE EACH YEAR BY AMERICANS

Eating Well for
Disease Prevention
Rita P. Smith, MS, RD, CDE
Registered Dietitian
Certified Diabetes Educator
[email protected]
“If you don’t take care of
your body,
Where are you going to live?”
Anonymous
Menu of Topics
A Healthy Weight
Caloric Balance
USDA Guidelines:
Fats, Carbohydrates & Protein
Soy Good
Homocysteine
Phytonutrients
Calcium and Sodium
Average Intake Each Year!!
• 764 donuts
• 60 pounds of cake and cookies
• 23 gallons ice cream
•
7 pounds potato chips
• 22 pounds candy
• 365 servings soda
Daily Food Intake of Kids
Percentage of infants and toddlers who
consume daily:
9 – 11
Food
month-olds
Candy
3%
Pizza
2%
Soft drink
4%
French Fries
9%
Hot dogs, bacon
7%
19 – 24
month-olds
10%
11%
23%
21%
25%
Reference: Archives of Pediatric and Adolescent
Medicine 2003; 157: 789-896.
We Eat FAST !!
$6 billion
spent on fast food in 1970
$110 billion
spent on fast food in 2000
$240 billion
estimated annual health-care costs
in the U.S. from obesity
Source: Fast Food Nation, Houghton Mifflin, 2001.
On-the-Go Fare:
The Good and Not-So-Good
Item
Calories
McDonalds grilled chicken
w/ nonfat dressing
130
Taco Bell chicken soft taco
190
Auntie Anne’s glazing raisin pretzel
510
BK whopper w/ cheese
780
Sbarro’s sausage & pepperoni stuffed
880
On-the-Go Fare:
The Good and Not-So-Good
Item
Onion rings, 1 side order
BK double whopper w/ cheese
Taco Bell mucho grande nachos
Cheesecake Factory carrot cake, 1 sl
Beef burrito w/ beans & guacamole
Calories
900
1,020
1,320
1,560
1,640
Excess Calorie Intake
• From sugar: more than 150 lb./year
• From fat: more than 80 g/day
• From carbs: mostly refined and processed
Fiber intake: less than 15 g/day
• From beverages: sodas, fruit drinks, alcohol
Portion Distortion
• Portions are LARGER than ever
• We
SUPERSIZE meals
• We order JUMBO size drinks
The Weight Facts:
65% of adults are
overweight and obese
39% of children and
adolescents are
overweight and obese
Excess Weight
Increases Disease Risk
•
•
•
•
•
•
•
•
•
•
High blood pressure
Coronary artery disease
Stroke
Type 2 diabetes (adult onset)
Asthma
Gallbladder disease
Arthritis
Sleep apnea
Disorders of reproduction
Certain cancers, including colon, endometrial and postmenopausal breast cancer
An Extra 100 Calories
1 granola or cereal bar or
1 tablespoon margarine
adds up to 36,500 calories in 1 year.
That’s 10 pounds gained!
Exercise Makes a Difference
Walking 30 minutes each day
will use 210 calories.
That is 76,650 calories in 1 year or
22 pounds lost.
Many Weight Loss Options
(Calorie-saving options)
High-Protein, Low-Carb:
Dr. Atkins
Protein Power
High Carb, Low-Fat:
Ornish Vegetarian
Pritikin
Mod-Carb, Mod-Fat
Mediterranean
Weight Watcher’s
The DASH
The Zone
South Beach
Lifestyle Changes
Can Make A Difference
in a matter of weeks
Feb. 3
Weight
208 lbs
Total Cholesterol 280 mg
HDL-Cholesterol 45 mg
LDL-Cholesterol 182 mg
Triglycerides
265 mg
Feb. 26
197 lbs
224 mg
49 mg
150 mg
123 mg
23 days
-11 lbs
-56 mg
+4 mg
-32 mg
-142 mg
Healthy Changes
An early morning walk
Grilled chicken sandwiches
and wraps
Tossed salads
Calorie - free beverages
Lifestyle Changes
Can Make A Difference
in a matter of months
Weight
Total Cholesterol
HDL-Cholesterol
LDL-Cholesterol
April
June
266 lbs
236 mg
34 mg
167 mg
205 lbs
146 mg
28 mg
94 mg
3 months
-61 lbs
-90 mg
-6 mg
-73 mg
Healthy Changes
Breakfast: Decaf coffee and a fresh bagel
Snack:
Fresh fruit
Lunch:
Pasta with marinara sauce
Grilled chicken salad
Vegetable soup
Vegetarian stirfry
Exercise with wife after work
Dinner: Vegetarian entrees
Shared entrée with wife
A Great Resource: MyPyramid
Source: www.usda.gov
USDA Dietary Guidelines:
Control Calorie Intake
Calories DO count for weight control, not the
proportions of protein, fat, and carbohydrates.
The healthiest way to reduce calories is to lower:
Saturated fats
Added sugar
Alcohol
Source: www.usda.gov
USDA Dietary Guidelines:
Energy Balance
Eating 500 calories less/day =
1 lb. weight loss/week.
Control portion sizes to reduce calories,
especially from calorie dense foods.
USDA Dietary Guidelines:
Choose Fats Wisely
Total fats: 20% - 35% of total daily calories
(Example: 30-55 grams for a 1500-calorie diet)
Saturated fats: less than 20% of total daily calories
(Example: < 16 grams for a 1500-calorie diet)
Trans fats: Less than 1% of total daily calories
(Example: < 2 grams for a 1500-calorie diet)
Nutrition Facts Label
Effects of Dietary Fat on Blood Lipids
Food Source
Effect on Lipids
Saturated:
dairy fat, animal fat,
chicken skin
Increases total cholesterol
Increases LDL-cholesterol
Little effect on HDL-cholesterol
Polyunsaturated:
corn, safflower, sunflower,
cottonseed, soybean
Decreases total cholesterol
Decreases LDL-cholesterol
Decreases HDL-cholesterol
Monounsaturated:
olive, canola & peanut oils;
nuts: walnuts, peanuts,
almonds, pecans, etc.
Decreases total cholesterol
Decreases LDL-cholesterol
Little effect on HDL-cholesterol
Omega-3 fatty acids:
fish, especially salmon,
tuna, trout, sardines
flaxseed; walnuts
Decreases total cholesterol
Decreases LDL-cholesterol
May increase HDL-cholesterol;
Trans fatty acids &
hydrogenated fats:
stick margarine, shortening
Increases total cholesterol
Increases LDL-cholesterol
May decrease HDL-cholesterol
Healthy Fats: Nuts
Daily consumption of nuts can lower blood
cholesterol levels and high blood pressure.
(1/4 cup serving per day)
Peanuts
Almonds
Walnuts
Pecans
Reference: American Journal of Clinical Nutrition, 2003.
Healthy Fats: Fish Oils
Benefits:
• Reduces sudden death
• Anti-inflammatory
• Lowers triglycerides
How Often? (from AHA)
• 2 servings of fish per week
Best Sources:
• Salmon, tuna, mackerel,
sardines, herring
Mercury Warning
Mercury is highest in
Shark
King mackerel
Swordfish
Tilefish
Pregnant or nursing women:
avoid these fish completely
< 12 ounces fish/week if purchased
in stores or restaurants
Source: Food and Drug Administration
Healthy Fats: Flaxseed Oil
Benefits:
• Source of omega – 3 fatty acids and fiber
• Reduces heart disease risk
• Contains cancer-fighting lignans
Hints:
• Grind the seeds just before using
• Store the seeds in the refrigerator
• Sprinkle on cereal, salads, baked potatoes,
cottage cheese and yogurt
• Add to muffin and bread recipes
Healthy Fats:
Plant Stanols & Sterols
Benefits:
Interferes with dietary cholesterol absorption in the gut
Decreases LDL-cholesterol by 10-15% in 2 weeks
How Much?
Take Control or Benecol margarine - 2 Tbsp/day
Benecol Smart chews - 4/day
Minute Maid Heartwise orange juice – 2 cups/day
USDA Dietary Guidelines:
Healthy Carbohydrates
Total carbohydrate intake:
45-65% of total daily calorie
(Example: 190-245 grams for a 1500-calorie diet)
Fiber intake: 14 grams per 1000 calories
Include healthy carbohydrate foods daily:
Fruits, vegetables, whole grains, legumes, and
low-fat milk products.
Healthy Carbs
Grains Group:
• 6+ servings per day
• whole grain breads,
cereals, rice, pasta,
crackers, pretzels, etc.
Healthy Carbs
Vegetable Group:
• 5 servings per day
• raw, cooked or juice
Fruit Group:
• 4 servings per day
• fresh, frozen, light-packed canned,
dried or juices
Healthy Protein
Protein Group:
• 2 small servings per
day (5 ounces total)
• fish, poultry, red meat,
nuts, nut butters,
cheese, eggs, dried
beans and peas,
veggie burgers
Soy Protein
Action:
Reduces Total and LDL-cholesterol
Reduces triglyceride levels
Improves elasticity of arteries
How Much Per Day ?
FDA suggests 25 grams per day for heart health
(2-3 servings of soy products)
More information: www.soyfoods.com; www.talksoy.com
Dietary Soy Additions
Breakfast:
Snacks:
Lunch:
Dinner:
Soy milk on cereal
Soy milk fruit smoothie
Soy milk yogurt (SILK)
Roasted soy nuts
Soy milk cheese added
to sandwich or salad
Marinated tofu – ricotta cheese
stuffed shells
Soy ground beef chili
Soy burger on whole grain bun
Homocysteine
High levels of this amino acid in the blood
may increase heart disease risk.
Higher homocysteine levels are found in …
Men
Advanced age
Excess weight
Excess alcohol
Smoking
High blood pressure
Without multivitamin - mineral supplement
B-Vitamins To Reduce
Homocysteine
Folic Acid
dried beans and peas, spinach,
orange juice
Vitamin B6
bananas, avocados, spinach and
other greens
Vitamin B12
beef liver and fish
Shop By Color
BLUE
blueberries
RED
cherries, raspberries, grapes
strawberries, tomatoes, peppers
PURPLE
grapes, cabbage
GREEN
spinach, broccoli, collard greens,
peppers, kiwi
ORANGE oranges, tangerines, cantaloupe,
carrots, sweet potatoes
Vitamin A (Beta Carotene)
RDA=5,000 IU
IU
Carrots, 1 large, raw
11,000
Sweet Potato, 1 small
8,100
Carrots, ½ cup cooked
7,600
Spinach, ½ cup cooked
7,200
Winter Squash, ½ cup
4,300
Cantaloupe, half
3,300
Broccoli, 1 large stalk
2,500
Apricots, 2 dried
1, 600
Tomato sauce, ½ cup
1,100
Polyphenols
Don’t forget the dark chocolate
for protective polyphenols!
Reference: Journal of the American Medical Association, 2003.
Calcium-Rich Foods May…
• Prevent high blood pressure
• Protect bones and prevent osteoporosis
• Help with weight loss
• Prevent colon cancer
Bone Up on Calcium
Calcium Recommendations
Teens
Adults (over 22 years)
Postmenopausal women
Men over age 65 years
Source: NIH Consensus Conference on Calcium
1,200 mg/day
1,000 mg/day
1,500 mg/day
1,500 mg/day
Calcium Food Sources
Yogurt, 1 cup
Milk, 1 cup
Calcium-fortified
soy milk, 1 cup
orange juice, 1 cup
Cheese, 1 oz
Tofu, ½ cup
Salmon, 3 oz.
Turnip greens, ½ cup
400 mg
300 mg
300 mg
300 mg
200-250 mg
260 mg
200 mg
100 mg
DASH to Better Health
(Dietary Approaches to Stop Hypertension)
Daily Recommendations from the DASH Study:
Lots of Fruits and Veggies
8 – 10 servings
Low-fat Dairy Products
2 – 3 servings
Fish, Poultry, Lean Meat
1 – 2 small servings
Nuts, Seeds, Legumes
4 – 5 servings per week
Reference: www.nhlbi.nih.gov/health
Sodium Guidelines
Adequate Intake Per Day
Young and middle aged adults
50 years and older
70 years and older
1,500 milligrams
1,300 milligrams
1,200 milligrams
Reference: The Institute of Medicine
Safe upper limit:
2,500 milligrams
Note: 1 teaspoon salt = 2,300 mg sodium
Menu Ideas
Breakfast
Old-fashioned oatmeal
w/ fresh blueberries
Skim or soy milk
Snack
Seasonal fresh fruit
Menu Ideas
Lunch
Soup w/ beans, barley, and vegetables
Rye Krisp or whole grain crackers
Low-fat yogurt w/ fresh fruit
Snack
Seasonal fresh fruit
Menu Ideas
Pre-Dinner
Grape juice, 1 cup + Handful of nuts
Dinner
Fresh salmon, brushed w/ olive oil
Baked sweet potato
Steamed spinach tossed w/ olive oil & garlic
Snack
Seasonal fresh fruit cup
Eat Well
to Be Well
Rita Smith, MS, RD, CDE
Registered Dietitian
Certified Diabetes Educator
[email protected]