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HEALTHY EATING Good Health Lifestyle Optimum Nutrition Healthy Diet Physical activity Good Health 360 degree approach Health Check Up Awareness Manage Stress 2 CARDIAC RISK FACTORS NON-MODIFIABLE • Age • Gender • Heredity • • • • • • • • MODIFIABLE Food habits Stress Smoking Drinking alcohol Obesity Hyperlipidemia Hypertension Hyperglycemia HEART HEALTHY GUIDELINES • • • • Appropriate body weight Cholesterol profile Blood pressure Overall healthy eating pattern APPROPRIATE BODY WEIGHT • Slow and steady wins the race! Lose no more than 1/2 to 1 kg / week. • Beware of weight loss products • Find out your ideal body weight from your dietician or doctor. • Exercise regularly and keep up an active lifestyle as allowed by the physician What is Body Mass Index (BMI)? BMI Class Value (Kg/m2) Underweight < 19 Normal Weight 19 -24 Overweight 25.0-29.9 Obese I 30.0-34.9 Obese II 35-39.9 Obese III ≥ 40.0 Health Risks of Obesity “Reduce Your Weight” • If you are overweight or obese, a 10% reduction in BWT may help to… – – – – – – Lower Blood pressure Lower Cholesterol level Lower Triglyceride level Lower Blood Sugar Levels Improve overall health Lower risk of heart disease CHOLESTEROL Cholesterol Cholesterol is a waxy fat circulating in our blood HDL High Density Lipoproteins ‘Good cholesterol’ LDL Low Density Lipoproteins ‘Bad cholesterol’ Normal Artery Cholesterol Clogged Artery ‘Bad Cholesterol’ (LDL) sticks to artery walls and contributes to plaque build-up ‘Good Cholesterol’ (HDL) is stable and carries ‘Bad Cholesterol’ (LDL) away from the arteries. 10 DESIRABLE BLOOD LIPID VALUES Total cholesterol160-200mg/dl Triglycerides 50-180mg/dl HDL-C 35-55mg/dl LDL-C 100-130mg dl DIETARY CHOLESTEROL • Cholesterol is found only in animal foods. • It increases LDL-C but not as much as saturated fats. • Red Meat, organ meat, egg yolk need to be restricted in the diet as they are high in cholesterol. Poultry, egg white and fish could be had in the diet. • Allowance - 150 mg / 300 mg /day. Cholesterol 13 CHOLESTEROL CONTENT OF SOME FOODS Food Serving Egg yolk 1 Chicken liver 50 g Cow’s milk 244 ml Chicken (no skin) 86 g Pomfret 100 g Ghee 1 tbsp Cheddar cheese 28 g Lamb (lean) 64 g Cholesterol (mg) 272 316 35 73 80 33 30 60 FAT IN MILK AND MILK PRODUCTS • Whole cream milk may contain as much as 6% fat! (>1 tsp ghee per 100ml) • Toned milk is 3 – 3.5% fat (3/4 tsp ghee /100ml) • Milk fat is saturated • Look for low fat milk – Skim milk is available in ‘Long Life’ milk – 1.5% Fat double-toned fresh milk may come to the market soon “Lowering Trigylcerides” • Avoid Alcohol. – Beer, wine, or hard liquor. • Avoid Sugar. – Candy & regular soda. • Eat Fewer Carbohydrates. – Breads, cereals, rice, pasta, fruits, & dairy products. TRIGLYCERIDES • Eating too much carbohydrate (starch and sugar) can lead to high blood triglycerides and lower HDL- C (good cholesterol) • Unprocessed / fibre rich starchy foods are better than sugars and refined products. • Excessive alcohol will raise triglycerides. • Uncontrolled blood sugar in diabetes will also have this effect. ALCOHOL • • • • Limited alcohol intake may be beneficial Higher consumption has undesirable effects Alcohol may affect blood pressure It is a source of ‘empty’ Calories beware if trying to lose weight. • May increase triglycerides BLOOD PRESSURE Normal Value - 120/80 mm/Hg SODIUM • Reduce the sodium in your diet to control the hypertension. • Limit salt intake to one teaspoon or less per day. • Reduce salt in cooking. • Do not add salt at the table. SODIUM Foods to avoid or limit • • • • • • • • Table salt / cooking salt Salted snacks, chips Papads, vadakams Cheese Baked goods Salted nuts Pickles Commercial soups • • • • • Processed meats Bottled sauces Convenience foods Salt-preserved meats Monosodium glutamate (Ajinomoto) • Canned foods • Dry fish • Instant noodles CAFFEINE • Caffeine is found in coffee, tea, cocoa, chocolates and colas. • It is a stimulant that can affect blood pressure and heart rhythm. • Limit to two medium cups of coffee or equivalent per day. OVERALL HEALTHY EATING PATTERN • Cereals and grains 5 - 12 servings • Fruits and vegetables 5 - 10 servings • Milk and milk products 2 - 4 servings • Meat and alternatives 2 - 3 servings Basic & Planning The food that you eat gives you………. • Proteins • Carbohydrates • Fat • Vitamins & Minerals • Water • Fiber • Antioxidants 25 Fats • Fats are used as source of energy. There are 2 main types of fats. • Animal fats (saturated) • Plant fats (unsaturated) 26 HOW MUCH OIL/ FAT SHOULD YOU CONSUME IN A DAY? • Limit the amount of cooking oil. 4-5 teaspoons per day per person recomended. • Not more than 25% of your energy intake (calories) should come from fat. • This means 40-50 g fat per day on a 1800 kcal diet. • But don’t forget the hidden fats! DIETARY FATS Types of dietary fat • Saturated • Unsaturated – Polyunsaturated – Monounsaturated • NOTE: All fats are a mix of many types of fatty acids TYPES OF DIETARY FATS SATURATED POLYUNSATURATED Butter Sunflower oil Coconut oil Safflower oil Ghee Corn oil Palm oil Soybean oil Lard Gingelly oil Dalda (Sesame) Blended vegetable oil Animal fats MONOUNSATURATED Olive oil Canola oil Groundnut oil (Peanut) Mustard oil NOTE: All fats are a mix of many types of fatty acids AVOID / LIMIT FOODS SUCH AS THESE! “Lowering Cholesterol & LDL levels” • Eat less saturated fat. – Saturated fats are usually found in animal products. – However you should avoid coconut, palm, and palm kernel oil as they are high in saturated fat. Why is it Bad? • Trans fat is as bad for you as saturated fat. • It has been shown to – raise LDL levels – lower HDL levels – increase your risk for heart disease TRANS-FATTY ACIDS • These are formed during hydrogenation. • They increase LDL-C and reduce HDL-C • They are found in margarines, daldas and made using them in bakery products. MONO-UNSATURATED FATTY ACIDS • A diet high in this type of fat lowers total cholesterol LDL-C & triglycerides • It does not lower HDL-C • Heart disease risk is reduced • Good sources are: Olive oil Peanut (groundnut) oil Canola oil Mustard oil Nuts OMEGA-3 FATTY ACIDS • These are found in fish oils, canola, soy bean oil, some seed, and nuts. • Two servings of fish/ week contain adequate amounts. • Omega 3 fatty acids reduce •Heart rhythm problems •Triglycerides •Blood clotting tendency •Heart disease and heart attack in women •LDL cholesterol. • They also increase HDL cholesterol WHAT FOODS ARE HIGH IN PROTEIN? • Animal products - eggs, meat, chicken, fish, etc. • Milk, cheese, curds, paneer, etc. • Pulses and legumes - dhals, grams, dry peas, soybeans, rajma, etc. • Nuts and seeds - peanuts, almonds, cashews, etc. Carbohydrates Carbohydrates are utilized for energy. • The carbohydrates you consume may be simple or complex carbohydrates • Prefer complex to simple carbohydrates • Take more complex carbohydrates like Cereals and whole grains • Avoid simple carbohydrates like sugar and chocolate • It should be about 60% of total diet. • E.g.: wheat, bajra, jowar, nachni, corn, roti, bread, bhakri, idli, dosa, thepla, rice, pulav. 38 Vitamins and Minerals • Vitamins are available from the various fruits we eat • Minerals are available from the vegetables we eat • Regular intake of Fruits and Vegetables will ensure adequate intake of vitamins and minerals. • E.g.Citrus fruits like oranges, sweet lime rich in vit C Papaya, carrots rich in Vitamin A. Palak, beet,pomegranate rich in iron. Dudhi rich in calcium. 39 Anti-Oxidants Free radicals are produced in our body due to oxidation Lead to aging, loss of memory, increased risk of CHD Anti-oxidants help combat free radical production They delay aging, improve memory and reduce risk of CHD. E.g. lime, Soya, almond, walnut, pista, flax seeds, green tea, all citrus fruits. 40 DIETARY FIBRE Dietary fibre is of two types SOLUBLE • Pectins, gums, mucilages, hemicelluloses • Found in oats, legumes, dhals and fruit INSOLUBLE • Cellulose and lignin • Present in skins and seeds of fruit and vegetables and whole grains Fiber There are 4 main advantages of having fiber regularly • Reduction in cholesterol • Reduction in blood sugar • Reduction in body weight • Reduction in stomach/ digestion related problems. E.g. : Oats, barley, nachni, whole wheat,bran, nuts, flax seeds, Psyllium husk, raw salad, fruits & vegetables with skin. 42 HOMOCYSTEINE • High levels of homocysteine is associated with heart disease. • Vitamins folic acid, B6 and B12 are needed to reduce homocysteine in the blood. Low folic acid and B6 have been connected with heart disease. • Be sure to eat foods containing these vitamins – B6 - Whole grains, meats, chicken, potatoes, bread, cereals, dark green vegetables, nuts – Folic acid - Dark green leafy vegetables, liver, eggs, legumes Water • Regular Water intake necessary to keep us hydrated • At least 10 – 12 glasses required daily. (1 glass = 200 ml) • Deficiency may lead to : Dehydration Fatigue. Urinary infections Kidney stones 44 EATING OUT • Eat a small low fat snack before going out • Choose baked, steamed or dry roasted items such as idlis, idiappams, plain rice, pulkas or naans • Limit or avoid dishes with coconut or cream. • Choose unsweetened low calorie beverages instead of sweet, creamy or alcoholic beverages. • Order fruit for dessert instead of rich desserts, ice-cream or Indian sweets • Avoid salty snacks and foods. • Eat in moderation. THE HEART HEALTHY DIET • • • • • • Low total fat Low saturated fat Low cholesterol Low sodium Low simple sugars Moderate carbohydrate • Moderate energy • Moderate protein • High fibre THANK YOU!