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Diet, Diabetes, and Obesity

Your dietary habits affect your risk of heart disease. Modifying your diet to control weight, blood sugar, and cholesterol levels is a critical component of a healthy heart lifestyle.

Obesity places an added workload on the heart which is directly proportional to body weight. The risk of developing heart disease increases as body weight increases. The heart requires more oxygen, because it must pump harder to supply blood to a larger area. Obesity is closely linked with a poor diet (a high fat and cholesterol intake), and a sedentary lifestyle.

Elevated cholesterol levels are also linked to heart disease. Cholesterol deposits on the walls of blood vessels may lead to clogged arteries. Cholesterol can be controlled by diet, weight loss, and medication.

Diabetes is characterized by an elevated blood sugar level due to an inadequate secretion or absence of insulin. It is a major risk factor for atherosclerosis and is compounded in the presence of other risk factors. Those with diabetes tend to have high cholesterol, triglycerides, and blood pressure. Therefore it is important to maintain good control of this disease with proper body weight through diet, exercise, regular medical checkups, and medication if ordered by a physician.

Food Guide Pyramid

The USDA’s Food Guide Pyramid makes it easy to choose a balanced diet from the five major food groups. The base of the pyramid contains the largest portion of food in the form of grains: bread, cereal, rice, and pasta. Add the recommended number of servings from the fruit, vegetable, milk, and meat groups for a balanced diet. It is important to eat a variety of food from each group. The chart below shows examples of serving sizes.
Please note: This is a general guide for people without dietary restrictions and may be modified by your physician or dietitian.

Bread, Cereal, Rice, and Pasta Group
1 slice bread
3 to 4 small crackers
1 oz. of ready-to-eat cereal
½ cup of cooked cereal, rice, or pasta
Vegetable Group
1 cup of raw leafy vegetables
¾ cup of vegetable juice
½ cup of other vegetables, cooked or chopped raw
Fruit Group
1 medium apple, banana, orange
¾ cup of fruit juice
½ cup of chopped, cooked, or canned fruit
Milk, Yogurt and Cheese Group
1 ½ ounces of natural cheese
2 ounces of process cheese
1 cup of milk or yogurt
Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts Group
2-3 ounces of cooked lean meat, poultry, or fish
½ cup of cooked dry beans, 1 egg, 1/3 cup nuts, or 2 tablespoons of peanut butter count as 1 ounce of lean meat

Dietary Fats and Heart Disease

Fat – An essential nutrient used by the body for many functions including energy, thermal insulation, vital organ protection, cell structure, and function. It is recommended that less than 30% of food calories come from dietary fats, which are present in foods of both animal and vegetable origin.

Cholesterol – A waxy, fat related compound in the body tissues and organs of man and animal, cholesterol plays a vital role in metabolism. However, cholesterol is a key part in the creation of fatty deposits in the arterial walls and increased blood cholesterol is a risk factor in coronary artery disease. Cholesterol is found only in foods of animal origin. It is recommended that the daily intake of dietary cholesterol be no more than 200 – 300 mg. per day.

Low Density Lipoprotein (LDL) – A type of cholesterol carrier which deposits cholesterol on the walls of blood vessels.

High Density Lipoprotein (HDL) – A type of cholesterol carrier which helps remove cholesterol from the bloodstream.

Saturated Fat – Fat that is usually solid or semisolid at room temperature and can be found in meat and vegetable sources. A diet high in saturated fat frequently increases blood cholesterol and LDL.

Polyunsaturated Fat – Fats primarily from vegetable sources which are generally liquid at room temperature. When used in moderation, they tend not to effect blood cholesterol levels.

Monounsaturated Fat – Fats which help to lower blood cholesterol when used in place of saturated fat in the diet.

Omega-3 Fatty Acids – Fats found in fish sources which help to lower LDL cholesterol.

Reducing Dietary Cholesterol

Protein is essential for good health. But many protein-rich foods are animal products which are also high in saturated fats and cholesterol. Fatty cuts of “red” meat, and organ meats are the worst offenders. In order to obtain the best protein with the least amount of fat and cholesterol, eat more fresh water fish, legumes (dried peas, beans, and grains), and skinless poultry. When you do eat meat, trim all visible fat before cooking and limit the portion size to three ounces/day (the size of a pack of cards).

Skim milk, yogurt, and skim milk cheeses are the best dairy choices. When buying cheese (which is traditionally high in saturated fat), look for low fat varieties such as farmer’ s cheese, pot cheese, uncreamed cottage cheese, or part-skim ricotta.
Whole grain breads, cereals, and pastas are your best choices. When buying baked products, such as muffins, read labels carefully. Many obtain half their calories from saturated fats such as palm and coconut oil.

With few exceptions, fresh fruits and vegetables are naturally low in saturated fat. Palm oil, palm kernel oil, coconut oil, and hydrogenated vegetable oils are highly saturated.
Many fat calories come from the fats we add to foods in the form of butter, sauces, spreads, etc. To reduce added fats:

  • Spread sandwiches with mustard instead of mayonnaise.
  • Switch to “light” mayonnaise (1/2 the fat).
  • Buy “old-fashioned” peanut butter with no added fat and pouring off the oil instead of mix it into the peanut spread.
  • Use tub or pourable margarine instead of stick margarine or butter.
  • Sauté foods in broth, bouillon, or using oil sprays.
  • Substitute two egg whites for the whole egg in recipes.
  • Buy skim milk or 1% fat dairy products (which contain 28% of their calories from fat) and the leanest of meats.
  • Use more skinless poultry, fish, low fat dairy products, tofu, and legumes for protein sources rather than red meat.
  • Prepare small portions of meats by baking, broiling, stir frying, poaching, steaming, or microwaving. Do not prepare meats with additional fats. Drain cooked burgers on paper towels.
  • Use nonstick pans and spray.
  • Skim the fat off of all gravies, soups, and sauces (best to chill it first).
  • Use spices and herbs instead of added fat.
  • Use low-fat cottage cheese and yogurt, instead of sour cream and cream cheese, in dips and on potatoes.
  • Use fruits, ice milk, or nonfat yogurt for dessert.
  • Make complex carbohydrates (whole grain starches, fruits, and vegetables) a larger part of your meals.

Food Sources of Fat in the Diet

When you must use fats, use poly or monounsaturated vegetable oils.

POLYUNSATURATED MONOUNSATURATED  SATURATED
corn oil canola oil lard
safflower oil peanuts butter
sunflower oil peanut oil egg yolk
soybean oil olives whole milk
tub margarine olive oil cream
pumpkin seed avocado meats
sunflower seed cashews/pecans organ meats
walnuts filberts palm
  almonds coconut oil

Be Aware of Food Sources High in Sodium

Many cardiac patients are restricted to 2000 mg. (2gm) of sodium/day to minimize fluid retention and reduce the workload on the heart. All the sodium we need can be found naturally in balanced meals excluding the use of processed foods, added salt during cooking, or at the table. The following are some foods to avoid:

A-1 steak sauce
anchovies
bacon
bacon fat
baked stuffing mix
baking powder
baking soda
bologna
bouillon cubes or powders
buttermilk
canned gravies or sauces
canned ravioli or spaghetti
canned stews
canned vegetables
catsup
caviar
celery salt
cheese doodles
cheeses: regular, processed and spreads
chili sauce
Chinese food: canned or restaurant
commercial Italian foods
corned beef
flavored salts: Adolph’s, etc.
frankfurter/hot dogs
frozen breaded fish
frozen breaded fish
frozen breaded meats
frozen T.V. dinners
garlic salt
gefilte fish
ham, smoked or cured
Hamburger Helper mix
hamhocks
herring
instant cereals
Kitchen Bouquet
knockwurst
kosher meats
lite salt
liverwurst
lox
luncheon meats
malted milk
meat extenders
meat tenderizers
mono-sodium glutamate (Accent)
nuts (salted)
olives
onion salt
party spread and dips
pastrami
pickled pigs feet
pickles
pork substitute (Morningstar)
pot pies
prepared condiments: mustard, horseradish, barbecue sauce
relishes
salad dressing: commercial
salami
salt
salt pork
sardines
sauerkraut
sausage
scrapple
sea salt
seasoned salts
smoked salmon
smoked tongue
snack foods (salted): pretzels, potato chips, corn chips
soups: canned or dry
soy sauce
tomato juice (regular)
Worcestershire sauce

Please note:

  • 1 teaspoon table salt contains approximately 2000 mg sodium.
  • 1 tablespoon soy sauce contains 1029 mg sodium.
  • 1 teaspoon regular meat tenderizer contains approximately 1750 mg sodium.
Texas Surgical Associates