Erasmus : Eating Healthy

We talk about our simple dietary scheme
namely our formula of meal plus fibre plus water plus packers. PLUS System issues such as fat selection and national heart foundation recommendations for dietary food intake are discussed.

I.   Eat A variety of Foods and Especially vegetable type foods
II.  Eat Foods for their Content Vitamins, Minerals and Accessory Pro-Cytokine
Inducing Nutrients.
III. Reduce Cholesterol In your Diet through low saturated fat food intake, with a
subfocus on cholesterol content
IV.  Reduce Sodium Intake

Dr Xxxxx : My emphasis on food recommendations is for pro-immune or cytokine agents to feature in your diet. This class of foods is especially represented in raw vegetable esp. green veges and in nuts, (supposedly containing anti-oxidants).

Dr Xxxxx : Try to eat a wide variety of foods from each of the five food groups. This provides an interesting (not-boring) diet with a range of nutrients, likely to meet basic requirements through diversity of intake.
*    Plenty of vegetables, fruits and wholegrains.
*    A variety of healthy protein sources (especially fish and seafood), legumes (such as beans and lentils), nuts and seeds. Smaller amounts of eggs and lean poultry can also be included in a heart healthy diet. If choosing red meat, make sure it is lean and limit the meat intake to 1-3 times a week.
*    Unflavoured milk, yoghurt and cheese. Those with high blood cholesterol should choose reduced fat varieties.
*    Healthy fat choices –  nuts, seeds, avocados, olives and their oils for cooking.
*    Herbs and spices to flavour foods, instead of adding salt.

Maintain portion sizes suitable for dietary Requirements: 2000 Cal a day for men (approx. 9kJ) and 1800 Cal a day for women, (approx. 8 kJ).

Erasmus : My recommendation for most meals is more basic:
# With every meal: have a meal.
# With every meal: have a glass of water with the meal
# With every meal have a glass of fibre: with the meal or just after the meal
# With every meal, have 2 apple sized chunks of LOW CALORIE FOODS- I call them packers. E.g. Fruit and raw veges. (Not starchy vegetables like potato or pumpkin).

Erasmus : This means that at every meal, you can only eat a fraction of the high calorie foods most of us call a meal, because we also have to eat the other items. In short, our high Cal meal portion becomes a quarter of previous quantities. But now eat fewer calories, though having to eat “more”.

Ideally, the healthy cooked “meal” portion would include servings of – ¼ protein, ¼ carbohydrates and ½ vegetables.

Dr Xxxxx : The Heart Foundation, Australia suggests
As well as sticking to a varied and healthy diet, try these tips to help you manage your cholesterol:
*    Limit takeaway foods to once a week (such as pastries, pies, pizza, hot chips, fried fish, hamburgers and creamy pasta dishes).
*    Limit salty, fatty and sugary snack foods to once a week (these include crisps, cakes, pastries, biscuits, lollies and chocolate).
*    Eat plenty of vegetables – aim for 5 serves of vegetables every day. (1 serve is ½ a cup of cooked vegetables).
*    Choose wholegrain breads, cereal, pasta, rice and noodles.
*    Snack on plain, unsalted nuts and fresh fruit (ideally two serves of fruit every day).

*    Include legumes (or pulses) – such as chickpeas, lentils, split peas), beans (such as haricot beans, kidney beans, baked beans three-bean mix) into at least two meals a week. Check food labels and choose the lowest sodium (salt) products.
*    Use spreads and margarines made from healthy unsaturated fats (such as canola, sunflower or extra virgin olive oil) instead of those made with saturated fat (such as butter, coconut oil and cream).

*    Use healthy oils for cooking – some include canola, sunflower, soybean, olive (extra virgin is a good choice), sesame and peanut oils.
*    Use salad dressings and mayonnaise made from oils – such as canola, sunflower, soybean, olive (especially extra virgin), sesame and peanut oils.
*    Include 2 or 3 serves of plant-sterol-enriched foods every day (for example, plant-sterol- enriched margarine, yoghurt, milk and bread).
*    Have 2 to 3 portions (150 grams each) of oily fish every week. Fish may be fresh, frozen or canned.

*    A Maximum of up to 7 eggs every week.
*    Select lean meat (meat trimmed of fat, and poultry without skin) and limit unprocessed red meat to less than 350g per week.
*    Choose reduced fat, no added sugar milk, yoghurt, or calcium-added non-dairy food and drinks.
*    Limit or avoid processed meats including sausages and deli meats (such as salami).

Dr Xxxxx : Dietary fibre
If you are trying to lower your cholesterol, aim to eat foods that are high in dietary fibre (particularly soluble fibre), because they can reduce the amount of LDL (bad) cholesterol in your blood.

Dr Xxxxx : These foods include:
*    fruit
*    legumes (such as chickpeas, lentils, soybeans, three-bean mix and baked beans)
*    Wholegrain cereals and foods (for example, oats and barley).

High Fat Foods to Avoid

Dr Xxxxx : Dietary fats
Following a healthy, balanced diet that is low in saturated fats and trans-fats can help to lower your cholesterol.
Aim to replace foods that contain unhealthy, saturated and trans-fats with foods that contain healthy fats.

Dr Xxxxx : Unhealthy fats
Foods high in (unhealthy) saturated fats include:
*    fatty cuts of meat
*    full fat dairy products (such as milk, cream, cheese and yoghurt)
*    deep fried fast foods
*    processed foods (such as biscuits and pastries)
*    takeaway foods (such as hamburgers and pizza)
*    coconut oil
*    Butter.

Dr Xxxxx : Foods high in (unhealthy) Trans fats include:
*    deep fried foods
*    baked goods (such as pies, pastries, cakes and biscuits)
*    Butter.

Dr Xxxxx : Healthy fats
Foods high in (healthy) polyunsaturated fats include:
*    margarine spreads and oils such as sunflower, soybean and safflower
*    oily fish
*    Some nuts and seeds.

Dr Xxxxx : Foods high in (healthy) monounsaturated fats include:
*    margarine spreads and oils (such as olive, canola and peanut)
*    avocados
*    Some nuts.

 

Erasmus : What is cholesterol?
Dr Xxxxx : Cholesterol is a fat-like substance in the body. It is produced naturally by cells in the body. It is also ingested in food. The blood cholesterol levels are a composite of 50% body production and 50% dietary intake.

It's important to keep cholesterol in check because high cholesterol levels increase the risk of heart disease (heart attack / myocardial infarct) and stroke. There are different types of cholesterol:
*    Low-density lipoprotein (LDL) — ‘bad’ cholesterol
*    High-density lipoprotein (HDL) — ‘good’ cholesterol.
*    These can be readily assessed by a fasting blood test for “Fasting Lipids including HDL Cholesterol and ratio” generally available from your family doctor or GP in Australia.

Plaque narrowing an artery

When you gain weight, the body handles lipids and fats differently. This leads to an unfavourable profile of fat and cholesterol accelerating arterial damage – leading to increased risk of heart attack or stroke. So hence the importance of low saturated fat diet, and exercise to reduce dyslipidaemia (unfavourable lipid profile)

Dr Xxxxx : High-density lipoprotein (HDL cholesterol) is often called the ‘good cholesterol’ because it helps to remove other forms of cholesterol from your bloodstream and helps to keep cholesterol from building up in the arteries. Low-density lipoprotein (LDL cholesterol) is often called the ‘bad cholesterol’ because it is the main source of cholesterol build-up and blockage in the arteries.

Narrowing in an artery.

 

Dr Xxxxx : How to lower your cholesterol
Healthy diet
You can lower cholesterol over time by eating fewer of the foods that cause high cholesterol and more of the foods that lower cholesterol.
Eat plenty of vegetables, fruits and wholegrains.
Eating foods high in fibre may help reduce the amount of cholesterol in the blood. These include:
*    oats
*    beans
*    peas
*    lentils
*    chickpeas
*    fruit and vegetables

Dr Xxxxx : Aim to eat at least five portions of fruit and vegetables each day.
Choose reduced fat dairy foods such as milk (preferably unflavoured), yoghurt (preferably
unflavoured) and cheese.

Dr Xxxxx : Eat a variety of healthy proteins
The best choices of protein are fish and seafood, legumes (such as beans and lentils), nuts and seeds. You can eat smaller amounts of eggs and lean poultry but limit red meat to 1-3 times a week.

Dr Xxxxx : Flavour foods with herbs and spices rather than salt, and avoid processed foods as these contain a lot of salt too. Salt can lead to high blood pressure, which can increase your risk of heart disease.
Choose healthy fats There are two main types of fat: saturated and unsaturated. Eating foods that are high in saturated fat can raise cholesterol levels in the blood.

Dr Xxxxx : Foods that are high in saturated fat include:
*    meat pies
*    sausages and fatty cuts of meat
*    butter
*    lard
*    cream
*    hard cheese
*    cakes and biscuits
*    foods that contain coconut or palm oil

Dr Xxxxx : Try to replace foods containing saturated fats with foods that are high in unsaturated fats, such as:
*    avocadoes or olives
*    oily fish (for example, mackerel and salmon)
*    nuts (for example, almonds and cashews)
*    seeds (for example, sunflower and pumpkin)
*    vegetable oils and spreads (for example, sunflower, olive, corn, walnut and rapeseed oils)

Dr Xxxxx : Trans fats can also raise cholesterol levels. These fats can be found naturally at low levels in some foods, such as animal products, including meat and dairy.

Artificial Trans fats can be found in hydrogenated fat, so some processed foods such as biscuits and cakes will contain Trans fats.
You should also reduce the total amount of fat in your diet. Try microwaving, steaming, poaching, boiling or grilling instead of roasting or frying. Choose lean cuts of meat and go for low-fat varieties of dairy products and spreads (or eat just a small amount of full-fat
varieties).

Dr Xxxxx : Foods containing cholesterol
Some foods contain cholesterol. This type of cholesterol is called 'dietary cholesterol'. Foods such as eggs and prawns are higher in dietary cholesterol than other foods. The cholesterol found in food has much less effect on the level of cholesterol in your blood than the saturated fat you eat. The Heart Foundation recommends that you should limit eggs to 7 a week if you need to lower your LDL cholesterol. Actually prawns contain a cholesterol like substance and are low in fat. So most people eating shop bought prawns will actually reduce their blood cholesterol levels.

Erasmus : If your doctor has advised you to change your diet to reduce the level of cholesterol in your blood, the most important thing to do is to cut down on saturated fat. It's also a good idea to increase your intake of fruit, vegetables and fibre.

Dr Xxxxx : Cholesterol-lowering products
There is evidence that foods that contain certain added ingredients, such as plant sterols and stanols, can reduce levels of cholesterol in the blood. Plant sterols and stanols are found in nuts, seeds and legumes, vegetable oils, breads and cereals, and fruits and vegetables. You need to eat 2 to 3 grams a day of plant sterols and stanols to assist in reducing high cholesterol. Eating more is not harmful, but you won't get any additional benefits.

One way to boost your intake of plant sterols and stanols is to eat foods that have been enriched. In Australia, these enriched foods include some margarines, low-fat milks, low-fat yoghurts and breakfast cereals, lower fat cheese and processed cheese. People who do not have high cholesterol should not eat these products regularly, particularly children and pregnant or breastfeeding women.

If you do eat foods that are designed to lower cholesterol, read the label carefully to avoid eating too much.

Dr Xxxxx : You should not eat foods fortified with plant sterols as a substitute for medication. You can use plant sterol-enriched foods while taking cholesterol medication, but check with your doctor first.

Exercise Class

Erasmus : Get active
An active lifestyle can help to lower cholesterol levels. Activities range from walking and cycling to more vigorous exercise such as running and dancing. Doing 30 minutes of moderate-intensity aerobic activity on most days can improve your cholesterol levels.
Moderate-intensity aerobic activity means you work hard enough to raise your heart rate and break a sweat.

One way to tell whether you are working at moderate intensity is if you can still talk but you cannot sing the words to a song.

Dr Xxxxx : Quit smoking
Smoking lowers levels of HDL (‘good’) cholesterol. Quitting smoking is important to prevent your risk of heart disease or stroke, especially if you have high cholesterol.

Fruit and Veges

Dr Xxxxx : Snacks
Nuts and seeds are a rich source of cholesterol-lowering unsaturated fats as well as cytokine modifying anti-oxidants. A small handful of nuts / seeds as a snack between larger meals can keep you feeling fuller for longer, and regular consumption is linked to lower levels of LDL cholesterol.  Heart disease risk appears reduced when these types of “natural antioxidants appear in a person’s diet.

Dr Xxxxx : Other key tips
*    Use healthier oils. Saturated and trans fats raise your bad (LDL) cholesterol levels, so switch to fruit, nut or seed-based oils and spreads (such as canola, olive or sunflower) rather than choosing butter and other animal-based fats.

*    Include a variety of healthy proteins. With this in mind, lean cuts of meat and reduced fat dairy products can also help keep your cholesterol down and your heart health up!
*    Including foods fortified with plant sterols can also help to reduce LDL cholesterol.

If you are having trouble with your cholesterol levels, a dietician can help you to eat healthily for your specific needs.

 

Dr Xxxxx : Medication
The most common type of medications to lower cholesterol are called statins . These lower the level of LDL or ‘bad’ cholesterol in the blood and reduce your risk of heart attack or stroke.

Dr Xxxxx : These medications are important in the long term for reducing your risk. However, most people feel no different in any way as a result of taking these medications. The benefit can be difficult to assess if you only look at heart attack risk. However, in angina patients, starting on statins stops progression of angina and stops reblockage of arteries after CABG – Coronary Artery Bypass Grafting.