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Live Web Chat Transcript : Melissa Ohlson, R.D. |
Cleveland_Clinic_Host: Welcome Melissa, and thank you for joining us today. It is wonderful that you can join us. We look forward to an interesting chat today. Welcome! Let's begin with one of the questions! Speaker_-_Melissa_Ohlson: Hello - thank you for having me. Coumadin and Diet saturn: Could you address the use of coumadin in a healthy heart diet? Many times walnuts, oils, broccoli etc affect the INR adversely. Speaker_-_Melissa_Ohlson: Interesting that you asked this question, in the Health Section of today's paper (Cleveland Plain Dealer), they discussed the interaction between warfarin and vitamin k rich foods - and actually provide a reference for more information. Speaker_-_Melissa_Ohlson: Vitamin K is the nutrient that tends to work against coumadin, in fact promote more blood clotting. There are many foods that are rich in vitamin k, such as dark leafy green vegetables, certain teas, and other foods. It is best to work along side your physician if you include vitamin k rich foods frequently in your diet. Your INR can be tracked as well as the dosage you need - we don't want to encourage you to take vitamin K out of the diet as these foods are rich in other cardio-protective nutrients - however, a consistent amount is needed in your diet each day to not adversely affect your dosage. ritco: can veggie burgers affect my inr Speaker_-_Melissa_Ohlson: I am unsure of the vitamin K of veggie burgers - maybe you can contact the manufacturer. Omega 3 saturn: Is there any other fish beside salmon than provides omega 3? We understand that pacific fish is preferable to Atlantic because of mercury. Speaker_-_Melissa_Ohlson: Any cold water variety of fish - sardines, anchovies, and herring also are high in Omega 3. See http://www.clevelandclinic.org/heartcenter/pub/women/nutritioncorner_omega.htm for more information about Omega 3, fish, amount of omega 3 in each fish, and more. metoo: Good Afternoon! What are some good foods for memory? I know that there are vitamins (B6 and Ginseng) however, I would like to incorporated better foods in my diet for energy and memory retention. Speaker_-_Melissa_Ohlson: What a great question! Omega 3 rich foods have also been linked to memory and reducing age related mental decline. In addition to a diet rich in fresh fruits, whole grain, vegetables, and legumes, I would encourage you to include foods like walnuts, ground flax seed, soy, canola, dark leafy greens and fatty fish. And - other omega 3 fortified foods such orange juice, eggs, etc. Speaker_-_Melissa_Ohlson: For my personal experience foods that maintain my energy and memory are foods that do not contain a lot of added sugars or cause a large fluctuation in blood sugar. Weight Management and Healthy Diet cjaward: I had open heart surgery in 2005. Since then I have had two children, and am now a bit over weight. I am 5'1'' and I weight about 175. What is my ideal weight and what are some healthy diet alternatives that I can do? Speaker_-_Melissa_Ohlson: Anywhere from 115 to 130 would be considered in the normal range in the Body Mass Index scale - a measurement of your weight relative to height. But, more importantly research shows a 5 - 10 percent drop in body weight can significantly reduce risk factors for diabetes and cardiovascular disease. Here is a page on BMI - http://www.clevelandclinic.org/heartcenter/pub/women/bmi.htm Speaker_-_Melissa_Ohlson: Here are some healthy tips: Speaker_-_Melissa_Ohlson: Always eat a high fiber breakfast. Never skip meals. Always include 1 to 2 healthy snacks throughout the day (maybe these should not exceed 200 calories). Speaker_-_Melissa_Ohlson: Once you get physician clearance, engage in a regular physical activity program. Work toward a goal of 60 minutes of exercise most days of the week - brisk walking is a great start. Consider taking your children for a walk or join a gym that has daycare services. Speaker_-_Melissa_Ohlson: One other things, plate your meals in a heart friendly manner. Half should be fresh or cooked colorful vegetables. One quarter should consist of a lean protein - fish, chicken or beans. And the last quarter of the plate should consist of a handful (closed fist size) of whole grain starch. Speaker_-_Melissa_Ohlson: See our weight management tips - http://www.clevelandclinic.org/heartcenter/pub/women/weightmanagementtips.htm Speaker_-_Melissa_Ohlson: There is a picture of what your plate should look like. kjf52: Is south beach diet a good diet to lose weight? Speaker_-_Melissa_Ohlson: Like many diets, the south beach has a "catch." I don't necessarily agree with its induction period - excluding certain food groups. However, I do like its emphasis on whole foods, whole grains and lean meats and fish. Excessive calories coming from any food group can lead to weight gain. I would suggest meeting with a dietitian to come up with a meal plan that fits your individual health needs. amyd: I have heard about a drug that helps you lose weight by blocking fat in your diet - is that true - is that a good diet? Speaker_-_Melissa_Ohlson: It is likely a high fiber supplement of some kind. However, I would suggest you sway against any such products as research shows, the greatest success with losing weight and maintaining it is through exercise and a healthy eating plan. I am very leery of the side effects or potential risks of such supplements. Speaker_-_Melissa_Ohlson: On second thought you may be thinking of Alli - also known as Xenecal, which does block the absorption of a certain amount of fat and does help people who follow a calorie restricted diet lose an addition 5 percent per their research. amyp: Is diet pop ok - I have heard that you can gain weight - how can that happen? Speaker_-_Melissa_Ohlson: There is controversy surrounding the use of sugar substitutes and weight loss. Some believe just eating or drinking something sweet, regardless if it is sugar, enhances the desire for more sugar. Speaker_-_Melissa_Ohlson: Stay tuned for more research to be done in this area. robbie: I have seen meat like bison in the supermarket - is that a better cut of meet to eat. If you like red meat, what type of meat should you eat? Speaker_-_Melissa_Ohlson: Bison tend to be leaner as does lean cuts of pork and beef. Look for cuts ending in ion - tenderloin, sirloin. Choose 92% or leaner beef products. Choose cuts that have the least amount of marbling. Flax Seed dlafond: Are there any real benefits to using flax seed? Speaker_-_Melissa_Ohlson: Yes. Flax can be a great addition to your diet. For starters it is a good source of cholesterol lowering soluble fiber. Adding 1 - 2 tablespoons a day can be part of a heart healthy diet. In addition, flax is a good source of omega 3 fat, which has additional heart protective benefits. Lastly, flax is a good source of cancer fighting lignins. Speaker_-_Melissa_Ohlson: You don't get these benefits from flax seed oil because the fiber and lignins are removed. Remember to always grind or purchase your flax seed milled or ground. Sodium, High Blood Pressure and Your Heart ckyoho: I had a mitral valve repair and maze procedure a year ago. I do not have high blood pressure. My resting heart rate is 80. Do I need to watch salt? And if so, why? Speaker_-_Melissa_Ohlson: All of us should be aware of our sodium intake, taking no more than 1500 to 2400 mg of sodium a day for most healthy people. Talk with your doctor. He may be limiting your salt for other medical reasons. sandy: my husband had bypass surgery. he was told to watch his fat. my father had a heart attack and he was told to watch his salt. does my husband have to watch his salt too? Speaker_-_Melissa_Ohlson: For your father, there may have been damage to the heart muscle, which can cause the added need to watch salt. But your husband should also be aware of the salt content of his. As I mentioned before, we all should limit our sodium content. If you are concerned, you should speak to your husband's doctor. whynot: I heard there was a diet that can help if you have high blood pressure - can you tell me more about that. I know I need to eat less salt - but what else? Speaker_-_Melissa_Ohlson: This is called the DASH diet - dietary approaches to stop hypertension. This diet includes fresh vegetables, whole grains, lean meats, low fat dairy, and healthy fats. It is basically a heart healthy diet rich in potassium, calcium and other heart protective nutrients. Here is an article on DASH - http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/askdietician/ask3_02.htm Speaker_-_Melissa_Ohlson: Also go to the NHLBI website for a detailed description of DASH. danielle3958: My dad has a low ejection fraction -- 30%. They said watch your diet. What does that mean? Speaker_-_Melissa_Ohlson: It is best to talk to your doctor. They will have specific guidelines on what to include and not include in their diet. Speaker_-_Melissa_Ohlson: Patients with low ejection fraction are often told to maintain a low sodium diet and are given specific sodium restrictions - here is a handout that may help you - http://www.clevelandclinic.org/health/health-info/docs/1800/1834.asp?index=8122 Healthy Snack Foods kjf52: What are good snacks that are low in calorie but good for your heart - I usually get hungry around 3 pm - what should I eat? Speaker_-_Melissa_Ohlson: Here are some suggestions that are low in calories: 1. non-fat yogurt with a tablespoon of nuts sprinkled on; 2. raw veggies dipped in about 1/4 cup of hummus; 3. piece of fruit and 1 low fat string cheese; 4. small bowl of instant plain oatmeal; 1/4 cup of home-made trail mix. Portion size is key and try to always choose foods that are the least processed - whole foods. kjf52: Fruits are sugars and for example south beach does not want you to eat fruit without a protein. How much fruit should you or can you eat each day? Speaker_-_Melissa_Ohlson: For a healthy diet, we encourage you to consume at least 3 servings a day of fruit. More or less depending on your calorie of fruit - a serving is about the size of a tennis ball for apples or pears. About a 4 inch banana, 1/2 grapefruit, 1 cup berries. High Cholesterol and Healthy Diet babs: my friend had high cholesterol and went on the Atkins diet. he swears his cholesterol got better - I also have high cholesterol and I am thinking of trying it to lower my cholesterol - what do you think? Speaker_-_Melissa_Ohlson: I highly recommend NOT using the Atkins diet to lower your cholesterol. Any weight loss will likely lower your cholesterol and that may be the reason your friend's cholesterol went down. The traditional Atkins diet includes all foods that traditionally raise cholesterol. I would suggest a Mediterranean dietary pattern, which is rich in heart protective foods that can lower cholesterol - here is a link for more information - http://www.clevelandclinic.org/heartcenter/pub/women/nutritioncorner_mediterranean.htm High Fiber metoo: What is a good high fiber breakfast for someone on the run? At work early, stays late! Speaker_-_Melissa_Ohlson: Keep a container of rolled oats, some frozen berries, fresh fruit, and nuts at your work area or fridge. Oats cook up in 2 minutes. Speaker_-_Melissa_Ohlson: If you can't heat something up, try whole grain bread with natural peanut butter and all fruit preserves. The mix of protein and high fiber carbohydrate is a sure fire way to keep your appetite at bay. metoo: Whole grain vs. whole wheat - which is better and why? Don't these breads also contain high levels of sodium? Speaker_-_Melissa_Ohlson: Whole wheat is included in the general term whole grain. Whole grain includes whole oats, rye, corn, brown rice, whole wheat, etc. Make sure the word "whole" is the first ingredient whatever the grain may be when choosing foods. Nuts and Healthy Diet ccornrose1: I love peanuts- how bad are they for me Speaker_-_Melissa_Ohlson: They are not bad. They are a good source of mono-unsaturated fats, zinc, protein and other nutrients. The problem lies in the processing - try to get dry roasted, unsalted and the quantity you consume - about 1 oz a day is all you need for heart health. Nutrition Resources jean22: what are good diet websites for information about fat in food? Speaker_-_Melissa_Ohlson: Here is a list of helpful resources - http://www.clevelandclinic.org/heartcenter/pub/women/nutritioncorner_resources.htm Speaker_-_Melissa_Ohlson: Also we have a handout that describes the different fats and how they affect the heart. See http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/nutrition/strategies.htm Transplant and Diet dlafond: I was reading an article about transplant patients should not eat eggs that are over easy. Is this true? Speaker_-_Melissa_Ohlson: I am not aware - check with your doctor. However, undercooked eggs that are not pasteurized always pose a risk for salmonella. Cheese bneed: What kind and amount of cheese should be used to maintain the fat content? Speaker_-_Melissa_Ohlson: Regular cheese is high in saturated fat and generally should be limited if your cholesterol is high. Everyone varies depending on calorie requirements. I suggest you purchase reduced fat or non-fat alternatives. Fat, Cholesterol, Lipids and Diet marktom: Are there foods you can eat to raise your HDL? Also if I have high triglycerides, what foods should I avoid? Speaker_-_Melissa_Ohlson: There are not many foods that can raise HDL. However, lowering triglycerides, if elevated, losing weight, and engaging in raising in regular sustained aerobic activity most days of the week, may raise HDL. Speaker_-_Melissa_Ohlson: To lower triglycerides, limit added sugar in your diet. Also - choose omega 3 rich foods - choices you can find above. Spacing your meals and not eating too much at one time and avoiding very high fat foods can also help. andee: What does Benecol do? Speaker_-_Melissa_Ohlson: Benecol, as well as Promise active spreads and supershots, contain phytosterols or plant sterols or stanols. These are naturally occurring substances found in all plant foods but the amount we need to consume for heart health benefit would greatly exceed our caloric needs. These substances compete with cholesterol in our bodies for absorption. Consumption of sterols or stanols at about 2 grams or servings per day may result in a 14 percent reduction in LDL cholesterol. Speaker_-_Melissa_Ohlson: Benecol contains stanols and Promise products contain sterols. Most other products on the market contain sterols and lower cholesterol about the same. popeye: I saw a healthy heart recipe that had avocado in it - I thought avocados where high in fat - but are they good for you - can you eat guacamole - is that ok? Speaker_-_Melissa_Ohlson: Yes - they are a great source of potassium and monounsaturated fats and should not be excluded from the diet. Portion control is key because they are calorie dense. A little guacamole with your meals can and should be enjoyed. Caffeine and your heart jqsmith: Is it ok to drink caffeine if you have a heart condition? How much is too much? Speaker_-_Melissa_Ohlson: The amount of caffeine your body can tolerate is very individualized - you should check with your doctor - as there is no actual guideline provided. Water kjf52: If you drink water that has ice tea mix in it or flavored water with crystal lite - does that count for water for the day? Speaker_-_Melissa_Ohlson: Yes - it does count as your fluid. Healthy Breakfast jane: Are there any milk shakes (pre-made) or breakfast bars that you know of that are low in calorie and healthy for your heart? I am on the go and want to grab something for breakfast Speaker_-_Melissa_Ohlson: I don't know particular brands but look for products that have less than 2 grams saturated fat per serving and contain at least 3 grams of fiber. The same goes for the bars. Speaker_-_Melissa_Ohlson: Just take note that 5 minutes spent making a peanut butter sandwich or whole grain cereal over yogurt and eating in the car can provide you with a less processed alternative and much healthier for your heart. Chocolate saturn: Is dark chocolate (60%) good for ones heart? Doesn’t the high fat content raise the triglycerides and LDL? Speaker_-_Melissa_Ohlson: The darker the chocolate or the higher percentage of cocoa content, the more bitter the taste - and therefore the higher flavanol (phyto-nutrient) content that derives the purported health benefits of chocolate. Speaker_-_Melissa_Ohlson: So, as part of an overall heart protective diet, rich in fruits, vegetables, whole grains, yes this chocolate can fit. However, the consensus is not out on exactly how much we would need to consume of dark chocolate to get a specific amount of heart benefit. Don't ever bank on chocolate to save your heart - it is just nice to know we can include it and enjoy it. Speaker_-_Melissa_Ohlson: With respect to LDL and triglycerides, the least processed dark chocolate - meaning with out nougat, nuts, extra sugars added - should not significantly raise LDL nor triglycerides - as long as it fits into your overall caloric needs. The saturated fat content of chocolate is comprised mainly of stearic acid which is generally neutral on lipids. However, portion control is always important. Speaker_-_Melissa_Ohlson: A lot of you have obviously shown interest in nutrition and I thank you for your great questions. If you would like more sound nutrition advice or a diet plan more specific to your individual needs, please consider seeing a local dietitian in your town, coming to our main campus Preventive Cardiology Nutrition Program - or seeing me online for a remote nutrition consult at http://www.eclevelandclinic.org Cleveland_Clinic_Host: If you would like more information regarding healthy eating, please visit the Cleveland Clinic Heart and Vascular web site at http://www.clevelandclinic.org/heart . For general health information you may also wish to visit www.clevelandclinic.org/health More information:
Technology for web chats paid in part by an educational grant from AT&T Ohio and the AT&T Foundation (formerly SBC). © Copyright 2008 The Cleveland Clinic Foundation. All rights reserved 4/08 |
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