Live Web Chat Transcript:

Heart Healthy Eating — November 21, 2007

Julia Zumpano, R.D.
Dietitian, Section of Preventive Cardiology and Rehabilitation
Cleveland Clinic Department of Cardiovascular Medicine

Cleveland_Clinic_Host: Welcome Julia Zumpano and thank you for being with us today. Let's begin!

Speaker_-_Julia Zumpano: Thank you for having me.

Eating Healthy For the Holidays

Cleveland_Clinic_Host: Welcome Julia, lets start with a hard one...during the holiday season it is so hard to keep fit and eat well, do you have any tips?

Speaker_-_Julia_Zumpano: The first tip would be to try to get moving in any way - take a walk, get up an exercise. Make a more conscious effort to be active during the holidays.

Speaker_-_Julia_Zumpano: The second tip would be to aim for five a day of fruits and vegetables combined - get in your fruit and vegetable servings for the day because those are low calorie foods that will help you avoid over-eating the starches and meats.

Speaker_-_Julia_Zumpano: Limit to one unhealthy food a day - dessert food or snack food. The holidays seem to span throughout the month - it is not just Thanksgiving or Christmas. So, try to limit yourself to just one unhealthy food per day.

Speaker_-_Julia_Zumpano: Four. Never go to a party hungry. Small frequent meals are a good way to keep yourself satisfied. At least three meals a day. If you go to a party hungry, you are more likely to over-eat.

Speaker_-_Julia_Zumpano: Five. If you are going to a party, try to plan ahead and bring a low calorie dish with you so you know that there is at least something that you are able to have.

Speaker_-_Julia_Zumpano: Last, focus on socializing and not eating. Stay away from the food table. Portion one plate and try to stay away from temptation.

karenk: is it possible to eat healthy during the holidays?

Speaker_-_Julia_Zumpano: Yes - but it is probably the most challenging time to do it. Keep in mind the tips that were stated in the beginning of this chat.

margaret: Is it possible to create stuffing that is healthy?

Speaker_-_Julia_Zumpano: Yes. Adding vegetables, removing meats and cutting down on the fat source creates a healthier stuffing.

brenda: if you have vegetarian guests for the holidays, what can you serve?

Speaker_-_Julia_Zumpano: Serve several vegetable based dishes. Such as, a salad, cooked yams, green beans, or 5 bean salad. Replace meat with beans or textured vegetable protein. There are different types of vegetarians so you may want to ask your guests what they are able to eat.

JennyK: Do you have any good ideas for appetizers that would be low in fat but taste good?

Speaker_-_Julia_Zumpano: You can check out many healthy recipes on our website. Such as - minted fruit kabobs, veggies and dip. Also our Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook also has many recipes. Try to keep appetizers under 5 grams of fat per serving.

Special Diets

hope1958: do you know anything about detox diets? Do they work? are they good for you to detox for cholesterol lowering and weight loss?

Speaker_-_Julia_Zumpano: Detox diets are predominately very high fiber and vegetable diets that clean you out. I have never heard that they are recommended for cholesterol reduction. It is commonly used to help initiate a weight loss diet.

jonathan: I was told to restrict my carbs. Is fruit really bad for you? Can I eat fruit?

Speaker_-_Julia_Zumpano Fruit is an excellent source of vitamins, minerals and fiber. Fruit should be restricted to three servings per day on a low carb diet.

hetsock: If you want to decrease carbs in your diet -what is the best type of pasta? whole wheat? Is spinach pasta ok?

Speaker_-_Julia_Zumpano: The best kind of pasta to choose is whole grain pasta with greater than 3 grams of fiber per serving. Spinach pasta is most likely made with bleached or enriched flour, therefore is not recommended, unless the first ingredient is listed as a whole grain and the fiber meets the goal.

briank: I am confused. My doctor told me to watch my fat in the diet. I eliminated all meat - I eat fish and poultry only sometimes. I eat a lot of vegetables and grains My cholesterol is down a little bit but my HDL is very low. Someone told me I should eat more protein and less grains or carbs. I really don't know what I am doing. Can you tell me what is best for raising HDL and lowering cholesterol?

Speaker_-_Julia_Zumpano: The best for lowering cholesterol would be restricting saturated fat to less than 7 percent of calories, transfat as low as possible (less than 1 percent of calories); and dietary cholesterol to less than 200 mg/day.

Speaker_-_Julia_Zumpano: For increasing HDL cholesterol, exercise provides the most benefit, although the addition of unsaturated fats in moderate amounts has been shown to have a marginal benefit. Unsaturated fats include olive oil, canola oil, nuts, seeds, olives, avocados.

dutchy: i got prostate problems what not to eat?

Speaker_-_Julia_Zumpano: The best thing to do is to talk to your doctor or meet with a dietitian to assess your full medical history and make specific recommendations.

tk334: Can you really show regression of plaque with diet? what type of diet would you need to follow?

Speaker_-_Julia_Zumpano: Our cardioprotective strategies are on our website at http://www.clevelandclinic.org/heartcenter/pub/guide/prevention/nutrition/strategies.htm. You may want to make an appointment with a dietitian to assist in developing a personalized plan to meet your goals.

Snack Foods

cynthia: If you are hungry and you want to eat snacks - what is better: high protein, fruit, what are the best snack foods?

Speaker_-_Julia_Zumpano:The best snack food is a combination of protein and a complex carbohydrate. Such as - fruit and nuts; whole grain toast and peanut butter; or low fat cottage cheese or cheese.

Speaker_-_Julia_Zumpano:Complex carbohydrates are foods that provide carbohydrate and fiber.

Medications and Diet

karenl: If you are on coumadin what are foods you should avoid? Are there types of lettuce you can eat for a salad?

Speaker_-_Julia_Zumpano:People who are on Coumadin should avoid foods that are high in vitamin K. The lettuce you can eat in a salad include cabbage, arugula, iceberg, and redleaf. These are medium to low sources of vitamin K.

nan: I heard you should not eat grapefruit with your pills. I like grapefruit. Is there a time when you can eat it again or should you just avoid it always.

Speaker_-_Julia_Zumpano:You should not eat grapefruit with statin drugs. Review the medication interactions provided from your pharmacy.

ms70: I have high cholesterol. I take zocor. I am an avid tennis player. What types of snacks can I eat before or after intense exercise?

Speaker_-_Julia_Zumpano:Again - ideally a source of complex carbohydrate and protein. Examples would be fruit and nut trail mix, whole grain cereal, low fat yogurt and fruit. You could eat a whole grain snack bar with less than 2 grams of saturated fat and greater than 5 grams of protein per bar.

Nutrition Resources

Cleveland_Clinic_Host: Julia, can you talk about the different heart nutrition services available at Cleveland Clinic

Speaker_-_Julia_Zumpano:The first would be individual - one-on-one, face-to-face counseling.

Speaker_-_Julia_Zumpano:Secondly, we offer online nutrition counseling. In the comfort of your own home, via our new eNutrition Counseling - a web-based nutrition counseling program Pull down the menu “My Consult” and go to “Nutrition.” http://eclevelandclinic.com/

Speaker_-_Julia_Zumpano:In addition, we offer a variety of Culinary Classes and a 10-week group weight loss program, which is a comprehensive program, that includes group exercise and educational classes, individual nutrition consultations, and exercise prescription.

markB: do you know a good website for looking up the nutritional information of food?

Speaker_-_Julia_Zumpano:http://mypyramid.gov is a governmental based nutrition website.

Recipe Substitutions

susan: Can you use low-fat margarine instead of butter in the same measurement in a recipe? What about sugar - can you use splenda instead?

Speaker_-_Julia_Zumpano:Yes to both of those questions. Same measurement for both butter and margarine - and for splenda and sugar.

sb62: Is it better to cook with kosher salt or sea salt rather than regular salt?

Speaker_-_Julia_Zumpano:Kosher salt and sea salt both contain sodium. Therefore, if you were told to restrict your sodium (salt) intake, these should be avoided or used in very limited amounts.

Susan: Can you cook with benecol? Is it ok if my children use it as butter too?

Speaker_-_Julia_Zumpano:You can cook with Benecol. Cook with the regular Benecol and not the light Benecol.

Speaker_-_Julia_Zumpano:Yes, it is acceptable for children above the age of 2 years old.

Healthy Breakfast Ideas

BobS: Do you have any fast healthy breakfast ideas?

Speaker_-_Julia_Zumpano:Yes - low fat yogurt and fruit. Cottage cheese and fruit. Toast and peanut butter. Dry high fiber cereal and low fat milk. Low fat high fiber granola bar. Low sodium V8 or vegetable juice or six ounces of 100 percent fruit juice. Whole grain frozen waffle with fruit puree or light margarine.

Sterols

marybeth: You mention sterols are found in animal cell membranes as well as plants. Then why are animal foods not listed as sources of sterols?

Speaker_-_Julia_Zumpano:The amount of sterols you get through food is very low unless taken in great amounts. Large amounts of animal products are not recommended for heart health due to them being a source of saturated fat and cholesterol.

Speaker_-_Julia_Zumpano:Good sources of sterols are whole grains, fruits, vegetables, legumes, vegetable oils, nuts and seeds.

Fish

hetsock: Fish is good for you for omega fatty acids. I heard you should only eat so much due to mercury or something? What is the amount of fish you should eat each week and what types are best?

Speaker_-_Julia_Zumpano:Fish intake should not exceed 12 ounces per week. The best kinds include light tuna (not albacore), salmon, herring, sardines, sea bass. The fish that contain large amounts of mercury include swordfish, tilefish, shark and mackerel.

Water

karen: how much do you need to drink a day? does it have to be water?

Speaker_-_Julia_Zumpano:You should drink at least 64 fluid ounces of non-caffeinated low sugar or sugar free beverages a day.

Cleveland_Clinic_Host: I'm sorry to say that our time with Julia. Thank you again for taking the time to answer our questions today.

Speaker_-_Julia_Zumpano: Thank you for having me today.

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