HealthHints

New Year – New Food Choices
Tips for choosing & preparing the right foods for heart health

January 2008 – Vol. 12, No. 1

Editors: Janet M. Pollard, MPH; and Carol A. Rice, Ph.D., R.N.

It’s the New Year, and many of us are trying to refocus our efforts for better health, so let’s get practical with these efforts. The goal of this issue of HealthHints is simply to give you practical tips on how to choose and prepare foods that will help you substitute good fats for bad ones and make healthy choices for overall heart health.

Fats & Cholesterol

When trying to alter your diet for better health, first try focusing on cutting fats. Doing so can give you a concrete goal with which to start. Don’t just cut total fat though; recent research reports the need to look at the type of fat we eat.1 We need to substitute good fats (unsaturated) for bad fats (trans and saturated). All fats, however, should be eaten in moderation. Eating too much bad fat is one of the major risk factors for heart disease. Eating large amounts of polyunsaturated fat, however, may increase the risk for some types of cancer.2

While it is important to limit fat in your diet, don’t try to cut it out completely, as some fat is needed for your body to function properly. Focus on reducing foods high in saturated fat, trans fat, and cholesterol; select more foods made with unsaturated fats3 (called polyunsaturated and monounsaturated fats). The following tips can also help:

  • Choose foods naturally low in saturated fat, which are often low in cholesterol and trans fat, too. These foods include a diet rich in fruits, vegetables, whole grains, high-fiber, low-fat or fat-free dairy products, and lean cuts of meat.2,4,5 (See more details in the sections below on meats, dairy, and fiber.)
  • Choose lean, protein-rich foods such as soy, fish, skinless chicken, very lean meat, and fat free or 1 percent dairy products.
  • Select lean cuts of meat, and trim off all visible fat before cooking.6
  • Serve moderate portions, and try “low-meat” dishes featuring pasta, rice, beans, and/or vegetables.
  • Limit commercially fried foods, processed foods, and commercially prepared baked goods made with shortening or partially hydrogenated vegetable oils. Not only are these foods very high in fat, but that fat is also likely to be very hydrogenated, meaning a lot of trans fat. Eat fried fast food infrequently. French fries, doughnuts, cookies, crackers, muffins, pastries, pies, and cakes are examples of foods that are high in trans fat. Don’t eat them often.2,5
  • If you must eat processed foods, look for foods made with unhydrogenated oil rather than partially hydrogenated or hydrogenated vegetable oils or saturated fat.5
  • Cut back on foods high in dietary cholesterol (limit most animal products, such as egg yolks, cheeses, whole milk, cream, ice cream, fatty meats, and large portions of meats).2 Try to eat less than 300 mg of dietary cholesterol each day. Some commonly eaten cholesterol-containing foods include whole eggs (about 200 mg per yolk), shellfish (50 to 100 mg per ½ cup), “organ” meats such as liver (375 mg per 3 oz), and whole milk (30 mg per cup). Egg whites don’t contain cholesterol and are good protein sources, so they’re fine. In fact, you can substitute two egg whites for each egg yolk in many recipes that call for eggs.7
  • Use cooking methods that require little or no fat — boil, broil, bake, roast, poach, steam, saute, stir-fry, or microwave.6
  • Replace saturated fats with healthier substitutes. Use liquid vegetable oils and soft margarines in place of hard margarine or shortening. Use naturally occurring, unhydrogenated liquid vegetable oils such as canola, safflower, sunflower, or olive oil most often.5,7 Use soft margarine as a substitute for butter, and choose soft margarines (liquid or tub varieties) over harder stick forms. Look for “0 g trans fat” on the Nutrition Facts label.5
  • When your own recipe calls for butter, lard, bacon, bacon fat, or chicken fat, use margarine that contains no more than 2 grams of saturated fat per 1 tablespoon or use unsaturated vegetable oil.6

Note: Children under age 2 should NOT be on a fat-restricted diet because cholesterol and fat are thought to be important nutrients for brain development.2

Meats

Avoid fatty meat and poultry with the skin.4 “Choose lean meats and poultry without skin, and prepare them without added saturated and trans fat.”7 “Most meats have about the same amount of cholesterol, roughly 70 milligrams in each three-ounce cooked serving (about the size of a deck of cards). The American Heart Association recommends eating no more than six ounces of cooked lean meat, poultry, fish, or seafood a day.”7 Learn to choose the healthiest cuts of meat, and try these tips at home:

  • The leanest beef cuts usually include sirloin, chuck, loin, and round. Choose “choice” or “select” grades rather than “prime.” Select lean or extra lean ground meats.
  • Lean pork cuts include tenderloin or loin chops.
  • The leanest lamb cuts come from the leg, arm, and loin.
  • Remove all visible fat from meat and poultry before cooking.
  • Remove skin from poultry before eating.
  • Choose white meat most often when eating poultry.
  • Duck and goose are higher in fat than chicken and turkey.
  • Grill, bake, or broil meats and poultry.
  • Organ meats—such as liver, sweetbread, kidneys, and brains—are very high in cholesterol.
  • Cut back on processed meats that are high in saturated fat and sodium.7

Meat – Cooking Tips

Even lean meat has fat in it. Here are some ways the American Heart Association suggests to reduce the saturated fat in meat:

  • Broil rather than pan-fry meats such as hamburger, lamb chops, pork chops, and steak.
  • Use a rack to drain off fat when broiling, roasting, or baking. Instead of basting with drippings, keep meat moist with wine, fruit juices, or an acceptable oil-based marinade.
  • Cook a day ahead of time. Stews, boiled meat, soup stock, or other dishes in which fat cooks into the liquid can be refrigerated. Then the hardened fat can be removed from the top.
  • Make gravies after the fat has hardened and can be removed from the liquid.
  • When a recipe calls for browning the meat first, try browning it under the broiler instead of in a pan.6

Fish

Guidelines suggest eating at least two servings of fish each week. Fish can be fatty or lean, but it’s still low in saturated fat. Try replacing two servings of red meat or poultry each week with two servings of fish.

  • Eat oily fish containing omega-3 fatty acids (for example, salmon, trout, and herring), which may help lower your risk of death from coronary artery disease.
  • Prepare fish baked, broiled, grilled, or boiled rather than breaded and fried.7
  • See Which Foods to Choose (PDF) for more information about the health benefits of fish and omega-3 fatty acids.

Dairy

Minimize your intake of whole-fat dairy products.

  • Select fat-free, 1 percent fat, and low-fat dairy products.
  • Minimize whole-fat products such as butter and whole milk or 2 percent full-fat dairy products (yogurt, cheeses).
  • If you drink whole or 2 percent milk or use full-fat dairy products, gradually switch to fat-free, low-fat, or reduced-fat dairy products.
  • Look for fat-free or low-fat cottage cheese, part-skim milk mozzarella, ricotta, and other fat-free or low-fat cheeses.7

Fiber

“Fiber is classified as either soluble or insoluble. When regularly eaten as part of a diet low in saturated fat and cholesterol, soluble fiber has been shown to help lower blood cholesterol and may also help reduce the risk of diabetes and colon and rectal cancer. The American Heart Association recommends that you eat at least 25–30 grams of dietary fiber—in both soluble and insoluble forms—every day. The more calories you require to meet your daily needs, the more dietary fiber you need. Try to eat at least 14 grams of fiber per 1,000 calories you consume.”7

  • Foods high in soluble fiber include oat bran, oatmeal, beans, peas, rice bran, barley, citrus fruits, strawberries, and apple pulp.
  • Foods high in insoluble fiber include whole-wheat breads, wheat cereals, wheat bran, cabbage, beets, carrots, Brussels sprouts, turnips, cauliflower, and apple skin.
  • Replace low-fiber foods (white bread, white rice, candy, and chips) with fiber-containing foods (whole-grain bread, brown rice, fruits, and vegetables).
  • Try to eat more raw vegetables and fresh fruit, including the skins when appropriate. Cooking vegetables can reduce their fiber content, and skins are a good source of fiber.
  • Eat high-fiber foods at every meal. Bran cereal for breakfast is a good start, but try to include some fruits, vegetables, whole-grains, and beans in your diet, too.
  • Be sure to increase your fiber intake gradually, giving your body time to adjust, and drink at least six to eight 8-oz. glasses of fluids a day.7

Note: Read the Nutrition Facts label on all packaged foods that claim to contain oat bran or wheat bran. Many of these products actually contain very little fiber and may also be high in sodium, calories, and saturated or trans fat.7

Whole Grain Help

Adding whole grains to your diet is a great way to increase your fiber, but exactly what are whole grains, and how can we identify them when selecting foods? Whole grains, according to the United States Department of Agriculture (USDA) definition, are “foods made from the entire grain seed, usually called the kernel, which consists of the bran, germ, and endosperm. If the kernel has been cracked, crushed, or flaked, it must retain nearly the same relative proportions of bran, germ, and endosperm as the original grain in order to be called whole grain.”8

Whole grain foods are “not processed much, so they keep most of their nutrients. At least half the grains you eat should be whole grains.”9 “As grains are processed (refined), they lose fiber and nutrients. White grains are often refined. This means white bread, white rice, and flour tortillas are not as healthy as whole-grain versions, such as whole-wheat bread, brown rice, or whole-grain tortillas.”9

It is important to check the food’s Nutrition Facts label to see if the grains in your foods are whole or refined. Claims on food packaging can be misleading. “Even if a package says the food is a whole-grain product, check the ingredients.”9 Unless a whole grain is listed first, the food might not be as healthy as the package makes it sound. “Here’s a hint: Wheat bread isn’t a whole grain. Whole-wheat bread is. Make sure to read the fine print!”9

Any bread or breakfast cereal that lists a whole grain (such as whole wheat or whole rolled oats) as the first ingredient is a good choice. “Ingredients are listed from most to least, so if a whole grain is first, you know the food has a lot of it.”9 Be aware, however, that added fat and sugar, like in sugar cereals, make grains less healthy.9 Other foods made with whole grains, such as oatmeal, barley soup, wild rice pilaf, and buckwheat noodles are also good choices.9

To learn more about whole grains and how to add more to your diet, see the following resources:

Sodium

“Most of us eat much more sodium than we need. In some people, this can lead to high blood pressure, which increases the risk of stroke, heart disease, and kidney disease.”6 Choose and prepare foods with little or no salt to lower your sodium intake. “Foods low in salt lower your risk for high blood pressure and may help you control it.”7 Try to consume less than 2,400 mg of salt or sodium per day (about 1 teaspoon of salt). “Some people—including African Americans, middle-aged and older adults, and people with high blood pressure—should have less than 1,500 mg per day.”7 Most of the sodium in our diets is added either during processing, while preparing food, or at the table (with table salt). To help reduce sodium in your diet:

  • Use less salt or no salt at the table and in cooking.
  • Use herbs and spices or some of the salt-free seasoning mixes in place of salt. Use lemon juice, citrus zest, or hot chiles to add flavor.
  • Read the labels of all foods carefully. Even bakery products and cereals can be major sources of sodium in the diet. 6
  • Compare the sodium content of similar products (for example, different brands of tomato sauce), and choose the products with less sodium.
  • Choose frozen foods, soups, cereals, baked goods, and other processed foods that are labeled “reduced-sodium.”
  • Limit high-sodium condiments and foods such as soy sauce, steak sauce, Worcestershire sauce, flavored seasoning salts, pickles, and olives.
  • Limit your intake of foods high in added sodium, such as:
    • canned and dried soups,
    • canned vegetables,
    • ketchup and mustard,
    • salty snack foods,
    • olives and pickles,
    • luncheon meats and cold cuts,
    • bacon and other cured meats,
    • cheeses, and
    • restaurant and carry-out foods (such as French fries, onion rings, hamburgers).
  • To reduce the salt in canned vegetables, drain the liquid; then rinse the vegetables in water before eating.
  • Try rinsing other high sodium foods, such as canned tuna and salmon, feta cheese and capers, to remove some of the sodium.7
  • Look for “unsalted” varieties of the canned foods and snack foods listed above. Some foods may be labeled “no salt” or “without added salt.”
  • Ask restaurants not to add salt to your order.

Sugar

When it comes to cutting back on calories, we often need to look at sugars. “Cut back on beverages and foods with added sugars. Many snack foods and beverages have added sugars. Cut back on added sugars to lower your total calorie intake and help control your weight. These foods also tend to be low in vitamins and minerals, and the calories add up quickly.”7

  • Examples of added sugars are sucrose, glucose, fructose, maltose, dextrose, corn syrups, high-fructose corn syrup, concentrated fruit juice, and honey.
  • Read the ingredient list. Choose items that don’t have added sugars in their first four listed ingredients.7
  • Limit calorie-containing beverages that may not make you feel full. “This could tempt you to eat and drink more than you need and gain weight.”7

Making it Personal

Now is the time to make a personal plan. You can start by using heart-healthy dietary guidelines to find out what your numbers of calories and fats grams should be. (See the December issue of HealthHints (PDF) on how to use dietary guidelines to cut fats and cholesterol in your diet and the handout Making Sense of the Guidelines–Finding Your Numbers [PDF].)

Then learn to read food labels to make healthy, personal choices. Finally, start making modifications to your diet using the tips above as well as the information found in the following handouts and websites:

This document is meant for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.

References:

  1. Harvard School of Public Health (2007). Fats & cholesterol [on-line]. Retrieved June 21, 2007. From http://www.hsph.harvard.edu/nutritionsource/fats.html.
  2. U.S. National Library of Medicine (2007). Fat [on-line]. Retrieved October 10, 2007. From http://www.nlm.nih.gov/medlineplus/ency/article/002468.htm.
  3. Mayo Clinic (2007). Dietary fats: Know which types to choose [on-line]. Retrieved September 26, 2007 http://mayoclinic.com/health/fat/NU00262.
  4. Mayo Clinic (2006). Lowering cholesterol: Could your diet use some TLC? [on-line]. Retrieved September 26, 2007. From http://mayoclinic.com/health/lowering-cholesterol/CL00014.
  5. American Heart Association (2007). Know your fats [on-line]. Retrieved September 26, 2007. From http://www.americanheart.org/presenter.jhtml?identifier=532.
  6. American Heart Association (2007).Cooking for lowering cholesterol [on-line]. Retrieved September 26, 2007. From http://www.americanheart.org/presenter.jhtml?identifier=515.
  7. American Heart Association (2007). Make healthy food choices [on-line]. Retrieved September 26, 2007. From http://www.americanheart.org/presenter.jhtml?identifier=537.
  8. United States Department of Agriculture (2005). Dietary guidelines for Americans 2005: Appendix C glossary of terms [on-line]. Retrieved November 19, 2007. From http://www.health.gov/dietaryguidelines/dga2005/
    document/html/appendixC.htm#foot16
  9. Northern Inyo Hospital (2005). Nutrition and MyPyramid: Grains [on-line]. Retrieved November 20, 2007. from http://nih.dev.kramesonline.com/3,S,8876
  10. American Heart Association (2007).Tips for eating out [on-line]. Retrieved September 26, 2007. From http://www.americanheart.org/presenter.jhtml?identifier=531.
  11. Mayo Clinic (2006). Trans fat: Avoid this cholesterol double whammy [on-line]. Retrieved September 26, 2007. From http://mayoclinic.com/health/trans-fat/CL00032.

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Last updated: 26 July, 2010

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