Heart Healthy Eating
Learn about eating for health with this great interview with a Dietitian specializing in preventive cardiology.
Thank you for joining us I’m your host Nada Yousef and today we’re talking to our featured experts about heart-healthy eating and as always we are taking your questions so send any questions you have in the comment section below today our featured experts is registered dietician Kate Penn Kate works specifically in preventive cardiology here at Cleveland Clinic thank you so much for coming in today and as always keep in mind that this is for informational purposes only and not to replace your own physicians advice so thank you again for being here if you can just take a few minutes to introduce yourself to our viewers sure I work here at main campus and preventive cardiology which is a specialty clinic for patients who are either at rest risk for heart disease or who already have heart disease so it’s a multidisciplinary clinic with cardiologists and dieticians exercise physiologists nurses so if you’re really concerned about your risk for heart disease you can make an appointment and you don’t need a referral either great so do you need to be a heart patient than two you don’t necessarily have to know like I said so if you’re just at risk for heart disease I know you have some risk factors like high blood pressure or high cholesterol or diabetes or if you’re overweight just any of those respecters or just a really high family history strong family history then you can still come make an appointment great great well I want to kind of talk a little bit about fat because fat used to be you know such a taboo thing and now there’s healthy fats that we can kind of talk about and it’s very important heart-healthy fats are known to lower bad LDL cholesterol and raise good HDL cholesterol so can you talk a little bit about where we can find these heart-healthy fats sure that’s true so what we know is that the key is actually trying to replace those some of the bad fat in your diet with the butter types of fats so the butter fats are monounsaturated and polyunsaturated fats monounsaturated fats come from things like olives and avec and they’re found in all types of nuts and found in certain oils though olive oil extra virgin olive oil canola oil peanut oil so those are good sources of fat a monounsaturated fat that’s we do want to consume daily polyunsaturated fats come from a variety of different sources so both some plant-based sources so like I’m actually more abundant and walnuts and actually in like soy products and then we get some polyunsaturated fats specifically omega-3 fats that’s a really healthy type of fat that has a lot of hurt protective benefits we found that in fish like salmon and tuna and some plant-based sources too like flaxseed and walnuts too great so so you said plant-based and also fish there’s a specific kind of fish that we can find the most yes omega-3 fats are found in pretty much all types of fats but the fish that are more dense and those omega-3 fats are like the salmon the tuna sardines herring does have more airing threes so great get the fish twice a week in your diet even up to three times per week and a more Mediterranean style diet they eat it three times a week great now when we talk about nuts studies suggest that eating just 30 grams of nuts per day may help reduce the risk of developing heart disease by 30 to 50 percent but what is 30 grams so 30 grams is a one ounce okay weighing them okay so if you have a food scale at home you can weigh it you know if not I tell patients typically like a handful to around like 1/4 of a cup is a good portion to have either just as a snack or kind of spread that out and maybe have some in your cereal in the morning have some in a salad at lunch that’s a good way to get that and are do the nuts very because I know some probably have more oil than others yeah that’s true so one of the one of the major studies that we know that has a lot of proven research on heart health benefits is the Mediterranean style diet and in this big study that came out a couple years ago subjects were eating the 30 grams per day and it was almonds walnuts and hazelnuts so I always tend to promote those first as trying to get those but I know you know some patients like more like cashews or pistachios so I think it’s okay to still get a variety but I I promote the walnuts the almonds hazelnuts the most so 30 grams okay great and speaking of healthy fats I want to talk a little bit about the ketogenic diet because it promotes healthy fats right and and low carbs and it I guess we’ll talk about ketosis and that’s what your body goes through can you tell our viewers a little bit about what ketosis is and if it’s good for your heart sure sure so ketogenic diet is fairly trendy right now so the energetic diet is we’re actually a really the majority of calories in your diet are coming from fat so it’s almost about like 70% of your calories and then another 20% from protein and only 10% from carbohydrate so since you’re eating mostly fat that’s what your body is gonna use actually as a fuel source – for energy so you’ll be getting fat that you eat in your diet but then your body can also burn its own fat for fuel and so that’s where some a ketogenic diet can be pretty beneficial for weight loss because your body starts to burn its own fat for fuel and so you lose weight that way however though there hasn’t been a lot of research on you know a ketogenic diet long term and its effect on our heart so you know if you know you do have heart disease I would still caution against it or consider talking to your doctor before you start acute on a diet sure so what you’re saying is ketosis is your body using your own fats to burn energy so yeah carbohydrate is your body’s typically the main source of energy in our diet but so then when you eliminate it pretty much from your diet you know then the next source of energy would be fat because protein your body needs just to stay intact it’s my efficient energy source right right great well as a registered dietician and preventive cardiology what do you eat would eat for breakfast what would you promote what do you feel on so like I mentioned before I really promote the Mediterranean diet the most just because it’s proven to have such heart health benefits so starting off the day you know for breakfast could vary from oatmeal to a sprouted grain toast with some almond butter or natural peanut butter or some you know whole-grain cereal with in Greek yogurt and some slivered nuts and flaxseed okay and obviously for a Mediterranean style diet you want to eat a variety of both the plant-based protein sources and the animal so trying to get in especially the beans and lentils and that’s sometimes a tricky part yeah for patients who you know might not like those types of foods that are eating a meal without me especially for Matt and it’s hard I think sure sometimes think about not having a real burger and having the bean burger or you know having a salad with chickpeas yeah chicken right why encourage patients to try and make some of those swaps and substitutions okay so that’s a you’re not getting as much of the animal fat which is you know if in access you’re consuming too much saturated fat that can raise your LDL cholesterol whereas the beans and lentils have no animal fat but they still give you protein and lots of fiber and they have a type of fiber in them that helps with cholesterol lowering so that’s how I’m very healthy it’s a variety of all that yeah so a variety of right the plant-based proteins from the beans or not as well as getting into fish a couple times a week lean poultry choosing that and avoiding you know fried types of foods and then trying to keep the beef and pork veal lamb – they’re just a little bit more sparingly okay and making sure you choose lean cuts what do you do consume it okay great well let me start with some questions that we have here I have Michael how does fasting with a standard American diet compared to a ketogenic diet that doesn’t require any fasting can you talk a little bit about fasting and if that’s sure so fasting on an American diet would mean I assume you know you’re just you’re only eating during you know a certain amount of time period during the day right so that obviously a you know kind of limits your total caloric intake it also then limits you know the amount of time that your your pancreas you know is working to actually you know help digest food and release that insulin so it can help with improving blood sugar levels um but you’d still be eating you know carbs protein fat so I’m just doing a specific time period so that to kind of control the calories and help control blood sugars sure whereas then you know a ketogenic diet without fasting like I said that’s completely different that’s when you’re just on a really high high-fat diet I’m and your body’s burning that fat but you know depending on what your goals are you know even eating too many calories on a ketogenic diet you know without sure can be harmful shado sure depends on what your goals are and you’re perfect and then I have Genet is regular salt unhealthy for a 60 year old man that has that has had a heart attack so salt in general we do need to limit in our diets actually for all Americans the average American diet is very high in the end young so and so too much sodium even if you have a healthy heart though you know puts you at risk for developing you know high blood pressure and things like that so given that he has had a heart attack and he’s you know over the age of 50 his sodium needs are a lot less so only about 1500 milligrams per day is what’s recommended so when she says this regular salt unhealthy what is you know no matter what all forms of salt really come down to the same sodium chlorite you still want no more than 1,500 milligrams 1,500 milligrams a day okay so you know averages out to be 500 milligrams so and that’s not impossible to follow if you kind of choose more Whole Foods you know that are minimally processed not packaged so you know going back to eating lots of fruits and vegetables and eating you know oatmeal has you know no sodium versus some box cereals are really high as I am right or you know cooking yourself versus you know eating out speaking of I mean 1500 milligrams a day what is like a normal can process yeah goodbye yeah or another way to look at it too is even considering the actual table salt so one teaspoon of table salt is 2,300 milligrams oh so if you’re you know a eating processed foods and be like adding salt to that like seasoning your food it’s then you’re really consuming too much but so a good rule of thumb the one you are is to start reading the Nutrition Facts labels and an individual food that has 140 milligrams of sodium or less per serving that’s considered like a low sodium food okay it’s still you know acceptable if you want to have a serving a cereal or like a slice of bread they’re actually the one of the biggest sources of sodium and American diet the American Heart Association’s labeled six foods the salty six that our biggest sources of sodium so one is Brad’s rolls tortilla anything like that cuz salt just added as a preservative the bread fresh deli meats so many Depa deli meat or cured me is very salty and as a preservative and then other big source would be canned soups or any type of soup internal because it the broth another thing to watch out for would be chicken sometimes is like injected with a sodium solution to preserve it and keep it fresh often sometimes when it’s in those like big freezer bags yeah it’s like frozen and has like a coating on it so watch out for that okay and then sandwiches are considered a big source of sodium because of the Brad and the deli meat and has everything you try to exactly one meal that’s one and then the other one is pizza oh yeah it is you know a bread sauces and condiments like tomato sauce you know can be salty but it’s the cheese and then the toppings so the pepper sausage things like wow there’s a lot of salt and a lot of places we don’t think about yeah so I have jameelah FDA has issued a warning against binging on black licorice can you explain why sure so that’s it has an ingredient that research shows can really affect like the rhythms of your heart and cause like fast you know palpitations and so we just don’t want people to is that like an ingredient in black licorice and right just the black jelly licorice moderation yes how about Chuck he recently had heart surgery and one is it okay for me to eat red meat okay there’s red meat eaters out there you know oh yeah that’s fine obviously yeah red meat has benefits it’s a really good source of iron so you know after heart surgery you know there’s no problem you know immediately eating it you know as long as you’re able to eat solid foods but like I said as part of a Mediterranean diet you know just want red meat to be not very often so sparingly you know once or twice a week and just making sure it’s like I said a lean cut nothing like prime rib with a lot of fat on it and avoid bacon yeah those higher fat meats but something lean you know with a lot of the fat trimmed off would be okay and it’s important to watch the portion size too right you’re just trying to keep that meat about the size of the palm of your hand great awesome and then Tanner I use coconut oil regularly in my recipes should I stop because of the saturated fats so great so coconut oil is considered a plant-based source of saturated fat and it is you know very high mm-hmm and so we know saturated fats the type of fat that can raise your bad cholesterol sure and so coconut oil has been studied and there’s you know you hear a lot of mixed things about it in the research but really as far as being like heart protective there really isn’t any research to support it okay so I would say you know definitely if you you know are you know hip free of heart disease and you know have high cholesterol it’s definitely okay to use occasionally in cooking but as far as using it every single day you know I would go olive oil right and they’re very different too and how you cook up like the coconut oil is beneficial because it can be cooked at a very high heat so then so using small amounts for that’s okay whereas like extra virgin olive oil you’re really not supposed to cook with at a very high heat because it’s gonna kill a lot of it so the extra virgin olive oil is better for dressings salad dressings and you know dips yet coconut oils sparingly is okay but so you’re referring to like the smoking point right because every oil needs okay excellent so extra virgin olive oil don’t really cook with it put it on your salads on top of things just not cooking right okay great let’s see and then Jess I changed my entire family’s diet to fish skinless chicken and veggies all cooked in olive oil is there such a thing as too much olive oil there is you know because oils even the healthy oils and the healthy fats fats are more calorie dense than carbohydrate and protein so you know just like one teaspoon of oils 50 calories show you know if you’re still obviously still want patients to watch their weight because that’s a nervous factor for heart disease so yeah there’s still a thing of – the thing of too much so again moderation mm-hmm right but obviously if you’re cooking for an entire family you may use a larger portion but that’s dispersed is sharing the whole family exactly exactly no I would still encourage you to to use and then that’s the thing is like you can use olive oil which is from like the later pressings of Olives you can use that to cook what that lowered or matter it heats so you’re saying extra virgin there’s a difference yes hmm okay what is what is extra pro can I ask you what is that like the very first pressing of olives like once olives are ripe okay very first press that comes out of it is the is the strong large eye so then you’re kind of getting like the freshest flavor yeah most you know nutritional value great great that’s good to know because I always look at the different rice I’m like what does it really actually mean and then mark what is the best for heart health okay we touched a lot about that you know fish is one of those things that people tend to only like certain types and so I mean I’m happy seeing patients eat you know any fish but like I said we do know that the omega-3 rich fish like salmon and tuna hearing sardines you know you get more of that which is a really heart-healthy type of fish so you encourage those most but you know shellfish yes it has a little bit more cholesterol in it but I think that’s still okay if you like shrimp and scallops tons like that so shrimp is in the house actually it’s really low in calories and pasta so it is okay but if your cholesterol is high you still want to be a little cautious okay sure great and then I have Mickey do the amount of nutrients change when cooked versus raw so when you cook a meal versus raw are the nutrients changing so as typically patients ask this question about vegetables yeah you know because if you’re steaming something you know death and yeah it’s really mushy then you ask you do you know lose some of that that nutritional value so yeah raw vegetables you know gonna be kept intact so yeah a little bit more nutrient-dense cooked vegetables so you know try not to get them to death just tell them yeah after the essence you like and you’ll still get the nutritional value you know vitamins minerals fiber those even certain vegetables like tomatoes actually they’re they’re like ability to be absorbed in our body actually is enhanced and what I’m when they’re cooked when it comes and you combine it in a meal with some healthy fat because certain vitamins like a D E and K they’re called the fat soluble vitamins so you do want to consume fat with them so tomatoes are more nutrients when no any actually – yeah you’re gonna absorb it better when you consume it with a fat like olive oil Oh interesting interesting because I know like sometimes garlic yes–that’s is then that that’s kind of a similar thing um the Friday med study which is that big trainee and study that I was referring to earlier subjects in that study work consumed a dish called sofrito a couple times a week yes and that’s where it was like sauteing the tomatoes and the olive oil and the garlic together so that combination is very heart healthy sounds delicious do you have a insta pot because I’ve heard about insta pot that cooks food really fast and I don’t know if that’s gonna make you more nutritious when you’re cooking your vegetables I mean it cooks it and like half yeah it’s like oh it’s like a pressure cooker so I heard that it’s it’s also nutritious because a lot of people are like is a nutritious seasons apart or not yeah you can you can do I think either or you can even saute in it but but yeah but that’s that’s a really good one as well so I want it I actually have this question because I actually just saw that something about bananas and too much potassium can mess with your heart something about the electric as well is that is that true about bananas are very high in potassium and so the average American diet though is actually tends to be low in potassium okay because fruits and vegetables are the best source of potassium and most Americans don’t eat enough fruits and vegetables yeah but if you do eat a lot of fruits and vegetables are a lot of bananas you had too much potassium actually can throw off again the rhythm of your heart I’m just like that come the ingredient in the black licorice like calcium then because potassium is a mineral that helps with our hydration Yelp’s with a lot of you know physiological functions in our body and one is heart rhythms so yeah too much you can’t do that I think one of the reasons is nowadays to just does the wave fruits are grown you know they’re still ours you know but yeah it could be like a foot long right but really a serving of a banana from you know a wheat management perspective or just a controlled portion size is only like four inches oh that’s the thing is that people might be eating that entire fruit thinking it’s it’s good for them but even you know too calories from fruit charlize good either sugar and yeah right yeah it is natural sugar but you much even natural sugar very interesting and then avocado has even more potassium than bananas is that correct they’re very high in potassium – okay yeah yeah yeah high calorie because they might fat so that thing like patients come in and tell me like I eat an avocado every day like a lot of healthy fat but oftentimes their goal is weight loss so I say you need to yes yeah okay great let’s see I have Michelle I got to eat with my family at least once a week at different restaurants do you have any tips when choosing heart-healthy options oh sure one of the biggest things you have to watch out for when dining out really is the sodium yes and food so I would you know number one just make sure you kind of tell your server to try and prepare things without added salt so you can control that um and just be you know mindful you know of your choice and and try and choose something that includes a lean protein maybe a whole grain starch and still has vegetables you know either as a side or get a side salad with it you know try and just tweak things even though the meal it might not come the way you like it you know try to do things gonna be even more just a la carte on the side so that’s a really good idea just to avoid the obvious things like the fried things and the breaded things and you know ask for salad dressing on this side so you can control how much you you’re using sure sure great yeah and obviously portions are usually very big at restaurants so share sugar yeah there was your pairing or like asking for a box right away so you can like box up half your portion share for us for like a lunch size portion now when we talk heart-healthy we don’t talk we don’t think about kids usually but you know I have two little ones I know you have little ones is the too early to think about heart healthy nose eating for little ones that Mediterranean diet yeah from the beginning yeah yeah obviously lots of fruits and vegetables and you know introducing them to toppings and cherisher and nuts and you know yeah giving them the leaner proteins and you know not too much you know burgers and yeah yeah obviously you know milk is still important part of kids growing bodies you know you know just but low-fat milk is what most pediatricians recommend great yeah yes still cooking with the olive oil and again it getting their taste buds used to fish and things like I think that’s one a lot of people maybe struggle with because if your kids are not used to that kind of tasting more you know mac and cheese sure yeah I I struggle with that myself with my kids karl is asking how can someone know how much of their cholesterol came from diet versus what was created by their own body unfortunately we really can’t you know know that hmm because yeah our liver does make cholesterol for us I see and so it’s it’s hard to identify but we do you know obviously total cholesterol when we get like our blood drawn is made up of three different types triglycerides your H gel and your LDL hmm so if we do know that you know triglycerides are affected by our diet dietary choices HDL not too affected too much by our diets affected more by genetics and whether you exercise and smoked an LDL cholesterol though is affected you know by our diets so we can you know improve it by making adjustments but you know a lot of patients have you know genetic conditions our familial you know hyperlipidemia so it’s it’s hard to know exactly tell what’s coming but your your new your cardiologist often can run some other blood tests to to tell if there’s other you know genetic kind of risk factors that you know puts you at greater risk of heart disease great Thank You Jenni speaking of bananas my 16 month old eats most of a banana every morning is that too much oh I don’t think so I mean I think you know kids who are growing and need those galleries you know that shouldn’t hurt them and has any you know heart rhythms yeah yeah let’s hear it to you okay awesome so we’re good with a banana every morning yeah obviously yeah kids aren’t consuming that many calories sure site right compared to adults mm-hmm Laura what do you recommend for getting caffeine while still being heart-healthy just so I think there’s nothing you know wrong with caffeine and less typically doctors want you to limit it if you do have you know arrhythmias okay or you know abnormal heartbeats you know then typically it’s recommended to avoid caffeine but you know caffeine in moderation is definitely a part of a healthy diet so obviously coffee tends to be the most you know dense source of caffeine but you know tea is lower in caffeine herbal teas are typically very low or not you would discourage caffeine from soda because yeah so it really has no Cheryl so 1 to 2 cups of coffee would you say is probably ok ok excellent ok we have a few minutes left I’ll do one more question here Phil’s asking should I still be getting just egg whites for breakfast or am i okay to consume the yolk so the yolk is a big source of cholesterol but is also the source of a lot of other good nutrients too so a lot of different vitamins and minerals in there so you know my opinion on that is you know if your cholesterol is normal nothing wrong with with having a yolk every day ok if your cholesterol is high and you’re working on trying to lower it then that would you know discourage the yolks to maybe just a few times per week and then eating more of the egg whites but there was a paper that was released last year in the consensus from a group of cardiologists was that you know cholesterol from eggs does have a cholesterol raising a fact though eating too many yolks can sharing to raise your cholesterol that’s right so as long as your heart healthy you can yeah in moderation um some yolks with your eggs awesome awesome well before I let you go is there anything you want to tell our viewers or listeners that maybe you haven’t touched on we kind of touched on everything I think great so much training diet dr. Ghali you’re not yeah I try to you know comply with that it as as much as you can watching your sodium and great we didn’t talk about beverages a little coffee but yet trying not to drink your calories we didn’t talk a lot about dairy which is another kind of yeah controversial by having kids but do you think adults should be drinking dairy I think you can mm-hmm so milk is gonna be a source of saturated fat too so right if you’re ready watch your cholesterol then we’d want to you know limit that so then the alternatives would be there’s lots of non-dairy milks though yes for example soy has almost you know the same amount of protein as cow’s milk does and then nowadays though you have like the almond milk and even coconut milk really popular trendy yeah so almond milk you know has no saturated fat but it’s also a lot lower in protein I’ll time so it just depends on you know what you’re looking for if you just want that like milk consistency and taste and you’re getting protein from somewhere else sure then you know all the milks a great choice also low-calorie too just depends on what what your goals are so research what you’re drinking with it and you like all types of milk they’ll have you know the same amount of calcium yeah vitamin D usually the non-dairy milks Ralph should be fortified most of them with vitamin D which is important great vitamin that we need – great well thank you so much for coming in today appreciate that and that’s all the time that we have for today and make sure to join us next week as we go live with a featured expert doctor bang to talk about what a chiropractor does so don’t miss out and for our viewers that would like to get notified every time we go live you can tap on the follow button on the live video if you’re not already following us and opt in to get notified every time we go and for more health tips and information please follow us on Facebook Twitter Instagram and snapchat at Cleveland Clinic just one word thank you and see you again next time.
Dieting Plan for a Healthy Heart
