Cardiovascular Disease: can you escape it?

I have had the privilege of working with a Registered Dietitian at Hines VA Hospital for the past three weeks in the cardiology department.  These patients typically come in with problems such as congestive heart failure, heart attacks, strokes, and blockages in their arteries.  The medical team run tests to find the exact cause, they prescribe specific medications, surgery or therapy depending on what they find, and we support them with nutrition education!  It is absolutely critical to understand these patient’s lab results, medication interactions, and the lifestyle habits that created the disease in order to intervene with a diet that supports their health. 

We’ve all heard over and over that “heart disease is the #1 killer of Americans!”, but I didn’t truly grasp the meaning until I started interacting with my patients at the hospital.  Let me tell you, these cardiovascular diseases are extremely serious, painful, scary, and hard to recover from.  Many of the patients have a long history of smoking, are obese, and eat very low quality food.  There is so much each of us can do in our day-to-day life RIGHT NOW to prevent going down this road.  

I had the opportunity last week of teaching a “Heart Healthy” nutrition class to a group of patients who are recovering from cardiac surgeries.  Here is the hand-out I’ve created for them:

Heart Healthy Class

Now, my audience at the hospital is a little different than the general population.  Also, these are people who already have heart disease.  However, there are some things we all can do to lower our risk for cardiovascular disease.  For the average person:

Reach and maintain a healthy body weight

Incorporate physical activity into your daily life

Replace foods high in saturated fat with unsaturated fat sources

Increase the amount of fiber in your diet (from food sources)
Stay away from trans fats (look for "hydrogenated" on the label!)

My class went over very well.  The patients were receptive and drilled me on all the hot topics:  red wine, sea salt vs. table salt, chocolate, egg yolks.  I'm not positive my "heart healthy" recipes were that well received....quinoa with walnuts and blueberries for breakfast and a black bean burger with a whole wheat bun.  One step at a time I guess....I'm freaking people out with my crazy Seattle ways!

Spicy Thanksgiving Cranberry Sauce

Ingredients

• ½ cup brown sugar
• ½ cup white sugar
• 1 cup  water
• 4 cups (2 packages) of fresh  cranberries, rinsed and picked through
• 2 cinnamon sticks
• 1 orange, zested and juiced
• 1 teaspoon nutmeg

                                                   Instructions

• In a saucepan, bring water and sugar to a boil, stirring to dissolve sugar
•  Add cranberries and cinnamon, return to a boil
• Reduce heat, simmer for 10 minutes .  You will hear the berries popping open.
• Turn off the heat and add the orange juice and nutmeg
• Cool completely at room temperature and then chill in refrigerator. Cranberry sauce will thicken as it cools
•  Garnish with orange zest and serve

   Yield:  ~3 cups

           Native Americans originally called cranberries “atoca” or “sassamanash” and  enjoyed them cooked and sweetened with honey or maple syrup.  The Pilgrims learned about this recipe from the Native Americans and it was very likely included in the early New England Thanksgiving feasts and welcomed by starving settlers. By the beginning of the 18th century, the tart red berries were already being exported to England by the colonists. Cranberries were used by Native Americans decoratively as a source of red dye, and medicinally as a poultice for wounds since not only do their astringent tannins contract tissues and help stop bleeding.  We now also know that compounds in cranberries have antibiotic effects, and their high vitamin C content is good for collagen production and skin health.  Additionally, they used them as a preservative to extend dried meat as they contain a natural compound called benzoic acid. 

          In 1840, Massachusets  Revolutionary War Vet, Henry Hall noticed these large berries grew well when sand was swept into his bog by the local winds and tides. The sandy bog provided  the perfect  growing conditions for the cranberries by limiting the growth of shallow-rooted weeds and enhancing that of the deep rooted cranberries.  Further, because cranberries are exposed to so much more sunlight in these growing conditions, it vastly increases their antioxidant capacity, making them one of the most concentrated sources of “polyphenols” around.  You can always tell a fruit has this type of bioactive compound/antioxidant by the intense color (acai berry, blueberry, grape).  Cranberries have high levels of vitamin C, vitamin A, fiber, and mineral manganese.  Today, cranberries are a major crop in Massachusetts, New Jersey, Oregon, Washington, and Wisconsin as well as many provinces in Canada.

(information adapted from WHfoods.com - a very helpful website when learning about the world's healthiest foods!)

Fall Cider

At our pumpkin carving party this year we decided to make a crock-pot hot spiced cider that turned out amazingly.  Here’s the recipe – it would be fantastic for Thanksgiving, Christmas, or anytime in the upcoming cold weather months. 

Ingredients

• 2 quarts apple cider (get the good stuff!  Ours came from a farm and had tons of apple sediment on the bottom) 
• 1 whole apple with ¼ cup whole cloves stuck in the skin
•  4 cinnamon sticks
• 1 large orange, sliced
• You can also float a tea-ball/tea infuser full of cloves if you have one and you like extra spice. 

Instructions

1.    Heat the mixture on medium for about 3 hours in the crockpot or on the stove.  The clove apple will shrivel up and look really mushy – then you know it’s done!
2. If you are adding rum (Captain Morgan’s spiced rum is easy and delicious), then let the cider cool a little so the alcohol doesn’t evaporate.  We turned off the crock pot for 20 minutes or so and added 1/3 of a fifth of rum and it was a real crowd-pleaser.  Please be careful, though - it can be quite strong.                                                                                                                                            *Original recipe by Ginger Hultin 11/1/11

My Own Food Pyramid!

Food guides:  whether a plate, a pyramid, a pagoda, or a rainbow – everyone seems to have their opinion these days on what we all should eat.   I get asked all the time about what I think of the new USDA “Plate Method” that took over this year.  Big changes like this demand attention and explanation.  The USDA is telling you what to eat.  What do they mean?   Where did it come from?  Complaints about the old pyramid centered on the fact that it was confusing and didn’t really explain how to eat.  The plate method is a more approachable way to visualize how your actual plate should look at any given meal.  It is a good idea in theory.

Basically, this model gives you a feasible example of how you can set up your own plate at any meal of the day in an effort to get the nutrition you need.  The bottom line is:  eat mostly vegetables and fruit with smaller, equal portions of protein and grains/starch at every meal.  And always have a side of dairy.  I like it because it is more visual and realistic to follow than a pyramid, but it’s not without its flaws. 

I’ve been working on my own pyramid for a while.  It’s definitely not an easy task, telling the general public what to eat.  How do you take dietary preferences, health, culture, and enjoyment into consideration for all ages and lifestyles for a public as diverse as ours?  All I can do is present what I have learned in school and what I experience in practice.  I am not sponsored by anyone – I don’t base my information off of what anyone else says it should be.  

Ginger's Pyramid

Basically, I went back to the pyramid.  I like it as a snapshot of the types of foods to consume in a whole day.  I put the foods I think we should consume the most at the bottom (grains/starch and veg) and I give an example of some of my favorites in each category.  Are the lists exhaustive?  Not by a long shot;   they are more of an example of some choices you could include.  Next up is fruit and protein in the same line.  I believe it is incredibly important to take into consideration alternative protein sources to meat.  Further, in my opinion, dairy fits into the protein category.  It is not a necessary part of our diet – it is a choice like consuming animal protein, legumes, or tofu.  You can have a perfectly healthy, balanced diet without dairy – many people do.  If you enjoy it and tolerate it, it can be a great source of protein and minerals for you.  Fat comes next – all types of fat.  I suggest experimentation with new types in your cooking.  Finally, there is a flavor category.  Have a glass of wine!  Use honey to sweeten when needed!   Drink a cup of coffee!  These are add-ons that have a place, within reason, to any day if you like.

I don’t like that my “Limit” list is so large.  There are not many foods I like to limit, but these ones truly deserve their place on my inverted pyramid.  Soda and juice – why drink them EVER?  Fake sugar…..no.  Avoid all the RED/YELLOW/BLUE dyes and preservatives used to extend the life of foods that would naturally expire.  Candy and corn syrup:  so hard to avoid, yet so important to our health.  The rest seem self-explanatory to me – basically, processed food or food that has been treated with disrespect or lack of care should be limited in my opinion.  We all eat these foods sometimes  – I do.  That’s why they are in the “limit” category.  Limit is not “never”.

This rough pyramid is my personal interpretation.  Obviously, there is no perfect outline for every person and the format needs to be continuously updated as new information surfaces.  If you need an example of how to set up a meal, look at the plate model!  If you need a general outline, check out a pyramid.  If you have any questions or need some individualization..... make an appointment with a registered dietitian (RD).