Heart-Healthy Meals: Small Changes Can Make a Big Impact

Do the words "heart-healthy meals" make you want to race out for a 16-ounce rib-eye steak or fries smothered in gorgonzola cream sauce? Stop and take a breath. Picking up healthy eating habits is a lot easier than you think.

The keys to eating healthier are simple: Don't panic and don't do too much too soon. Experts say the biggest mistake someone can make when they're trying to make over their diet to protect their ticker is fixing everything at once.

When they meet with someone for the first time, dietitians Diana Walters and Michelle Weinbender say they like to zero in on a just a few changes each week and slowly build on those healthier habits.

"We choose some areas to target. Just one or two things that you're going to do differently," says Walters, who works with patients at the preventive cardiology program at Deaconess Center for Health and Wellness in Spokane, Wash.

"I think it's important for people to go slow. For some people it's a huge transition. It can be mind-boggling," she says.

Many of her patients have had heart attacks or are at risk for heart trouble due to heart disease, diabetes, obesity or another medical condition.

"You really have to decide where you're at in the process of changing your diet and what is feasible to try first," says Weinbender, who works with heart patients at Spokane's Providence Sacred Heart Medical Center.

Eating lunch out five days each week? Try cutting back to one or two. Eating when you're not hungry? Try tracking your hunger for the week. Drinking lattes all morning and having a big dinner every night? Make it a goal to eat breakfast a couple of times. Snacking on junk food between meals? Don't buy chips when you make this week's grocery run. Since most people won't wake up tomorrow with the experience and motivation for a perfect diet, we asked Walters and Weinbender for their advice on where to begin. There's a lot to learn, but if you follow these recommendations you'll have a good start on eating habits that will protect your heart. Color Your Palate Add color to your plate, Walters says. "I just can't emphasize that more to my clients," she says. "That is a mantra that we have here, 'Where's the color?' instead of 'Where's the beef?'" You can't go wrong with increasing vegetables and fruits (just make sure they're the non-starchy kind). Throw in some blueberries on top of oatmeal or pancakes in the morning. Have fruits for dessert and snacks. Stack your tuna sandwich with spinach leaves, red onion slivers, tomato and cucumber. One serving of vegetables at dinner is great, but how about two or three? Fill half your plate with vegetables.
Have a salad and stir-fried broccoli with garlic and lemon. Put raw veggies on the table so you and your family can snack while dinner is coming together. Low-fat ranch dip or hummus can be good ways to encourage people to eat more vegetables. Think whole, fresh and less processed, Walters says. "Even under the skin of an apple you've got plant phytochemicals that can benefit you versus applesauce that has been more processed," she says. "Fresh is always better." Don't worry; vegetables frozen without sauces are fine, too. Weinbender loves the SteamFresh bags for a quick way to add a variety of vegetables to dinner. Fill up with vegetables and it will steer you toward a diet of plant-based foods, one that's lower in sodium and higher in fiber, which is better for your heart that the traditional American diet, Walters says. Downsize Everything For people who are overweight or obese, losing weight is an important step toward heart health. Follow Brian Wansink's advice in his book "Mindless Eating," says Walters. The Cornell University researcher's work details the environmental factors that influence how much people eat, hunger notwithstanding. People eat more when they're using bigger plates. They scoop more ice cream into bigger bowls. They serve more cereal out of warehouse store-size boxes and more chips from supersize bags. They drink more out of short, wide glasses.
"If we put the same food on this bigger plate, it is not going to be as appetizing," Walters says. "You think, 'I can eat more than that.'" Using a smaller plate will help eaters say closer to the recommended serving sizes for foods. While you're at it, memorize a few tricks that can help when judging portions, says Weinbender. A deck of cards, or the palm of your hand, is a good guide for a 3-ounce meat serving. Since chicken breasts can be two servings or more, Weinbender splits them in half or uses two or three chicken tenders instead. "Think of the money you'll save, too," she says. "A pound of ground beef should be enough to feed four people." A checkbook is about the size of a fish serving. A CD is a good guide for pancakes or waffles. A fist is about a cup of cooked vegetables, potato, rice or pasta. That cup is one serving of fruits or veggies, or two servings of a grain or starch. Need help with a basic outline for healthy eating? Find a dietitian to consult at www.eatright.org or review dietary guidelines at www.mypyramid.gov. Be Fat Savvy Dietitians used to steer their patients toward olive oil, but now they say any fats and oils from vegetable sources are better for you. That's canola, olive, corn, safflower and nut oils.
"Any plant fat can lower cholesterol," Walters says. "The biggest problem with the American diet is saturated fat, animal fats," she says. "And what would probably be one of the biggest culprits is cheese, as well as milk fat from sour cream and ice cream. People don't realize that a serving of ice cream is just one scoop." Avoiding saturated fats means steering clear of fats that are solid at room temperature, Weinbender adds. Trim visible fat and find lean cuts of meat. Buy loin and round such as tenderloin, sirloin, round steak and ground round, which comes from the leaner parts of an animal. Grilling meats allows the fat to drip away during cooking. "Visually checking the marbling in red meat is a good way to avoid saturated fats," Weinbender says. Stay away from trans fats. That recommendation has had much attention lately and it has made it easier for eaters to avoid them, the dietitians say. Add omega-3 rich fish into your weekly menus. Fatty fish like salmon, trout, tuna and sardines contain fish oils that are protective for the heart, Walters says. Have two or three servings a week. Work a few nuts, seeds and avocados into your diet. "They're high in fat, but it's the better kind of fat for your heart," Weinbender says. Make Friends With Fiber Start cutting out refined grains and adding whole grains to your diet.
"Make fiber your friend, but you have to get friendly with it," says Walters. "You have to gradually increase fiber because you won't like it if you start out with a whole big bowl of bran cereal. ... Your tummy is going to be upset and you're going to get gas and bloating." Eventually, shoot for 25 to 35 grams of fiber per day, Walters says. Those who are older than 50 should have 20 to 30 grams each day. Eat whole fruits and vegetables. Choose whole-grain breads. Put barley in your soups. Eat oatmeal for breakfast. Switch to brown rice. Legumes -- beans and lentils -- are a great way to bump fiber. "We know that high-fiber foods -- a whole orange, versus juice -- will help maintain satiety," Walters says. "You'll stay fuller, longer." Make a big pot of brown rice and freeze small portions so it is ready to go when dinner is done. Do the same thing with black beans and toss them into soups and taco meat. Cook a big pot of old- fashioned oatmeal or steel- cut oats and refrigerate it in just the right portions for breakfast later in the week. Barley and oatmeal both have soluble fiber, which has protective benefits for the heart. Get the Salt Out "We really shouldn't be adding salt to anything," Weinbender says.
The sodium requirement for an average adult is 2,500 milligrams. A teaspoon of salt contains 2,400 milligrams sodium. "Increased salt intake can increase blood pressure, which then can be a risk factor for heart disease," she says. It's something everyone should think about, whether they have been diagnosed with high blood pressure or not. Besides, a high-sodium diet tends to be high in fat. Focusing on whole, fresh and less processed foods will help, Walters says. Students in one of her classes recently compared a wild rice mix sold in the bulk bins to a packaged mix from Uncle Ben's. The packaged mix had 620 milligrams of sodium per serving, while the other mix had none. Plan, Plan, Plan If you've been living on meat and potatoes or cheese and noodles, eating plain chicken breast, steamed broccoli and salad without dressing seven days a week will make you miserable and, eventually, a failure, dietitians say. Find some great recipes and make it a goal to try a new one each week. Not ready for that? Try a new one each month. Pencil out three days worth of meals and use leftovers as the basis for the other meals. Serve roast chicken one night and plan to have enough leftovers to make chicken tacos or chicken salad. Plan a vegetarian meal once a week. Pick one night and serve seafood.
When you're putting away dinner for the night, pack your lunch for the next day. "I really just don't think that you can get any of this done if you don't do a little planning," Weinbender says. And before you hit the steakhouse for one last hurrah, consider this: "We find people can have a major heart attack after one huge fat load. So, they go out to a steakhouse and they have the big steak, the baked potato with the sour cream and the butter and ... the salad with the blue cheese and they go home and have a heart attack," Walters says. "Just one meal can make the fat in your blood go crazy."
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