Small changes in your diet can have a big impact
Do the words “heart-healthy eating” make you want to race out for a 16-ounce rib-eye steak or fries smothered in gorgonzola cream sauce? Don’t panic: Local registered dietitians 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.
“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 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.
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.
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.”
Easy Rosemary Lemon Baked Salmon
From Healthy U, the preventive cardiology program at Deaconess Medical Center. The recipe comes from a longtime member of the maintenance class, who raved about his wife’s recipe and shared it with the staff and clients there. Salmon is rich in protein and omega-3 fatty acids.
1 salmon fillet or salmon steaks
1 teaspoon fresh or dried rosemary, or to taste
1 lemon peel, grated
1 clove garlic, crushed
Black pepper, to taste
Smart Balance Light Buttery Spread, to taste
Place salmon fillet or steaks in a glass baking pan sprayed with vegetable oil, skin side down. Top with rosemary, lemon peel, garlic, black pepper and small shavings of Smart Balance every 4 to 6 inches.
Bake at 350 degrees until salmon is opaque and flakes easily, usually about 20 to 30 minutes depending on the size of the fillet or steaks.
Note: This salmon is delicious served with lemon wedges, a mushroom wild-brown rice pilaf, spinach salad and frozen berries drizzled with vanilla yogurt. Chicken breast can be substituted for salmon.
Approximate nutrition per 4-ounce serving: 175 calories, 13 grams fat (2.6 grams saturated), 25 grams protein, no carbohydrate, 69 milligrams of sodium.
From Grain Gourmet cracked wheat bulgur. This is one of the recipes registered dietitian Diana Walters hands out to clients at Deaconess’ Healthy U.
1 tablespoon olive oil
1 cup uncooked cracked wheat bulgur
1 cup sliced mushrooms
1/2 cup green onion, sliced (or chopped yellow onion)
1/2 cup chopped red bell pepper (optional)
1 clove garlic, minced
1 (14.5-ounce) can low-sodium or salt-free chicken broth, adding water to make 2 cups
1/2 teaspoon curry seasoning
Heat oil in a heavy skillet over medium heat. Add bulgur, mushrooms, onion and garlic. Saute 5 minutes or until onion is tender.
Stir in broth and curry. Bring to a boil. Reduce heat, cover and simmer 15 minutes or until bulgur is tender. Remove from heat and let stand 5 minutes, covered.
Yield: 4 servings
Roasted Asparagus with Garlic
From “The New American Plate” cookbook. Registered dietitian Diana Walters says this recipe also works great with other vegetables. She likes broccoli or cauliflower.
1 pound fresh asparagus
2 teaspoons olive oil
2 cloves garlic
Freshly ground pepper and salt, to taste (or omit salt)
Lemon wedges, for garnish
Preheat oven to 500 degrees. In a shallow roasting pan, toss asparagus with oil to coat. Sprinkle with garlic and season with salt and pepper.
Roast uncovered for 6 to 8 minutes, until crisp but tender, shaking pan occasionally. Serve immediately with lemon wedges.
Yield: 4 servings
Thai-Style Halibut with Coconut-Curry Broth
From Ellie Krieger, registered dietitian and cookbook author.
2 teaspoons vegetable oil
4 shallots, finely chopped (about 3/4 cup)
2 1/2 teaspoons red curry paste (see note), or 2 teaspoons curry powder
2 cups low-sodium chicken broth
1/2 cup light coconut milk
1/2 teaspoon salt, plus 1/4 teaspoon, plus more for seasoning
4 (6-ounce) pieces halibut fillet, skin removed
Steamed spinach (see note)
1/2 cup coarsely chopped fresh cilantro leaves
2 scallions, green part only, thinly sliced
2 tablespoons fresh lime juice
Freshly ground black pepper
2 cups cooked brown rice, for serving
In a large sauté pan, heat the oil over moderate heat. Add the shallots and cook, stirring occasionally, until beginning to brown, 3 to 5 minutes.
Add the curry paste and cook, stirring, until fragrant, about 30 seconds. Add the chicken broth, coconut milk and 1/2 teaspoon salt and simmer until reduced to 2 cups, about 5 minutes.
Season the halibut with 1/4 teaspoon salt. Arrange the fish in the pan and gently shake so the fish is coated with the sauce. Cover and cook until the fish flakes easily with a fork, about 7 minutes.
Arrange a pile of steamed spinach in the bottom of 4 soup plates. Top with the fish fillets. Stir the cilantro, scallions and lime juice into the sauce and season to taste with salt and pepper. Ladle the sauce over the fish and serve with rice.
Note: Red curry paste is available in the Asian section of most supermarkets. Steam or microwave 5 cups of washed baby spinach for 2 minutes.
Yield: 4 servings
Chipotle Orange Glazed Pork Chops with Maple Squash Puree and Spinach-Green Apple Salad
From “So Easy,” by Ellie Krieger
2 tablespoons pure maple syrup
2 tablespoons thawed frozen orange concentrate
1 teaspoon finely chopped, seeded, canned chipotle chiles plus 1/2 teaspoon adobo sauce it comes in
4 (3/4-inch) thick center cut, bone-in pork loin chops (about 8 ounces each)
1/2 teaspoon salt
1 recipe Maple Squash Puree (recipe follows)
1 recipe Spinach-Green Apple Salad (recipe follows)
In a small bowl, combine the maple syrup, orange juice concentrate and chipotle.
Spray a nonstick grill pan or grill with cooking spray and preheat over medium-high heat. Sprinkle both sides of the chops with the salt. Brush one side of the chops generously with the maple-orange glaze. Place the chops on the grill pan, glazed side down. Brush the other side with glaze.
Cook over medium-high heat until cooked through but with a slight blush in the center, 3 to 4 minutes per side.
Serve with the Maple Squash Puree and Spinach- Green Apple Salad.
Note: Chop the leftover chipotle peppers and divide them, along with the adobo sauce, among three or four small sealable plastic bags, then store them in the freezer.
Yield: 4 servings
Approximate nutrition per serving (1 pork chop, 2/3 cup squash puree and 2 cups salad): 550 calories, 24 grams fat (6 grams saturated), 36 grams protein, 51 grams carbohydrate, 100 milligrams cholesterol, 5 grams dietary fiber, 550 milligrams sodium.
Maple Squash Puree
2 (12-ounce) packages frozen cooked butternut squash or winter squash
1/3 cup water
2 tablespoons maple syrup
1 tablespoon butter
Salt, to taste
Put the frozen squash and water into a large saucepan. Cover and cook over medium heat, stirring frequently, until the squash is thawed, about 10 minutes. Whisk in the maple syrup and butter and season with salt, if desired.
Yield: 4 servings
Spinach-Green Apple Salad
2 tablespoons extra-virgin olive oil
1 tablespoon cider vinegar
1 teaspoon Dijon mustard
Salt and freshly ground black pepper, to taste
5 ounces baby spinach leaves (about 5 cups tightly packed)
1 Granny Smith apple
1/3 cup toasted walnut pieces (see note)
In a small bowl, whisk together the oil, vinegar and mustard. Season with salt and pepper. In a large bowl, toss the spinach with the dressing until evenly coated, then divide the spinach among 4 serving plates.
Core the apple and slice it into matchsticks. Sprinkle a quarter of the apple pieces on top of each salad. Follow with the walnut pieces. Serve immediately.
Note: Toast walnuts in a dry skillet over medium-high heat until fragrant, about 2 minutes.
Yield: 4 servings
Year-Round Gingersnap Pumpkin Custard
From HeartHealthy, Providence Sacred Heart Medical Center
1 cup broken pieces of low-fat gingersnap cookies (12 small cookies)
1 (15-ounce) can pumpkin
2 teaspoons cinnamon
4 egg whites
1 cup fat-free evaporated milk
1/4 cup honey
2 teaspoons vanilla
1/4 cup chopped walnuts
Preheat oven to 350 degrees.
Spray ramekins with canola oil and divide the cookie pieces evenly in the bottoms of the bowls. Place the remaining ingredients in a large bowl and mix with an electric mixer.
Ladle the pumpkin mixture over the cookies, sprinkle with nuts and place ramekins in a deep pan filled with water to about halfway up the ramekins. Bake for 20 minutes. Test for doneness.
Let rest 10 minutes and serve.
Note: This can also be made in a 9-inch pie pan; proceed as above without the water-filled pan. Cook for 1 hour. Leftovers keep well in the refrigerator for several days.
Yield: 8 servings
Approximate nutrition per serving: 168 calories, 3 grams fat (no saturated fat), 7 grams protein, 42 grams carbohydrate, 32 milligrams cholesterol, 2 grams dietary fiber, 149 milligrams sodium.