Smart_Heart_Grotto

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Smart Heart: Nutrition Advice for Diverse Groups : 

Smart Heart: Nutrition Advice for Diverse Groups David Grotto, RD, LDN Author of 101 Foods That Could Save Your Life! Men’s Health and Fitness magazines’ nutrition advisor Ask the Guy-a-titian, Chicago Wellness Magazine Produce for Kids\PBS Kids Advisory Board Chair President, Nutrition Housecall, LLC Society for Nutrition Education, July 20, 2008

Agenda : 

Agenda Illustrate gender, ethnic and cultural differences in heart health education strategies. Describe seven nutrition and lifestyle strategies that can be applied to anyone interested in developing more “heart smarts.”

What we know : 

What we know

Heart Smarts (what to eat less of): : 

Heart Smarts (what to eat less of): Saturated fat Trans fat Dietary Cholesterol Van Horn L, et al. The Evidence for Dietary Prevention and Treatment of Cardiovascular Disease. J Am Diet Assoc. 2008;108:287-331.

Diet Reduces Mortality in Primary Prevention Trials : 

Parikh P et al. J Am Coll Cardiol. 2005;45:1379-87. Trichopoulou A et al. BMJ. 2005;330:991-7. Knoops KTB et al. JAMA. 2004;292:1433-9. 2005 European Prospective Investigation into Cancer and Nutrition–elderly cohort (N = 74,607)† *Blood levels of n-3 fatty acids inversely related to death †Greater adherence associated with lower mortality 2002 Nurses’ Health Study(N = 84,688) 2004 The Healthy Aging: A Longitudinal Study in Europe (N = 2,339) 2002 Physicians’ Health Study(N = 20,551)* 2003 Cardiovascular Health Study(N = 5,201)* 2003 European Prospective Investigation into Cancer and Nutrition–Greek cohort (N = 22,043)† Diet Reduces Mortality in Primary Prevention Trials

Majority have poor diets 1 year after CHD diagnosis : 

Majority have poor diets 1 year after CHD diagnosis “About 80% of patients are not doing what they are supposed to be doing. I think cardiology patients are confused…keeping the message simple will be the key to improving dietary advice to patients.” --Dr. Barbara Olendzki, co-author Ma Y, et al. Dietary Quality 1 Year after Diagnosis of Coronary Heart Disease. J Am Diet Assoc. 2008;108:240-246.

Trend Surveys : 

Trend Surveys Aramark (over 2 billion meals served annually) survey revealed people have become tired of being told what not to eat.

Messaging to Men : 

Messaging to Men

Health Perceptions of Mexican American Men : 

Health Perceptions of Mexican American Men “They have to be healthy to be good fathers, husbands, brothers, sons, workers, and community members.” Pain and disability are motivating factors in finding ways to regain their health. Machismo sustains health and illness beliefs of Mexican American men .J Am Acad Nurse Pract. 2006 Aug;18(8):348-50.

Health Perceptions of African American Men : 

Health Perceptions of African American Men Definitions of health went beyond the traditional "absence of disease." Physical, mental, emotional, economic and spiritual. Having a job – provider. Stress was the dominant negative influence on health. Positive influences - supportive social network and feeling valued. African-American men's perceptions of health: a focus group study. J Natl Med Assoc. 2006 Apr;98(4):544-50.

Messaging to Men: What Not to Do! : 

Messaging to Men: What Not to Do!

Slide 14: 

You shouldn’t be eating that!

Are You a Food Cop? : 

Are You a Food Cop? I ask my partner what he/she has eaten when we aren’t together. I scold my partner for eating certain foods. I snoop around to see what he/she has eaten. I try to influence what or how much my partner eats. The words “you shouldn’t be eating that” have come out of my mouth. Source: Your Diet is Driving Me Crazy by Cynthia Sass, MS, RD. Da Capo Press-2004

Slide 16: 

The Saboteur

Messaging to Men: What to Do! : 

Messaging to Men: What to Do!

Humor : 

Humor

Slide 21: 

Spokesperson

K.I.S.S. : 

K.I.S.S.

Performance Based Approaches vs. Disease Prevention Model : 

Performance Based Approaches vs. Disease Prevention Model

Slide 24: 

How Can Health Professionals Help?

Focus on New Priorities : 

Focus on New Priorities Taste Do-ability Positive Nutrition

Seven Nutrition and Lifestyle Strategies That Can Be Applied to Anyone : 

Seven Nutrition and Lifestyle Strategies That Can Be Applied to Anyone

1. “Add in” Before Ever Taking Away : 

1. “Add in” Before Ever Taking Away

101 Food Philosophy : 

101 Food Philosophy No “Bad” Foods Research suggests “adding in” positively effects markers of health

2. Eat Breakfast! : 

2. Eat Breakfast!

Breakfast is a great place to start : 

Breakfast is a great place to start People who skip breakfast are four to five times more likely to gain unwanted weight compared to morning eaters. --Yunsheng Ma, et al., American Journal of Epidemiology Source: Ma Y, et al. Association between Eating Patterns and Obesity in a Free-living US Adult Population. American Journal of Epidemiology. 2003;158(1):85-92. Dr Daniela Jakubowicz, MD 2008 Endocrine Society Annual Meeting Women who ate a big breakfast (610 kcal breakfast, ?Carb ?Pro) lost more weight than those who ate 1/3 of the calories.

The Breakfast Calculator : 

The Breakfast Calculator www.BreakfastResearchInstitute.org

3. Get in More Soluble Fiber! : 

3. Get in More Soluble Fiber!

Oatmeal-Cholesterol Connection : 

Oatmeal-Cholesterol Connection Jan/Feb 2008 American Journal of Lifestyle Medicine article confirmed health claim: Oatmeal-Cholesterol Connection: 10 years Later

Slide 34: 

1st FDA approved healthclaim for a food Numerous clinical studies Acts like a sponge to absorbcholesterol-rich bile ? total blood cholesterol ? LDL No ? in HDL Oats

3 g oat soluble fiber/day = ? : 

3 g oat soluble fiber/day = ? 1-1/2 cups cooked oatmeal 3/4 cup dry oatmeal 3 cups oatmeal squares (ready-to-eat cereal) 1 cup or less of cooked oat bran, depending on beta-glucan content

Protect the Protectors Program : 

Protect the Protectors Program Firefighters are more likely to die from heart disease than smoke inhalation or burns. Heart disease causes 45% of the deaths that occur among firefighters while they are on duty: Fire suppression Alarm response Physical training

Protect the Protectors Program : 

Protect the Protectors Program Recruited firefighters from four cities across the country: Chicago, San Francisco, NYC, Denver Diverse groups Every firehouse had a nutrition coach Medical center/staff

Results : 

Results All firehouses did well: Denver reduced cholesterol by 14 points Chicago and NYC by 12 points San Francisco by 3 points Developed healthy habits Learned that small steps can make a difference

Results : 

Results Dave Grotto did REAL well: Reduced total cholesterol 70 points in 1 month! Lost 10 pounds in 1 month Gave up nothing Synergy? Reaffirmed 101 Foods Approach!

4. Get in More Heart-Healthy Fats! : 

4. Get in More Heart-Healthy Fats!

Heart Healthy Fats : 

Heart Healthy Fats Almonds MUFA Vitamin E EVOO CVD HTN Oleocanthal – COX2 inhibitor Avocado MUFA Beta Sitosterol

Omega-3 fatty acids : 

Omega-3 fatty acids Multiple healthful physiological effects ALA vs. EPA/DHA Problems with n6:n3 ratio Food vs. supplements Source: Engler M and Engler M. Omega-3 Fatty Acids Role in Cardiovascular Health and Disease. Journal of Cardiovascular Nursing Vol. 21, No. 1, pp 17-24.

5. Get in More Potassium! : 

5. Get in More Potassium!

Potassium-rich Foods : 

Potassium-rich Foods Fruits Orange, orange juice Cantaloupe, honeydew melons Bananas, pears, apricots Dried fruit Vegetables Tomatoes, tomato juice Potatoes Dairy products Milk, yogurt, kefir

OJ : 

OJ Orange juice is a good source of potassium 450 mg in 8 ounces or 13% DV No age group in the US consumes the recommended levels of potassium Potassium is essential in fighting HTN & Stroke Over 60 million Americans have HTN - Stroke is 3rd leading cause of death in US

6. Get in More Polyphenolics! : 

6. Get in More Polyphenolics!

Polyphenolics : 

Polyphenolics

7. Get in More Physical Activity! : 

7. Get in More Physical Activity!

Exercise regularly : 

Exercise regularly 30 minutes/day is good, and more is better, to a reasonable extent Source: Bassuk S, et al. Physical Activity and Cardiovascular Disease Prevention in Women: How Much Is Good Enough? Exerc. Sport Sci. Rev., Vol. 31, No. 4, pp. 176–181, 2003. Metabolic syndrome GOAL

Slide 50: 

Choose Your Icons Well!

Thank You!! : 

Thank You!!

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