1. “Eating” To Your Heart’s Content: The Role of Diet and Supplements in Heart Health Penny Kris-Etherton, PhD, RD, Pennsylvania State University October 6, 2010

2. How can I use nutrition to support my heart health? The role of proper nutrition Food groups and nutrients to emphasize Benefits of fish oil Benefits of plant sterols Amounts needed everyday to realize the benefits Where do supplements fit in?

3. Role of Proper Nutrition Increase nutrients that are heart healthy Omega-3 fatty acids, dietary fiber, plant sterols, unsaturated fat Reduce nutrients that are not heart healthy Saturated fat, trans fat, sodium, dietary cholesterol Maintain a healthy weight Target calories based on age and gender Balance food intake with physical activity

4. How proper nutrition can reduce the risk of heart disease Supply essential nutrients Magnesium, potassium, calcium, fiber, etc. Lowering cholesterol reduces risk of heart disease. 1 percent reduction in cholesterol = 1 percent reduction in risk Balance nutrition with physical activity, stress reduction, and smoking cessation to further reduce risk.

5. Food groups and nutrients to emphasize Soluble dietary fiber Can lower cholesterol levels by decreasing the amount of cholesterol absorbed in the intestine Are also known as viscous fiber and can be found in fruits and vegetables such as okra, bananas, eggplant, whole grains and legumes.

6. Food groups and nutrients to emphasize Consuming unsaturated fat in place of saturated fat Reduces cholesterol levels. Smart tip: choose fats that are liquid at room temperature (unsaturated) rather than those that are solid at room temperature(saturated) Examples of easy substitutions are cooking with vegetable oil instead of lard or spread nut butter on your toast instead of butter The American Heart Association recommends keeping your total saturated fat intake to less than 7% of your total daily calories

7. Food groups and nutrients to emphasize Fish oil Fish oil contains the omega-3 fatty acids DHA and EPA, which are important to consume because the human body does not make very much of these. The American Heart Association recommends that those with CHD eat one gram of DHA and EPA per day (in consultation with your doctor).

8. Benefits of fish oil Reduces the risk of heart disease Supports a healthy blood pressure Helps maintain normal triglyceride levels

9. Amounts needed for prevention and treatment Fish Oil Dose needed 2 servings of fish per week, preferably fatty for prevention of coronary disease 1 serving = 3 oz. 3 oz of Atlantic Salmon contains ~1 gram of omega-3 About the same as one daily dose of fish oil supplements 1 gram per day for persons with coronary disease 2-4 grams per day for triglyceride lowering Amount of food to achieve the dose You would have to eat on average 3.0 oz. of salmon every day to consume the same amount of omega-3 fats in one daily dose of a (~1.0 g) fish oil supplement.

10. Food groups and nutrients to emphasize Plant sterols Have been recognized by the FDA for their cholesterol lowering benefits. Fruits and vegetables contain sterols, but not in high enough doses to be therapeutic. Benefits of sterols Decreased cholesterol levels by binding of bile acids to prevent absorption of cholesterol in the gut

11. Amounts needed for prevention and treatment Plant Sterols 2 grams per day of plant sterols In order to get this amount through food, you’d have to eat every day: 1 ¼ cup sesame seeds or more than 1 lb. of broccoli or 80 apples or More than 1 cup of corn oil

12. Role of supplements in heart health promotion Achieving effective dose – evaluate and recommend by physician Evaluate dietary and lifestyle choices Formulate customized recommendations for diet and lifestyle Integrate supplements to complement diet and lifestyle Choose supplements that have demonstrated quality and efficacy standards Look for USP seal Demonstrate calorie savings from supplements Calories in one pound of broccoli= 170 kcal more per day Calories in 0.5 ounces of salmon= 25 kcal more per day Calories in > 1 cup corn oil= 1,980 kcal more per day

13. Conclusions Take control of your heart health by Choosing foods that can reduce risk Limiting foods that provide harmful nutrients Maintaining a healthy weight Making other lifestyle modifications Including supplements such as fish oil and plant sterols

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