Heart Calcium Scoring & Heart Healthy Nutrition - PowerPoint Presentation

1. Heart Calcium Scoring & Heart Healthy NutritionLisa Ihlenfeldt, MSN, RN BellinMaggie Koch, BSN, BS, RN BellinLee Hyrkas, RD, CD, NASM-CPT Bellin

2. 2019 – Calcium Score Test added as PreventiveIn-network calcium score test now covered as preventive for Foth medical plan participantsUp to $250/yearDirect bill to insurance OR submit Medical Reimbursement Claim form

3. Foth’s Nurse/WellcoachFoth’s Nurse/Health Coach is available Mondays 1-4 p.m. and Thursdays, 8-11 a.m. (CT) to all Foth members and spouses (confidential, free of charge).Health coaching for lifestyle related issues (i.e. nutrition, exercise, smoking)Chronic care management (i.e. diabetes, blood pressure)Information on age-appropriate screening and testsBasic care for sore throats, ear aches, sinus infections, flu or cold symptoms, and more (includes on-site testing such as rapid strep and blood sugar)Basic ergonomic adjustments or recommendationsOnsite first aid for injuriesOnsite immunizations such as flu, tetanus and pneumonia

4. Cholesterol, CAD & ScreeningMaggie Koch, RN, BSN, BSHeart Lung & Vascular Clinical Coordinator4

5. Cholesterol: Key TermsCholesterol = Waxy water proofHDL = Happy Helper (Good Stuff)LDL = Lazy (Bad Stuff)Triglycerides = Energy Saver5

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12. Coronary Artery Disease (CAD)3/11/2019Footer Text12

13. Causes of CADHigh CholesterolHigh Blood PressureSmokingDiabetesOverweight or ObeseLack of Physical ActivityUnhealthy DietFamily Hx of Heart Disease3/11/2019Footer Text13

14. How Does CAD Form?3/11/2019Footer Text14

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20. Statins “Cholesterol Lowering Drugs”3/11/2019Footer Text20

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23. 3/11/2019Footer Text23https://webcast.gigtv.com.au/Mediasite/Play/fc8682662596428891773c1035b2c4e61d

24. Screening for Coronary Artery Disease (CAD)Heart Calcium Scoring3/11/2019Footer Text24

25. What is a Heart Calcium Scoring?ScreeningTo identify hard calcified plaque in coronary arteriesGives participants risk score Snap shot of chest cavity looking at lungs, liver, kidney and aorta.3/11/2019Footer Text25

26. Who qualifies?InclusiveMen > 30Women > 40Hx of smokingFamily hx of CAD,Elevated b/pHigh cholesterolDiabeticExclusiveIf you have had a heart attack, bypass surgery or stents placed.We already know you have CAD3/11/2019Footer Text26

27. Why is this important?Prevention is KeyChances are you or someone you know may be at risk of CADProvides snap shot Baseline AssessmentIdentify your riskAllows pt to receive intervention or get connected to healthcare team based on results3/11/2019Footer Text27

28. What do the results tell you?3/11/2019Footer Text28

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30. Calcium scoring ResultsAdditional Findings IdentifiedPulmonary nodulesScaring in LungsCysts on LiverThoracic Aortic AneurysmPericardial EffusionCalcification Aortic Valve3/11/2019Footer Text30

31. Questions?3/11/2019Footer Text31

32. Eating for Heart Health Lee Hyrkas, RD, CDERegistered DietitianPerformance Nutrition Specialist

33. Today’s AgendaNutrition Tips The Scoop on Fats Tips on Salt & Added Sugars

34. Keys to Heart HealthEat whole foods more often. Go lean with your protein. Add more fiber rich foods weekly. Choose your fats wisely.Watch those added sugars.

35. Mediterranean Meal PlanMeal plan to reduce heart disease and diabetes risk. Plentiful amounts of foods rich in fiber, potassium, unsaturated fats, lean protein. Mediterranean Meal Plan:2-3 servings fruit daily2-3 servings vegetables daily6-7 servings whole grains daily2 servings fermented dairy daily 4 oz. or less meat daily2-3 servings of fish weekly 2-3 servings of beans weekly 4-5 oz. of nuts/seeds weekly6-7 whole eggs weeklyLimited amount of sweets weekly Moderate red wine consumption5 oz. women, 10 oz. men dailyoldwayspt.org

36. 20 oz. Coke® - 240 cals1/2 bag potato chips – 640 calsSnickers® bar – 250 cals1/2 Jack’s® pizza – 1500 cals Which one looks like a better deal?Total: 2,630 calories 1 banana – 100 cals2 cups blueberries – 160 cals1 lb. bag carrots – 175 cals1 cup Greek yogurt – 130 cals1 medium sweet potato – 110 cals2 cups broccoli – 60 cals 1/2 cup beans – 114 cals 3 oz. chicken breast – 130 cals2 string cheese – 160 cals3/4 cup egg whites – 90 cals 3/4 cup brown rice – 160 cals 1/2 avocado – 120 cals6 cups salad greens – 40 cals Total: 1550 caloriesFiber and Protein PoorFiber and Protein Rich

37. Go Lean Lean red meats (look for “grass finished”)Loin, tenderloin, round, eye of round, and flank cuts Lean ground meat (90/10, 95/5)Pork loin Trim excess white fatLean white meats Chicken or turkey breast (skinless)Lean ground turkey/chicken (90/10, 93/7, 95/5)Low-fat/sodium deli meat (turkey, ham, chicken etc.)Nitrate/Nitrite free

38. Calories = 120Total Fat = 3.5 gSaturated Fat = 1 gSodium = 45 mgProtein = 22 g Comparing Foods Calories = 260Total fat = 21 gSaturated Fat = 8Sodium = 680 mgProtein = 14 gSave 140 calories and 17.5 g fat and 7 g saturated fat! Pork Tenderloin – 3 oz. 1 Brat Vs.

39. Meat Alternatives (Vegetarian Friendly) Quality Sources of Non-Meat Protein:Dairy products (milk, yogurt, cheese) Soy milk or yogurt Eggs or egg whitesNuts or peanut butter Beans (kidney, black beans, lentils)Tofu or edamame (soy beans)Quinoa or bean pastasRich in fiber, calcium, iron and zinc.

40. Easy Protein OptionsUse tuna or salmon pouches for quick protein option.Stock-up on easy to make protein.Greek yogurt cups, cottage cheese, milk, string cheese, edamame, nuts, nut butter, Kefir, hardboiled eggs, etc… Photos courtesy of Google images

41. FiberLook for grains and breads with 2-3 grams or more per serving.

42. Oatmeal/oat branNuts and seeds PeasBeans – all types Lentils ApplesPearsBerries – all typesGround flaxseeds Chia seeds Types of FiberWhole grain breads Barley Couscous Brown or wild riceCarrotsZucchinis Sweet potatoBrussels sprouts Salad greens Broccoli Aim for ~25-38 grams of fiber daily. Soluble InsolubleVs.

43. Easy Produce Options Have more of these options around the house. Steam bag veggies, frozen fruit, spiralized veggies, riced veggies, mashed cauliflower, canned veggies/beans, etc… Photos courtesy of Google images

44. Go CarbsFruit (all types)Starchy vegetables, beans Kodiak pancakes or Kodiak waffles Whole wheat or bean pastas Whole grain breads (≥ 2-3 g fiber)Sprouted grain breads or rye breadsOatmeal or cream of wheatQuinoa, amaranth, millet Brown rice or wild riceWhole grain mini bagel or wraps Whole grain crackers (Triscuit, Nut-Thins)

45. Whoa Carbs(aka fun carbs) SodaEnergy drinksFlavored coffee drinks (cappuccino)CandyCookies, cinnamon rolls, etc. Cakes, brownies, pies, fry bread, etc. Ice cream or sherbet Jell-O® or pudding French fries or onion rings Chips

46. Be Mindful of FatsCut back on high fat red meats (rib meats, bacon, etc.). Go lean (loin, tenderloin, round cuts, 90/10 ground meats, etc.) Aim for 2 times per week or less for red meatAvoid “partially hydrogenated oils”.Be cautious with your butter portions. 1 tsp. = 1 servingLimit fried food and fast food weekly. Reduce to 1 time per week or lessGo easy on coconut oil.

47. Saturated FatThis fat tends to raise LDL cholesterol.Limit to ~12-14 grams per day. Look for foods with 2-3 grams or less.Food Sources: butter, cream, processed meats, fried foods, fast food, sweets, bacon

48. Trans FatSource: FDA.govKeep this number as close to zero as you can. Foods high in trans fat: stick margarine, deep-fried foods, baked goods, chips, cake mixes

49. Mono and Polyunsaturated FatsSource: FDA.govThese are heart healthy fats.Foods Sources: Avocados, nuts, seeds, peanut butter, fish, olive oil, etc…

50. Fish & seafood Omega-3 eggs (pasture raised)Walnuts Flaxseeds, chia seeds Tofu, soybeans Grass-fed meats Green vegetables Omega-3 Fats

51. SodiumSource: FDA.govKeep sodium ≤2300 mg/day. Aim for foods with less than 200mg per serving. Sodium can affect your blood pressure and is often higher in processed foods.

52. Breads & RollsLuncheon Meat & Cured Meat PizzaPoultry (injected with sodium solution)Canned Soup SandwichesCerealsThe Salty SevenAdapted from: American Heart Association

53. Banana, medium (425 mg)1/2 cup broccoli (230 mg)1/2 avocado (490 mg)1/2 cup beans (595 mg)1 cup low-fat milk (390 mg)1 cup yogurt (300-400 mg)1 oz. nuts (200 mg)1 medium potato (900 mg)1 medium tomato (290 mg)1 cup leafy greens (300-700 mg)Potassium Powerhouses Aim for ~4700 mg per day.

54. SugarSource: FDA.govIncludes both natural and added sugars. Check the ingredient panel to determine if sugar has been added.Limit to ~30-50 grams added sugar per day.

55. New Food Label (January 2020)Source: FDA.gov

56. Soft DrinksCandyBakery Ice cream Specialty Coffee Drinks Cold Breakfast CerealsThe Sugary SixAdapted from: American Heart Association

57. Focus on Simple ChangesHow much sugar in a small flavored coffee?35-45 grams per cup

58. Focus on Simple ChangesHow much sugar in a large bowl cereal?40-44 grams

59. Key TakeawaysFocus on having more whole foods at home. Watch those labels for saturated fat and added sugar.Be mindful of the salty seven. Give the Mediterranean diet a chance.

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61. Heart.orgMalik, V.S. (2012, January 31). Sweeteners and Risk of Obesity and Type 2 Diabetes: The Role of Sugar-Sweetened Beverages. Curr Diab Rep , 12, 195-203.Stanhope KL. Sugar consumption, metabolic disease and obesity: The state of the controversy. Critical reviews in clinical laboratory sciences. 2016;53(1):52-67. doi:10.3109/10408363.2015.1084990.Sugarscience.ucsf.eduU.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.References