The role of nutrition in promoting heart health
Heart disease is the leading cause of death in both women and men in the United States; maintaining a heart healthy diet is key to lowering your risk. Here's a case example of a client who is looking to improve her health and body composition, and what a sample menu representing the recommended diet.
February 6, 2024 | Francine Blinten, MS, CCN, CNS
Heart disease is the leading cause of death in both women and men in the United States. Risk drivers include high blood pressure, high low-density lipoprotein (LDL) cholesterol, high triglycerides, diabetes, smoking and secondhand smoke exposure, obesity, unhealthy diet, and physical inactivity.
As a clinical nutritionist, I work with clients seeking to lower their risk factors through dietary modifications. The dietary pattern I most often recommend is the Mediterranean diet*. Conformity with the traditional Mediterranean Diet is associated with better cardiovascular health outcomes, including clinically meaningful reductions in rates of coronary heart disease, ischemic stroke, and total cardiovascular disease.
The nutrition consultation starts with a review of the client’s current clinical data. Specifically, I’m interested in fasting glucose, lipid panel, blood pressure and C-Reactive protein (a measure of inflammation). Body weight and waist circumference are also measured. We establish metabolic targets for out-of-range markers.
Together we evaluate the baseline diet and identify areas for improvement to meet the targets. We discuss lifestyle factors such as cooking skills, meal and hunger patterns as well as food preferences.
If the client has extra bodyweight, we need to address it because being overweight influences several risk drivers of disease. In my experience, a 5% reduction in baseline weight leads to significant clinical improvement.
The diet plan is tailored to the client’s age, gender, activity level and metabolic goals. Food allergies and sensitivities are noted. Portion sizes for each food category are outlined. In my experience, it is better to make small permanent changes rather than a complete overhaul; the latter usually fails.
A 50-year-old woman presents with:
LDL cholesterol elevated at 145 mg/dL
Borderline fasting glucose at 110mg/dL
Borderline triglycerides at 150 mg/dL
Normal weight but waist measures 38”
Blood pressure is normal 120/80
Her target is:
< 100 mg/dL
80 – 95 mg/dL
< 100 mg/dL fasting
maintain weight, waist < 35”
She eats three meals and an afternoon snack. Breakfast is cereal or a muffin; lunch is a sandwich or salad; dinner is chicken with a starch and a vegetable or pasta and a salad. She likes eggs but is afraid to eat them because of her cholesterol, so she eats cereal or a muffin instead. She likes fish but doesn’t prepare it at home. Snacks are protein bars or chocolate. She also exercises three times a week playing pickleball.
Her breakfast is low in protein and fiber. She plays pickleball after breakfast, so I recommended she start the day with more protein to better fuel her game.
I suggested 7 eggs/week for her, preferably with vegetables or fruit, as well as adding more fish and a few vegetarian meals each week. She should limit refined carbohydrates such as cereal and muffins, as they are likely raising her LDL, triglycerides, and blood sugar. The pancreas must produce more insulin in response to the rise in glucose. Over time, insulin resistance leads to fat placement in the abdomen.
Yogurt with almonds and berries
Eggs with spinach and mushrooms
Minestrone soup, cucumber and tomato salad
Grilled chicken and chickpea salad with olives and feta, olive oil and balsamic vinegar
Bell pepper with humus
Apple and almond butter
Roasted salmon with garlic and brussels sprouts
Turkey chili and roasted butternut squash
Sweet potato black bean chili
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Francine Blinten, MBA, MS, CCN, CNS, is a nutritionist who specializes in disease prevention, management of chronic disease, weight management, gastrointestinal disorders and bone support. She also has a subspecialty in oncology nutrition.