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	James L. Holly, M.D.

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Your Life Your Health - American Heart Association 2006 Revised Dietary Recommendations

James L. Holly,M.D.

September 07, 2006

Your Life Your Health - The Examiner

As you apply what we have reviewed in the seven-part series on the effects of exercise and diet on chronic disease, we need practical directions for how to eat. The following is a summary of the 2006 revised dietary and exercise recommendations of the American Heart Association.

Healthy food habits can help you reduce three of the major risk factors for heart attack -- high blood cholesterol, high blood pressure and excess body weight. They'll also help reduce your risk of stroke, because heart disease and high blood pressure are major risk factors for stroke. Here is a summary of the revised recommendations:

Use up at least as many calories as you take in.
Aim for at least 30 minutes of physical activity on most, if not all, days. To lose weight, do enough activity to use up more calories than you eat every day.
Eat a diet rich in vegetables and fruits.
Choose whole-grain, high-fiber foods.
Eat fish at least twice a week.
Limit how much saturated fat, trans fat and cholesterol you eat.
Select fat-free, 1 percent fat, and low-fat dairy products.
Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
Cut back on beverages and foods high in calories and low in nutrition, such as soft drinks and foods with added sugar.
Choose and prepare foods with little or no salt.
If you drink alcohol, drink in moderation (one drink or less a day)

Know How Many Calories You Should Eat

To avoid gaining weight over time, you should aim to burn up as many calories through basic metabolic function and physical activity as you take in. To know whether you're on track, you need to be able to estimate how many calories you need based on your age, gender and level of physical activity.

The calorie ranges shown in this table allow for the needs of people of different ages within an age group. Adults need fewer calories at older ages. For example, an active 31-year-old man needs about 3,000 daily calories, but an active 50-year-old man needs only about 2,800 calories.

		Activity Level and Estimated Calories Burned
Gender	Age (years)	Sedentary 1	Moderately Active 2	Active 3
Female	19-30	2,000	2,000-2,200	2,400
	31-50	1,800	2,000	2,200
	51+	1,600	1,800	2,000-2,200
Male	19-30	2,400	2,600-2,800	3,000
	31-50	2,200	2,400-2,600	2,800-3,000
	51+	2,000	2,200-2,400	2,400-2,800

Sedentary means you have a lifestyle that includes only the light physical activity associated with typical day-to-day life.
Moderately active means you have a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
Active means you have a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.

To get the most benefit from your dietary choices, keep these recommendations in mind:

Replace high-calorie foods with fruits and vegetables.
Eat especially the deeply colored vegetables and fruits, such as spinach, carrots, peaches and berries. They tend to be higher in vitamins and minerals than others, such as potatoes and corn.
Eat whole vegetables (fresh, frozen or canned) and fruits instead of drinking juices.
Choose frozen and canned vegetables and fruits in water without added sugar, saturated and trans fat, or salt when fresh foods are not available to you.
Prepare vegetables and fruits without added saturated and trans fat, sugar, and salt.

Choose Whole-Grain, High-Fiber Foods

The fiber found in unrefined whole-grain foods can help lower your blood cholesterol, which is important in preventing heart disease and stroke.

Choose foods such as whole wheat, oats and oatmeal, rye, barley and corn. Also include popcorn, brown rice, wild rice, buckwheat, bulgur (cracked wheat), millet, quinoa and sorghum.
Choose breads and other foods that list whole grains as the first item in the ingredient list.
Aim for about 25 grams of fiber each day.

Eat Fish

Fish, especially oily fish, is rich in omega-3 polyunsaturated fatty acids. Research has established a link between eating fish and a lowered risk of death from coronary heart disease. The American Heart Association recommends that you eat at least two servings of fish each week. (One serving equals about 3 ounces cooked, or a serving about the size of a checkbook).

Examples of fish relatively high in omega-3 fatty acids include salmon, trout and herring.
Grill, bake or poach fish. Limit commercially fried fish and don't add cream sauces.
Prepare fish without added saturated and trans fat.

Eat a Wide Variety of Foods

This chart shows the suggested number of servings from each food group based on a daily intake of 1,600 or 2,000 calories. There is a right number of calories for you, depending on your age, physical activity level and whether you are trying to lose, gain or maintain your weight. If you need fewer calories than shown below, decrease the number of servings and increase the servings if you need more calories.

Food Type	1,600 calories	2,000 calories	Sample Serving Sizes
Grains At least half of your servings should be whole-grain	6 servings per day	6-8 servings per day	- 1 slice bread - 1 oz dry cereal (check nutrition label for cup measurements of different products) - ½ cup cooked rice, pasta, or cereal (about the size of a baseball)
Vegetables Eat a variety of colors and types	3-4 servings per day	4-5 servings per day	- 1 cup raw leafy vegetables (about the size of a small fist) - ½ cup cut-up raw or cooked vegetables - ½ cup vegetable juice
Fruits Eat a variety of colors and types	4 servings per day	4-5 servings per day	- 1 medium fruit (about the size of a baseball) - ¼ cup dried fruit - ½ cup fresh, frozen, or canned fruit - ½ cup fruit juice
Fat-free or low-fat dairy products	2-3 servings per day	2-3 servings per day	- 1 cup fat-free or low-fat milk - 1 cup fat-free or low-fat yogurt - 1½ oz fat-free or low-fat cheese (about the size of 6 stacked dice)
Fats and oils Use liquid vegetable oil and soft margarines most often	2 servings per day	2-3 servings per day	- 1 tsp soft margarine - 1 Tbsp mayonnaise - 1 tsp vegetable oil - 1 Tbsp regular or 2 Tbsp low-fat salad dressing (fat-free dressing does not count as a serving)
Nuts, seeds, and legumes	3-4 servings per week	4-5 servings per week	- 1/3 cup or 1½ oz nuts - 2 Tbsp peanut butter - 2 Tbsp or ½ oz seeds - ½ cup dry beans or peas
Sweets and added sugars	0 servings per week	5 or fewer servings per week	- 1 Tbsp sugar - 1 Tbsp jelly or jam - ½ cup sorbet and ices - 1 cup lemonade

Eat less of the nutrient-poor foods

There is a right number of calories to eat each day based on your age and physical activity level and whether you are trying to gain, lose or maintain your weight. You could use your daily allotment of calories on a few high-calorie foods and beverages, but you probably wouldn't get the nutrients your body needs to be healthy. Limit foods and beverages that are high in calories but low in nutrients, and limit how much saturated fat, trans fat, cholesterol, and sodium you eat. Read labels carefully — the Nutrition Facts panel will tell you how much of those nutrients each food or beverage contains.

As you make daily food choices, base your eating pattern on these recommendations:

Choose lean meats and poultry without skin and prepare them without added saturated and trans fat.
Select fat-free, 1 percent fat, and low-fat dairy products.
Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
Cut back on foods high in dietary cholesterol. Aim to eat less than 300 milligrams of cholesterol each day.
Cut back on beverages and foods with added sugars.
Choose and prepare foods with little or no salt. Aim to eat less than 2,300 milligrams of sodium per day.
If you drink alcohol, drink in moderation. That means one drink per day if you're a woman and two drinks per day if you're a man.
Follow the American Heart Association recommendations when you eat out, and keep an eye on your portion sizes.

Use the Same Principles When You Eat Out

Many of us eat out for most of our meals. Here's the danger: Many types of "away from home" meals, including prepared meals you buy at the grocery store, are high in saturated fat, trans fat, cholesterol, added sugars and sodium. And portion sizes have increased dramatically over the last several years, which means more calories to eat.

To keep portions smaller, split an entrée with your dining partner or take half home when dining alone.
Ask for sauces and dressing on the side to control the fats, sodium and calories you eat.
When ordering, choose foods that have been grilled, baked, steamed or poached instead of fried, sautéed, smothered or au gratin.
Try ordering two or three appetizers instead of a full meal and add a salad (watch the dressing) or soup.
If you choose a dessert, split it with your dining partners or ask for fresh fruit. Another alternative is a fat-free cappuccino or espresso beverage instead.

Remember, it is your life and it is your health and "you are what you eat!"

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