Nutrition RUA i. Cardiac Unit ii. Caucasian middle aged American

Introduction a. Nutrition plays a vital role in cardiac health. Determining the correct diet for every patient is an important part of treating their overall health and preventing future complications. b. This presentation will demonstrate both good and bad menu examples for cardiac health, focusing on the middle aged adults in Arizona (United States) that may be from the Caucasian culture. Merriman, S. (2013). Cardiovascular disease and diet: the way to a healthy heart. Nursing & Residential Care, 15(1), 22–25. Menu One Breakfast ● 1 cup cooked oatmeal, sprinkled with 1 tablespoon chopped walnuts and 1 teaspoon cinnamon ● 1 banana ● 1 cup skim milk Lunch ● 1 cup low-fat (1 percent or lower), plain yogurt with 1 teaspoon ground flaxseed ● 1/2 cup peach halves, canned in juice ● 5 Melba toast crackers ● 1 cup raw broccoli and cauliflower ● 2 tablespoons low-fat cream cheese, plain or vegetable flavor (as a spread for crackers or vegetable dip) ● Sparkling water Daily menus for heart-healthy eating. (2019, January 9). Retrieved from Menu One cont. Dinner ● 4 ounces salmon ● 1/2 cup green beans with 1 tablespoon toasted almonds ● 2 cups mixed salad greens ● 2 tablespoons low-fat salad dressing ● 1 tablespoon sunflower seeds ● 1 cup skim milk ● 1 small orange Snack ● 1 cup skim milk ● 9 animal crackers Daily menus for heart-healthy eating. (2019, January 9). Retrieved from Evaluation of Menu One Calories: 1,562 Total fat: 45 g Saturated fat: 10 g Monounsaturated fat: 15 g Polyunsaturated fat: 16 g Cholesterol: 126 mg Sodium: 1,257 mg Total carbohydrate: 207 g Dietary fiber: 24 g Protein: 92 g What this Menu Presents: ● Healthy cardiac diet ● Directed towards Arizona patients or an “American” diet, middle aged ● The diet provides sufficient amounts of: sodium, fat, cholesterol, fiber, protein, carbohydrates, vitamins, and minerals. ● Balanced meal plan for a day/ weekly routine, that would support a cardiac patient significantly and benefit a healthy heart ● Allows for differences in cultures/ ages due to items/ foods being easily interchanged with another. Menu 2 Breakfast ● Whole-wheat bread, 1 med. slice ● Jelly, regular, 2 tsp ● Cereal, shredded wheat, ½ C with Milk, 1%, 1 C ● Orange juice, ¾ C ● Coffee, regular, 1 C with Milk, 1%, 1 oz Lunch ● Roast beef sandwich ○ Whole-wheat bread, 2 med. slices ○ Lean roast beef, unseasoned, 2 oz ○ American cheese, low-fat and lowsodium, 1 slice (¾ oz) ○ Lettuce, 1 leaf ○ Tomato, 3 med. slices ○ Mayonnaise, low-calorie, 2 tsp ● Apple, 1 med. ● Water, 1 C How Many Calories Should I Eat To Lose Weight? (n.d.). Retrieved from Menu 2 Continued Dinner ● Salmon, 3 oz edible ○ Vegetable oil, 1½ tsp ● Baked potato, ¾ med. ○ Margarine, 1 tsp ● Green beans, seasoned ○ with margarine, ½ C ● Carrots, seasoned ○ with margarine, ½ C ● White dinner roll, 1 med. ● Iced milk, ½ C ● Iced tea, unsweetened, 1 C ● Water, 2 C Snack ● Popcorn, 2½ C ○ Margarine, 1½ tsp How Many Calories Should I Eat To Lose Weight? (n.d.). Retrieved from Menu 2 Analysis Unhealthy Menu Selections - Jelly, regular, 2 tsp - Coffee with Milk - Mayonnaise, low-calorie, 2 tsp - Vegetable oil - Baked potato - White dinner roll - Iced milk Healthy Menu Selections - Whole-wheat bread - Cereal, shredded wheat, with Milk - 2 oz Lean roast beef, unseasoned - Salmon, 3 oz edible - low-fat and low-sodium, American cheese - Apple, 1 med. - Lettuce, 1 leaf - Tomato, 3 med. Slices - Green beans, seasoned - Carrots, seasoned - Orange juice, ¾ C - Iced tea, unsweetened, 1 C - Water - Popcorn, 2½ C Nutritional Value of Menu ● Calories: 1490 ● Total fat: 29% ● Cholesterol: 142 ● Sodium: 1,341 mg ● Total carbohydrate: 52 % ● Protein: 19% Dinu, M., Pagliai, G., & Sofi, F. (2017). A Heart-Healthy Diet: Recent Insights and Practical Recommendations. Current Cardiology Reports, 19(10), 95. Analysis of Menu 2 ● This menu gives a range of nutrient requirements but is lacking in carbohydrates from fruits. ● This menu is focused on the typical American adult and would fit the general adult population in Arizona. ● The menu provide appropriate amounts of protein, fats, carbohydrates, vitamins and minerals. Though the amounts are correct it would not be sufficient for a cardiac diet. The menu should focus on carbohydrates from fruit and vegetables rather than bread or starchy vegetables such as potatoes. This menu also uses fats such as margarine or low calorie mayonnaise, which should be substituted for more healthy fats like avocado, or monounsaturated oils (canola or peanut). Increasing the leafy vegetables will also increase the amount of vitamins and minerals the person receives. Merriman, S. (2013). Cardiovascular disease and diet: the way to a healthy heart. Nursing & Residential Care, 15(1), 22–25. ● This menu does not offer enough fruits and vegetables and has more than the recommended intake of margarine. ● Over one week I feel the patient would not be receiving enough nutrient rich fruits and vegetables. ● The menu also recommends caffeinated beverages which can dehydrate the person. In order to offer a balanced diet over a week this menu needs to be modified adding more water intake . ● This diet can be modified to accommodate different cultures. Many of the options that are not idea for a cardiac diet can be easily replaced with healthier heart options. Sample Cardiac Menu Breakfast -¾ cup cantaloupe -¾ cup whole grain cereal -1 cup/serving low fat yogurt -8 oz skim milk -1 slice wheat bread with 1 tsp soft tub margarine Snacks -10 unsalted almonds or walnuts -1 medium apple or orange -8 oz skim milk -½ cup sorbet Sample Cardiac Menu Lunch -3oz sliced grilled chicken on 2 slices of whole grain bread with lettuce, tomato, avocado, and fat free mayonnaise -½ cup carrot and celery sticks -8 oz water or seltzer water Dinner - 3 oz grilled salmon -1 cup quinoa -1 cup mixed greens with 1 tsp olive oil/vinegar -½ cup asparagus or broccoli -16oz water Sample Cardiac Menu Evaluation & Comparison ● The created menu offers a variety of healthy options. ● The created menu is aimed towards American adults with cardiovascular disease. ● Foods offered are nutrient enriched and fat-free or lowfat. ● This menu is in favor of improving health by providing options of unsaturated fats, lean meats, foods with natural oils as well as fat-free dairy options. ● Healthy portion sizes are provided based on the recommended daily intake. ● The menu provides examples of heart healthy meals - which can create a foundation for the client to then use such options at home. Barriers ● Lack of Education -None or very little discharge teaching ● Socioeconomic Status -Income or transportation ● Busy Lifestyle -Work, School, Children Summary Overall, it is important to make sure patients are fully educated on what a true cardiac diet consists of and provide them with information of foods that they can/can’t consume. -Low sodium, low fat, and low cholesterol foods. -Increase intake of: (Protein) lean chicken/fish, (Omega3 fatty acids) walnuts/almonds, (Fiber) apples/broccoli/oatmeal, (Potassium) bananas/spinach/avocado. Everybody is different, but by assessing a client's current situation and feelings towards the matter - You can gauge a better understanding of how to educate the client and ideally create a plan together that will improve their health in the long run. WORKS CITED Cardiac Diet Low Fat, Low Cholesterol, Low Sodium. (2008). Retrieved April 11, 2020, from Daily menus for heart-healthy eating. (2019, January 9). Retrieved from Dinu, M., Pagliai, G., & Sofi, F. (2017). A Heart-Healthy Diet: Recent Insights and Practical Recommendations. Current Cardiology Reports, 19(10), 95. Foods To Love and Foods To Avoid For a Heart Healthy Diet (infographic). (2015). Retrieved April 11, 2020, from How Many Calories Should I Eat To Lose Weight? (n.d.). Retrieved from WORKS CITED cont. Merriman, S. (2013). Cardiovascular disease and diet: the way to a healthy heart. Nursing & Residential Care, 15(1), 22–25. Nyhus, J. (2019). The cardiac diet explained. Nursing Made Incredibly Easy!, 17(6), 5–8. doi: 10.1097/01.NME.2.35054.d2. Sharp, Pamela, PhD, RN, Salyer, Jeanne & PhD, RN. (2012). Self-efficacy and Barriers to Healthy Diet in Cardiac Rehabilitation Participants and Nonparticipants. Journal of Cardiovascular Nursing, 27, 253-262. UCSF Health. (2019, October 31). Eating Right for Your Heart. Retrieved from