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I’m a Dietitian and found out I had high blood cholesterol…so here’s what I did to lower it

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One blue dumbell beside a white, heart-shaped bowl that is filled with heart healthy foodsLast summer at my annual check-up, I found out that my blood cholesterol level was HIGH – it was over 6.2 mmol / L.

WHAT?! Honestly, I was shocked.

I eat well and have been active all my life, so what was going on?

Could it be stress?

Admittedly, I was going through a very stressful period, lasting months. According to the Heart and Stroke Foundation, stress can affect our heart health and prolonged or chronic stress (lasting months to years) can increase blood cholesterol and blood pressure.

Studies from the Medicine journal and Scandinavian Journal of Public Health found that both psychological stress and job stress can increase blood triglyceride levels as well as the “bad” LDL (Low Density Lipoprotein) cholesterol.

In addition to stress, I have non-modifiable risk factors for high blood cholesterol – I’m female, over the age of 50 and have a family history of high blood cholesterol. Interestingly, research shows that total cholesterol levels peak in women at age 55-65.

So I did these 13 things to lower my blood cholesterol

I focused on doable, daily, dietary and lifestyle actions that were simple and sustainable. I followed healthy eating principles from the Portfolio Diet, recommended by the Canadian Cardiovascular Society.

1. I consistently ate oatmeal for breakfast. Oatmeal is a whole grain and contains a special type of soluble fibre called beta-glucan which is known to reduce blood cholesterol levels. According to Health Canada, 3 grams of beta glucan fibre per day can lower total and LDL cholesterol by about 5-8%. A serving of oatmeal (1/3 cup) contains 40% of the fibre amount needed. Bonus – I added a couple of tablespoons of All Bran Buds cereal for pysllium which is another cholesterol-lowering fibre. Get my Hearty Morning Oatmeal recipe!

2. I swapped out 2% Greek yogurt for 0%. Even though 2% milk fat is considered “low fat”, I wanted to reduce my saturated fat intake even more since this type of fat can raise blood cholesterol levels. With 0% milk fat products, there is zero saturated fat. I also cut back on my portions of cheese (a source of saturated fat). Lower fat cheese just doesn’t do it for me, so I prefer to eat regular cheese less often and in smaller amounts. And I reduced my butter intake, which I really only used on freshly baked bread.

3. I ate barley on repeat. Barley is another whole grain which contains that wonderful cholesterol-lowering beta-glucan fibre. My favourite way to eat barley was in Beef Barley Soup and Barley & Butternut Squash Risotto.

 4. I made more dinners with plant-based proteins. I aimed to make at least two plant-based dinners a week. These included tofu stir-fries, baked tofu, edamame beans and lentil bolognese. Compared to animal-based proteins, plant-based proteins are lower in saturated fat plus they can add extra fibre.

5. I ate nuts and seeds every day. I used to snack on nuts in the afternoon. But whenever my work day got too busy, I’d forget about my snack. So I added nuts and seeds to my morning oatmeal so that I didn’t miss out on the heart healthy fats found in these foods. Bonus: nuts and seeds offer plant-based protein.

6. I ate fish as least once or twice a week. Salmon is my favourite for heart healthy omega-3 fats. I tried a Maple-Pistachio Crusted Salmon recipe and made a few batches of Salmon Chowder which uses canned salmon! Sometimes, canned sardines with crackers were in the rotation for lunch.

7. I ate leafy greens every day. I ate a lot of veggies already, but paid extra attention to leafy green veggies. Not only is this important for my brain and eye health, but also for heart healthy nutrients like magnesium. My go-to greens were Sautéed Mushroom & Spinach Salad, and Beet Salad with Goat Cheese and Arugula.

8. I enjoyed fruit for dessert…most of the time! I love dessert, especially when it’s home-made! Most of the time, I opted for fresh berries or a small piece of dark chocolate. I didn’t deprive myself of rich desserts though – I just saved them for special occasions and enjoyed a smaller portion.

9. I built in daily physical activity. Using my home exercise equipment, I was active daily. And I’d walk the dog at least once or twice every day. On vacations, I purposely planned cycling and hiking excursions. To dial up the intensity and variety of my workouts, I joined a gym. I created a great training routine combining cardio, strength, balance and flexibility.

10. I prioritized sleep. Sleep was key to my stress management. My sleep routine involved quiet time, reading, stretching and deep breathing. I aimed to get at least 7-8 hours of sleep each night.

11. I took time off from social media. While fun and entertaining, social media can also be draining and damaging to mental health. When I started comparing myself to the images I was seeing, I knew it was time to take a break. Now, I set limits on what I watch and how often I even go on social media.

12. I listened to more audio books. I love learning and always looked forward to my “me time” with a good audio book. These days, I’m learning a new language!

13. I went outside every day. No matter what the weather, I stepped outside, often with puppy at my side. Fresh air and a good sweat are such great stress busters!

And now, 6 months later…

My total blood cholesterol has dropped 12% and is in a good range. I’m still going strong with each of the 13 actions above.

There are many risk factors to high blood cholesterol, including diet, physical activity, stress, age, gender, family history, smoking and alcohol. If you’re trying to make changes, ask yourself what actions you can realistically do – and more importantly – maintain over time. Are there any ideas above that you can try? Every small action adds up! For more information, check out the Heart and Stroke Foundation.

 

Note: This information is for educational purposes and not intended to replace the medications and / or recommendations advised by your health care professional. My results may be different from your’s. Please reach out to a dietitian for personalized dietary advice.

 

 

 

Nutrition Tip of the Month: Eat a plant-based meal this week

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A big platter of bean and corn salad.It’s Heart Month and our food choices can have a big impact on our heart health.

The Portfolio Diet is a way of eating that has been shown to reduce blood cholesterol levels and lower your risk of heart disease. One element of the Portfolio Diet is to eat 50 grams of plant protein every day. Compared to animal proteins, there’s less saturated fat and more fibre in plant-based proteins. If you find it tough to eat plant-based proteins, start by aiming for 25 grams.

Make meals using plant-based ingredients like: beans, chickpeas, lentils, tofu, edamame beans / soy beans, fortified soy beverage, tempeh, veggie burgers and soy based “meats.” Blend these ingredients with some of your favourite meals. For example, add a cup of canned lentils to a spaghetti sauce, toss a handful of edamame beans into a salad or make a latté with fortified soy beverage.

Here are a few recipes ideas:

– Black Bean, Corn and Avocado Salad (pictured)

– BBQ Tofu Burger

– Lentil Bolognese 

– Chickpea Lettuce Wraps

Enjoy!

 

 

 

 

Eat More Fruits & Veggies BINGO

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A BINGO sign with animated carrot, avocado, eggplant and red pepperAlright, we all know that eating fruits and veggies are good for you. In fact, eating at least 5 servings of fruits and veggies every day can lower your risk for health problems such as heart disease and type 2 diabetes.

The problem though is that most of us aren’t eating enough fruits and veggies. New data from the Canadian Risk Factor Atlas, released by the Public Health Agency of Canada shows that almost 71% of adults have low fruit and veggie consumption. Put another way, less than 30% of us are actually getting enough!

So, I’ve created a fun “Eat More Fruit & Veggies” BINGO card below with easy ways to eat more fruits and veggies throughout the day. Feel free to print the BINGO card for yourself and your family, or have fun making your own BINGO cards!

A BINGO card with 9 squares. Each square has a tip for eating more fruits and veggies.

Need some recipe inspo? Try these recipes:

Chicken Quinoa Salad

Beet Salad with Goat Cheese & Arugula

Black Bean, Corn & Avocado Salad

Beef Barley Soup

Air Fryer Chicken Fajitas

Strawberry Ricotta Toast

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Strawberry ricotta toast

Strawberry Ricotta Toast

A fast, easy and colourful breakfast. Pair with a smoothie or latte for extra protein.
Print Recipe Pin Recipe
Course Breakfast

Ingredients
  

  • 1 loaf whole grain bread
  • 1 cup ricotta cheese
  • 1 Tbsp honey, plus extra for drizzle
  • 1 cup sliced strawberries
  • fresh mint for garnish

Instructions
 

  • Slice bread and toast it.
  • In a small bowl, combine honey with ricotta cheese.
  • Spread the ricotta mixture on toast and top with sliced strawberries.
  • Drizzle with honey and garnish with mint leaves.

Notes

Strawberry ricotta toast
Keyword breakfast, ricotta toast, strawberry, Strawberry Ricotta Toast

Heart Healthy Breakfast Ideas

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Sue Mah in the TV kitchen studio with host Lindsey Deluce

 

For February Heart Month, I showed 3 heart healthy breakfast ideas on TV. Check out the recipes below and watch the full interview clip.

Strawberry Ricotta Toast

BLT Breakfast Salad (Barley, Lettuce, Tomato)

Chickpea Flour Waffles

 

 

 

 

 

 

BLT Breakfast Salad

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Salad with barley, lettuce, tomatoes, cucumber and hard cooked egg

BLT Breakfast Salad

Wny not try a salad for breakast (or lunch or dinner)? The "B" stands for barley!
Print Recipe Pin Recipe
Course Breakfast, Dinner, Lunch
Servings 4

Ingredients
  

Salad

  • 1 cup cooked barley
  • 3 cups romaine lettuce, chopped
  • 1 cup grape tomatoes, sliced
  • 1 cup cucumbers, diced
  • 4 hard cooked eggs, sliced

Dressing

  • 2 Tbsp canola oil
  • 2 Tbsp cider vinegar
  • 1 Tbsp lemon juice
  • salt and pepper to taste

Instructions
 

  • In a large bowl, combine barley and veggies.
  • In a small bowl, whisk together dressing ingrdients.
  • Drizzle dressing over salad and toss.
  • Top with sliced eggs.
Keyword barley salad, BLT Breakfast Salad, breakfast, breakfast salad

Chickpea Flour Waffles

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Chickpea waffles

Chickpea Flour Waffles

Made with chickpea flour, these waffles are a greart way to introduce beans to the family!
Print Recipe Pin Recipe
Course Breakfast
Servings 4

Ingredients
  

  • 1 1/2 cups chickpea flour
  • 2 Tbsp granulated sugar
  • 2 tsp baking powder
  • 1 tsp cinnamon
  • 1/4 tsp salt
  • 1 cup milk or plant-based beverage
  • 2 eggs
  • 1/2 tsp vanilla extract

Instructions
 

  • In a large bowl, whisk together the chickpea flour, sugar, baking powder and salt.
  • Stir in milk or plant-based beverage. Whisk in eggs and vanilla extract until smooth. Let batter rest for 5 minutes.
  • Preheat waffle maker and spray with non-stick spray. Pour 1/3 to 1/2 cup of batter, depending on the size of your waffle maker.
  • Cook waffles to desired doneness and top with fresh berries.
Keyword breakfast recipes, chickpea flour, Chickpea Flour Waffles, Waffles

Good Things Grow in Ontario!

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Sue smiling and holding two strawberries as earrings in strawberry field

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This post reflects my learnings after attending a sponsored event, hosted by Farm and Food Care Ontario, GreenBelt, More than a Migrant Worker, Ontario Apple Growers, Ontario Berries and the Ontario Produce Marketing Association. All opinions are my own.

When I was a kid, I remember singing the tune ‘Good things grow in Ontario!’ And that lyric still holds true today.

I was recently invited to a farm tour in beautiful Norfolk County, sponsored by Farm Food Care Ontario where we had the chance to learn more about food and agriculture!

First stop: Strawberry Tyme Farms

Dalton and John Cooper standing in a high tunnel strawberry field

Meet Dalton Cooper, a 4th generation berry farmer and his dad John. Originally an apple farm since 1939, the family now grows berries using innovative varieties and growing techniques. Traditionally, strawberries harvest in June but a new ‘day-neutral’ strawberry fruits for 5-6 months, extending the typical strawberry season from June / July well into October.

John gave us a little strawberry physiology lesson to understand how this works. ‘June strawberries’ are named as such because they fruit in June. These berries are planted in the Fall when the days are short, and bear fruit in June when the days are long. On the other hand, ‘day-neutral’ strawberries are an annual variety planted in the spring with berries ready to pick about 12 weeks later. The berries continue fruiting regardless of the length of the day, which is why they’re called ‘day-neutral’!

The strawberries are grown on table tops in high tunnels which protect the berries from damaging heavy rains and maintains a moderate temperature. Not to mention, it’s much easier to pick these berries! The Cooper family also grows long cane raspberries, a growing technique where the berries are grown in pots and produce fruit in their second year.

Fun facts: There are 675 farms across Ontario which grow strawberries. Ontario growers produce between 6,000-7,000 tonnes of strawberries each year!

 

Next stop: Suncrest Orchards

Farmers Amanda and Hayden with their family of Jamaican workers

Image: Facebook Suncrest Orchards

Farmers Amanda and Hayden Dooney have owned the Suncrest Orchards since 2019 and work with a wonderful Jamaican family of eight employees including Raymond and George.  They’re seasonal agricultural workers who come up to the farm as early as March and stay until the end of October or longer. The farm grows and harvests seven different varieties of apples: Paula Red, Ginger Gold, Sunrise, Golden Delicious, Honey Crisp, Royal Gala and Ambrosia.

Red gala apples growing on a bush

At lunch, we had the wonderful opportunity to chat with some of the workers. Amanda says, “We have huge respect and appreciation for the sacrifice they make to come up and help with our orchard.”  Livian, (pictured front left below), for example, has worked seasonally on farms for 25 years and is proud to have supported his four kids through university. Indeed, let’s all give our thanks to the amazing farmers and seasonal agricultural workers who work so hard to grow delicious and nutritious food!

Are you hosting an educational tour? Contact me to cover the event and share highlights!

 

 

Test Your Sodium IQ

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Split screen image of TV host Anne Marie Mediwake and dietitian Sue Mah

Cardiovascular disease is still the number one cause of death globally (1). Eating too much sodium is linked to high blood pressure which is a major risk factor for heart disease. Here are 5 questions to test your sodium IQ!

Watch Sue’s national TV interview on YouTube or click on the image below.

 

 

 

 

1. True or False: We need sodium to stay healthy.

True!  We do need some sodium to maintain our blood pressure and fluid levels in our body. Sodium is also needed to keep our muscles and nerves running smoothly. The problem is that most of us are getting too much sodium, which can lead to health problems such as hypertension (high blood pressure) and cardiovascular disease.

On average, we should stick to less than 2,300 mg of sodium a day, but we’re eating about 1½ times that amount (2). In fact, 3 out of 5 Canadians eat too much sodium (2). A report by Health Canada found that 72% of kids between the ages of 4 to 13 are eating too much sodium. And over 95% of males aged 19-30 are eating too much sodium (2).

Eating too much sodium today can lead to high blood pressure later in life. According to a report by the Heart and Stroke Foundation, about 20% of Canadians have high blood pressure or hypertension, and another 20% of Canadians have pre-hypertension (where their blood pressure is above normal but not quite diagnosed as high yet) (3).

2. True or False: Sodium is the same thing as salt.

False!  Salt and sodium are often used interchangeably, but they’re not exactly the same thing. Sodium is a mineral that’s found naturally in foods and / or added to foods. Salt or table salt is a combination of sodium plus chloride. Salt is the main source of sodium. Other sources of sodium include sodium bicarbonate (baking soda), sodium benzoate (a preservative) and monosodium glutamate (a seasoning).

3. True or False? Sea salt is healthier for you than table salt.

False!  The main differences between sea salt and table salt are the taste, texture and how they’re made.

Sea salt is made by evaporating sea water and can taste differently depending on where it’s from. There are some trace minerals in sea salt such as calcium and iron, but the amounts are very low. The sea salt crystals can be large.

Table salt is made from fine crystals mined from ancient dried up salt lakes, and then ground to give it a finer texture. You may find iodine in table salt – it’s a nutrient that’s added to lower the chances of developing an iodine deficiency.

Kosher salt is the same as table salt, but has larger crystals and no iodine. And Pink Himalayan salt is actually mined in Pakistan. The pink color is from the iron in the salt.

By weight, all of these types of salt have about the same amount of sodium as table salt.

By volume however, (i.e. if you’re measuring it with a teaspoon), sea salt, Kosher salt and Pink Himalayan salt will have slightly less sodium because they have larger crystals.

Whichever type of salt you prefer, use less to cut down on your overall sodium intake. Boost the flavour of food with sodium-free ingredients like herbs, spices, garlic, lemon juice or citrus zest.

4. True or False? You can tell which foods are high in sodium because they taste salty.

False!  Some foods such as bread and cereal don’t really taste salty, but they do contain sodium. Sodium can also be hidden in salad dressings, soups, pasta sauces, different condiments and baked goods like cookies and muffins. Read food labels and look for foods that generally contain less than 15% of the Daily Value (%DV) for sodium. Or look for foods that are specifically labelled “low sodium”.

The image below shows a Nutrition Facts table for crackers. You can see that 4 of these crackers contain 6% of the Daily Value (DV) for sodium. A %DV that is 5% or less is considered “a little” and a %DV that is 15% or higher is considered “a lot”.

Nutrition Facts table for crackers, showing 6% DV for sodium

Image source: Sue Mah

 

 

 

 

 

 

 

 

 

5. True or False? Most of the sodium we eat comes from the salt shaker.

False!  Only about 11% of the sodium we eat comes from the salt shaker when we add salt to our cooking or to our food at the table Almost 80% of the sodium we eat comes from packaged foods. The rest is from sodium found naturally in foods.

In fact, the top 6 sources of sodium in are diet are:

  • Bakery products (e.g. bread, muffins) – salt is added to baking, and even though the food doesn’t taste very salty, but we tend to eat a lot of these foods, so the sodium adds up
  • Appetizers and entrées (e.g. pizza, frozen meals)
  • Processed meat
  • Cheese
  • Soups
  • Sauces and condiments

Fast food / restaurant meals also tend to be higher in sodium. Sodium is added to foods to act as a preservative and also to bring out the flavour of foods. To cut back on sodium, enjoy more wholesome fruits and veggies because they’re essentially sodium-free. If you’re making a recipe, try cutting down on the ingredients which contain sodium. If you’re eating out, ask for sauces, salad dressings and gravy on the side so that you can control the amount of sodium that you eat.

 

References:

1) World Heart Foundation (no date). World Heart Day is celebrated every year on 29 September. Retrieved September 20, 2020 from https://www.world-heart-federation.org/world-heart-day/about-whd/

2) Health Canada (no date). A salty situation. Retrieved Sept 20, 2020 from https://www.canada.ca/content/dam/hc-sc/documents/services/publications/food-nutrition/infographic-salty-situation/26-18-2058-Sodium-Infographic-eng-08.pdf

3)  Heart and Stroke Foundation (2014 August). Position statement – Dietary sodium, heart disease and stroke. Retrieved September 20, 2020 from https://www.heartandstroke.ca/-/media/pdf-files/canada/2017-position-statements/dietary-sodium-ps-eng.ashx?rev=29762d89e1e3446084fa988ac9b0c3d7&hash=6523A0B22CEB23AC5B87207DB5C00E8C

 

5 Things You Need to Know about that Red Meat Study

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A piece of marbled red meat on a plate.
[Image: Canva]

Yes, red meat is in the news…again. Headlines last week announced that we may not have to cut back on red meat or processed meat after all, based on conclusions published in the Annals of Internal Medicine.

This stirred up quite a bit of controversy especially since many health organizations offer different advice. The Canadian Cancer Society for example, recommends limiting red meat (beef, veal, pork, lamb and goat) to 3 servings a week (a serving is 85 grams or 3 ounces of cooked meat – smaller than the size of a deck of cards) and avoiding processed meats.   The World Cancer Research Fund (WRF) advises that if you eat red meat, limit it to no more than about three portions per week (total of 350-500 grams or 12-18 ounces per week). And the WCRF also recommends eating very little, if any, processed meat like bacon, ham, hot dogs and sausages.

So, is that confusing or what? It sure is! And it took me a while to read through the science to figure it out.

Here are 5 things you need to know about the study to help you understand how and why the guidelines were made:

  1. This wasn’t a new study about red meat. Basically, a panel of scientists reviewed existing studies looking at the impact of red meat on health. They looked at “absolute risk”. In other words, they considered how many people per 1000 people would likely benefit from eating 3 fewer servings of red meat or processed meat (e.g. going from 7 servings/week of red meat to 4 servings/week or going from 4 servings/week to 1 serving/week). They found that out of 1,000 people, only between 1 to 18 people would have a lower chance of heart disease, type 2 diabetes or cancer if they ate 3 fewer servings of red meat or processed meat.
  2. The evidence for this guideline is “low” to “very low”. The panel found “low” to “very low” certainty evidence for their conclusions. The panel even admitted that their guideline for adults to “continue current unprocessed and processed red meat consumption” is a weak recommendation. In fact, three out of the 14 panel members didn’t agree with this recommendation.
  3.  Observational studies were reviewed. In observational studies, researchers observe the effect of something – in this case, the effect of eating red meat and processed meat. When it comes to making recommendations though, observational studies aren’t as strong or conclusive as experimental studies in terms of showing a cause and effect relationship. In experimental studies, typically two or more groups are compared – for example, an experimental study could compare the health status of Group A who ate red meat versus Group B who didn’t eat red meat. Plus, many of the observational studies lumped red meat and processed meat together, and didn’t consider other dietary factors or the cooking methods (e.g. broiling versus BBQ).
  4. Pros versus cons. The researchers believed that for most people, the desirable effects from eating less red / processed meat (a potential lower risk for cancer and heart disease) did not outweigh the undesirable effects (impact on life, burden of modifying cultural and personal meal preparation and eating habits).
  5. Other issues were not considered. The researchers acknowledge that their guideline didn’t consider issues of animal welfare and potential environmental impact. They admitted that their guideline may be less relevant for people who see these as important issues.

So what’s the bottom line?

Remember that we choose foods for many different reasons – cost, taste, nutrition, health, animal welfare and environmental concerns. No single food completely causes or prevents a health condition. But we do know that an overall healthy pattern of eating plus lifestyle habits can make a big difference to your well-being. News headlines can be sensational and the stories may not always give you the full picture.

As a dietitian and chef’s daughter, I wholeheartedly believe in enjoying delicious, wholesome food. Processed meat can add extra saturated fat and sodium to the diet – these are the nutrients we’re trying to limit. From a nutrient point of view, red meat is packed with protein, iron, zinc and vitamin B12. Whether you choose to eat red meat or not, keep your portions in check. Moderation is truly the key. And make sure to fill at least half your plate with Mother Nature’s superheroes – fruits and veggies.

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