Heart Health

A Heart-Healthy Eating Toolbox

Do you wish you had a wider variety of tools to help you talk to clients about heart-healthy eating habits?

I recently returned from presenting at the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) annual meeting, where I had the chance to connect with colleagues from around the country practicing in cardiac rehab. Here’s an update on some valuable tools—available free of charge—that you may want to add to your toolbox.

“Cardiac College” for Patients
Health e-University is an effort of the University Health Network at the Toronto Rehabilitation Institute in Ontario, Canada, with the aim of promoting health literacy for patients and their families and helping people live and thrive with chronic disease. Paul Oh, MD, MSc, FRCPC, medical director of the Cardiovascular Prevention & Rehabilitation Program at the institute presented at the AACVPR meeting about its program called “Cardiac College.” The program promotes a Mediterranean-style diet for heart health. Nutrition Facts labels shown are Canadian, but that shouldn’t be an obstacle for clients in the United States. The program offers the following education materials, all of which are grounded in research on patient education and behavior change and are developed by health care professionals with input from patients:

Brief two-minute videos with corresponding tip cards on healthful eating can be downloaded from the website. Topics include choosing healthful options for breads, cereals, cooking oils, sauces and condiments, legumes, and more.
The “Eat Healthy” section of the Cardiac College website covers choosing healthful fats, increasing dietary fiber, and reducing sodium. And clients can download three- to four-minute videos featuring RDs talking about eating more fruits and vegetables, including legumes, and reducing sugar.
The institute also offers a much more comprehensive tool for patient education, “A Guide to Help You Live and Thrive with Cardiovascular Disease.” You can download the entire guide, which includes sections on how the heart works, common types of heart problems, managing stress, staying active, and setting goals. Or you may want only the 84-page section called “Eating Well for a Healthy Heart.” Various parts cover fat, fiber, reducing added sugars and sodium, managing blood lipids and blood pressure, and reading food labels.
Another tool that may be helpful in working with people on heart-healthy eating is THRIVE—a 12-week challenge for improving habits through small changes. It’s built around adult education principles of “Learn-Plan-Do-Reflect”; participants create weekly action plans and reflect on how things went as part of learning for the future.

Clinician’s Lifestyle Modification Toolbox
In talking with colleagues in cardiovascular care at the AACVPR meeting, I was surprised to hear that many were unaware of tools available free of charge from the National Lipid Association as part of its Clinician’s Lifestyle Modification Toolbox.

Patient education tear sheets, developed by RDs specializing in cardiovascular nutrition, include information on several cardioprotective dietary patterns. For example, you can find handouts on DASH, Mediterranean, Latino, Asian/Indian, and Vegetarian styles of heart-healthy eating. Several are available in Spanish.
Other tools cover soluble fiber to reduce LDL cholesterol, sterols in foods and supplements, omega-3 fats, and steps to reduce elevated triglycerides. Handouts also address sleep and stress.

Assessing Eating Habits
At the AACVPR annual meeting, Ellen Aberegg, MA, RDN, LD, FAACVPR, and I presented on tools for dietary assessment in cardiac rehab. We discussed how to evaluate tools and shared insights on options currently available.

Our recommended criteria include alignment with current dietary recommendations (eg, focus on total dietary pattern, not just saturated fat), established validity and reliability, practicality (eg, time, cost, readability), and match for intended use. Our review concluded that many commonly used tools are practical, but don’t meet the other criteria.

However, two tools meet all criteria: an online questionnaire tool, NutraScreen (by Viocare), and a free tool called Picture Your Plate developed by a group of RDs from the Sports, Cardiovascular and Wellness Nutrition Dietetic Practice Group. Scores correlate strongly with those on the Alternative Healthy Eating Index. The first paper from the tool’s validity study has been submitted for publication and still is in review. The tool can be accessed from this webpage, which we’ll keep updated on publications about it.

— Karen Collins, MS, RDN, CDN, FAND, is a nutrition consultant specializing in cancer prevention and cardiometabolic health, and nutrition advisor to the American Institute for Cancer Research. Karen’s trademarked tagline, “Taking Nutrition from Daunting to Doable”, highlights her focus on translating current research to help people see beyond headlines and put complex information in perspective. You can follow her blog, Smart Bytes®, through her website and follow her on Twitter @KarenCollinsRD and Facebook @KarenCollinsNutrition.

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