At the Hunger and Health Coalition, we not only ensure people are fed, but also aim to consider our community's health holistically.
Out of the individuals that get medically tailored food boxes through the Hunger and Health Coalition, heart disease and hypertension are the top chronic conditions we see in our clients. The Centers for Disease Control and Prevention states that heart disease is the leading cause of death in Americans. Each year, the White House declares February as American Heart Month, the monthly observance being recognized by organizations such as the U.S. Department of Health and Human Services and the American Heart Association.
Overseeing our nutrition efforts — under the brand of Food is Medicine — at the Hunger and Health Coalition is Director of Strategic Initiatives Maura McClain, MS, RDN, LDN. Joining her in this program is Food is Medicine Assistant Jonathan Farrior, MS, RDN, LDN. Together, with the help of a rotating nutritional grad assistant, the nutrition team provides recommendations for the medically tailored food boxes HHC provides.
When community members sign up for services, HHC staff will ask if they have any diet-linked diseases that we should take into account when preparing their food boxes. These medically tailored food boxes meet the Dietary Guidelines for Americans provided by the U.S. DHHS and the U.S. Department of Agriculture and used by the American Heart Association and American Diabetes Association.
As a Registered Dietician, Maura had to receive bachelor's and master's degrees in nutrition, complete 1,200 hours of supervised practice, pass an exam, and receive continuing education hours. Maura chose to go into the scope of practice that includes community nutrition as she believes nutrition information should be accessible.
"I love being able to share nutrition information for free, and I’m lucky to work at a place where I can share it for free without any red tape like going through insurance," Maura said.
When advising HHC staff on what food items are healthiest for clients, Maura said she tries to be realistic and think about how we can provide clients with food items for a meal and not just random ingredients.
"I think, 'what would I like to eat?' If I wouldn’t eat it, I don’t recommend it," Maura said. "That’s not what you typically see in a food pantry. Things that could potentially be unhealthy, like dessert, we provide a healthier dessert option. I eat dessert every day, I’m not going to tell someone not to."
What Do We Mean By Heart Healthy?
For those with heart disease or trying to prevent heart disease, Maura has two main components she recommends the community consider:
Dietary Fat Intake Community members are encouraged to consume a fair amount of unsaturated fat and limit the intake of saturated fats. Maura explained that the unsaturated fats are fats we don’t find in animal products such as olive oil, canola oil, avocados and nuts. Saturated fats tend to come from animal sources like butter, lard and fat on meats.
Humans do need fat in their diets, as it can provide help for energy and hormone regulation. Maura just recommends trying to limit the saturated fats while eating enough of the unsaturated fats. Too much consumption of saturated fats can lead to an increase of LDL (low-density lipoprotein) cholesterol, which is the type of cholesterol associated with clogged arteries and can lead to heart attacks. HDL (high-density lipoprotein) cholesterol helps to clear out arteries and have a healthier heart — which can be aided by unsaturated fats.
Fiber
Maura calls fiber her "favorite" nutrient, adding that most Americans don't eat enough fiber. Fiber can help to reduce the LDL cholesterol in your body. She recommended at least 25-38 grams of fiber depending on your personal health journey. Fiber can be obtained by eating fruits, vegetables, whole grains, nuts and seeds.
What Would Our Nutrition Team Recommend For Heart Health?
"I always like to say nutrition by addition not restriction," Maura said. "While I am saying to limit some things, just don’t eat them in excess. Look at your diet and see where you can add small changes."
Maybe this means your household tries adding some fruit to breakfast or some vegetables to your dinner. If you want to or can, try switching to whole grain noodles instead of white pasta. You could try snacking on some nuts or adding it to the snack you have. When asked about fruit and vegetable recommendations for heart health, Maura said whichever fruit or vegetable a person will eat is the best option.
"While there are some (fruits) that are going to be higher in fiber — like berries are high in antioxidants — it’s whatever fruit you will eat or have access to," Maura said. "If you don’t have access to (whole grains) or like it, add more vegetables in. There are different ways you can add fiber without being miserable."
While fiber supplements — such as pills or powders — are an option, Maura recommends trying to obtain fiber by whole foods first. If someone may be only getting their fiber intake through a fiber supplement, Maura said that would be adequate. However, she said getting the added benefits of vitamins, minerals and water in addition to the fiber from food would likely be more affordable and beneficial.
In addition to tweaks to a diet, Maura said overall physical activity is recommend based on general guidelines, such as those suggested by the American Heart Association found here. Rather than focusing on exercise, maybe try thinking about changing your lifestyle to just being more active. Maura said activity such as playing with your dog or standing to do the dishes can add up, as long as you're getting your heart rate up at some point.
"The best exercise is the one you’ll do or can do," Maura said. "You should enjoy it; it should not be a punishment. If you’re at the point where you can follow guidelines, like a certain amount of cardio or adding resistance training, that’s great. If not, just adapt (physical activity) to you and your life and not making it a chore."
Maura said it isn't uncommon for those who struggle with heart disease to be told by healthcare professionals to lose weight, and may not have been given much guidance or given unrealistic expectations. At the end of the day, Maura said to find your motivation for having a healthy heart such as wanting to play with grandkids or wanting to garden. Whatever your internal motivator, Maura said to focus on making taking care of your body and less on stressing about weight loss.
To speak with a member of our nutrition team for free nutritional counseling, call (828) 262-1628. More information on Food is Medicine, nutritional counseling and suggested recipes can be found here.
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