Unlock the Power of Nutrition and Movement for Your Heart ❤️
Introduction. Did you know that small dietary changes can reduce your risk of heart disease by as much as 30%? That’s the incredible power of nutrition! By embracing heart-healthy habits, you can significantly lower your cholesterol levels, improve your cardiometabolic health, and feel your best.
In my clinical practice as a Registered Dietitian, high cholesterol is a common concern among my clients—particularly women going through menopause, and individuals with a family history of heart disease, which can significantly impact their risk. Statistics show that 40% of Canadian adults have high cholesterol, a leading risk factor for heart disease, which remains the second leading cause of death in Canada.
But here’s the good news: with the right strategies, you can take charge of your heart health. For our December Blog / Newsletter, I’m thrilled to share evidence-based insights on managing cholesterol and improving cardiometabolic health to support a Healthier U
NOTE: If you scroll down to the end, I created a Healthy U Heart Healthy Grocery List to make it all easier for you to adopt the recommendations outlined in this newsletter!
Take Our Quick Heart-Healthy Survey. Is your menu working in your heart’s favour? Take this quick quiz to find out:
Do you include plant-based proteins like lentils, chickpeas, or tofu at least twice a week?
Yes, regularly
Sometimes
Rarely or never
Do you eat a variety of nuts and seeds daily (e.g., walnuts, chia seeds, flaxseeds)?
Yes, daily
A few times a week
Rarely or never
How often do you cook with heart-healthy fats like olive oil?
Almost always
Sometimes
Rarely or never
Do you consume a minimum of 7 servings of fruits and vegetables daily?
Yes, every day
A few days a week
Rarely or never
Do you limit red meat and processed meats in favor of fish or poultry?
Yes, I limit them
I eat them occasionally
No, they’re a regular part of my diet
Your Results:
Mostly A’s – You’re a Heart Health Champion! Keep up the great work.
Mostly B’s – You’re on the right path—small tweaks can make a big difference.
Mostly C’s – Time to embrace more heart-healthy habits. Start with one change today!
In this newsletter, we’ll explore evidence-based dietary approaches to improving heart health, including the Portfolio Diet and Mediterranean Diet—two scientifically proven approaches to supporting heart health. Discover simple, effective strategies to lower cholesterol, enhance overall well-being, and support a healthier heart for the long term!
What is Cholesterol? Cholesterol is a waxy, fat-like substance found in your blood. It’s essential for building cell membranes, producing hormones, and making vitamin D. However, an imbalance in cholesterol levels—particularly elevated levels of low-density lipoprotein (LDL)—can lead to the build-up of plaques in arteries, increasing the risk of heart disease and stroke.
Cholesterol is measured in millimoles per litre (mmol/L) in Canada and consists of several key components:
LDL-C (Low-Density Lipoprotein Cholesterol): Known as "bad cholesterol," it contributes to plaque build-up in arteries.
HDL-C (High-Density Lipoprotein Cholesterol): Known as "good cholesterol," it helps remove cholesterol from the bloodstream.
Triglycerides: A type of fat that provides energy but, at high levels, increases cardiovascular risk.
Total Cholesterol: A combination of LDL, HDL, and triglycerides.
Additional Markers to Assess Risk
Lipoprotein(a) [Lp(a)]
Lp(a) is a genetic marker that contributes to plaque formation in arteries. Elevated Lp(a) levels increase cardiovascular risk, particularly in those with family histories of heart disease.
Elevated Levels: > 30 mg/dL (varies based on lab standards)
Apolipoprotein B [ApoB]
ApoB reflects the number of atherogenic particles (including LDL and other lipoproteins). It’s a stronger predictor of cardiovascular risk than LDL-C alone.
High-Risk Threshold: > 0.8 g/L
Cholesterol Targets According to the Canadian Cardiovascular Society (CCS)
Marker | Target for Low Risk | Target for Intermediate Risk | Target for High Risk |
Total Cholesterol | < 5.2 mmol/L | <4.5 mmol/L | <4.0 mmol/L |
LDL-C | ≤ 3.5 mmol/L | ≤ 2.6 mmol/L | < 2.0 mmol/L or a ≥ 50% reduction |
HDL-C | ≥ 1.0 mmol/L (men) ≥ 1.3 mmol/L (women) | ≥ 1.0 mmol/L (men) ≥ 1.3 mmol/L (women) | ≥ 1.0 mmol/L (men) ≥ 1.3 mmol/L (women) |
Triglycerides | ≤ 1.7 mmol/L (fasted) ≤ 2.0 mmol/L (non-fasted) | ≤ 1.7 mmol/L (fasted) ≤ 2.0 mmol/L (non-fasted) | ≤ 1.7 mmol/L (fasted) ≤ 2.0 mmol/L (non-fasted) |
Non-HDL-C *Non-fasted *High TG | ≤ 4.3 mmol/L | ≤ 3.4 mmol/L | ≤ 2.6 mmol/L |
ApoB | Not routinely measured | ≤ 0.8 g/L | ≤ 0.7 g/L |
Connecting Food and Movement to Cholesterol. Your lifestyle plays a powerful role in managing your cholesterol levels and overall heart health. The foods you choose and how often you move can directly impact your bloodwork by helping to reduce LDL cholesterol (the "bad" cholesterol), increase HDL cholesterol (the "good" cholesterol), and lower triglycerides. These changes can significantly reduce cardiovascular risks and support long-term heart health.
Research shows that key adjustments, like reducing saturated fats to 7–10% of your daily intake (as recommended by the Canadian Cardiovascular Society), paired with regular physical activity, can improve your cholesterol levels and enhance your overall bloodwork.
Let’s dive into how food and movement work together to create a healthier, more balanced heart! ❤️
Top 5 Evidence-Based Tips to Lower LDL Cholesterol with Food and Exercise. Managing LDL cholesterol (the “bad” cholesterol) is achievable by combining healthy eating patterns with regular physical activity. Strong evidence from Canadian guidelines, the Mediterranean Diet, and the Portfolio Diet supports these strategies for effectively lowering LDL cholesterol and reducing cardiovascular risks.
Below are 5 specific, science-backed strategies based on diet, exercise, and lifestyle adjustments:
1. Reduce Saturated Fat to 7–10% of Daily Calories
Why it works: Saturated fat is directly linked to raising LDL cholesterol levels. Reducing it lowers the risk of cardiovascular disease.
What to Avoid: Fatty cuts of meat, whole-fat dairy, butter, processed snacks, and fried foods (SEE CHART BELOW ).
What to Choose: Lean proteins (chicken breast, turkey, fish), olive oil, avocado, and plant-based sources of healthy fats (SEE CHART BELOW )..
Example Swap: Replace butter with olive oil; swap full-fat cheese for low-fat options.
Here’s a quick guide to how much saturated fat is recommended based on calorie needs:
Calorie Intake | 7% Saturated Fat | 10% Saturated Fat |
1,500 calories | 12 grams | 17 grams |
2,000 calories | 16 grams | 22 grams |
2,500 calories | 19 grams | 28 grams |
Foods Containing Saturated Fats
Food | Portion Size | Approx. Saturated Fat | Suggestions to Reduce It |
Bacon | 1 slice | 1.1 grams | Choose turkey bacon or leaner cuts of pork. |
Butter | 1 tbsp | 7 grams | Swap for olive oil or avocado spread. |
Caesar Salad Dressing | 2 tbsp | 2.5 grams | Use vinaigrette or a light yogurt-based dressing. |
Cheese (Cheddar) | 1 oz (28g) | 6 grams | Use reduced-fat cheese or smaller portions. |
Chicken (with skin) | 3 oz (85g) | 3 grams | Remove the skin and choose skinless cuts like breasts. |
Cottage Cheese (4%) | 1/2 cup | 2 grams | Opt for low-fat or 2% cottage cheese. |
Cream | 1 tbsp | 3.5 grams | Substitute with unsweetened almond or oat milk. |
Ground Beef (80% lean) | 3 oz (85g) | 6 grams | Opt for 90% lean or ground turkey. |
Ice Cream | 1/2 cup | 4.5 grams | Try frozen yogurt or sorbet as a lower-fat alternative. |
Lamb | 3 oz (85g) | 8 grams | Trim visible fat and choose leaner cuts like leg or loin. |
Mayonnaise (Regular) | 1 tbsp | 1.6 grams | Choose light mayonnaise or avocado-based alternatives. |
Milk (Whole) | 1 cup (240mL) | 4.5 grams | Switch to 1% or skim milk. |
Pastries (Croissant) | 1 small | 6 grams | Choose whole-grain options or limit portion sizes. |
Ricotta Cheese (Whole) | 1/2 cup | 8 grams | Use part-skim ricotta for lower saturated fat. |
Sausage (Pork) | 1 link (35g) | 5 grams | Try chicken or turkey sausage instead. |
Sour Cream | 1 tbsp | 2 grams | Replace with Greek yogurt for a tangy, lower-fat option. |
Yogurt (Whole Milk) | 1 cup (240mL) | 5 grams | Opt for low-fat or nonfat yogurt. |
2. Adopt the Mediterranean Diet Principles
The Mediterranean diet has strong evidence supporting its ability to reduce LDL cholesterol and improve heart health. It emphasizes whole, unprocessed foods, healthy fats, and lean proteins.
Key Principles to Follow:
Focus on plant-based foods: fruits, vegetables, whole grains, nuts, and legumes.
Prioritize healthy fats: extra virgin olive oil and fatty fish (rich in omega-3s).
Limit red meat and refined sugars.
Eat plenty of fresh fruits and vegetables.
Incorporate herbs and spices instead of salt for flavor.
Sample Meals: Grilled salmon with roasted vegetables; Greek-style salads with chickpeas, olive oil, and feta; or lentil-based soups.
3. Follow the Portfolio Diet for Cholesterol-Lowering Foods
The Portfolio diet focuses on foods that target LDL cholesterol by incorporating key cholesterol-lowering components. Evidence strongly supports this diet for its ability to reduce LDL by up to 20%.
Core Portfolio Diet Daily Foods:
1. Nuts & Seeds (45 g Daily)
A handful of nuts or seeds daily supports heart health without weight gain.
Try almonds, walnuts, or chia seeds as snacks or toppings.
2. Plant Protein (50 g Daily)
Examples: 1 ¼ cups soy milk, ½ cup chickpeas, or ½ cup tofu.
Swap animal protein for soy milk, lentils, or veggie burgers.
3. Viscous Fibre (20 g Daily)
Sources: Oats, barley, psyllium, apples, oranges, berries, and eggplant.
Add psyllium to water or smoothies and prioritize legumes in meals.
4. Healthy Fats (45 g Daily)
Sources: Olive oil, canola oil, avocados, and fatty fish like salmon.
Replace butter with olive oil and eat fish twice weekly.
4. Get 150 Minutes of Moderate Aerobic Exercise Each Week
Physical activity has proven effects on lowering LDL and triglycerides while increasing HDL cholesterol. Aerobic movement supports overall cardiovascular health.
Activities to Include:
Moderate-intensity activity can be identified as 4–6 on the 10-point Rate of Perceived Exertion (RPE) scale, where 0 is resting, and 10 is maximal effort. It’s also defined by a heart rate of 50–70% of your maximum.
Walking, cycling, swimming, rowing, or dancing for 30 minutes, 5 times a week.
5. Incorporate Strength Training & Resistance Training 2x Per Week
While aerobic exercise improves cardiovascular fitness, strength training builds muscle and supports metabolism, improving cholesterol balance and overall health.
Examples of Strength Training Exercises:
Bodyweight squats, lunges, push-ups, and planks.
Resistance band exercises.
Weightlifting using light-to-moderate weights.
Top 5 Evidence-Based Tips to Increase HDL Cholesterol with Food and Exercise
HDL cholesterol—often referred to as the "good" cholesterol—plays an important role in heart health by helping transport excess cholesterol to the liver for removal. Increasing HDL cholesterol reduces the risk of cardiovascular disease and supports heart health.
Here are the top 5 actionable tips backed by evidence to help you increase HDL cholesterol through diet and movement:
1. Incorporate Healthy Fats into Your Diet
Healthy fats, such as those found in omega-3 fatty acids and monounsaturated fats, are proven to increase HDL cholesterol.
Healthy Fat Sources:
Fatty Fish: Salmon, mackerel, sardines, and trout.
Avocados: Packed with monounsaturated fats.
Olive Oil: A heart-healthy fat choice for cooking or drizzling on vegetables and salads.
Nuts: Almonds, walnuts, pistachios
2. Engage in Regular Aerobic Exercise
Aerobic exercise has a direct effect on raising HDL cholesterol levels. Activities that get your heart pumping and involve sustained movement improve blood lipid profiles.
Recommended Activity:
Brisk walking, cycling, swimming, rowing, or dancing.
Goal: At least 150 minutes of moderate aerobic activity per week.
3. Strength Training—Build Muscle to Improve HDL
Resistance or strength training can boost HDL levels while improving your overall metabolism.
Examples of Strength Training:
Bodyweight squats, push-ups, lunges, planks, and light weightlifting.
Resistance band workouts.
Guideline: Include two sessions per week of strength training to support cardiovascular health and HDL production.
4. Increase Fibre Intake with Whole Foods
Soluble fibre has been shown to positively impact HDL by improving the body’s ability to regulate cholesterol levels.
Sources of Soluble Fibre:
Oats, barley, lentils, beans, whole grains, fruits (e.g., apples, pears), and vegetables.
Tip: Aim for 25–30 grams of fibre per day to support heart health.
5. Focus on Whole Grains and Low Glycemic Index Foods
Refined carbohydrates and added sugars can lower HDL levels and promote fat storage, negatively affecting heart health.
What to Avoid:
Sugary beverages like soda.
Refined grains such as white bread and pastries.
High-glycemic index starches, which cause rapid blood sugar spikes.
What to Choose:
Whole Grains: Look for options with >4g fibre and <8g sugar per serving like whole wheat bread, oats, and quinoa.
Low-Glycemic Index Starches: Prioritize foods like sweet potatoes, lentils, and barley, which provide steady energy and better blood sugar control.
Natural Sweeteners: Use fresh fruit to satisfy sweet cravings instead of processed snacks.
Top 5 Evidence-Based Tips to Decrease Triglycerides with Food and Exercise
Triglycerides, a type of fat in the blood, are an essential energy source but can contribute to heart disease when elevated. High triglycerides often accompany other risks, such as low HDL cholesterol or high LDL cholesterol. The good news? Lifestyle changes, particularly in food and movement, are incredibly effective in lowering triglycerides and improving overall cardiovascular health.
Here are 5 proven strategies to reduce triglycerides through diet and exercise.
1. Reduce Added Sugars and Refined Carbs
High intake of added sugars and refined carbohydrates can increase triglyceride levels by promoting fat production in the liver and negatively impact heart health.
What to Avoid:
Sugary Drinks: Limit soda, energy drinks, and other sweetened beverages.
Sweets: Minimize pastries, cookies, and candy.
Refined Grains: Reduce consumption of white bread, pasta, and rice.
What to Include:
Whole Grains: Prioritize low-glycemic options such as quinoa, barley, and whole wheat bread with >4g fibre and <8g sugar per serving.
Natural Sugars: Focus on whole fruits in moderation, as their natural sugars are balanced with fibre.
Fibre-Rich Foods: Incorporate foods like legumes, vegetables, and oats to stabilize blood sugar and support heart health.
Diabetes Canada recommends that added sugars should make up no more than 10% of your total daily calories, which typically equates to ~50 grams (12 tsp) per day for most adults. For additional health benefits, aim for less than 5% of daily calories from added sugars—about 25 grams (6 tsp) daily.
2. Focus on Healthy Fats—Minimize Processed Foods
Palm and palm kernel oils, commonly found in processed foods as replacements for trans fats, are high in saturated fats, which can elevate triglycerides. Meanwhile, omega-3 fatty acids have been shown to reduce triglycerides and improve heart health.
Limit:
Fried foods, processed snacks, and baked goods containing palm or palm kernel oils.
Full-fat dairy products and fatty cuts of meat high in saturated fats.
Include:
Fatty fish like salmon, mackerel, and sardines (2 servings per week).
Plant-based sources of omega-3s such as walnuts, chia seeds, and flaxseeds.
Fish oil supplements, if recommended by a healthcare provider.
3. Limit Alcohol Intake
Alcohol is high in calories and can contribute to increased triglyceride levels, especially when consumed in large amounts.
Guidelines:
Moderate Amounts: Stick to no more than 1 drink per day for women and 2 drinks per day for men—or less if triglyceride levels are elevated.
Healthier Choices: Swap high-calorie cocktails for refreshing options like sparkling water with a splash of lemon or herbal teas.
Making mindful choices about alcohol can support heart health while keeping your calorie intake in check.
4. Adopt Regular Physical Activity
Aerobic exercise burns triglycerides stored in the body, reducing blood levels over time.
Recommended Activities:
Walking, jogging, cycling, swimming, or HIIT workouts.
Combine cardio with strength training for greater metabolic benefits.
Goal: At least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week.
5. Manage Meal Sizes and Timing
Large meals can spike blood sugar and increase triglycerides. Spreading meals evenly throughout the day helps stabilize levels.
Practical Tips:
Eat smaller, balanced meals with 1/4 plate protein, 1/4 plate whole grains, and 1/2 plate vegetables (Canada’s Food Guide).
Avoid skipping meals to prevent overeating later.
Practice the Order of Bites: Start meals with protein to reduce post-meal fat production.
Heart-Healthy Grocery Chart. This grocery list highlights the core principles of a heart-healthy menu by emphasizing nutrient-dense, low-glycemic, and high-fibre foods. It prioritizes lean proteins, healthy fats, low-fat dairy, whole grains, and a variety of fruits and vegetables, all while incorporating foods rich in omega-3s and plant-based proteins to support optimal cholesterol levels and cardiovascular health.
Category | Items |
Vegetables | - Kale, spinach, arugula, Swiss chard - Broccoli, cauliflower, Brussels sprouts - Garlic, onions, shallots - Sweet potatoes, carrots, beets - Eggplant, okra - Celery, cucumber, cherry tomatoes, bell peppers |
Fruits | - Blueberries, raspberries, strawberries (berries, low GI) - Oranges, grapefruits (citrus) - Apples, pears (high-fibre, moderate GI) - Kiwi, guava (tropical; in moderation) |
Dairy | - Skim milk, 1% milk, low-fat Greek yogurt, low-fat cottage cheese - Unsweetened almond or soy milk, <8g sugar - Low-fat mozzarella (less than 20% MF), part-skim ricotta (5% MF) |
Lean Animal Proteins | - Skinless chicken breasts, turkey breast - Lean cuts like sirloin, tenderloin - Omega-3 enriched or pasture-raised eggs |
Plant-Based Proteins | - Chickpeas, black beans, lentils, kidney beans - Firm tofu, fermented tempeh - Frozen shelled edamame |
Breads & Starches | - Bread with >4g fibre and <8g sugar per serving (whole grain bread) - Whole wheat or chickpea-based pasta - Brown rice, wild rice - Barley, quinoa, bulgur |
Inner Aisles | - Almonds, walnuts, chia seeds, flaxseeds, pumpkin seeds - Extra virgin olive oil, avocado oil, balsamic vinegar, tahini - Natural almond or peanut butter (no added sugar) - No-salt-added tomatoes, beans, lentils - Plain popcorn, whole-grain crackers |
Fish | - Salmon, mackerel, sardines, herring (oily fish) - Cod, haddock, sole (white fish) - Tuna (light, in water), sardines (in olive oil; canned options) - Frozen wild salmon fillets, shrimp |
Key Takeaway Message. Adopting targeted nutrition and exercise strategies can significantly reduce the risk of heart disease and high cholesterol. Key changes like incorporating heart-healthy foods, increasing fibre intake, and engaging in regular physical activity help improve lipid profiles and overall cardiovascular health. Empower yourself to take small, actionable steps toward a healthier lifestyle—whether by cooking more meals at home, prioritizing whole grains and lean proteins, or aiming for at least 150 minutes of moderate-to-vigorous exercise weekly. Consistency and personalized goals make all the difference in achieving lasting heart health!
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