Beth: Welcome back to Fresh focus, I am your host Beth, I’m sitting here with a special guest fellow dietitian and VISN 15 MOVE coordinator, Kristine. Tell our Fresh Focus listeners a little about yourself. And how long have you been at the VA?

Kristine:
thanks for having me on I’m excited to be here today, I have been at the VA for sixteen years and I work at the St Louis VA Health Care System in St. Louis MO. I’ve been facilitating MOVE since 2006, so quite a long time and have held the lead MOVE position for the visn 15 network since 2012. I love working with vets and helping them get healthy!

Beth: We as dietitians want to encourage veterans and their family members and caretakers to be open to making changes, but know that it can be difficult and we understand that. We want to be able to help. If you have been diagnosed with congestive heart failure or coronary artery disease or maybe have been told you have high blood pressure recently or maybe just got home from the hospital, Please reach out to your local RD for individualized help and assistance on individual nutrition needs. in today’s episode we wanted to review some of the top lifestyle changes we can do to help improve our heart health, if you have been listening to Fresh Focus for a while now you may be familiar that us dietitians kind of like lists.

Kristine: So true

Beth: We thought it would be good to review our top lifestyle changes we can do to help improve our heart health. What would be your go to be when talking to veterans?

Kristine: my top 3 would definitely be
1.) nutrition and what’s on your plate
2.) being physically active
3.) being mindful of your weight

Beth: On making some heart healthy changes what would be the first step or what do you recommend to veterans to start with?

Kristine: Keeping our hearts healthy is very important and Nutrition can play a big role in helping with this. It is important that we aim for a diverse diet which includes a variety of heart healthy food from different food groups. One big diet change is to consider adding fiber to your meals and snacks. Fiber can help us naturally lower our cholesterol and keep us feeling full so we can reduce our tendency of overeating during meals. Fruits, vegetables, and whole grains are all great sources of fiber.
Beth: Fiber is so important if you want some more tips go back and check out episode 22 where Tori provides all kinds of great information!

Kristine: It is, When grocery store shopping remember the saying “eat the rainbow”. Select a variety of colorful fruit and veggie choices to ensure a wide array of vitamin/minerals at to add pizazz to your plate. Whole grains are another great fiber source. Aim to make at least half of your grain services whole grains. Great things to include are oats, WG bread, brown rice, barley, and even popcorn- yes fresh popped popcorn (not the extra butter movie theatre kind) is a whole grain! Perfect for snack time!
Beth: Also a good idea to have a list when you go grocery shopping, in one of the MOVE classes we just reviewed module 7 with menu planning and shopping module, I love that one I actually call it the candy land game of how to plan healthy meals, if you can visualize the board game with colorful spaces all along.

The very first spot you’d put your game piece on is start, and you first start with mapping out your week, look at your schedule if there are any nights you won’t be home? Games kids sports work meetings etc, those details are important we want to set ourselves up for success!, then going along your game board the second phase is planning your meals, writing down those meals we have often, like if you have oatmeal for breakfast every morning that is ok you don’t have to change it just write those down on your meal plan and looking for that balance just like looking for ways to add in fiber at your meal and the 3rd phase moving our game piece down the board making meal time a success… we want to put it together, if there are things in your freezer you want to utilize this week you need to put on the calendar to thaw them out right that can prevent that oh my goodness I was going to start dinner when I got home from work and realized it would take like several hours to prepare an item so we want to help prepare for that and make meal time a priority.

Kristine: it’s so true tips to get started really can be beneficial for all Veterans and their families. I remember a few years ago reviewing one of my weight loss Veterans food journal. 2 meals were being eaten out at restaurants or fast food every single day. We discussed the importance of meal planning and instead of eating out for lunch, considering the possibly of packing their own lunch while incorporating meal planning and prep. Slowly but surely she started to replace two, then three, then four lunch meals/week with a packed lunch from home instead of fast food. After 5 weeks she was able to reduce her blood pressure pill and had lost over 18 lbs! She felt great and that really put a smile on both of our faces.

Beth: I love that story, I love hearing from veterans where they have been successful in their health goals, so if someone is first starting out and looking at mapping out their week for their meals, what should be in our fridge or pantry or do you have any go to items you recommend?

Kristine: My go-to top 5 items to keep on hand to support a heart healthy diet are:
• 1. Fruit and veggies: frozen, fresh, and even no added salt canned are great choices
• 2. Oats- a whole grain product, can make oatmeal, homemade granola or snack bars, muffins, or even cookies.
o Maybe just mention that we aren’t discussing sugar sweetened/flavored oats because they will, for sure, make that connection.
• 3. Olive oil- healthy fats are included on a heart healthy diet. Olive oil is full of monounsaturated fats, the kind that do not cause plaque build up in our arteries. It is a much better choice than our solid, saturated fats such as butter, lard, bacon grease, and Crisco.
o “Olive oil is probably one of our most common healthy fat sources, and can provide great flavor to our whole food items, such as vegetables. We definitely want more healthy fats such as olive oil, avocados, nuts and seeds, etc. in our intake, and less of things like other less-stable vegetable oils, Crisco, and fat from heavily processed foods and processed meats.
• 4. Salt Substitute such as Mrs. Dash. Reducing the amount of salt you use and cook with is a great way to reduce your overall sodium intake. Which will help us keep our blood pressure in healthy ranges.
• 5. Peanut Butter! Check out the ingredient list to make sure peanuts are the main ingredient. You may see oil at the top of the jar and need to stir then refrigerate it because it does not have the added preservatives that other brands can have.

Beth: I said this on an episode not too long ago I hear this so often folks say dietitians want me to eat things that don’t taste good and that is so not true

Kristine: absolutely!

Beth: a heart healthy plate can be made up of delicious items that taste fantastic.

Kristine: yes, a plate with lots of colors, half of the plate should be non-starchy vegetables, (maybe grilled asparagus and a side salad) the other ¼ may be a whole food source of carbohydrates (such as whole grain bread, beans, fruit, and sweet potatoes), and the other ¼ may be filled with a whole food-based, minimally processed source of protein. So, ideally, we want that protein to be coming straight from the animal, whether it’s chicken, turkey, fish, seafood, beef, pork, venison, eggs, etc. We can also get protein from plant-based sources, such as beans, nut butters, and tofu. We should strive to get variety with our foods, proteins included, and avoid heavily processed meats such as hot dogs, spam, sausage, lunchmeat, fast food meats, etc. Focus on the total context, and quality, of your intake, as opposed to individual foods or nutrients.
Also important to stay hydrated. So next to that plate I would have a tall glass of ice water. Other great drink choices can include unsweetened tea, hot tea, carbonated water if you like a little bubbly on your tongue, or dairy plant based milk choice we just want to look for unsweetened so we aren’t adding in excess sugar and calories in our beverages.
Beth: Now we have reviewed meal options of a heart healthy lifestyle, what about adding in activity and movement in their day any recommendations you start with when talking to veterans?

Kristine: Being physically active is very important to help keep our hearts and bodies strong! Our goal is to work up to 30 minutes of movement 5 days/week. Any activity counts. Really, we are just trying to sit less.
Beth: I’m going to repeat that some activity is better than no activity its important to note that as I’m sure some folks are like ok I hear you say to add more steps in parking the car further away taking the stairs or walking around the house but it doesn’t feel like much but it all adds up! what type of activity do you like to do during the day?
Kristine: One of my favorite movement moment is taking a 20 min walk break over lunch while I am at work. I listen to different Podcasts, many times the Fresh Focus podcast, or music and the 20 minutes goes by quick when listening.
Beth: Yes absolutely taking a walk during the day can also be good stress management technique as well.
Kristine: It may be easier to remember when we break down movement into 3 categories: Lifestyle activities; Cardiovascular activities (these really strengthen our heart muscle!) and flexibility/stretching.
o Lifestyle activities usually involves movement that comes from your daily activities or chores. Ex may include washing your car, vacuuming, yardwork, playing with grandchildren.
o Cardiovascular activities are usually programmed bouts of movement and can include walking, jogging, dancing, cycling, or using machines such as ellipticals or treadmills.
o Flexibility and stretching types of activity elongate your muscles and can help with balance. Some common movements are tai chi, core exercises, Pilates of yoga. We offer many of these classes through your local VA.
Beth: I have heard only good things about our yoga and tai chi classes and I know in our Marion location the recreational therapist is adding more classes so be sure to check out what is available at your location. What is another tip to help improve heart health?

Kristine: Maintaining a healthy weight also supports a healthy heart. Most folks do not know that losing as little as 5% of your current weight lowers your risk of heart disease and hypertension! We are lucky at the VA, their national weight management program titled MOVE! Is a great program to help with weight management and getting started on finding that overall health and wellness for veterans. Contact your local VA MOVE Coordinator they can help you get connected with classes in your area.
Beth: Thank you, I love all your tips and suggestions! I am so glad you were able to hop on with me today on this episode.
Kristine: Thanks for having me, I feel like we gave folks lots of information but just remember making small, realistic changes in eating and physical activity can help so don’t feel like you have to make all the changes all at once.
Beth: Exactly, we don’t want anyone overwhelmed, we are here to help assist you in reaching your health goals. Remember to reach out to your local VA dietitian for more individualized tips and suggestions or to find out more about the MOVE program and classes like yoga or tai chi and other resources that are available.

Thank you for listening, don’t forget to like and subscribe to this podcast and leave a review.