hearthealth! 2016 - CHI Franciscan Health

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CHI Franciscan Health

hearthealth!

Compliments of the Puget Sound’s Leader in Heart and Vascular Care

2016

Healthy living for the whole family!

Classes and support groups

Recipes and health tips

Heart Health 2016_00.indd 1

Easy steps to reduce your risk for heart disease, stroke and diabetes

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Getting to the c Enjoy this gift of health inspiration and support, from our CHI Franciscan Health family to yours!

When you take care of your heart, wonderful things begin to happen. Your risk for heart attack and stroke drops. Managing your weight, and chronic conditions like diabetes, gets easier. And your energy level soars.

So how do you take care of your heart?

Eat well.

People in the Mediterranean have done it for centuries, and so can you. Nourish your body and palate with food that is simple, colorful and delicious.

Mouth-watering recipes begin on page 20.

Know your numbers.

Better yet, own your numbers. Partner with your doctor to learn where to concentrate your efforts and determine the target numbers that are right for you.

Start the conversation with questions to ask and topics to discuss found on page 35. Then follow our simple tracking chart on pages 6 and 7.

Move more.

We’re not talking about complicated exercise routines and hours in the gym.

Walk the dog, play with the kids, and whenever possible, conduct your life standing, rather than sitting. Yes, it’s that easy.

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the c of it all.

Connect deeply.

Family, friends and community contribute greatly to our overall health and wellness. Take time to enjoy the people, places and activities that bring joy and meaning to your life.

Living a heart-healthy lifestyle can add years to your life, and life to your years. Browse our pages to find simple changes that work for you and that, with little effort, you can incorporate into your daily life. You will reap great health rewards for years to come!

CHI Franciscan Health is proud to be a regional leader for heart care in the Pacific Northwest. Our heart and vascular surgeons, cardiologists and nurses are highly qualified to care for you and your family.

We consistently receive accreditations and quality outcome designations from national organizations.

Learn more about our excellent care and commendations at chifranciscan.org/heartcare under “Awards and Distinctions.”

See page 36 for all of the convenient locations where CHI Franciscan offers heart and vascular care.

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Franciscan Well-Fed Heart Feed your heart smart.

We can help, with ongoing, step-by-step support.

Franciscan Heart Health e-News

Di pr Ch dia in

FranciscanWellFedHeart.org

7 •

Fresh tips and recipes arrive in your in-box once a month to help you stay motivated and easily plan nutritious meals on a budget.

Your go-to website with everything you need to feed your family well. Each month you’ll find:

•

• New free videos, with pantry makeovers, recipe demonstrations and more • Three new seasonal recipes with photos

•

• A comprehensive archive – you have an entire cookbook and video library at your fingertips!

•

From pantry makeovers to snacking for success, FranciscanWellFedHeart.org has what you need to succeed.

reversed- white above

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© 2016, wellfedheart.com

Visit FranciscanWellFedHeart.org and sign up for Heart Health e-News today!

• • •

Your Lifestyle Ma�s Live the Mediterranean Way

EASY CHANGE Did you know up to 80% of heart disease can be prevented by the lifestyle choices we make every day?

Chronic conditions such as cardiovascular disease, diabetes, cancer and metabolic syndrome are lowest in populations that follow a Mediterranean-inspired lifestyle.

In this column, you will find small changes that make a big difference.

7 Benefits of the Mediterranean Lifestyle • Lower your risk of chronic disease such as cardiovascular disease, diabetes and some cancers • Improve brain function and protection from Alzheimer’s disease • Live longer and age gracefully with improved eye and oral health • Support weight loss and maintenance • Ward off depression • Prevent Parkinson’s disease • Improve symptoms of rheumatoid arthritis

© 2016, wellfedheart.com

Oldways Preservation and Exchange Trust, 2015.

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high

Blood Pressure Fasting Blood Sugar Triglycerides Waist Circumference HDL

low

3 or more of these risk factors = Metabolic Syndrome, leading to chronic diseases: Metabolic syndrome and prediabetes are interrelated conditions that carry serious long-term risks of stroke, heart attack, dementia, cancer and fatty liver.

a T

Cho

Sources: National Cholesterol Education Program, American Heart Association

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s

Type II Diabetes People with diabetes have a three times higher risk of developing cardiovascular disease. The same good habits that prevent heart disease can also prevent diabetes.

Vascular Disease Clogging and hardening of the arteries occurs when blood vessels become damaged from chronic high blood pressure, plaque buildup and inflammation. Restricted blood flow can cause tissue damage, stroke or death.

Coronary Heart Disease One of many diseases of the heart and blood vessel system.

Symptoms can be life-threatening, such as a heart-attack.

Cardiovascular disease is the No. 1 cause of death for Americans.

These diseases are usually preventable and often reversible with food and lifestyle changes.

They are associated with overweight and sedentary lifestyles and are only partially genetic in origin.

EASY CHANGE: Choose 1 risk factor to improve and continue reading to learn how.

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Know Your Numbers Vital Statistics W h a t ’ s Y o u r N u mW b he ar ? t ’s c h a n g e d ?

Heal�y

At Risk

High Risk

Less than 100

101-125

126 and above

Systolic

Less than 120

121-139

140 or higher

Diastolic

Less than 80

81-89

90 or higher

Women

Less than 35”

35” or greater

Men

Less than 40”

40” or greater

Women

Less than 0.8

0.81-0.84

0.85 or greater

Men

Less than 0.9

0.91-0.99

1.0 or greater

Less than 180

181-239

240 and above

Less than 100

101-159

160 and above

Women

60 or higher

51-59

50 or less

Men

60 or higher

41-59

40 or less

151-199

200 and above

Fas� Blood Sugar Blood Pre�ure

Waist Circumference

Waist: Hip Ratio*

Total Choles�ol (TC) LDL (Lousy) Chol HDL (Healthy) Chol

6

TC: HDL RATIO

Less than 5:1

TRIGLYCERIDES

Less than 150

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Da

For a projected 10-year risk evaluation of cardiovascular disease, visit americanheart.org or ask your doctor for a screening. To track your numbers electronically, check out American Heart Association’s Heart 360 secure database program.

Risk

Date

Your #’s

Date

Your #’s

above

higher

EASY CHANGE

higher

Track your numbers here.

Create a partnership with your doctor.

The numbers on this chart are only part of your health profile. Talk with your doctor about what’s most important for you.

greater

reater

Waist:Hip Ratio Calculation (in inches)

above above

Waist Hip

= Ratio

less less

above

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Eat Like A Mediterranean Back to Basics

Meats and Sweets Less often Meats & Sweets (least often)

Poultry, Eggs, Cheese and Yogurt Moderate portions, daily to weekly

Poultry. Eggs,

Wine Cheese, & Yogurt In moderation (moderate portions

Fish and Seafood Often, at least two times per week

daily to weekly)

Wine eration)

Water Drink often

r n)

Fish & Seafood (often, at least two times per week) Fruits, Vegetables, Grains (mostly whole),Olive Oil, Beans, Nuts, Legumes & Seeds, Herbs & Spices

Fruits, Vegetables, Grains (mostly whole),Olive Oil, Beans, Nuts, Legumes and Seeds, Herbs and Spices Base every meal around these foods

Be Physically Active; Enjoy Meals with Others

Š 2009 Oldways Preservation and Exchange Trust,

Be Physically Active; Enjoy Meals with Others www.oldwayspt.org

No matter your culture and food preferences, eating like the Mediterraneans can be adapted into any cuisine. Asian, Southwestern, Indian - whatever cuisine your family enjoys, measure it up to the Mediterranean pyramid. Are you eating enough vegetables? Too much meat?

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nd ods

sically Enjoy with

The foundation of the Mediterranean pyramid is community – working together, pl�ing together and dining together. Your community, in addition to diet and exercise, should be considered for overall health.

The Mediterranean diet focuses on • Plants- fruits, vegetables, whole grains, beans, legumes, nuts, seeds, olive oil and herbs and spices.

These should be the centerpiece of all meals.

• Fish and seafood are the preferred proteins. They are generally leaner than other meats, and some are rich in heart-healthy omega-3s.

• Poultry, eggs and dairy should be enjoyed as a complement to a predominantly plant-based dish.

• Meat and sweets should be consumed sparingly, a couple times a month preferred.

• Water is the beverage of choice. If you drink wine, drink in moderation (no more than 1 drink per day for women and 2 for men).

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Mediterranean Meets Your Plate Yo u r W e l l - F e d H e a r t P l a t e

1

/4 /2 Non-Starchy WholeGrains or Starchy Vegetables & Vegetables Fruits 1 /4 Lean Protein 1

• Focus on filling half your plate with non-starchy vegetables at meals; fruit makes a great snack. • Note that beans, legumes and lentils fit into both the whole grain and lean protein groups.

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Eat the Rainbow F o c u s o n Va r i e t y

Phytochemicals are substances found in plants that give fruits, vegetables, beans and legumes their vibrant colors. We are just beginning to understand their health benefits. The most important thing to understand is that no fruit or vegetable is more ‘super’ than the rest. Each contributes its own unique set of fibers, vitamins, minerals and phytochemicals.

Strawberries Raspberries Apples Grapefruit Watermelon Pomegranate Tomatoes Red Peppers Radishes Rhubarb Cranberry Beans Kidney Beans Red Lentils

Pineapple Mango Apricot Oranges Peaches Cantaloupe Lemons Papaya Sweet Potatoes* Orange Bell Peppers Yellow Bell Peppers EASY CHANGE

Carrots* Pumpkins* Winter Squash* Summer Squash Corn* Yellow Lentils

Kiwi Avocado Green Grapes Figs Pears Green Apples Limes Honeydew Green Bell Peppers Sugar Snap Peas Asparagus Leafy Greens (Collards, Kale, Spinach, Romaine) Celery Brussels Sprouts Bok Choy Broccoli Zucchini Okra Artichokes Lima Beans Edamame Fresh Herbs

Blueberries Blackberries Cherries Cranberries Plums Red Grapes Dates Red Cabbage Eggplant Red Onion Purple Potatoes* Beets* Black Beans Potatoes* Mushrooms Jicama Onions Garlic Shallots Leeks Green Onions Cauliflower Turnips* Cannellini Beans Navy Beans *starchy vegetables to be included in the whole grains/starchy vegetables quarter of your plate.

Highlight 2 foods from each color category to add to your next grocery list.

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Sugar – Fat – Sa When you eat a Mediterranean diet, you don’t have to worry as much about added sugar, fats or salts in your food. Minimally processed, whole foods are intrinsically low in sugar and salt, and high in fiber. It leaves you more time to focus on the other aspects of a healthy lifestyle, like moving more!

•F g a

•I -

The Simple Sugar Solution

-

• Sugar is sneaky! Be sure to check ingredient lists on packages for any added sugars. It’s not just in cookies and cakes but bread, tomato sauce, flavored yogurts, salad dressings and cereals.

• Limit added sugar to less than 3 teaspoons for children, 6 for women and 9 for men per day. On a food label, that's less than 12 grams for children, 24 for women and 36 for men.

(1 teaspoon = 4 grams of sugar) • Added sugar is easiest to identify in the "Ingredients" section of the food label. See "Understanding Label Lingo" on the following page.

Sodium or Potassium?

• Highly-processed foods account for more than 80% of our sodium intake. If you eliminate processed foods, your sodium intake is reduced dramatically.

• Focus on eating foods high in potassium and magnesium, minerals that regulate blood sugar, nerve function and blood pressure.

Foods highest in potassium: sweet potatoes, squash, coconut water, bananas, avocado, spinach, Swiss chard, beans and legumes.

Foods highest in magnesium: leafy greens, sesame and pumpkin seeds, beans, legumes and whole grains.

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•D -

•C o t

at – Salt – Fiber

rry mally salt,

he ge.

The Truth About Fats • Fat is an essential nutrient for optimal heart function. Focus on getting it from the right sources like olives, avocados and nuts and the oils produced from them.

• Increase Omega-3's: - Fatty fish like salmon, herring or sardines - Whole or ground flaxseed - Walnuts - Grass-fed meat and dairy products - Pasture-raised chicken and eggs • Decrease Omega-6's: - Refined vegetable oils such as soybean, corn and sunflower – and the highly processed foods that contain them.

• Check the ingredient list on food labels for hydrogenated or partially hydrogenated oils. Trans fats are so detrimental to heart health, they are being banned from all US foods.

Fiber Facts • Eating a plant-based diet will provide all the fiber you need in a day with no worry.

erals

• If you’re starting a fiber-rich diet, start slow to allow your body to adjustand be sure to drink enough fluids.

t umes.

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Understand� Label L�o Ignore nutrition claims on the front of the package; the truth is on the Nutrition Facts label. Use this guide to make informed choices.

Is this serving size reasonable?

If you know you’re going to consume twice as much, multiply the numbers by 2 Limit these fats and sodium Aim for at least 3-5 grams of fiber per serving Most adults need between 1,500 and 2,000 calories per day.

Adjust your numbers as needed

Nutrition Facts Serving Size: 1 cup (226 g) Serving Per Container: 1 Amount Per Serving

Calories 170

Calories from Fat 27 % Daily Value*

Total Fat 3g Saturated Fat 1.5g Trans Fat 0g Polyunsaturated Fats 1g Monounsaturated Fats 0.5g Cholesterol 5 mg Sodium 80 mg Total Carbohydrate 25g Dietary Fiber 0g Sugars 18g Protein 10 mg

6% 8% 0%

1% 3% 8% 0%

Vitamin A 15% • Vitamin D3 20% Calcium 20% • Iron 10% *Percent daily are based on a 2,000-calerie diet. Your daily values may be higher or lower depending on your calorie needs:

Calories: Total Fat Less than Sat Fat Less than Cholesterol Less than Sodium Less than Potassium Total Carbohydrate Dietary Fiber

2,000 65g 20g 300mg 2,400mg 3,500mg 300g 25g

Calories per gram: Fat 9 • Carbohydrate 4

•

2,500 80g 25g 300mg 2,400mg 3,500mg 375g 30g

Protein 4

Ingredients: Cultured Pasteurized Grade A Milk.

Sugar,Peaches, Modified Corn Starch, Kosher Gelatin, Natural and Artificial Flavor, Aspartame, Potassium Sorbate added to maintain freshness, Acesulfame Potassium, Citric Acid, Vitamin A Acetate, Vitamin D3

The 5/20 Rule 5% or less of the Daily Value is low and 20% or more is high

Watch out for added sugars, highlighted below Get enough of these nutrients

Ingredients are listed in descending order by weight

Look for a new and improved food label coming soon to your grocery store.

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.

Phase In

Phase Out

1. Homemade dressings, marinades and sauces

1. Store-bought dressings, marinades and sauces

2. Plain, low-fat yogurt.

Add real fruit and/or honey

2. Fruit-flavored or “fruit-on-bottom� yogurts

3. Whole grains: barley, quinoa, oats, brown rice, bulgur and 100% whole-grain bread, pasta or crackers

3. Refined grains: white and highly processed pasta, rice, bread or cracker products

4. Low-fat milk, unsweetened iced tea, coffee, flat or sparkling water

4. Sweetened and artificially flavored waters, teas, coffee and juices

5. Legumes: black, white, navy, kidney; and garbanzo beans, lentils, peas and edamame

5. Canned baked beans, chilis and soups

6. Fresh or frozen veggies: steamed, sauteed or roasted

6. Mashed potatoes and veggies with added cream and butter

7. Plant-based fats: avocados, nuts, nut-butters and plant-oils (olive, flax, walnut)

7. Highly-refined vegetable oils, including margarine and mayonnaise

8. Canned fish: herring, tuna, salmon, sardines

8. Heavily processed, cured and salted meats

Use this chart to replace common foods in your kitchen with heart-friendly versions for a smooth transition to better health.

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Physical Activity

Sitting: The New Smoking EASY CHANGE Moving Adds Up! Your body burns 3x as much energy walking or doing light activities as it does at rest.

We all know it’s important to exercise 30-60 minutes per day but research reveals that it’s just as important to reduce sitting time. The more often you stand and move, the better.

How much do you sit?

Add up the hours, you may be surprised!

Hours

C M Y K

35 33 71 4

C M Y K

41 11 80 2

Breakfa Snack 1 Lunch Snack 2 Dinner Drinks/

Work Commute Socializ� TV Compu� En�tainment Wai� (e.g.: bus stops, airports, waiting rooms) Total

Ideas for Movement • Stand during meetings or phone calls • Get up during commercials on TV • Stand while folding laundry, riding on the bus or train • Rethink your office; are there any high countertops you could work at on your computer?

• Set timers on your phone or send yourself email reminders to get up and move • To optimize your metabolism and build muscle strength, walk at least 10,000 steps daily.

16 2

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Tracking Food & Activity Increasing Accountability

EASY CHANGE Tracking daily food intake is found to be the #1 tool when it comes to sustainable weight loss. It holds us accountable for the choices we make and sets us up for greater success.

There are a lot of online food and exercise tracking programs, as well as apps. If you like pencil and paper, here’s what to include: What I Ate How Much What I Ate How Much Breakfast Breakfast Snack 1 Lunch Snack 1 Snack 2Lunch Snack 2 Dinner Dinner Drinks/Fluids

Keep a journal for three days, recording all your activity and food intake.

This will show where you can improve.

Drinks/Fluids

Activity

Duration

Depending on your goals, you can also track Activity Duration servings of fruit and vegetables, fish or water intake.

Including goals in your food and activity log will result in more favorable outcomes.

Here are a few examples of goals to set: Goal 1 Cook dinner at home Pack lunches at night Goal 2 Drink more fluids Goal 3 Set alarm to get up from computer every 30 minutes

daily.

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Meal Planning

20 Minutes to Success

EASY CHANGE Cook Once, Eat Twice By doubling or tripling recipes, you’ll have leftovers in the fridge or freezer to save time on busy nights.

Here’s a common complaint: “Eating healthy at home takes too much time.”

Our answer: In just 15-20 minutes, you can plan the coming week’s meals and snacks.

MEAL PLANNING TIPS: • Incorporate 2-3 new recipes each week, mingling our recipes with yours. Plan to use what’s already in your freezer and pantry.

• Make tonight’s dinner tomorrow’s lunch • After planning for one month, you’ll have a model for the rest of the season.

• Don’t forget to plan for snacks; for satisfying and healthy ideas, read on.

• To save time and money, meal plan around what you already have on hand and what’s in-season and on special at the grocery store.

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Your Mediterranean Food Pyramid R e c i p e s t o G u i d e Yo u

Follow along as these recipes take you through each level of the Mediterranean Food Pyramid. If you struggle in a certain area, like cooking fish, we have you covered.

Our recipes are simple, quick and always 5 steps or less!

MEAT RECIPES EGGS/DAIRY RECIPE FISH/ SEAFOOD RECIPES

PLANT-BASED RECIPES

COMMUNITY RECIPES

Easy Tzatziki & Creamy Walnut Dressing Busy Morning Breakfast Bites

Smoked Salmon Chowder Rainbow Pesto Fish Triple-B Burgers Wilted Kale & Sweet Potato Salad Mediterranean Stuffed Zucchini Sweet Citrus Barley Salad

Easy Summer Salad Omega Power Spread Tuscan White Bean Salad

You will find %DV throughout the following recipes. Like on the food label, %DV stands for “percent daily value” to help you identify potassium and magnesium to increase intake of these healthy nutrients.

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Tapas Spread: Big

D i n i n g To g e t h e r w i t h M

Omega Power Spread ½ cup low-fat cottage cheese 2 canned sardines, mashed ½ tsp smoked paprika

Easy Summer Salad 1 1 2 2

cup cucumber, diced cup cherry tomatoes, halved Tbsps fresh basil, cut into ribbons Tbsps balsamic vinegar

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ad: BigTastes, Small Plates her with Mediterranean-Inspired Recipes

Tuscan White Bean Salad 1 1 1 6

(15 oz) can small white beans, drained and rinsed stalk celery, chopped, including leaves (6 oz) can good-quality tuna, drained marinated artichoke hearts, drained & quartered 1 /3 cup red onion, diced Dressing 1 Tbsp artichoke marinade from jar 1 Tbsp white wine vinegar 1 tsp Dijon mustard Pepper to taste

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Sweet Citrus Barl� Salad Serves 4 as a main dish, 8 as a side

Both pearled and hulled barley work here, but hulled barley is the whole-grain choice.

Seasoned Cook Once you understand the portions of the main ingredients, then any grain, green, fruit, nut or cheese can be substituted.

To make sure the grain keeps its shape, use a quarter cup less water than the packaged recipe calls for when preparing.

2 ½ 2 1 1 ½ ½ 1

cups cooked barley cup fennel, thinly sliced cups Brussels sprouts, shredded navel orange, skin grated, peeled, sectioned and cut into bite-sized pieces bunch green onions, thinly sliced cup chopped pecans cup feta cheese, crumbled cup fresh parsley, stems removed & finely chopped

Dressing

1 2 1 2

Tbsp apple cider vinegar Tbsps extra virgin olive oil Tbsp orange juice Tbsps orange peel

1. Combine salad ingredients in a large serving bowl and toss lightly.

2. Combine dressing ingredients in a small jar with lid and shake well.

3. Pour dressing over salad, toss and serve.

Per main serving: 370 calories, 9g protein, 41g carbohydrate, 20g fat (4g sat, 16g mono/poly), 10g fiber, 175mg sodium, 16%DV potassium, 24%DV magnesium

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ium

Mediterranean Stu�ed Zucchini Serves 8

Zucchini

Stuffing

2 large zucchini or 4 med.

1 Tbsp lemon zest 2 cloves garlic, minced 1-2 Tbsps harissa 1/3 cup extra virgin olive oil

2 cups cooked dense whole grain, like farro 2 green onions, finely chopped ¼ cup golden raisins ¼ cup almonds, slivered and toasted 1 cup cherry tomatoes, halved ½ cup sweet pepper, chopped 1 Tbsp extra virgin olive oil 1 Tbsp lemon juice

Garnish

1 cup plain yogurt ½ cup parsley or cilantro, chopped

1. Heat oven to 400°.

2. Cut zucchini in half lengthwise and scrape out seeds.

Score flesh with diagonal cuts 2” apart going both ways, creating a criss-cross pattern.

3. Place zucchini halves on baking sheet flesh side up.

Combine next 4 ingredients and brush on flesh of zucchini.

Bake until zucchini becomes fork tender but not mushy, 20-40 minutes, depending on the size of the zucchini.

4. Meanwhile, combine stuffing ingredients in large bowl.

Use vegetables that provide a rainbow of color.

5. Place cooked zucchini portions on each plate and heap with stuffing. Top with yogurt and herbs.

Every summer brings more zucchini than we can handle. This is a great way to use those big ones to create an easy and flavorful vegetarian entrée or a hearty side dish complimentary to seafood or chicken.

Seasoned Cook If you can’t find harissa, make your own with cumin, paprika and dried chili flakes. Need more heat? Add a dash of cayenne.

Per serving: 350 calories, 12g protein, 47g carbohydrates, 14g fat (2g sat, 12g mono/poly), 9g fiber, 40mg sodium, 18%DV potassium, 36%DV magnesium

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Wilted Kale & Sweet Potato Salad Se rv e s 2 a s a ma in d i sh, 4 as a si de

This warm salad provides a beautiful contrast between hearty dark leafy greens and creamy orange potatoes.

Its sweet flavorrich sauce pairs wonderfully with roasted chicken or a pork tenderloin.

Seasoned Cook If you’re not a fan of kale, use Swiss chard or hardy spinach instead.

2 medium sweet potatoes 1 small sweet onion, thinly sliced 4 cloves garlic, crushed 4 cups kale leaves, chopped (stems removed) ½ cup golden raisins

Dressing

1 Tbsp balsamic vinegar 2 Tbsps extra virgin olive oil ½ Tbsp honey ½ Tbsp port or other dessert wine 1/4 tsp toasted sesame oil

1. Heat oven to 400°. Peel and chop potatoes into 1” cubes and roast for 20 minutes until tender and just barely brown.

2. In a lightly oiled skillet on medium heat, sauté onions and garlic. Cook until onions are softened and garlic is fragrant, about 5 minutes.

3. Turn heat to low and add all dressing ingredients to the pan. Heat and stir until honey liquefies.

4. Add kale to skillet, lightly sauté until kale starts to wilt, about 1-2 minutes.

5. In a large bowl combine contents of skillet and sweet potatoes. Toss, top with raisins and serve warm.

Per side-dish serving: 220 calories, 3g protein, 38g carbohydrate, 7g fat (1g sat, 6g mono/poly), 4g fiber, 35mg sodium, 10%DV potassium, 10%DV magnesium

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Triple-B Burgers Makes 6 patties

1 (15 oz) can butter beans, drained and rinsed ½ cup red onion, finely chopped 1/3 cup carrot, grated and finely chopped ¼ cup celery, finely chopped ¼ cup fresh cilantro, roughly chopped 1 whole egg, beaten

1 garlic clove, minced ½ tsp dried oregano 1 tsp ground cumin ¼ tsp each salt and pepper ¾ cup cooked brown rice, cooled 6-12 large butter lettuce leaves 2 Tbsps extra virgin olive oil

1. In a medium bowl, coarsely mash drained beans with a fork or potato masher.

2. Add the remainder of the ingredients through brown rice. Mix well.

3. Shape into 6 half-inch-thick patties. Refrigerate for at least 30 minutes.

4. Heat oil in a large skillet over medium heat.

Add patties to skillet and cook for 10-12 minutes or until heated through, turning patties once halfway through cooking.

5. Place in lettuce leaf. Try topping with avocado, sliced red onion, cilantro and tomatoes.

Butter beans, also known as lima beans, are packed with fiber and potassium for a healthy heart.

Seasoned Cook For a quick weeknight dinner, keep a stash of these patties in the freezer and reheat as directed in step #4. If it needs a little “something,” top with tzatziki sauce, pesto (see recipes).

Per patty: 145 calories, 6g protein,18g carbohydrate, 6g fat (1g sat, 5g mono/poly), 4g fiber, 230mg sodium, 8%DV potassium,12%DV magnesium

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Rainbow Pesto F� Serves 4

Fish is a staple of the Mediterranean diet. Its low-fat content, wild nature and antiinflammatory properties are just too important to be overlooked.

Luckily, cooking fish can be easy and this recipe shows you how.

Seasoned Cook This recipe makes 1 cup of pesto. Use extra as a base for salad dressing, to flavor vegetables or spread on sandwiches and wraps.

4 cups vegetables of choice, cut in 2” pieces (like bell pepper, yellow squash and red onion)

1¼ pound firm white fish (halibut, Pacific cod or rockfish) Pesto 2 cups fresh herb combination (basil, mint, cilantro and/or parsley) 4 garlic cloves, chopped

½ cup grated Parmesan or Romano cheese 1/3 cup raw pecan halves 1/3 cup extra virgin olive oil

1. Preheat oven to 450°. Place vegetables in a large bowl and lightly toss with olive oil and salt. Spread on 1-2 roasting sheets. Roast for 15 minutes.

2. Meanwhile, in a food processor fitted with an “s” blade, combine herbs, cheese, garlic and pecans. While food processor is running, slowly pour oil through top opening until desired texture and taste is achieved.

3. Rinse fish in cool water. Pat dry. Place on top of roasted vegetables and return to oven for an additional 10-12 minutes. Fish is done when it “bounces back” or flakes.

4. Plate the roasted vegetables, then top with fish and pesto.

Per serving: 170 calories, 20g protein, 6g carbohydrate, 7g fat (1g sat, 6g mono/poly), 2g fiber, 390mg sodium, 10%DV potassium, 13%DV magnesium

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ade, od

ted 2 es. pesto.

/poly),

Smoked Salmon Chowder Makes 8

2 cups yellow or green split peas 1 Tbsp extra virgin olive oil 2 cups onion, diced 1 cup carrot, diced 2 bay leaves

1-cup servings

6 cups water or stock 1/3 cup Dijon mustard 8 ounces smoked salmon, divided Pepper, freshly ground Parsley or chives (optional)

1. Rinse peas under cold water and pick over for odd pieces. Set aside.

2. Heat oil in a deep pot and sautĂŠ onion and carrot until onions are translucent, about 5 minutes. Add bay leaves, split peas and liquid.

3. Bring to boil, cover and reduce to simmer, stirring occasionally until peas break down into a thick puree, about 45-60 minutes. If necessary, add more water to keep peas from drying out.

4. Remove bay leaves. Stir in 6 ounces of the salmon, mustard and pepper until well blended.

5. Ladle into bowls, garnish with herbs and the remaining salmon.

Enjoy this heart-healthy variation on ham split pea soup.

Packed with omega-3 rich salmon and fi ber-fi lled split peas.

Seasoned Cook Don’t skimp on the Dijon mustard, which adds a zing to this recipe.

For a creamier texture, use an immersion stick or blender.

Per serving: 280 calories, 22g protein, 40g carbohydrate, 5g fat (1g sat, 4g mono/poly), 14g fiber, 380mg sodium, 18%DV potassium, 13%DV magnesium

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Busy Morning Breakfast Bites Makes 1 dozen

Ricotta is a great way to enjoy dairy.

Lower in fat and higher in protein than hard cheeses, ricotta is high in minerals such as potassium, calcium and magnesium – helpful in reducing blood pressure.

Seasoned Cook Make a batch on Monday and have on-hand for quick reheating anytime.

9 1½ 1-2 1 1 2

eggs cups ricotta Tbsps dried herbs tsp Dijon mustard tsp extra virgin olive oil cups mixed vegetables, cut into bite-sized pieces (like broccoli, red peppers and mushrooms)

1. Preheat oven to 350°.

2. In a large mixing bowl, crack eggs and whip.

Add ricotta, herbs, mustard and whip again.

3. Heat a small amount of oil in a medium skillet.

Add mixed vegetables and sauté until soft, about 3-5 minutes.

4. Evenly distribute cooked vegetables into lightly-oiled muffin tins and cover with egg batter.

5. Bake for 25-30 minutes. Eggs are done when they have puffed up and remain solid when shaken.

Remove and let cool.

Per 2 muffins: 210 calories, 18g protein, 6g carbohydrate, 13g fat (5g sat, 8g mono/poly), 1g fiber, 180mg sodium, 7%DV potassium, 9%DV magnesium

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y

m

Creamy Dre�ings Makes 1 cup each

Creamy Walnut Dressing ½ cup raw walnut pieces, soaked for 6-8 hours, rinsed and drained ¼ cup water 1 small clove garlic

1 large lemon, juiced 1 tsp each dried oregano, rosemary and thyme ½ tsp sea salt ¼ cup extra virgin olive oil

1. In a small food processor or blender, combine all ingredients except oil. Blend well.

2. While equipment is running, slowly add oil.

3. Refrigerate and serve chilled.

Per 2 Tbsp: 110 calories, 1g protein, 2g carbohydrate, 12g fat (1g sat, 11 mono/poly), 1g fiber, 145mg sodium, 1%DV potassium, 3%DV magnesium

Easy Tzatziki ½ English cucumber, grated 1 cup plain, low-fat Greek yogurt

2 cloves garlic, minced 1 Tbsp fresh dill or mint, minced Juice of 1 lemon (1-2 Tbsp) 1. Grate cucumber. Using a paper towel, squeeze out excess liquid.

2. Combine all ingredients and serve chilled.

Use these recipes to top your favorite cuts of meat. The walnut dressing pairs nicely with red meat such as beef and lamb while the tzatziki is great with lighter fare such as fish and chicken.

Seasoned Cook If you don’t have time to soak walnuts, cover them with water and microwave for 1-2 minutes.

Rinse, drain and continue as directed.

Per 2 Tbsp serving: 25 calories, 4g protein, 3g carbohydrate, 1g fat, 0g fiber, 20mg sodium, 2%DV potassium, 4%DV magnesium

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Whole Foo Rosemary Popcorn 3

Tbsps high heat oil cup popcorn kernels 1-2 Tbsps fresh (1-2 tsp dried) rosemary, finely chopped

1/3

1. In a large, heavy bottomed pot, heat oil on medium-high.

2. Drop one or two kernels into oil and wait to see a sizzle.

3. Add the remaining popcorn and rosemary, cover.

4. As kernels begin to pop, gently shake the pot back and forth until there are 1-2 quiet seconds between pops.

5. Quickly dump into a brown paper bag to absorb excess oil, lightly salt and shake to distribute.

Tamari Roasted Almonds 3 cups raw almonds 1/3 cup low-sodium tamari or soy sauce 1. Preheat oven to 300째. Spread almonds in a single layer on 1-2 baking sheets and bake for approximately 10 minutes.

Nuts are done when you can smell their sweet aroma; check frequently to avoid burning.

2. Remove almonds from oven, place in medium mixing bowl and add sauce. Stir until evenly coated.

Return to oven in a single layer for about 15 more minutes, stirring occasionally. Almonds are done when they appear dry and when sampled are crunchy.

3. Enjoy hot, fresh out of the oven or let cool and store in an airtight container.

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ole Food Snacking Watermelon Feta Cubes 3 ½ ¼ 2

cups watermelon, cubed fresh lime cup feta, crumbled Tbsps mint, chopped

1. Place cubed melon in a serving dish and squeeze lime juice over.

2. Top with feta and mint.

Crunchy Curry Roasted Chickpeas 3 cups (2- 15 oz cans) chickpeas (garbanzo beans), drained and rinsed 2 tsps smoked paprika 2 tsps curry blend of your choice 1 Tbsp extra virgin olive oil 1. Preheat oven to 450°.

2. After rinsing beans, reduce moisture by spreading out on a clean kitchen towel and patting dry.

3. In a medium bowl, combine all ingredients and stir. Spread in a single layer on 1-2 large, rimmed non-stick baking sheets.

4. Roast for 15 minutes, stir, return to oven for another 15 minutes. Chickpeas are done when they are slightly browned and crispy.

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Heďż˝-Friendly Pantry Basics In the Pantry Grains q Barley q Brown rice q Bulgur q Farro q Rolled oats q Popcorn q Quinoa q Whole-grain bread, pita or tortilla wrap q Whole-grain pasta q Whole-grain crackers _____________ _____________ Beans/Peas (canned and dry) q Black beans q White beans (butter, navy) q Garbanzo (chickpeas) q Lentils q Split peas _____________ _____________ Produce Basics q Onions q Garlic q Seasonal fruit q Seasonal vegetables q Fresh herbs _____________ _____________

Nuts, Seeds and Dried Fruit q Almonds q Flaxseeds q Sunflower seeds q Walnuts q Pecans q Raisins q Apricots q Cranberries q Dates q Shredded coconut _____________ _____________

Oils q Olive, extra virgin q High heat (avocado, coconut) q Sesame q Flax q Walnut _____________ _____________

Seasonings q Basil, bay leaf, black pepper, cayenne, chili powder, cinnamon, cumin, Canned Goods dill, harissa, ginger, q Broth, low-sodium nutmeg, oregano, (chicken, vegetable red pepper flakes, or beef) rosemary, sage, q Tomato sauce, sesame seeds, low-sodium smoked paprika, q Tomato, low-sodium thyme, turmeric q Tomato paste _____________ q Marinated artichoke _____________ hearts q Fish (salmon, tuna, Other Staples herring, mackerel) q Honey q Salsa _____________ q Soy sauce, _____________ low-sodium q Ketchup, low-sugar q Maple syrup Vinegars q Mustard (dijon, q Cider whole-grain) q Red wine q Baking soda q White wine q Baking powder q Balsamic q Sherry q Rice wine _____________ _____________

q q q q

Cornstarch Flours Sugar Vanilla extract _____________ _____________

In the Fridge q Eggs q Parmesan cheese q Milk, low-fat q Yogurt low-fat, plain q Butter, unsalted q Lemon and lime juices q Lean protein _____________ _____________ In the Freezer q Edamame q Green beans q Mixed vegetables q Peas q Berries q Homemade broth q Lean protein _____________ _____________

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Be P Acti Mea Oth

Fresh Ingredients Grocery List

Easy Summer Salad • 1 cucumber • 1 cup cherry tomatoes • Handful fresh basil Tuscan White Bean Salad • 1 stalk celery • 6 marinated artichoke hearts • 1/3 cup red onion Omega Power Spread • ½ cup low-fat cottage cheese

Triple-B Burgers • 1 red onion • 1 large carrot • 1 stalk celery • 1 bunch cilantro • 1 head butter lettuce Pesto Rainbow Fish • 4 cups vegetables of choice • 1¼ pounds firm white fish • 2 cups fresh herbs of choice • ½ cup grated Parmesan cheese

Sweet Citrus Barley Salad • 1 fennel bulb • 2 cups Brussels sprouts • 1 navel orange • 1 bunch green onions • ½ cup feta cheese • 1 bunch parsley

Smoked Salmon Chowder • 2 large carrots • 8 oz smoked salmon

Mediterranean Stuffed Zucchini • 2 large zucchini or 4 medium • 1 lemon • 1 bunch parsley or cilantro • 1 bunch green onions • 1 cup cherry tomatoes • 1 sweet bell pepper • 1 cup plain yogurt

Creamy Walnut Dressing • 1 large lemon

Wilted Kale & Sweet Potato Salad • 2 sweet potatoes • 4 cups kale • Port or dessert wine

Busy Morning Breakfast Bites • 1½ cups ricotta • 2 cups mixed vegetables of choice

Easy Tzatziki • 1 English cucumber • 1 cup plain, low-fat yogurt • Handful fresh dill or mint • 1 lemon Watermelon Feta Cubes • 1 small watermelon • ¼ cup feta cheese • Handful fresh mint • 1 lime

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Summary

8 Easy Changes for a Healthier Heart Making big changes can be daunting, but little ones don’t have to be.

Consider taking one easy step per week to boost your heart health.

1. Don’t smoke 2. Get regular check-ups 3. Aim for at least 6-8 hours of sleep per night 4. If you drink, drink in moderation 5. Maintain a healthy weight 6. Manage and reduce chronic stress 7. Plan, cook and eat more meals at home using fresh,

whole and minimally processed foods 8. Walk at least 10,000 steps, or aim for at least 30 minutes of exercise daily

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e.

Let’s talk, doc.

Start the conversation to ensure your best health!

At your next check-up, have a heart-to-heart with your doctor to understand your numbers, your lifestyle habits and how they affect your health and wellness. Together, set targets for improvement tailored just for you.

Questions to ask

1. Which screening tests are right for me?

2. Is there anything in my family history I should watch for?

3. How do you measure ‘BMI’ and what is mine?

4. What is my waist circumference and my waist-hip ratio?

5. What are my ‘bad’ and ‘good’ cholesterol levels? What is the ratio of my total cholesterol to my ‘good’ cholesterol?

Lifestyle topics to discuss

The more your doctor knows about your lifestyle, the better he or she can help you improve your health. Don’t be afraid to talk about challenges surrounding alcohol, drug and tobacco use; depression; stress; eating habits; and how much exercise and sleep you really get.

Your health habits impact your risk for obesity, heart disease, stroke, diabetes and more.

Our bodies and minds are closely connected. Even happiness, or a sense of well-being, may be linked to better immune function and help reduce your risk of heart disease.

Find a provider who is right for you. Visit FranciscanDoctors.org today or call 1 (888) 825-3227.

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Heart and vascular care in your community

L

We’r e eve r y w h e r e yo u f i n d C H I Fr a n c i s c a n .

Our heart and vascular care includes expert providers and services throughout the Puget Sound, ensuring you and your family always have access to the best care possible.

CHI Franciscan Health Facilities

Port Townsend

Sequim

Heart/Vascular Clinics Hospital/Emergency Department

Port Ludlow

Primary Care and Specialty Care Clinics

Poulsbo

Forks

Port Townsend

Sequim

Prompt Care/Urgent Care

Port Ludlow

Bainbridge Island

Silverdale Bremerton

Port Orchard Belfair

Po

West Seattle Burien Vashon

Silverdale

Tukwila

Des Moines

Need a heart surgeon?

• St. Joseph Medical Center, Tacoma • Harrison Medical Center, Bremerton

Learn more about our nationally recognized cardiac surgeons at chifranciscan.org/heartcare.

Federal Way

Gig Harbor University Place Lakewood

Bremerto

P

Auburn

Belfair

Tacoma Milton Puyallup

Enumclaw

Bonney Lake

Gi Har

Spanaway

U

For a full list of services and providers, visit chifranciscan.org/heartcare.

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Helping you to better health

Local classes and support groups • chifranciscan.org/support Freedom From Tobacco Weekly support groups offer multiple locations, days and times. No registration required; drop-ins welcome.

For more information call (253) 223-7538.

Living Successfully with Heart Failure A free, four-week course led by healthcare experts. Includes understanding heart failure, nutrition, medication, exercise and activity. Patients and families welcome. Call 1 (888) 825-3227.

Heart Failure Workshop Information and support to help patients achieve their greatest wellness. Led by a heart failure nurse.

Call (253) 426-6768 for locations, dates and times.

Franciscan Center for Weight Management Full range of surgical options to help patients manage their weight for life and lower their risk of chronic health problems. Learn more at FranciscanWeightLoss.org.

Better Breathers Group support for those with chronic respiratory diseases such as asthma or chronic obstructive pulmonary disease (COPD), lung cancer and more. Call Harrison Medical Center at (360) 744-6685.

Heart to Heart Support group for patients and families affected by heart disease.

Call Harrison Medical Center at (360) 744-5200.

Heart Health 2016_00.indd 40

Stroke Support Groups Open to those who have sustained a stroke, their caregivers and family, and the public. Visit chifranciscan.org/support for locations, or call 1 (888) 825-3227.

Franciscan Outpatient Nutrition Education Center Individual nutrition counseling, body composition analysis and more.

Call (253) 426-4926.

Heart Healthy Eating Four-week series covers types of fat, label reading, recipe substitutions, strategies for dining out and more.

Call 1 (888) 825-3227.

Diabetes Education and Support Certified diabetes educators help you manage diabetes and live well.

Call Franciscan Diabetes Center at (253) 426-4352, Highline Medical Center at (206) 431-5370, or Harrison Diabetes Center at (360) 744-6910.

A.W.A.K.E. Support Groups For continuous positive airway pressure (CPAP) wearers and their families, covers topics related to sleep apnea.

Call (253) 985-6951; for Harrison call (360) 744-6812.

Because we believe in the research, education and awareness the association provides to support the communities in which we live, work and play, CHI Franciscan Health is a proud premier sponsor of Go Red For Women.

life is why™ TM Go Red trademark of AHA, Red Dress trademark of DHHS.

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Talk to a doc 24/7 by phone or video chat for $35.* Discover a new way to feel better fast.

Learn what we treat, see how it works, or get a referral to a provider.

Go to FranciscanCareNow.org or call (855) 356-8053. *If your situation is quickly determined to be inappropriate for Virtual Care, you won’t be charged for the visit.

Due to federal regulations, patients who participate in government funded insurance programs are not eligible for telemedicine “virtual visit” service at this time.

Heart Health 2016_00.indd 41

We’ve got you covered.

– – – – – – – – – – – – – – –

Allergies Bites & stings Cough Cuts & scrapes Fever Flu symptoms Headaches Minor burns Pink eye Rashes Sinus issues Sore throat Stomach flu Strains & sprains UTI

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