So far, we've been talking about general rules for heart-healthy eating, and things like percent of calories from fat and grams of saturated fat. But what it all boils down to is the foods you eat. Here's a list of the food groups to choose from when you plan your new way of eating. Be sure to note the number of servings and serving sizes.

Turn back to the checklist of your current eating habits in (MEDFICTS). As you read through the shopping and cooking tips for each food group in the next sections, look to see where you need to make changes. Think about how you can change your eating habits so that you can meet your goal to eat in a heart-healthy way.

Daily Food Guide

Food Group	Number of Servings	Serving Size
Lean meat, poultry, fish, & shellfish	Step I: 6 ounces or less Step II: 5 ounces or less	N/A
Skim/low fat dairy foods	2-3	1 cup skim or 1% milk; 1 cup nonfat or low fat yogurt; 1 ounce low fat or fat free cheese that has 3 grams of fat or less in a serving
Eggs	Step I: 4 yolks per week* Step II: 2 yolks per week*	N/A
Fats and oils	6-8*	1 tsp. margarine or vegetable oil; 1 tbsp. salad dressing; 1 ounce nuts
Fruits	2-4	1 piece fruit; ½ cup diced fruit; ¾ cup fruit juice
Vegetables	3-5	1 cup leafy or raw; ½ cup cooked; ¾ cup juice
Breads, cereals, rice, pasta; dry peas & beans; grains; potatoes	6-11	1 slice bread; ½ bun, bagel, muffin; 1 ounce dry cereal; ½ cup cooked cereal, dry peas or beans, potatoes, rice or other grains; ½ cup tofu
Sweets and snacks	Every now & then	N/A

*Includes food preparation. For fats and oils, includes salad dressings & nuts.

To help you compare the Step I and Step II diets, here's how they differ:

• The Step II diet calls for smaller amounts from the meat and egg groups. Also, the Step II diet allows only the leanest cuts of meat, fish, and poultry.
• The Step II diet allows more servings of vegetable fats and oils (unsaturated fats) since total calories from fat remain at about 30 percent, and saturated fat is cut back.

See the shopping list for help in choosing heart-healthy foods at the market. Remember to eat foods from the different groups each day as well as a variety of foods from within each group to get all the nutrients you need.

Meats, Poultry, Fish, & Shellfish
Dairy Foods
Eggs
Fats & Oils
Fruits & Vegetables
Breads, Cereals, Pasta, Rice & Other Grains, and Dry Peas & Beans
Sweets & Snacks

1. Read the nutrition information.

Look for the amount of saturated fat, total fat, cholesterol, and calories in a serving of a product. Compare similar products to find the one with the smallest amounts. If you have high blood pressure, do the same for sodium.

2. Look at the ingredients.

All food labels list the product's ingredients in order by weight. The ingredient in the greatest amount is listed first. The ingredient in the least amount is listed last. So, to choose foods low in saturated fat or total fat, limit your use of products that list any fat or oil first -- or that list many fat and oil ingredients. If you are watching your sodium intake, do the same for sodium or salt. Use the chart below to find the sources of saturated fat and cholesterol in foods as they may appear in the list of ingredients.

Besides the ingredients list and the nutrition information that are on all packaged foods, you'll see certain claims on some food packages. These claims include words like "light" and "low fat" and are regulated by the government. To figure out what the claim on a food label means, access Table 14: The Low-Down on Food Label Claims.

Meats, Poultry, Fish, & Shellfish
Sauces, Soups, & Casseroles
Seasonings & Condiments
Convenience Foods

New Ways to Use Old Recipes

There are lots of special cookbooks and recipe booklets to help you with low fat cooking. But maybe you have a favorite cookbook that you've been using for years. You don't have to throw it out -- just cut down on the high fat ingredients and substitute ingredients lower in fat or saturated fat as much as possible.

Fat-Saving Recipe Substitutions

Instead of...	Use...
Whole milk	Skim or 1% milk
Evaporated milk	Evaporated skim milk
Light cream	Equal amounts 1% milk & evaporated skim milk
1 cup butter	1 cup margarine or 2/3 cup vegetable oil*
Shortening	Margarine*
Mayonnaise	Nonfat or light mayonnaise or salad dressing
1 whole egg	1/4 cup egg substitute or 2 egg whites
Cheese	Low fat cheese
Sour cream	Nonfat or low fat sour cream or yogurt
Fat for "greasing" pan	Nonstick cooking spray
*Note: The texture of baked goods may be different when you use these substitutions. Experiment to find out what works best for you.

Recipe Substitutions -- TRY IT!

Check off one of these things to try. Do it today!

The next time I bake, I'll use two egg whites for each whole egg, and I'll use margarine or oil instead of butter.

I'll switch from regular mayonnaise to light mayonnaise.

I'll make dips with nonfat yogurt instead of sour cream.

I will try to make puddings with skim or 1 percent milk instead of whole or 2 percent milk.

Choose restaurants that have low fat, low cholesterol menu choices. And don't be afraid to make special requests: it's your right as a paying customer.
Control serving sizes by asking for a small serving, sharing a dish with a companion, or taking some home.
Ask that gravy, butter, rich sauces, and salad dressings be served on the side. That way, you can control the amount you eat.
Ask to substitute a salad or baked potato for chips, fries, or other extras -- or just ask that the extras be left off your plate.
When ordering pizza, choose vegetable toppings like green pepper, onions, and mushrooms instead of meat toppings or extra cheese.
At fast food restaurants, go for salads, grilled (not fried or breaded) chicken sandwiches, regular-sized hamburgers, or roast beef sandwiches. Go easy on the regular salad dressings and fatty sauces. Limit jumbo or deluxe burgers or sandwiches.
At the salad bar, fill up on vegetables. Limit foods like eggs, bacon, and cheese, and prepared salads like potato or macaroni salad. Go easy on the salad dressings -- and choose low-calorie dressing or oil and vinegar when it's offered.
Try different ethnic cuisines. Many such as Chinese and Middle Eastern offer lots of low fat choices.

Here are some tips that will help you eat healthfully at social events:

At a buffet, look ahead in line to see what low fat foods are available. Fill up on low fat items and take only small servings of high fat foods.
Bring a low fat dish to a potluck dinner. That way, you'll have at least one low fat item from which to choose.
At parties, focus on activities other than eating. Sit away from the area where the food is being served so you won't be tempted to overeat.
Ask for help from your family and friends who know you are following a cholesterol-lowering diet. See if they will include some low fat dishes instead of the high fat favorites.
Have a few ready answers to politely say no to high fat foods. For example, "thank you, but I couldn't eat another bite -- everything was delicious."
If you do eat too many high fat foods at a social event, don't feel guilty. Just eat lightly the next day and get back on track.

For each style of food there are menus at two different calorie levels -- the average American man eats about 2,500 calories a day and the average American woman eats about 1,800 calories a day. For each of these calorie levels there is a menu that follows the guidelines for the Step I and Step II diets. So choose the kind of food you like, how many calories you should be eating, and which diet you need to follow:

American-style
Southern-style
Mexican American-style

Being physically active helps improve your blood cholesterol levels. It can also help you lose weight, if you are overweight (see Table 13: Calories Burned During Physical Activities). But you don't have to train like a marathon runner to benefit from physical activity! Any exercise, even if it's done for just a few minutes each day, is better than none at all.

You can fit physical activity into your daily routine in small but important ways.

Regular, vigorous physical activity -- called "aerobic" -- is especially good for your heart and can burn off extra calories. In aerobic activity, the body uses oxygen to produce the energy needed for the activity. Some aerobic activities are swimming, brisk walking, running, and jumping rope. This type of activity can condition your heart and lungs if you do it for at least 30 minutes, three to four times a week. But even if you don't have 30 minutes for an activity break, try to find two 15-minute periods or even three 10-minute periods. See Table 12: A Sample Walking Program to help you get started.

The eating plans in this booklet easily lend themselves to weight loss because cutting down on fat is a good way to cut down on calories. And you should take care to eat foods high in starch and fiber (like vegetables, fruits, and breads and cereals) instead of high fat foods. Choose low fat and low calorie items from each food group; the food charts in the back of the booklet will help. Finally, in addition to the kinds of foods you eat, you'll have to limit the amount -- or serving sizes -- as well.

But there's more to losing weight than just eating fewer calories. The most successful weight-loss programs seem to be those that combine changes in what you eat and increased physical activity. Combining changes in eating and physical activity leads to greater weight loss than either way achieves alone.

Does the program include working with you to help change your eating, activity, and personal habits?
Is counseling offered? How much?
Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists?
Is there training on how to deal with times when you may feel stressed and slip back to your old habits?
Is attention paid to keeping the weight off? How long is this phase?
Are food choices flexible and suitable? Are weight goals set by the client and the health professional?

How many people who start the program finish it?
How much weight do people who finish the program lose?
How much weight do people keep off at 1, 3, and even 5 years?
How many people have problems or side effects-and what are they?

The National Center for Nutrition and Dietetics' Consumer Nutrition Hotline at 1-800-366-1655;
Your local hospital and/or public health department; or
Your doctor.

Reading More About It. If you would like more written material about cholesterol, healthy eating, and physical activity, write the National Cholesterol Education Program (NCEP) of the National Heart, Lung, and Blood Institute at the address on the next page. The advice in this publication is for adults who want to lower their blood cholesterol level. This resource is part of a series from the National Cholesterol Education Program (NCEP). For more information, consult other publications from the NCEP:

• "So You Have High Blood Cholesterol" gives more detailed information to answer the basic questions about high blood cholesterol;
• "Exercise and Your Heart: A Guide to Physical Activity" tells you more about physical activity and how to get started; and
• other resources for children with high blood cholesterol and their parents.

To request more information and a catalog of publications, contact:

National Cholesterol Education Program
NHLBI Information Center
P.O. Box 30105
Bethesda, MD 20824-010