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 HEALTHY
HEART DIET
After a heart attack
or for that matter even after a routine preventive check up-
the question uppermost on most peoples’ minds is –“ What should
I eat to prevent future heart disease?” Both, medically as
well as socially, food is one of the most important elements
of life. Not only the amount of food we eat, but also the
different food groups we eat, make a significant impact on
the future occurrence of heart disease. Studies show that
as much as 80% of heart disease and 90% of diabetes is due
to unhealthy eating and other lifestyle factors (e.g. lack
of exercise). Diets rich in fruits, vegetables, nuts and dairy
products can lower blood pressure and “ bad” cholesterol as
effectively as many drugs. Reducing the portion size (amount
we eat) is also helpful to maintain the ideal body weight.
Finally, how we eat- slowly, chewing it; enjoying it; rather
than gulping it down; matters too. The basis of a good diet
is moderation, proportionality, variety, gradual improvement
and activity (Figure1). Dr. Ishi Khosla, a
noted nutritionist with a lifetime commitment to altering
the course of heart disease by diet therapy is a founder of
the “ Whole Foods”.
FIGURE 1: THE BASIS OF A GOOD DIET- MY PYRAMIDOne size doesn’t fit all THE BEGINNING OF CORONARY ARTERY DISEASE Atherosclerosis or
hardening of arteries is the main underlying cause of most
heart and blood vessel diseases. The process begins when we’re
young and can be well advanced by middle age. One of the main
causes of atherosclerosis is an imbalanced diet with bad fat. DIET AND HEART DISEASES The West has reduced heart disease by as much as 50-70% mainly by focussing on diet alteration for the whole population. Diet influences the course of heart disease by the following ways: 1. Weight
Control- thus, altering diabetes and Blood Pressure Control/
occurrence. 2. Blood
Cholesterol and triglyceride levels: The dietary fats. 3. Other
effects of diet: antioxidant levels depending upon Vitamin
A, E, C, beta-carotene etc. in diet and the anti- clotting/
anti- inflammatory properties of blood. HEALTHY HEART DIET Some
of the key principles of eating soundly are: 1. Eat
a variety of foods
e.g. whole grains, pulses, fruits, vegetables, dairy, nuts,
seeds, flesh foods (if taken) and cold pressed oils (Figure
1). 2. Eat
in moderation. No
food is good or bad. Control portion Sizes. Especially with
foods which may not be so healthy for you. These foods are
called “discretionary” foods, e.g. your favorite dessert,
or the cheesy pizza. These need not be eliminated from your
diet, rather eaten once in a while in smaller amounts. Daily
calorie requirement is Wt. In lbs. X 13 (15 if very active).
To lose weight, deduct say 250 cals. /day. If you lose 3500
calories, this equals ½ kg. Loss. 3. Balance
“in-take” with physical activity or by eating light in the
subsequent meals to achieve or maintain ideal body weight. Ideal body weight is Body Mass Index (BMI)
which is Wt. In Kgs. Divided by height in M2 and
should be <= 23 for Asians. 4. Restrict
total fat intake to 30% of which 10% is saturated fats.
Sources of saturated fats include butter, desi ghee, cheese,
cream, fatty meat, coconut oils, hydrogenated fats like vanaspati,
margarine, low fat bread spreads and chocolates. Say “no”
to hydrogenated fats found in commercial bakery, commercial
fried foods and vanaspati. Choose organic cold pressed oils
over refined ones. Include fatty fish 2-3/ week. 5. Reduce
cholesterol” intake” by choosing low fat dairy, lean
meats, egg yolk 3-4/wk. And avoiding liver, kidney or brain
on regular basis. 6. Restrict
total Carbohydrates “intake” and avoid refined carbohydrates
like white flour or polished rice and simple sugars. 7. Ensure
plenty of fresh and
dried fruits, vegetables, nuts and seeds like flaxseeds
for boosting anti-oxidant status. Limit salt “ intake”, caffeine
and alcohol “intake”. 8. Ensure
adequate fiber intake. Include soy and soy products wherever
possible. Dietary supplements under supervision. FOODS THAT MAY LOWER THE BLOOD CHOLESTEROL §
Cereals and Cereal products:
Whole meal Bread, Barley porridge, Oats, Oat Bran, Muesli,
Porridge. §
Pulses:
Bengal Gram, beans and lentils. §
Vegetables:
Onion, garlic, and pectin rich vegetables like bottle gourd
(Lauki), lady Finger, pumpkin. §
Fruits:
Apples, Pears, Figs, Prunes, dried fruits. §
Nuts and oil seeds:
Cold pressed vegetable oils except palm and coconut oil; fish
oils. §
Miscellaneous:
Psyllum (Isabgol), Alfa Alfa, Fenugreek Seeds (Methre) Avoiding simple sugars
and refined carbohydrates: This is useful in
keeping weight under control, lowering blood fat (triglycerides)
levels and keeping diabetes under control. Sources include
sweets, sweetened drinks including colas, bakery products,
bread, rice, naan, pasta, noodles, fruit juices and desserts. Excess salt
can be harmful for high blood pressure, heart failure, and
kidney failure. It may be found in papads, pickles, chutneys,
ajinomoto etc. Fresh homemade pickles in vinegar or lemon
Juice or chutneys of coriander, mint, tomatoes or garlic may
be used instead. The Caffeine Kick:
Sources of caffeine include coffee, tea, colas and chocolates.
Excess caffeine can be harmful by interfering with sleep,
increasing water loss from the kidneys leading to dehydration,
increasing heart rate (causing arrhythmias and high blood
pressure), causing excessive gastric secretion and heart burns,
increasing calcium loss in urine (Osteoporosis), and finally
it can be addictive and habit forming. So avoid excess caffeine. Alcohol:
In moderation alcohol has been shown to increase “good cholesterol”
and has “anti-clotting” benefits. However, alcohol intake
can increase blood pressure, causing irregular heartbeats
and hypoglycemia in diabetics. Alcohol may also raise blood
triglyceride levels and body weight. Therefore teetotalers
are not advised to drink and for those who drink; stick to
no more than two small drinks on alternate days. Fiber:
Taking adequate amount of fiber in diet is good. Among the
two types of fibers (soluble and insoluble), it is the soluble
fibers that help in the reduction of cholesterol. These are
found in whole grains, pulses, vegetables, fresh and dried
fruits, nuts, seeds or fiber supplements like oat bran, psyllum.
Special smart foods: these include Oats,
barley, coarse grains, millets, bengal gram, soyabeans, brightly
colored vegetables, fruits, red grapes, ginger, onion, green
tea, flax seeds, fenugreek seeds, pumpkin seeds, watermelon
seeds, cucumber seeds, amla, nuts, and sunflower seeds, wheat
germ, fatty fish (salmon, mackerel, hilsa, purva), olives
and olive oil, mustard oil, alfa-alfa etc. Include these in
your diet too. Health benefits of Garlic:
Garlic has anti-bacterial, anti-viral, anti-ulcer (inhibition
of H-pylori), and anti-clotting properties. It also reduces
cholesterol providing cardiovascular protection and also is
a good anti-oxidant (selenium). Thus, garlic has numerous
benefits-add it to your diet. Soyabean and heart Disease Benefits
include: §
Cholesterol Reduction: Adding 25 gms. Of soyabean
protein to the diet lowers blood cholesterol levels by 12-15%
(AHA). §
Anti- oxidant Property: Soya Isoflavones have
powerful antioxidant properties ideal for protection against
heart disease and stroke. §
Obesity Prevention: Soya Protein has high satiety
value.
Cooking Medium: Cold pressed oils
are superior to refined ones as they retain their essential
fatty acid composition which are lost during refining. Also
they do not contain harmful chemicals and trans fatty acids
found in refined oils. Examples include olive oil, mustard
oil and sesame oil. Choose a variety of vegetable oils instead
of a single source. MENUS THAT MEET THE CHALLENGES OF HEART DISEASES: Aim to achieve: Ateast three servings
of fruit per day. Atleast three servings
of vegetables per day. 1 serving=1/2 cup. Three servings of dairy products per day:
Give priority to low fat products such as ski milk, double
toned yogurt and cottage cheese. Soya milk can be substituted.
1 serving = 200 ml milk. One to two servings of pulse or soya per day:
These foods contain exceptionally high levels of isoflavones-
antioxidants which prevent heart disease. They also are high
in omega-3 fats which protect against coronary artery disease.
Include these special foods in your daily diet. 1 serving=1/4
cup raw beans. One serving of lean meat or poultry per
day and include fish or seafood two to three times a week.
Give priority to lean meats and poultry without skin. Eat
a variety of fish and prefer fatty fishes like salmon, hilsa,
purva, and seer which are rich in omega-3 fats. You may include
four to five eggs in your weekly menu. 1 serving=75-100 gms.
Choose whole grain products
such as whole-wheat chapatti, brown rice, ragi, amaranth,
millets, whole wheat breads, rolled oats, whole grain cereals
over the refined ones. These foods provide vitamins, micronutrients,
minerals and fiber. A maximum of two tablespoons
of visible fat per day including cold pressed oils like mustard,
olive oil, sesame. At least 15-20 gms. Of nuts daily, serving
size = 1 tablespoon. Vegetarians who do not eat meat
or fish should add an additional serving of cereals, pulse
products and soya to meet all their dietary needs. Strict
vegetarianism who do not eat dairy products should take a
calcium and vitamin b12 supplements. BEHAVIORS FOR MAINTAINING YOUR HEALTHY WEIGHT Here are some practical tips: 1. Stick
to a regular schedule. Start your day with breakfast, even
if it is a light one. Studies have shown that people who eat
3-5 small meals a day control their appetite well, and that
people who eat breakfast take in fewer calories throughout
the remainder of the day. 2. Pay
attention to what you choose. Eat with awareness and concentrate
on eating. When you watch television or read while you eat,
you’re likely to eat more. Instead, focus on your food. Enjoy
how it looks and tastes and notice how much you are eating.
Stop when you feel satisfied or when you have completed the
portion. 3. Eat
slowly and take small bites. What’s the rush, savor the food.
You will enjoy it more and will eat less. 4. Choose
small plates and bowls. Make smaller sizes of idlis, cutlets,
tikkis, small rotis etc. We psychologically use counting as
a yardstick to judge how much we have eaten. 5. Know
appropriate portion sizes and calorie content of foods in
consultation with your nutrition counselor. Do not fool yourself
about how much you are eating; you will pay for it with extra
calories. 6. Pay
attention to how you are feeling. Learn the distinction between
physiological and psychological hunger. Learn to cope with
emotional eating and boredom. Your moods can affect your food
intake. People often eat when they are feeling tired, angry,
upset or bored. 7. Do
you really feel hungry or are you saving urges (mental cravings
for food). Identify your cravings and discuss with your nutritionist. 8. Be
reasonable and realistic with yourself. Do not deprive yourself.
Eat your favorite foods every now and then. 9. Keep
a check on alcohol and empty calories. Choose dietary supplements
under the supervision of nutrition counselor. 10. Plan
your meals and snacks in advance. E.g. Festival time means
social activities and more “ energy dense” foods. So plan
your day accordingly. When travelling out carry appropriate
foods like vegetables, fruits, low fat milk, nuts and plenty
of water. 11. Exercise
is a must. The reason why exercise makes you feel wonderfully
alive is because it triggers the release of chemicals (endorphins)
in the brain that make you feel generally happier, calmer
and clear headed. In a Nut Shell The key to a good diet
is to follow a well balanced diet with sound nutritional principles
and to use some common sense. Ensure that the diet provides
atleast two meals with
a protein rich foods such as pulses, dairy, poultry or
fish; atleast two fruits,
two to three cups of vegetables, a few nuts and seeds and two to three
glasses of low fat milk or curd or soya milk. Choosing
the balance calories from whole grains and limiting the intake of sugary foods, oily
foods, refined flour, polished rice, refined oils, hydrogenated
fats, and alcohol to a minimum is needed. Eating right will
not only help you to lose weight but also prevent food cravings,
boost vitality, immune functions, and also improve skin/hair
health. Supplements under the guidance of a qualified nutritionist
or health counselor are suggested if needed only. Exercising
along with this can prove to be an excellent adjunct. Changing what, where,
why, when, and how we eat is all that will get results in
the end. Finally, even small changes in the diet can make
a large difference to your health. So just do it; begin today
and keep getting better and better day by day till you reach
your ideal body weight and begin to eat the right balance
of foods without giving up your favorites!!
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