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Heart disease and diet

Definition:
Diet is a major factor in reducing the risk of heart disease. The 2002 American Heart Association's nutritional recommendations provide practical guidelines for diet modification.

The purposes of the American Heart Association diet are:

• to reduce the risk of heart disease and ultimately heart attacks and stroke.
• to reduce the risk of certain contributors to heart disease, including high cholesterol, high blood pressure (hypertension), and excess body weight (obesity).
• to reduce the risk of other chronic health problems, including type 2 diabetes, osteoporosis, and some forms of cancer.

Most fruits and vegetables are appropriate for a heart-healthy diet. They are good sources of fiber, vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol.

Dairy products and milk are good sources of protein, calcium, the B vitamins niacin and riboflavin, and the vitamins A and D. Use skim, 1/2%, or 1% milk. Cheese, yogurt, and buttermilk should be low-fat or nonfat.

Eat low-fat breads, cereals, crackers, rice, pasta, and starchy vegetables (like peas, potatoes, corn, winter squash, and lima beans). These foods are high in the B vitamins, iron, and fiber. At the same time, they are low in fat and cholesterol.

Avoid baked goods made with eggs, such as egg rolls or egg noodles; butter rolls; cheese crackers; croissants; cream sauces for pasta and vegetables; and cream soups.

Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, the B vitamins, iron, and other vitamins and minerals.

• Eat skinless poultry, very lean beef, lamb, veal, and pork; lentils, legumes, dried beans and peas; egg whites; and wild game.
• Avoid prepared meats such as sausage, frankfurters, and high-fat lunch meats; marbled meats; prime cuts of high fat meats; duck; goose; and organ meats such as kidneys and liver.

Avoid oils and fats. They are high in fat and calories, and people should eat less of all types of fat. Some fats are better choices than others but should still be used in moderate amounts.

• Use liquid vegetable oils such as safflower, soybean, corn, sesame, olive, canola, avocado, and cottonseed. Use margarines made from any of these oils in their tub or squeeze form, not their stick form. Salad dressings and mayonnaise should be made with the recommended oils.
• Seeds, nuts, olives, avocados, and peanut butter are also acceptable in moderate amounts.
• Avoid butter, lard, bacon, shortening, sour cream, whipping cream, and coconut, palm, or palm kernel oil. These contain saturated fats and are not recommended.

Diet recommendations for children over the age of 2 years are similar to those of adults. Children and teenagers must have enough calories to support growth and activity level while they achieve and maintain a desirable body weight.

Children following low-fat diets may have difficulty maintaining desired levels of growth. Consult a physician or dietitian for assistance in planning adequate low-fat meals for children and adolescents.

Note: For an individualized meal plan incorporating the dietary guidelines of the American Heart Association, a nutrition consultation with a registered dietitian is helpful. Each state's American Heart Association is also an excellent resource for information on heart disease.

Recommendations:

• Maintain your ideal body weight and balance the number of calories you eat with the number you use each day. You can ask a dietician or a health care professional for help in calculating these numbers.
• Limit your intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that have lots of sugars.
• Eat 5 or more servings per day of fruits and vegetables.
• Eat 6 or more servings per day of grain products, including whole grains. Grain products provide fiber, vitamins, minerals, and complex carbohydrates. The daily calories should be appropriate for the maintenance of desirable body weight and should support growth in children and adolescents.
• Reduce total fat intake. Limit foods high in saturated fat, trans fat and/or cholesterol, and partially hydrogenated oils. (The average fat intake of most Americans is too high.) Reduce saturated fat -- the fat that raises your cholesterol level -- by using liquid or tub margarine, canola oil, or olive oil. These have 2g or less of saturated fat per serving.
• Eat less than 300mg of dietary cholesterol daily. (For example, one egg yolk contains an average of 213 mg.)
• Limit salt intake (salt is also called sodium chloride). Sodium chloride intake should be less than 6 g/day, which is equal to 2400mg of pure sodium per day. Increased salt intake can be associated with fluid retention, which leads to an increase in the blood volume and is a risk factor for high blood pressure and heart disease.
• Maintain a level of physical activity that keeps you fit and matches the number of calories you eat. Walk or do other activities for at least 30 minutes a day.
• Have no more than one alcoholic drink (such as beer) per day if you are a woman and no more than two if you are a man. Moderate alcohol consumption at this level has been linked by several major studies to health benefits, but excessive drinking can damage the heart and other organs.

EATING TIPS

• To reduce fat and cholesterol, eat no more than 6 cooked ounces of meat, poultry, and fish daily. One serving of meat should be about the size of a deck of cards on your plate.
• Use skinless turkey, chicken, fish, or lean red meat to reduce the amount of saturated fat in your diet. Lean cuts of red meat may be used occasionally.
• Trim all the visible fat prior to cooking the meat. Eat two servings of fish per week. Cook by baking, broiling, roasting, steaming, boiling, or microwaving rather than deep fat frying. For the main entree, use less meat or have meatless meals a few times a week. Use smaller amounts of meat to reduce the total fat content of the meal. Use no more than 5-8 teaspoons of fats or oils per day for salads, cooking, and baking.
• To reduce high cholesterol, do not use more than 3-4 egg yolks per week, including eggs used in cooking. Eat less organ meat (such as liver) and shellfish (such as shrimp and lobster).
• To reduce salt, reduce the amount of table salt used, and limit the use of prepared foods that have salt added to them, such as canned soups and vegetables, cured meats, and some frozen meals. Always check the nutrition label for the sodium content per serving.