The goal of a heart-healthy diet is to eat a variety of foods that help to obtain and maintain a healthy body weight, healthy blood lipid profile and to control blood pressure. One strategy for improving your blood pressure and blood lipid profile is to eat a well-balanced heart-healthy diet. For people with heart disease or who are at high risk of heart disease, the National Cholesterol Education Program (NCEP) recommends targeting not only total blood cholesterol levels but also low-density lipoprotein (LDL, “bad” cholesterol) levels. Based on decades of scientific research, the Therapeutic Lifestyle Change (TLC) diet developed by the NCEP to lower heart disease risk makes the following recommendations. These recommendations differ slightly, but not significantly, from the guidelines promoted by the USDA. The TLC diet includes:
Total fat should make up 25 to 35 percent of daily calorie intake. Since most foods high in fat are also high in saturated fat and calories, limiting total fat intake may help to maintain healthy weight and blood cholesterol levels.
Reduce saturated fat in the diet to less than 7 percent of total calorie intake. Studies have shown that diets high in saturated fat increase LDL cholesterol and total cholesterol levels. The good news is that the opposite is also true and reducing the amount of saturated fat in the diet can help lower your blood levels of LDL cholesterol and total cholesterol.
Trans fats should be limited as much as possible in the diet. Trans fats raise LDL cholesterol, increasing the risk of heart disease. Avoid hydrogenated or partially hydrogenated fats (listed under the ingredients list on food labels), hard margarines or packaged foods prepared with these ingredients. It is now required that all food labels include trans fat content.
Monounsaturated fats derived from plant oils and nuts can replace saturated fats in your diet up to 20 percent of total calories. Monounsaturated fats lower LDL or “bad” cholesterol without lowering high-density lipoprotein (HDL, “good” cholesterol) levels when substituted for saturated fats in the diet. People consuming a traditional Mediterranean diet high in fruits, vegetables, whole grains, fish and unsaturated fats (especially monounsaturated fat from olive oil) generally have lower rates of cardiovascular disease.
Polyunsaturated fats can also replace saturated fats in the diet for up to 10 percent of total calories. These fats lower LDL cholesterol and can cause small reductions in HDL cholesterol when substituted for the saturated fats in the diet. It is important that the dietary sources of polyunsaturated fats come from liquid vegetable oils and semi-liquid margarines that are low in trans fats.
Consume less than 200 milligrams per day of dietary cholesterol. Dietary cholesterol is found only in foods that are made from or contain animal products. Reducing dietary cholesterol intake can help to lower LDL cholesterol levels.
Weight loss is encouraged in overweight patients, with the goal of achieving and maintaining a healthy body weight (body mass index between 18.5 and 25). Weight loss of even a few pounds in overweight patients can reduce LDL cholesterol levels.
Carbohydrates should make up 50 to 60 percent of total daily energy intake. Very high intakes of carbohydrates (greater than 60 percent) may lower HDL cholesterol levels and increase triglyceride levels. Sweets or even “low-fat” foods, if high in sugar content, can cause weight gain, not to mention tooth decay. Sweets (foods high in simple sugars) such as cakes, candies, sweetened fruit beverages and regular sodas tend to be high in calories and low in essential nutrients (i.e., empty calories). Instead individuals should choose complex carbohydrates that are also a good source of dietary fiber.
Soluble fiber (five to 10 grams per day) can help to lower LDL and total cholesterol levels. Foods high in soluble fiber content include fruits and vegetables, legumes (beans) and cooked cereals such as oats and grains.
Plant stanols/sterols intake of 2 to 3 grams a day can help to lower LDL cholesterol levels. Sources are foods derived from plants such as fruits and vegetables. Margarine spreads that contain stanol/sterol esters are also available. These spreads may lower beta-carotene levels and are designed mainly for people diagnosed with high cholesterol levels. The presence of plant stanols/sterols is listed on food labels.
Drinking alcohol to excess has many harmful effects, including raising the risk of high blood pressure (hypertension) and adding empty calories to your diet. However, some studies have shown that moderate alcohol consumption (i.e., no more than one drink per day for women and no more than two drinks a day for men) may actually reduce the risk of heart disease. The choice of alcohol as a preventive tool, however, should be balanced with its potential risks and everyone is encouraged to discuss its use with their physician. Therefore, everyone is encouraged to talk to their physician. People who are encouraged to avoid alcohol include minors, individuals with a family medical history of alcoholism, pregnant women and persons on certain medications.
Limit salt intake to 2400 milligrams a day. This is about a teaspoon of salt per day. Salt contributes to high blood pressure. The Dietary Approach to Stop Hypertension (DASH) trial provided evidence that a diet high in fruits, vegetables, low-fat dairy products, whole grains, poultry, fish and nuts and low in fat, red meat and sweets can favorably influence blood pressure. When this diet pattern is combined with reduction in salt intake the benefits are additive and blood pressure is lowered even more.
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