Eat Healthy Foods - Lifestyle Changes To Protect Yourself: Heart Disease

Content provided by the Faculty of the Harvard Medical School

Eat healthy foods

The American Heart Association made eating right a little easier in 2000 when it revised its "Step 1" and "Step 2" dietary guidelines with recommendations that emphasize the big picture. The updated guidelines encourage people to establish a healthy eating pattern over an extended period rather than simply counting calories or demonizing particular foods.

Complex carbohydrates

Carbohydrates are the major component of bread, pasta, cereal, fruit, milk, vegetables, and beans. Simple carbohydrates are sugars; complex carbohydrates include starches and fiber. Although carbohydrates have been demonized in some popular diet books, the right types of complex carbohydrates are good for your heart. That means eating lots of fruits, vegetables, and whole grains, while avoiding refined carbohydrates like white bread.

Vegetables and fruit. Diets that include multiple servings of vegetables and fruit lower the risk for hypertension, heart disease, and stroke. Whole fruits (as opposed to juice) and those dark in color tend to be high in fiber, nutrients, and antioxidants — all of which are good for health. Aim for five or more servings of a variety of fruits and vegetables per day.

Grain products. You can find grains in cereal, pasta, and bread. The best strategy is to avoid highly refined grains (white bread, white rice, and the like) and instead opt for whole-grain foods, such as whole-wheat bread and brown rice. Why? First of all, the highly refined carbohydrates are digested quickly and tend to have a high rating on the glycemic index, a measure of the rate at which blood sugar rises after you eat a particular food. High-glycemic foods create a spike in blood sugar, or glucose, that triggers a surge of insulin to help cells use this nutrient. As glucose is metabolized, your blood sugar levels plummet, making you want to eat again. This "blood sugar rollercoaster" not only raises your risk for metabolic syndrome, but also boosts triglycerides, lowers helpful HDL cholesterol, and increases the risk for heart attack in people who are overweight. Whole grains, on the other hand, are digested more slowly and tend to be low on the glycemic index; they cause blood sugar levels to rise and ebb more slowly. You will feel full longer while obtaining more nutrients. Aim for six or more servings of healthy grains per day.

Fiber. Slowly digested carbohydrates also tend to be high in fiber, a form of indigestible carbohydrate found mainly in plant foods. Fiber can produce a slight decrease in both total and LDL cholesterol. Perhaps more significantly, a number of studies show that fiber helps to prevent heart disease and reduce the risk for a heart attack. The 2005 federal Dietary Guidelines for Americans recommend 14 grams of fiber for every 1,000 calories consumed — which works out to about 25 grams/day for many women and 30 grams/day for many men.

Proteins

Your body needs protein to build and repair muscles, skin, and cells. Protein is found primarily in meat, fish, poultry, dairy products, nuts, and beans and other legumes. Some protein sources are better than others when it comes to your heart. Red meat and dairy products made from whole milk are high in saturated fat, which can boost your cholesterol. The American Heart Association recommends that you eat other sources of protein, such as fish, poultry, nuts, and legumes.

Healthy fats

One of the biggest dietary developments since the 1990s has been the understanding that not all fats are bad. While saturated fat, derived primarily from animal products, does indeed clog your arteries and raise your risk for coronary artery disease, monounsaturated and polyunsaturated fats (found in fish, nuts, and some oils) actually protect your health by improving your cholesterol profile. Omega-3 fats, a type of polyunsaturated fat found in fatty fish and other foods, are particularly heart-healthy. Studies show that fish and omega-3 fats reduce your risk for heart disease, heart attack, and sudden cardiac death.

Although the protective mechanisms are not fully understood, it appears that omega-3 fats help maintain a steady heartbeat, reducing the risk for arrhythmias, which can cause sudden cardiac death. Omega-3s also decrease triglyceride levels, modestly lower blood pressure, and decrease the risk for blood clotting by making platelets less sticky. The omega-3s are known as essential fatty acids because the body can't make them on its own; instead, you must obtain them from food.

The health benefits of omega-3s are one reason that the American Heart Association recommends that everyone eat two or more servings of fish each week and try to consume foods containing omega-3 fats. The best sources of omega-3 fats are fatty fish such as salmon and mackerel. If you can't stomach fish, try plant-based sources of omega-3 fats, such as soybeans, walnuts, flaxseeds (grind these or they will pass through undigested), or oils made from them; canola oil is another good source.

If you're at high risk for heart disease, the American Heart Association ups the ante, recommending that you try to consume about a gram of omega-3 fats per day — preferably by eating fish, but fish oil capsules provide another option. Just remember to talk with your doctor ahead of time about whether you should take supplements. This is especially important if you are taking blood-thinning medications such as warfarin (Coumadin), as taking omega-3 supplements may lead to bleeding problems.

Alcohol

More than 60 epidemiological studies have suggested that moderate consumption of alcohol reduces the risk for heart disease. Although a few have found that wine is more beneficial than beer or hard liquor, most studies have found that any type of alcohol in moderation may help. It is not entirely clear why moderate alcohol consumption helps the heart, but it may raise helpful HDL levels and decrease the risk for blood clots. The key is moderation, however. Drinking more than two drinks of alcohol per day on a regular basis increases the risk of developing hypertension, while having more than three per day raises the risk for stroke, arrhythmia, and sudden death. Another factor to consider is that alcohol is addictive. The bottom line? If you don't drink, don't start consuming alcohol just to help your heart; eating better food and exercising are better lifestyle strategies. If you do drink, do so in moderation (one drink a day for women and two for men). And remember that a drink is defined as 1 1/2 ounces of hard liquor, 5 ounces of wine, or a 12-ounce beer.

Salt and sugar

You need only about 1/8 of a teaspoon of salt (300 mg of sodium) to meet your body's daily requirement. Eating too much salt raises blood pressure (see "High blood pressure"). Most Americans consume 1–3 teaspoons of salt (about 2,400–7,200 mg sodium) per day. The experts advise that you limit salt intake to about one teaspoon of salt (2,300–2,400 mg sodium) or less per day.

Average sugar consumption in the United States increased from about 120 pounds per person annually in 1970 to 150 pounds per person annually (almost half a pound per day) in 1995. High intakes of sugar lower helpful HDL cholesterol and can elevate triglyceride levels, as well as increase the risk for type 2 diabetes and contribute to weight gain and obesity. Studies dating back to the 1960s have shown that increased sugar intake raises the risk of developing coronary artery disease. The American Heart Association recommends limiting intake of sugar as much as possible. This means not only by doing the obvious (not adding heaping teaspoons of sugar to your coffee every morning), but also by avoiding foods with added sugars (such as sweetened soft drinks) and foods with a high glycemic index rating.

Last updated:	May 03, 2007