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September 1999 Issue
Diet and the Risk of Heart Disease
by Ronda L. Halpin
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Heart Healthy Diet DOs and DON'Ts

  1. DON'T wait to cut your total fat intake.

    The risk of heart disease falls sharply if you reduce fat to less than 30 percent of total calories (as opposed to the 34-54 percent that is typical in the United States). When you lower fat consumption, you also reduce your saturated fat intake, cut calories and lose weight.

    Exactly how much of your diet should come from fat is a matter of controversy. Too little fat may be as bad as too much, although this idea is somewhat controversial. It probably depends on your specific health profile.

    If you are on a low-fat, high-carbohydrate diet, yet you also have low HDL (good) cholesterol and high triglycerides, you may need to reconsider the quality of your low-fat diet plan. Your carbohydrates should be coming from whole-grain cereals and breads, fresh fruits and vegetables. Your diet should include only a minimal amount of sugar. If you are taking advantage of fat-free "fun foods," such as low-fat sweets, pretzels and pasta, along with fat-free ice cream and desserts, you may be unintentionally raising your triglyceride level.

  2. DO get more anti-oxidants.

    Anti-oxidants retard the development of "free radical" cells that are implicated in heart disease and cancer. Oxidized LDL (bad cholesterol) is damaging to the arterial wall. Certain vitamins and other compounds provide anti-oxidant effects.

  3. DON'T eat lots of cholesterol-rich food.

    Your daily cholesterol intake should be 300 milligrams or less. Certain animal foods are rich in cholesterol, but no plant foods contain cholesterol. Keep these food facts in mind.

    A single egg yolk has 255 milligrams of cholesterol; if you are healthy, you should eat no more than two egg yolks per week. (If you already have heart disease, you may be advised otherwise.) Egg white has no fat or cholesterol, so you might consider eating egg whites and egg substitutes frequently. Egg white is also an excellent form of protein. Organ meats and certain seafood -- shrimp, lobster and calamari -- have high levels of cholesterol.

    The body makes cholesterol. In most cases, the more cholesterol a person eats, the less the body makes. However, 20-30 percent of Americans are not able to balance the cholesterol they produce and the cholesterol they ingest this well; as a result, they may have excessively high cholesterol levels. Ask your physician about treatments available for people who fit into this category.

  4. DO increase the soluble fiber in your diet.

    Remember the oat bran craze? Well, there is nothing crazy about eating a lot of soluble fiber -- which is found in oat bran in abundance -- if you want to lower your cholesterol.

    The soluble fiber in oats, called beta-gluca, has specifically been proven to reduce blood cholesterol. A high daily intake of soluble fiber, through generous servings of oat- and bean-based foods, helps to eliminate cholesterol-laden bile acids and fats from your body.

    Soluble fiber is found primarily in these foods:

    • Oats
    • Legumes
    • Apples
    • Pears
    • Plums
    • Carrots
    • Okra
    • Barley

  5. DON'T eat excessive saturated fats.

    In terms of heart health, there is nothing good to be said for saturated fats! They are to blame for increasing total cholesterol, LDL cholesterol and triglycerides.

    Less than one-third of your fat intake should come from saturated fat. You find saturated fat in dairy fats such as cream, butter and cheese. Saturated fat is also in animal fats like chicken skin, visible fat on meat, and lard. The chemical structure of saturated fats makes them solid at room temperature.

  6. DO increase your use of monounsaturated fats within your total allotment for fat.

    Monounsaturated fats lower blood cholesterol and will reduce your risk of heart disease.

    Monounsaturated fats are liquid at room temperature. They are the main fatty acids in olive oil and canola oil. Use olive and canola oil in your cooking and in salad dressings to promote heart health.

  7. DON'T eat tropical oils.

    The tropical oils are palm, palm kernel and coconut oil. They are highly saturated. Many prepared foods contain them, so check the labels for ingredients. You are likely to find tropical oils in products like these:

    • Non-dairy coffee creamers
    • Whipped toppings
    • Baked goods
    • Cookies
    • Chocolate candy

  8. DO reduce your intake of trans fatty acids.

    Trans fatty acids are compounds that occur when foods are chemically modified by partial hydrogenation. The safety of trans fatty acids has been a controversial subject. Recent studies have helped resolve the issue. For instance, a US Department of Agriculture study showed that trans fatty acids from partially hydrogenated vegetable oil raise cholesterol as much as saturated fats do. Trans fatty acids may also reduce HDL cholesterol (good cholesterol).

  9. DON'T be afraid to try more soy protein.

    A number of studies have shown that soy protein lowers cholesterol. Soy has isoflavones, called daidzein and genistein, which are the plant estrogens that play a role in cholesterol metabolism. Soy protein is a good protein that can be substituted for animal protein in your diet. Here are some sources of soy protein:

    • Tofu
    • Tempeh
    • Veggie burgers made with textured vegetable soy protein
    • Soy milk

  10. DO use polyunsaturated fats.

    Polyunsaturated fats are the major fat source in vegetable oils such as safflower oil and corn oil. They generally lower total cholesterol, although they may also lower HDL cholesterol (good cholesterol).

    Try to use less hydrogenated margarine; liquid and tub margarine are better than stick margarine. Some less hydrogenated products may contain trans fatty acids, but you can avoid them by reading labels. The newest types of margarine are labeled "without transfats."

  11. DON'T think vitamins will do it all -- get your phytochemicals.

    Phytochemicals are plant chemicals that may help prevent not only heart disease, but also other chronic diseases and conditions such as diabetes, cancer and hypertension.

    Fruits and vegetables are chock-full of them; eating five servings a day is a good start on the road to better health.

    Garlic may help reduce blood cholesterol, LDLs and triglycerides; garlic pills are being studied now, but the results so far are inconclusive. It appears that raw garlic is the active ingredient.

  12. DO get your Omega-3 fatty acids.

    Omega-3 fatty acids are polyunsaturated fats from plant and marine sources. Omega-3 is an essential fatty acid, linolenic acid. The richest sources are fish that swim in cold waters, such as those listed here; try to eat them at least once a week. The numbers listed indicate the amount of Omega-3 fatty acids in a 3-ounce serving:

    • Salmon, Atlantic, cooked (1.8 g)
    • Anchovy, canned in oil (1.7 g)
    • Mackerel, Pacific and Jack, cooked (1.6 g)
    • Sablefish, cooked (1.5 g)
    • Salmon, pink, canned (1.4 g)
    • Sardines packed in tomato sauce (1.4 g)
    • Herring, Atlantic, pickled (1.2 g)
    • Rainbow trout, cooked (1.0 g)
    • Tuna, canned in water (0.7 g)

    The benefits of eating these sources of Omega-3 include the following:

    • Significant reductions in high triglyceride levels
    • Slower blood clotting
    • Prevention of abnormal heart rhythms
    • Enhanced immune function
    • Improved eye and brain development

    If you do not eat fish, be sure to include other foods rich in linolenic acid, such as these:

    • Walnuts
    • Walnut oil
    • Flaxseed oil

  13. DON'T give up all shellfish.

    Shrimp, although moderately high in cholesterol, is a very low-fat protein. Eaten once or twice a month it will not affect cholesterol levels. All other shellfish are also acceptable, except squid (calamari) and roe (caviar). Mollusks such as clams, mussels and scallops are all fine. Be sure shellfish are from reputable sources and are cooked well. Have your seafood baked, broiled, steamed or boiled -- but not fried. Use only oils low in saturated fat in preparing shellfish recipes which call for oil.

  14. DO get enough folic acid, vitamin B6 and vitamin B12.

    Low levels of folic acid and other B vitamins can cause excessive homocysteine to be produced in the body, and high homocysteine levels are an independent risk factor for heart attack and stroke.

    You need 400 micrograms of folic acid a day to prevent heart disease. A multivitamin will provide the recommended amount. Foods that will also do the job include the following:

    • Total cereal
    • Product 19
    • lentils
    • asparagus
    • spinach
    • kidney beans
    • orange juice
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