Simple, heart-smart substitutions: MedlinePlus Medical Encyclopedia

P A heart-healthy diet is low in saturated fat and cholesterol. It also limits salt, refined sugar, and processed foods.
P Making heart-healthy food choices does not mean you have to sacrifice flavor. The key is to substitute less healthy foods with fresh produce, whole grains, beans, lean meats, fish, and low-fat dairy.

T 1. Replace Saturated Fats
P Reduce the amount of fat in your dairy. Whole-fat dairy products are high in saturated fat. But there are healthier options.
- Instead of butter, cook with olive, canola, corn, or safflower oils.
- Replace heavy cream with evaporated skim milk.
- Whole-milk cheese, yogurt, and milk with low-fat versions.
P Experiment. If a recipe calls for whole milk, you can usually replace most or all of the volume with skim or low-fat milk with no reduction in final quality.
P Reduce fat and cholesterol in meat. Try meat substitutes with your meals.
- Beans are great in soups, salads, and over rice.
- Nuts liven up salads, stir-fried meals, and vegetables.
- Eggs make great dinners, as omelets and frittatas.
- Mushrooms add a meaty texture to sauces, casseroles, and stroganoffs.
- Tofu goes well with curries and stir fried dishes.
- Eat more fish, especially fish that are high in omega-3 fatty acids. This includes herring, sardines, salmon, tuna, trout, and mackerel.
- Shrimp has less cholesterol than chicken, pork, or beef.
P Choose lean meats. They have less fat and are better for your heart. When selecting and cooking lean meats:
- Remove the skin from chicken and turkey before serving.
- Choose lean cuts of pork, such as tenderloin or loin chops.
- Look for beef cuts labeled "choice" or "select."
- Avoid marbled cuts of beef, or cuts marked "prime."
- Cut off visible fat before cooking.
- Instead of frying, bake, roast, broil, or stir fry meat.
- If excess fat pools in the pan, pour it off before serving the meat.
P Prepare meat as just a part of the meal, rather than the main attraction. For example, stir fry pork with broccoli and serve over brown rice. Along with the meat, you get a serving of vegetable and whole grain.

T 2. Prepare Foods with Little or no Salt
P To cut back on salt, stock your kitchen with low- or no-salt prepared sauces, soups, canned foods, or mixes. Instead of salt, season your food with:
- Orange, lemon, or lime juice
- Spices and herbs
- Vinegar
- Salt-free herb blends

T 3. Cook with Whole Grains
P White flour, white rice, and other refined grains have been stripped of their nutrients. You often find them in foods that are high in sugar, sodium, and fat.
P Whole grains are loaded with fiber and nutrition. They can help lower cholesterol in your blood and make you feel full longer. As you shop for food, read labels for fat and sugar content. Be on the look out for:
- Whole grain breads, cereals, and crackers
- Whole wheat flour instead of white flour
- Brown or wild rice instead of white rice
- Whole wheat barley
- Oatmeal
- Other grains such as quinoa, amaranth, buckwheat, and millet

T 4. Cut Back on Sugar
P Too much sugar in your diet typically means many calories without many nutrients. To keep your weight in check and your heart healthy, limit the sugar you eat.
- Cut sugar in recipes by one third or more. You often will not notice a difference.
- In recipes, use unsweetened applesauce in equal amounts in place of sugar.
- Cook with carob instead of cocoa powder. It is sweeter so you can add less sugar.
- Use ginger, allspice, or cinnamon in oatmeal.

T Recipes
P Baked Salmon Dijon
- 1 cup (240 milliliters, mL) fat free sour cream
- 2 teaspoons (tsp), or 10 mL, dried dill
- 3 tablespoons (tbsp), or 45 mL, scallions, finely chopped
- 2 tbsp (30 mL) Dijon mustard
- 2 tbsp (30 mL) lemon juice
- 1 ½ lbs (680 g) salmon fillet with skin cut in center
- ½ tsp (2.5 mL) garlic powder
- ½ tsp (2.5 mL) black pepper
- As needed, fat-free cooking spray
- Whisk sour cream, dill, onion, mustard, and lemon juice in small bowl to blend.
- Place salmon, skin side down, on prepared sheet. Sprinkle with garlic powder and pepper. Spread with the sauce.
- Bake salmon until just opaque in center, about 20 minutes.
P Source: National Heart, Lung, and Blood Institute.
P Vegetarian Spaghetti Sauce
- 2 tbsp (30 mL) olive oil
- 2 small onions, chopped
- 3 cloves garlic, chopped
- 1 ¼ cups (300 mL) zucchini, sliced
- 1 tbsp (15 mL) oregano, dried
- 1 tbsp (15 mL) basil, dried
- 8 oz (227 g) can of low-sodium tomato sauce
- 6 oz (170 g) can of low-sodium tomato paste
- 2 medium tomatoes, chopped
- 1 cup (240 mL) water
- In a medium skillet, heat oil. Sauté onions, garlic, and zucchini in oil for 5 minutes on medium heat.
- Add remaining ingredients and simmer covered for 45 minutes. Serve over whole grain pasta, cooked without salt.
P Source: Your Guide to Lowering Your Blood Pressure with DASH, U.S. Health and Human Services.

T Alternative Names
P Coronary artery disease - heart smart substitutions; Atherosclerosis - heart smart substitutions; Cholesterol - heart smart substitutions; Coronary heart disease - heart smart substitutions; Healthy diet - heart smart substitutions; Wellness - heart smart substitutions

T References
P Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984 PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922.
P Gidding SS, Lichtenstein AH, Faith MS, et al. Implementing American Heart Association Pediatric and Adult Nutrition Guidelines A Scientific Statement From the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular Disease in the Young, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Nursing, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research. Circulation. 2009;119(8):1161-1175. PMID: 19255356 www.ncbi.nlm.nih.gov/pubmed/19255356.
P U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 - 2020 Dietary Guidelines for Americans. 8th Edition. Updated December 2015. health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf. Accessed May 5, 2016.
P U.S. Department of Health and Human Services, Your Guide to Lowering Your Blood Pressure with DASH, NIH Pub. No. 06-4082. Updated April 2006. www.nhlbi.nih.gov/files/docs/public/heart/new_dash.pdf. Accessed May 5, 2016.

T Review Date 4/24/2016
P Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

T Related MedlinePlus Health Topics
- Heart Diseases
- Low Cholesterol Diet
- Nutrition

