Heart disease and diet: MedlinePlus Medical Encyclopedia

P A healthy diet is a major factor in reducing your risk of heart disease.

T Function
P A healthy diet and lifestyle can reduce your risk of:
- Heart disease, heart attacks, and stroke
- Conditions that lead to heart disease, including high cholesterol, high blood pressure, and obesity
- Other chronic health problems, including type 2 diabetes, osteoporosis, and some forms of cancer

T Recommendations
P FRUITS AND VEGETABLES
P Most fruits and vegetables are part of a heart-healthy diet. They are good sources of fiber, vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol.
P Eat 5 or more servings of fruits and vegetables per day.
P Get more fiber by eating whole fruits instead of drinking juice.
P GRAINS
P Eat breads, cereals, crackers, rice, pasta, and starchy vegetables (such as peas, potatoes, corn, winter squash, and lima beans). These foods are high in the B vitamins, iron, and fiber. They are also low in fat and cholesterol.
P Choose whole grain foods (such as bread, cereal, crackers, and pasta) for at least half of your daily grain intake. Grain products provide fiber, vitamins, minerals, and complex carbohydrates. Eating too many grains, especially refined gain foods (such as white bread, pasta, and baked goods) can cause weight gain.
P Avoid high-fat baked goods such as butter rolls, cheese crackers, and croissants and cream sauces for pasta.
P EATING HEALTHY PROTEIN
P Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, B vitamins, iron, and other vitamins and minerals.
P You should:
- Avoid high-fat proteins. These include meats such as duck, goose, prime cuts of steak, organ meats such as kidneys and liver, and prepared meats such as sausage, hot dogs, and high-fat lunch meats.
- Adults should eat no more than 5 to 6 cooked ounces (142 to 170 grams) of lean meat, poultry, and fish daily. One serving of these foods should be about the size of a deck of cards on your plate.
- Trim off all visible fat before cooking the meat.
- Eat 2 servings of low-mercury, fish per week.
- Cook by baking, broiling, roasting, steaming, boiling, or microwaving instead of deep 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. Get protein from plant-foods instead
- Use skinless turkey, chicken, fish, or lean red meat to reduce the amount of saturated fat in your diet.
- Eat less organ meat (such as liver) and shellfish (such as shrimp and lobster). Healthy adults can eat 1 whole egg (with yolk) per day without raising cholesterol levels.
P Milk and other dairy products are good sources of protein, calcium, the B vitamins niacin and riboflavin, and vitamins A and D. Use skim or 1% milk. Cheese, yogurt, and buttermilk should be low-fat or non-fat.
P FATS, OILS, AND CHOLESTEROL
P Some types of fat are healthier than others. A diet high in saturated and trans fats causes cholesterol to build up in your arteries (blood vessels). This puts you at risk for heart attack, stroke, and other major health problems. Avoid or limit foods that are high in these fats. Polyunsaturated and monounsaturated fats that come from vegetable sources have many health benefits.
P You should:
- Limit total fat intake to 25% to 35% of your total daily calories. Keep saturated fats to only 10% of your total daily calories.
- Foods with a lot of saturated fats are animal products such as butter, cheese, whole milk, ice cream, sour cream, lard, and fatty meats such as bacon.
- Some vegetable oils (coconut, palm, and palm kernel oils) also contain saturated fats. These fats are solid at room temperature.
- Limit trans fats as much as possible by avoiding hydrogenated or partially hydrogenated fats. These are often found in processed foods and solid margarine.
- Use no more than 5 to 8 teaspoons (25 to 40 millimeters) of fats or oils per day for salads, cooking, and baking.
- Eat less than 300 mg of dietary cholesterol each day. (One egg yolk contains an average of 184 mg of cholesterol.)
P Think about the following when choosing a margarine:
- Choose soft margarine (tub or liquid) over harder stick forms.
- Choose margarines with liquid vegetable oil as the first ingredient. Even better, choose "light" margarines that list water as the first ingredient. These are even lower in saturated fat.
- Read the package label to choose a margarine that does not have trans fats.
P Trans fatty acids are unhealthy fats that form when vegetable oil undergoes hydrogenation.
- Trans fats can raise LDL (bad) cholesterol levels in your blood. They can also lower your HDL (good) cholesterol levels.
- To avoid trans fats, stay away from fried foods, commercial baked goods (donuts, cookies, and crackers), processed foods, and hard margarines.
P OTHER TIPS TO KEEP YOUR HEART HEALTHY
P You may find it helpful to talk to a dietitian about your eating choices. The American Heart Association is a good source of information on diet and heart disease. Balance the number of calories you eat with the number you use each day to maintain a healthy body weight. You can ask your doctor or dietitian to help you figure out a good number of calories for you.
P Limit your intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that contain a lot of sugar.
P Eat less than 2300 mg of sodium per day (about 1 teaspoon, or 5 mg, of salt per day). Cut down on salt by reducing the amount of salt you add to food when eating. Also limit 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. Eat season foods with lemon juice or fresh herbs or spices instead.
P Foods with more than 300 mg of sodium per serving may not fit into a reduced sodium diet.
P Exercise regularly. For example, walk for at least 30 minutes a day, in blocks of 10 minutes or longer.
P Limit the amount of alcohol you drink. Women should have no more than 1 alcoholic drink per day. Men should not have more than 2 alcoholic drinks each day.

T Alternative Names
P Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet

T Patient Instructions
- Cholesterol - drug treatment

T Images
- Healthy diet
- Fish in diet
- Fruits and vegetables
- Obesity and health

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 Heimburger DC. Nutrition's interface with health and disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 213.
P Mosca L, Benjamin EJ, Berra K, et al. Evidence-based guidelines for cardiovascular disease prevention in women -- 2011 update: a guideline from the American Heart Association. Circulation. 2011;123(11):1243-1262. PMID: 21325087 www.ncbi.nlm.nih.gov/pubmed/21325087.
P Mozaffarian D. Nutrition and cardiovascular and metabolic disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 46.
P US Food and Drug Administration. At a Glance: Highlights of the Final Nutrition Facts Label. Updated December 21, 2016. www.fda.gov/downloads/food/guidanceregulation/guidancedocumentsregulatoryinformation/labelingnutrition/ucm502305.pdf. Accessed April 3, 2017.

T Review Date 4/25/2015
P Updated by: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update 04/03/2017.

