Heart Healthy Eating

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Why do I need to be concerned about heart healthy eating?
How do I get started with planning a heart healthy diet?
What is cholesterol and what diets can help me lower or maintain healthy levels of cholesterol?
How do the Heart Healthy and TLC Diets work?
What diets can help me maintain a healthy blood pressure level?
How does the DASH Diet work?
What else can I do, besides diet, to keep my heart healthy?

See also…

• Heart and Cardiovascular Disease
• High Blood Cholesterol
• High Blood Pressure

Why do I need to be concerned about heart healthy eating?

Diet is one of the things that can affect your heart health, and your risk for getting heart disease. And, every woman needs to be concerned about heart disease. It is the #1 killer of American women (and men). The good news is that diet is one of the things you can control to improve your heart health and lower your risk for heart disease. Making relatively simple changes in your daily eating habits will pay off quickly - not only will you feel better, your overall health will improve as well!

How do I get started with planning a heart healthy diet?

We all know that too much fat and salt are not good for us. But, it can be hard to change your diet, particularly when you are busy and often don't have time for three healthy, home-cooked meals a day. While the thought of changing your diet might be daunting, there are diets out there to help you! It can be very confusing knowing what to eat, how much to eat, what type of fat to eat, what type of fat to avoid, and how much salt to use. We will describe three easy-to-follow diets in this FAQ, to help you reduce your risk for getting heart disease.

What is cholesterol and what diets can help me lower or maintain healthy levels of cholesterol?

Our bodies need cholesterol to function normally. But, if you have too much cholesterol in your blood, it can build up (called plaque) in your arteries (blood vessels that carry oxygen- and nutrient-rich blood from the heart and lungs to all parts of the body). High cholesterol adds to the narrowing and blockages in arteries, which cause heart disease. We all have "good" cholesterol, called HDL, which helps remove cholesterol from the blood. We also all have "bad" cholesterol, or LDL, which causes cholesterol to build up in the blood.

There are two diets that focus on lowering or maintaining levels of cholesterol - a natural, waxy substance found in all parts of the body, including the blood - to reduce risk for heart disease.

• The Heart Healthy Diet -  
  http://nhlbisupport.com/cgi-bin/chd1/step1intro.cgi helps you keep your blood cholesterol low, decreasing your chances of getting heart disease.

• Similar to the Heart Healthy Diet, the Therapeutic Lifestyles Changes (TLC) Diet http://nhlbisupport.com/chd1/tlc_lifestyles.htm) focuses on helping people lower their blood cholesterol. Sometimes a person may also need medicine prescribed by a health care provider to help lower their blood cholesterol.

It's important to note that diet isn't the only thing that can affect cholesterol levels. Your genes affect how fast cholesterol is made and removed from the blood, being overweight tends to increase your LDL ("bad" cholesterol), and physical activity (for 30 minutes most days of the week) helps lower your LDL. Before menopause (when your periods stop), women usually have cholesterol levels that are lower than those of men the same age. As women and men age, their cholesterol levels rise up until about age 60 to 65. But, after the age of about 50 (when menopause begins), women often have higher cholesterol levels than men of the same age.

How do the Heart Healthy and TLC Diets work?

Both of these diets help you to develop a personal eating plan. Be sure to talk with your health care provider first, before starting any type of eating plan. You might want to ask your provider for a referral to a registered dietician (RD) who can help you choose foods and plan menus, monitor your progress, and encourage you to stay on the diet. You might also want to enlist the help of a family member or friend, to give you support and help you stay on track. Finding a "buddy" to go on one of these diets with you can also provide support. Try to stay focused on your ultimate goal - to prevent heart disease and protect your health - and have some fun learning new recipes and different ways to cook!

Here are some general guidelines to follow, for both the Heart Healthy and TLC diets. Check the chart that follows to determine, for each diet, the daily amounts of saturated fat, total fat, cholesterol, and sodium that you should have.

• Choose foods low in saturated fat. Saturated fat raises your LDL - "bad" cholesterol level more than anything else you eat. It's found the most in animal foods like fatty cuts of meat, poultry with the skin, whole-milk dairy products, and in tropical oils like coconut, palm kernel, and palm oils. Most other vegetable oils are low in saturated fats. Foods low in saturated fat include fruits, vegetables, whole grain foods, and low fat or nonfat dairy products. Some processed foods (such as frozen dinners and canned foods) can be quite high in saturated fat - it' s best to check package labels before purchasing these types of foods.

• Choose a diet moderate in total fat. The good news is that you don't have to eliminate all fat from your diet! A diet moderate in fat will give you enough calories to satisfy your hunger, which can help you to eat fewer calories, stay at a healthy weight, and lower your blood cholesterol level. Keep in mind, though, that it's important to keep your total fat level within the levels on the chart below, depending on which diet you follow. You should substitute unsaturated fat for saturated fat, in order not to go over these levels.

• Choose foods low in cholesterol. Dietary cholesterol found in animal foods can also raise your blood cholesterol level; many of these foods also are high in saturated fat. To reduce dietary cholesterol, eat fruit, vegetables, whole grains, low fat or nonfat dairy products, and moderate amounts of lean meats, skinless poultry, and fish.

• Cut down on sodium. If you have high blood pressure (see next question) as well as high blood cholesterol - and many people do - your health care provider may tell you to cut down on sodium or salt. Even if you don't have high blood pressure or cholesterol, try to have no more than 2,400 milligrams of sodium a day. You can choose low sodium foods, which will also help lower your cholesterol, such as fruits, vegetables, whole grains, low fat or nonfat dairy products, and moderate amounts of lean meat. To flavor your food, reach for herbs and spices rather than high sodium table salt. There are many types of seasoning mixes in salt shaker-like containers you can find in grocery stores, but some do contain salt. Be sure to read the labels of these products before purchasing.

• Watch your body weight. It is not uncommon for overweight people to have higher blood cholesterol than people who are not overweight. When you reduce the fat in your diet, you cut down not only on cholesterol and saturated fat, but on calories as well. This will help you to lose weight and improve your blood cholesterol, both of which will reduce your risk for heart disease. If you are overweight, talk with your health care provider about the best ways to lose weight, including having a regular exercise program. Regular exercise is important, even if you are not overweight. It will help lower your blood cholesterol and blood pressure and improve your overall health.

  Heart Healthy Diet Every Day You Should Have:	TLC Diet Every Day You Should Have:
  8 to 10 percent of total calories from saturated fat	less than 7 percent of total calories from saturated fat
  30 percent or less of total calories from fat	25-35 percent or less of total calories from fat
  less than 300 milligrams (mg) of dietary cholesterol	less than 300 milligrams (mg) of dietary cholesterol
  no more than 2400 milligrams (mg) of sodium	no more than 2400 milligrams (mg) of sodium
  just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level*	just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level*

*Ask your health care provider or RD what is a
reasonable daily calorie level for you.

What diets can help me maintain a healthy blood pressure level?

Research has shown that diet affects the development of high blood pressure (hypertension). As blood is pumped from your heart through your body, the blood puts force or pressure against the blood vessel (or artery) walls. Your blood pressure is a reading, or measure, of this pressure. When that pressure goes above a certain point, it is called high blood pressure, another name for hypertension. High blood pressure is called the "silent killer" because it most often has no signs or symptoms. It makes the heart work too hard and if not controlled over time, it can lead to heart and kidney disease, and stroke.

Studies have shown that following the Dietary Approaches to Stop Hypertension or DASH Diet http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm and reducing sodium, lowers blood pressure. If you do not have high blood pressure, following the DASH diet and reducing your sodium intake may help prevent the development of high blood pressure.

How does the DASH Diet work?

The DASH diet is similar to the Heart Healthy and TLC diets. Like these diets, the DASH diet recommends no more that 2,400 mg of sodium a day. But, the DASH diet also recommends a lower level of 1,500 mg sodium a day. Talk with your health care provider before making any type of change in your diet. And, if you choose the DASH diet, ask your provider what amount of sodium (2,400 or 1,500 mg) you should not exceed on a daily basis. You can ask your provider for a referral to a registered dietician (RD), who can help you choose foods and plan menus, monitor your progress, and encourage you to stay on the diet. You might also want to enlist the help of a family member or friend, to give you support and help you stay on track. Finding a "buddy" to go on one of these diets with you can also provide support. Try to stay focused on your ultimate goal - to prevent heart disease and protect your health - and have some fun learning new recipes and different ways to cook!

The DASH diet is made up of foods that are low in saturated fat, cholesterol, and total fat, such as fruits, vegetables, and low fat dairy products. It also includes whole grain products, fish, poultry and nuts, and reduced amounts of red meat, sweets, and sugar-containing beverages. It is rich in magnesium, potassium, and calcium, as well as protein and fiber. Eating foods rich in potassium is especially important, since potassium seems to prevent high blood pressure. Try to have more than 3,500 mg of potassium per day. There are different amounts, or servings, of specific food groups for different daily calorie levels, described in the charts that follow.

*Ask your health care provider or RD what is a reasonable daily calorie level for you.

Ask your health care provider or RD what is a
reasonable daily calorie level for you.

Know that the DASH diet has more daily servings of fruits, vegetables, and whole grain foods that you may be used to eating. This increases the fiber in your diet, which can cause bloating and diarrhea in some persons. To avoid these problems, gradually increase your intake of fruit, vegetables, and whole grain foods. Also know that only a small amount of sodium occurs naturally in foods. Because most of the sodium we consume is in processed foods, be sure to carefully check the label of these types of foods before purchasing. While some processed foods do have low or reduced sodium levels, some are loaded with it!

Here are some other helpful tips to reduce sodium and salt in your diet:

• Aim for no more than 2,400 milligrams of sodium per day.

• Use reduced sodium or no-salt-added products.

• Buy fresh, frozen, or canned with no-salt-added vegetables.

• Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.

• Choose ready-to-eat breakfast cereals that are low in sodium.

• Limit cured foods (like bacon and ham), foods packed in brine (like pickles, olives and sauerkraut), and condiments (like MSG, mustard, horseradish, catsup and barbeque sauce). Limit even lower sodium versions of soy and teriyaki sauce.

• Be spicy instead of salty! Flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends. Start by cutting salt in half.

• Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which often contain added salt.

• Choose convenience foods that are lower in sodium. Cut back on frozen dinners, pizza, packaged mixes, canned soups or broths, and salad dressings - these often have a lot of sodium.

• Rinse canned foods like tuna to remove some sodium.

What else can I do, besides diet, to keep my heart healthy?

Regular physical activity can help you reduce your risk of heart disease. Being active helps you take off extra pounds, helps to control blood pressure, and boosts your level of "good" cholesterol. Some studies show that being inactive increases the risk of a heart attack. To reduce your risk for heart disease:

• Quit smoking - talk with your health care provider if you need help quitting.

• Exercise at least 30 minutes a day on most (if not all) days of the week.

• Lose weight if you are overweight and keep at a healthy weight.

• Check blood pressure, cholesterol, and blood sugar levels and keep them under control.

For more information…

You can find out more about the diets described in this FAQ and about heart disease by contacting the National Women's Health Information Center (800) 994-WOMAN (9662) or the following organizations:

National Heart, Lung, and Blood Institute
Phone Number (s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov/index.htm

National Cholesterol Education Program
National Heart, Lung, and Blood Institute
Internet Address: http://www.nhlbi.nih.gov/chd/

The Heart Truth
National Awareness Campaign for Women about Heart Disease
National Heart, Lung, and Blood Institute
Phone Number(s): (800) 793-2665
Internet Address: http://www.nhlbi.nih.gov/health/hearttruth/index.htm

National High Blood Pressure Education Program
National Heart, Lung, and Blood Institute
Internet Address: http://www.nhlbi.nih.gov/about/nhbpep/ 

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December 2002