Heart-healthy diet

Introduction

The goals of a heart-healthy diet are to eat foods that help obtain or maintain healthy levels of cholesterol and fatty molecules called lipids. You can achieve this by:

• Reducing overall cholesterol levels and low-density lipoproteins (LDL), which are harmful to the heart
• Increasing high-density lipoproteins (HDL), which are beneficial for the heart
• Reducing other harmful lipids (fatty molecules), such as triglycerides and lipoprotein(a)

Any diet should also help keep blood pressure and weight under control.

General Recommendations

The American Heart Association’s (AHA) current dietary and lifestyle guidelines recommend:

• Balance calorie intake and physical activity to achieve or maintain a healthy body weight. (Controlling weight, quitting smoking, and exercising regularly are essential companions of any diet program. Try to get at least 30 minutes, and preferably 60 - 90 minutes, of daily exercise.)
• Eat a diet rich in a variety of vegetables and fruits. Vegetables and fruits that are deeply colored (such as spinach, carrots, peaches, and berries) are especially recommended as they have the highest micronutrient content.
• Choose whole-grain, high-fiber foods. These include fruits, vegetables, and legumes (beans). Good whole grain choices include whole wheat, oats/oatmeal, rye, barley, brown rice, buckwheat, bulgur, millet, and quinoa.
• Eat fish, especially oily fish, at least twice a week (about 8 ounces/week). Oily fish such as salmon, mackerel, and sardines are rich in the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Consumption of these fatty acids is linked to reduced risk of sudden death and death from coronary artery disease.
• Get at least 5 - 10% of daily calories from omega-6 fatty acids, which are found in vegetable oils such as sunflower, safflower, corn, and soybean as well as nuts and seeds.
• Limit daily intake of saturated fat (found mostly in animal products) to less than 7% of total calories, trans fat (found in hydrogenated fats, commercially baked products, and many fast foods) to less than 1% of total calories, and cholesterol (found in eggs, dairy products, meat, poultry, fish, shellfish) to less than 300 mg per day. Choose lean meats and vegetable alternatives (such as soy). Select fat-free and low-fat dairy products. Grill, bake, or broil fish, meat, and skinless poultry.
• Use little or no salt in your foods. Reduce or avoid processed foods that are high in sodium (salt). Reducing salt can lower blood pressure and decrease the risk of heart disease and heart failure.
• Cut down on beverages and foods that contain added sugars (corn syrups, sucrose, glucose, fructose, maltrose, dextrose, concentrated fruit juice, honey).
• If you consume alcohol, do so in moderation. The AHA recommends limiting alcohol to no more than 2 drinks per day for men and 1 drink per day for women.
• People with existing heart disease should consider taking omega-3 fatty acid supplements (850 - 1,000 mg/day of EPA and DHA). For people with high triglyceride levels, higher doses (2 - 4 g/day) may be appropriate. The AHA recommends against taking antioxidant vitamin supplements (C, E, beta-carotene) or folic acid supplements for prevention of heart disease.

Women

Women who are pregnant or breastfeeding should avoid eating fish that is high in mercury content (shark, swordfish, mackerel, and tile fish). Choose fish and shellfish that are lower in mercury content and eat about 12 ounces/week. (The AHA recommends a higher weekly fish amount for women than for men. However, women of childbearing age should limit tuna to 6 ounces a week to reduce the risks for mercury contamination.)

Children

Atherosclerosis, the build-up of plaque in the arteries, begins in childhood. It is important for children and adolescents to adopt a heart-healthy diet to help prevent the development of heart disease later in life. Children should eat foods that are low in saturated fat, trans fat, and cholesterol. These foods include:

• Fruits and vegetables
• Whole grains
• Low-fat and nonfat dairy products
• Beans, fish, and lean meats

[For more information, see In-Depth Report #23: Cholesterol; Report #3: Coronary artery disease and angina; Report #14: High blood pressure; and Report #53: Weight control and diet.]

Highlights
Introduction
Nutrition Basics
Diet Plans
Lifestyle Changes
Resources
References

Review Date: 5/5/2009
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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