"Eating Smart for Your Heart"
By Lisa Drayer, MA, RD
February is American Heart Month--and with
coronary heart disease still ranking as the #1
killer among Americans, it's time that we stop
and take a look at how we can prevent this
deadly disease. Although having a family
history of heart disease does increase our
risk, it's important to banish the blame and
take a look at the other risk factors that are
in our control:
1. Eat Smaller Meals
A recent study from the American Heart
Association found that eating large meals
raises your risk of heart attack by about
four times, up to two hours after the meal!
Portion control is key, because eating too
much in one sitting puts extra stress on the
heart, especially because the blood flow is
directed away from the heart and towards
the stomach for digestion, and so the heart
has to work that much harder to maintain a
constant flow of blood to the rest of the body.
In addition to decreasing stress on the heart,
controlling portion sizes will help you keep
your weight in check, which is another
important factor for decreasing risk of
Research has also suggested that eating
smaller meals, more frequently throughout
the day, can positively affect cholesterol
levels, thereby reducing heart disease risk.
A recent study published in The British
Medical Journal found that people who
ate 6 or more small meals had lower
cholesterol levels than people who ate one
or two large meals each day. This supports
earlier research published in The New
England Journal of Medicine, which found
that “nibbling” (i.e. consuming 17 snacks
per day) showed metabolic advantages
as compared to “gorging” (consuming only
3 meals/day), including lowered total and
LDL (‘bad’) cholesterol levels. Both “nibbling”
and “gorging” diets were equal in total calories.
Portion control is simple. Keep your fish and
chicken to 3 ounces-which is about the size of
the palm of your hand, or a deck of cards, and
your pasta and rice to one cup-or about the
size of your fist. Also, invest in some measuring
spoons and cups-this will enable you to get
familiar with the portion sizes of different foods,
and you will eventually be able to eyeball
servings. And remember--avoid seconds,
unless they’re vegetables!
2. Include More Fruits, Vegetables, and
Low-fat Dairy Foods, and Limit the Sodium
in Your Diet
A recent study published in The New England
Journal of Medicine known as DASH-Sodium
Dietary Approaches to Stop Hypertension)
showed that following a heart-healthy diet with
limited amounts of sodium can greatly reduce
blood pressure, a risk factor for heart disease.
The study followed two groups. One was asked
to consume a DASH diet-a diet incorporating
lots of fruits, vegetables, and low-fat dairy
foods, and limiting red meat, sweets,
and saturated fats. In previous research,
this diet was shown to lower blood pressure
levels substantially. Another was given a
“typical”merican diet. Different sodium levels,
including 3,300, 2,400, and 1,500 mg were
given to the individuals every four weeks.
The study found that the individuals
following the DASH diet and limiting
sodium to 1500 mg/day experienced
the greatest reduction in blood pressure-in
fact, as compared to the “typical” diet with
3,300 mg of sodium, the DASH diet with
1500mg of sodium led to a decrease of
11.5 points (systolic) among individuals with
high blood pressure, and a 7.1 point decrease
among individuals without high blood pressure.
For both diets, however, the greater the
reduction in sodium, the lower the blood
While it’s a fact that not everyone is sodium
sensitive-that is, they experience an increase
in blood pressure with high sodium intakes
and a decrease in blood pressure with low
sodium intakes-it still won’t hurt to cut back
on salt. Keep in mind that most of the sodium
in our diet comes from processed food-such
as canned soups and sauces, cured meats,
and fast foods.
3. Avoid Foods High in Saturated Fats and
Trans Fats, and Consume More
Monounsaturated Fats and Omega-3
Saturated fats in the diet increase cholesterol
levels even moreso than dietary cholesterol!
Specifically, saturated fats increase LDL, or
the "bad" cholesterol, and decrease HDL
levels, also known as the "good" cholesterol.
Sources of saturated fats include: butter,
lard, cream, full-fat dairy products, red meat,
palm oil, and coconut oil. It’s best to limit
these foods much as possible.
By increasing LDL cholesterol to the same
extent as saturated fats, trans fats (formed
when vegetable oils undergo a process
known as “hydrogenation”) also increase
risk of heart disease. Trans fats are found
in margarine, French fries, and commercially
prepared foods such as cookies and cakes.
Right now, trans fats are not required to be
written on food labels. (That will hopefully
change soon). So in the meantime, look for
the words "partially hydrogenated vegetable
oil" on food labels-if this listed as one of the
first ingredients on a food label, and if the
food is high in total fat, then you can count
on the food being high in trans fats.
On the other hand, monounsaturated fats
lower LDL levels and keep HDL levels the
same (in fact, some studies show that they
increase HDL levels), and sources of these
fats include almonds, walnuts, peanuts,
avocados, peanut butter, olive oil and canola
oil. Omega-3 fatty acids, which are a type of
polyunsaturated fat, also have a protective
effect on the heart by preventing blood
clotting. Sources of omega-3’s include fatty
fish, such as salmon and mackerel, as well
as vegetable oils and flax seeds.
(Note: Although shrimp is high in cholesterol,
it's low in saturated fat, and is free of trans
fats. Thus, it can be enjoyed even among
those with high risk of heart disease!)
4. Experiment with Soy Protein
Studies have shown that soy protein, which
is found in tofu, tempeh, and soy-based
meat alternatives, can reduce LDL
cholesterol levels. Specifically, research
has shown that 25 grams of soy protein per
day can lower high “LDL” or “bad” cholesterol
levels by about 10%. This research is the
basis of a current food claim approved by
the Food and Drug Administration--the
claim states that diets low in saturated fat
and cholesterol that include 25 grams of
soy protein each day may reduce the risk
of heart disease. (According to the FDA,
foods must contain at least 6.25 grams of
soy protein per serving to qualify for the
Researchers believe that the isoflavones
in soy (which are estrogen-like compounds)
play a role in soy’s cholesterol-lowering
effects. Since the isoflavones in soy may
indeed act like estrogen, however, they
have the potential to promote the growth
of breast tumors. The research isn’t clear,
so if you have breast cancer or are at high
risk for the disease, then it’s best to avoid
large quantities of soy.
A good way to get soy protein with its
isoflavones is to try some of the soy products
in the supermarkets-such as the vegetarian
burgers and hot dogs, or a soymilk such as
Silk. You can also try a protein powder,
which can be stirred into various beverages.
Although soy bars are also a good source
of soy protein, many contain excess calories.
Still sound unappetizing? Head over to the
local bookstore, pick up a soy cookbook,
and try some recipes!
5. Enjoy Chocolate in Moderation
Yes, Valentine's Day is around the corner,
and if you can't get excited about a loved
one, get excited about chocolate. Why?
Because in addition to the fact that it tastes
great, research has shown that chocolate
offers us health benefits. Chocolate
contains antioxidants known as catechins,
and these substances may help to reduce
the risk of heart disease by decreasing the
harmful effects of LDL, or “bad” cholesterol.
Preliminary research (funded by Mars, Inc.)
suggested that the antioxidants in chocolate
do help to inhibit the oxidation of LDL
particles, thereby reducing the risk of heart
attack and stroke.
Another recent study found that the catechin
content of chocolate is four times greater than
tea! According to the study, Dark chocolate
had the highest total catechin content (53.5 mg
per 100 g), milk chocolate contained 15.9 mg
per 100 g, and black tea contained only 13.9
mg per 100 mL. In addition, a new study from
Pennsylvania State University further supported
the fact that flavonoid-rich chocolate, in
moderation, is beneficial for cardiovascular
Research also suggests that unlike other
saturated fats, the stearic acid in chocolate
(a saturated fat) may not increase LDL
But don't forget, when it comes to the bottom
line, fruits and vegetables are more nutritious
sources of antioxidants, and chocolate offers
us lots of calories...so be careful if you're
watching your waistline!
And an Extra Note: Be sure to exercise!
Research shows that cardiovascular exercise
increases HDL cholesterol levels, which lowers
the ratio of Total cholesterol/HDL, of which high
levels is an indicator of heart disease risk.
Aerobic exercise also helps us burn extra
calories and can increase our metabolism
for up to 8 hours after we stop exercising.
Check out DietWatch’s candy counter
to see how much exercise you’ll need to do to
burn off the calories in your favorite
Lisa Drayer is the eCounseling Program
Director for DietWatch.com, Inc. A member of
the American Dietetic Association, Ms. Drayer
has appeared frequently on television and radio
as an expert in nutrition. She also moderates
chat discussions and answers questions on diet,
nutrition, and weight management for
DietWatch.com and Cyberdiet.com.
We look forward to the opportunity of
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