heart disease and diet

Alternative Names
diet for coronary heart disease, known as CHD, diet for coronary artery disease, known as CAD, diet for cardiovascular disease, known as CVD

Definition Heart disease is a broad term for any condition that affects the heart and blood vessels. This includes:

Certain major risk factors have been shown to increase a person's chances of developing heart disease. Experts also believe other factors may also add to one's risk. These are called contributing factors. Some of these risk and contributing factors can be treated, or even prevented.

Major risk factors include:

family history of heart disease
early heart attack or sudden death of father or brother before the age of 55
early heart attack or sudden death of mother or sister before the age of 65
increasing age
45 years or older for men
55 years or older for women
being male

Other risk factors include:

smoking
high blood pressure
high blood cholesterol
being physically inactive
being overweight or obese
diabetes

Contributing factors include:

choosing unhealthy habits to handle stress, for example, driving too fast, drinking alcohol, or getting angry
using birth control pills when you are a smoker or have high blood pressure
drinking too much alcohol
having a change in sex hormone levels, as a result of natural or surgical menopause

What is the information for this topic?

The American Heart Association, called AHA, provides dietary guidelines for healthy eating which can reduce three risk factors for heart disease:

high blood cholesterol
high blood pressure
excess body weight

Apply the following guidelines to the overall eating pattern.

Achieve an overall healthy eating pattern.

Choose a balanced diet with foods from all major food groups, with an emphasis on fruits, vegetables and grains.
Eat 5 or more servings per day of fruits and vegetables.
Eat 6 or more servings per day of grain products, including whole grains.
Include fat-free and low-fat milk products, beans, skinless poultry, and lean meats.
Eat at least 2 servings of fish per week, especially fatty fish.

Achieve and maintain a healthy body weight.

Avoid excess intake of calories.
Maintain a level of physical activity that achieves fitness and balances energy output with calorie intake. For weight reduction, one must burn more calories through exercise than one takes in.
Limit foods that are high in calories and/or low in nutritional quality, including those with a high amount of added sugar.

Achieve a healthy cholesterol level.

Limit foods with a high content of saturated fat and cholesterol. Instead, substitute grains and unsaturated fat that comes from vegetables, fish, legumes, and nuts.
Limit cholesterol to 300 milligrams (mg) a day for those without heart disease or any heart disease risk factors. For those with heart disease or its risk factors, limit cholesterol to 200 mg a day.
Limit or eliminate trans-fats. Trans-fats are found in foods that have partially hydrogenated vegetable oils, such as packaged cookies, crackers and other baked goods, commercially prepared fried foods, and some margarines.

Achieve a healthy blood pressure level.

Limit salt intake to less than 6 grams or 2,400 mg of sodium per day. This equates to slightly more than 1 teaspoon of salt a day.
If a person drinks alcohol, daily intake should be held to no more than 1 drink per day for women and 2 drinks per day for men.

In summary, the AHA recommends that:

Total fat intake per day is no more than 30 percent of total calories.
Saturated fat intake is less than 10 percent of total calories.
Cholesterol intake is less than 300 mg per day.

Although the AHA guidelines were developed to help healthy people prevent heart disease, they can also benefit those with other medical conditions. This includes:

diabetes
kidney disease
preexisting heart disease
elevated LDL, the so-called "lethal" or "bad" cholesterol
congestive heart failure
obesity

For people who already have heart disease, AHA recommends following the National Heart, Lung, and Blood Institute's Therapeutic Lifestyle Changes, called TLC, diet. This diet is outlined in detail at www.nhlbi.nih.gov/chd/lifestyles.htm. Here is a summary:

Make sure less than 25-35 percent of each day's total calories come from fat.
No more than 7 percent of total calories per day should come from saturated fat.
Eat foods with less than 200 mg of cholesterol per day.
Limit salt intake to 2400 mg per day.
Eat just enough calories to achieve or maintain weight within a healthy range.

Anyone thinking about trying the TLC diet should talk with the doctor first to learn what is a reasonable daily calorie level for him or her. A registered dietician can also be helpful in making eating habit changes and in learning how to choose foods and plan menus.

When the TLC diet does not lower blood cholesterol levels enough, the doctor may suggest adding more fiber to the diet. There are also cholesterol- lowering foods available. These are foods such as margarines and salad dressings that contain plant sterol esters or plant stanol esters. Some people may also need to take cholesterol-lowering medicine.

Author:Kimberly Tessmer, RD, LD
Date Written:11/09/00
Medical Review:Daniel VanHamersveld, MD
Date Written:9/21/2006
Reviewer:Walt Larimore, MD
Date Reviewed:10/7/2006
Contributors
Potential conflict of interest information for reviewers available on request