Nutrition

Over the past several decades it has become clear that what we eat has a large impact on our overall health. Nutrition plays a major role in the development and progression of heart disease, which is the leading cause of death in the United States.

For better heart health, we recommend the following simple guidelines:

  1. Choose low-fat and reduced fat products.
  2. Use lean meats.
  3. Use skim milk and low-fat cheese products.
  4. Enjoy low-fat breads, cereals and pastas.
  5. Read and understand labels.
  6. Incorporate vegetarian meals into your diet several times per week by substituting grains and legumes for meat.
  7. Total fat should not be more than 30 percent of daily calories; saturated fat should be less than 10 percent of calories, and monounsaturated fat should be 15-20 percent of calories.
  8. Carbohydrates should make up 50-60 percent of your diet, with an emphasis on complex carbohydrates such as leafy vegetables, whole grains and fruits like strawberries, apples and pears.
  9. Adjust your calorie intake to maintain a desirable body weight.
  10. Sodium intake should be restricted to 3,000 milligrams per day or less.
  11. Drink at least six 8-ounce glasses of water per day, unless a doctor recommends you restrict fluid intake.
  12. Many recipes can be modified to become heart-healthy by altering the amount and type of fat, sugar and salt used. Choosing to bake, broil, roast or grill instead of frying foods also can make a big difference.

Follow these guidelines for low-cholesterol, low-triglyceride diets:

Foods to use

Meats, fish

Choose lean meats (chicken, turkey, veal, and non-fatty cuts of beef with excess fat trimmed) and remember that one serving equals 3 ounces of cooked meat. Also, use fresh or frozen fish, canned fish packed in water and shellfish, such as lobster, crab, shrimp and oysters. Limit consumption of shellfish to no more than one serving per week. Shellfish are high in cholesterol, but low in saturated fat and should be used sparingly. Meats and fish should be broiled in a pan or oven or baked on a rack.

Eggs

Egg substitutes and egg whites can be used freely. Limit egg yolks to two per week.

Fruits

Eat three servings of fresh fruit per day (1 serving = ½ cup). Be sure to have at least one citrus fruit daily; options include oranges, grapefruit, tangerines and lemons. Frozen or canned fruit with no sugar or syrup added can be a substitute for fresh fruit.

Vegetables

Eat lots of vegetables. Try to include one dark-green (string beans, escarole) or one deep-yellow (squash) vegetable in your daily diet. Cauliflower, broccoli and celery, as well as potato skins, are all good sources of fiber, which is associated with cholesterol reduction. If you don’t eat vegetables raw, it’s preferable to steam them. They can also be boiled, strained, or braised with polyunsaturated vegetable oil (see below).

Beans

Dried peas or beans (1 serving = ½ cup) may be used as a bread substitute.

Nuts

Almonds, walnuts and peanuts may be used sparingly (1 serving = 1 tablespoonful). Healthier options include pumpkin, sesame, or sunflower seeds.

Breads, grains

One roll or one slice of whole-grain or enriched bread may be used, or eat three soda crackers or four pieces of melba toast as a substitute. One half-cup of spaghetti, rice or noodles or half a large ear of corn may be used as a bread substitute. In preparing these foods, use soft margarine instead of butter or shortening. Also, use egg and sugar substitutes. Choose high-fiber grains, such as oats and whole wheat.

Cereals

Use ½ cup of hot cereal or ¾ cup of cold cereal per day. Add a sugar substitute if desired, with 99 percent fat-free or skim milk.

Milk products

Always use 99 percent fat-free or skim milk, dairy products such as low-fat cheeses (farmer’s, uncreamed diet cottage cheese), low-fat yogurt, and powdered skim milk.

Fats, oils

Use soft (not stick) margarine; vegetable oils that are high in polyunsaturated fats (such as safflower, sunflower, soybean, corn, and cottonseed). Always refrigerate meat drippings to harden the fat and remove it before preparing gravies.

Desserts, snacks

Limit to two servings per day and substitute each serving for a bread/cereal serving. Options include ice milk, water sherbet (1/4 cup); unflavored gelatin or gelatin flavored with sugar substitute (1/3 cup); pudding prepared with skim milk (1/2 cup); egg white soufflés; unbuttered popcorn (1 ½ cups). Substitute carob for chocolate.

Beverages

Limit fruit juice consumption to 4 ounces per day; black coffee, plain or herbal teas; soft drinks with sugar substitutes; club soda, preferably salt-free; cocoa made with skim milk or nonfat dried milk and water (sugar substitute can be added if desired); clear broth. Limit alcohol consumption to two servings per day.

Miscellaneous

You may use the following freely: vinegar, spices, herbs, nonfat bouillon, mustard, Worcestershire sauce, soy sauce, flavoring essence.

Foods to avoid

Meats, fish

Marbled beef, pork, bacon, sausage and other pork products; fatty fowl (duck, goose); skin and fat of turkey and chicken; processed meats; luncheon meats (salami, bologna); frankfurters and fast-food hamburgers (they’re loaded with fat); organ meats (kidneys, liver); canned fish packed in oil.

Eggs

Limit egg yolks to two per week.

Fruits

Coconuts (they are rich in saturated fats).

Vegetables

Avoid avocados. Starchy vegetables (potatoes, corn, lima beans, dried peas, beans) may be used only if substitutes for a serving of bread or cereal. Baked potato skin, however, is desirable for its fiber content.

Beans

Commercial baked beans with sugar and/or pork added.

Nuts

Avoid nuts. Limit peanuts and walnuts to one tablespoonful per day.

Breads, grains

Any baked goods with shortening and/or sugar. Commercial mixes with dried eggs and whole milk. Avoid sweet rolls, doughnuts, breakfast pastries and sweetened packaged cereals (the added sugar converts readily to triglycerides).

Milk products

Whole milk and whole milk packaged goods; cream; ice cream; whole-milk puddings, yogurt or cheeses; nondairy cream substitutes.

Fats, oils

Butter, lard, animal fats, bacon drippings, gravies, cream sauces, as well as palm and coconut oils. All these are high in saturated fats. Examine labels on “cholesterol-free” products for “hydrogenated fats.” These are oils that have been hardened into solids and in the process have become saturated.

Desserts / snacks

Fried snack foods like potato chips; chocolate; candies in general; jams, jellies, syrups; whole-milk puddings; ice cream and milk sherbets; hydrogenated peanut butter.

Beverages

Sugared fruit juices and soft drinks; cocoa made with whole milk and/or sugar. When using alcohol, keep in mind that one serving equals 1 ounce liquor, 5 ounces beer, or 2 ½ ounces dry table wine per serving. One serving of alcohol must be substituted for one bread or cereal serving and should be limited to two servings per day.

Special notes

  • Remember that even heart-healthy foods should be used in moderation.
  • While on a cholesterol-lowering diet, be sure to avoid animal fats and marbled meats.
  • While on a triglyceride-lowering diet, be sure to avoid sweets and to control the amount of carbohydrates you eat.
  • Buy a good low-fat cookbook, such as the one published by the American Heart Association.

Consult your physician if you have any questions.