Heart Check

The American Heart Association has recently published new dietary guidelines that will replace their Step 1 and Step 2 diets. The new guidelines are designed to help individuals achieve four goals, with two or three specific recommendations listed under each one. Use these as a checklist to make sure you are on track:1) A Healthy Eating Pattern• Consume a variety of fruits and vegetables and grain products, including whole grains.• Include fat-free and lowfat dairy products, fish, legumes, poultry, and lean meats. Note: it is important to use fat-free dairy products to limit saturated fat consumption. Legumes and fish are definitely more beneficial to your heart than poultry or lean meat.2) A Healthy Body Weight• Prevention of weight gain is important due to its association with increased heart disease.• If you want to lose weight, the AHA recommends a calorie reduction of 500-1000 calories per day and limiting fat to < 30%. They also suggest avoidance of a regular intake of high-sugar, nutrient-poor foods.• Physical activity is recommended as an integral weight-management strategy, with a suggested goal of 30-60 minutes on most days of the week.3) A Desirable Blood Cholesterol and Lipoprotein Profile• Restriction of saturated fat to < 10% of calories for the general population and < 7% for those with elevated LDL cholesterol is the most imporant strategy. Trans fatty acids should be considered a saturated fat and restricted.• The specific amount of total fat should be individualized according to other risk factors present.• The benefits of omega 3 fatty acids are mentioned, including reduction in arrhythmias, lowering of triglycerides, and reduction in blood clotting. At least 2 servings of fish per week are recommended, or plant sources of omega 3s such as flax, canola and soybean oils.• Dietary cholesterol intake should be < 300 mg for the general population and < 200 mg for those with elevated LDL or CVD.• Weight loss and increased physical activity are suggested for those with low HD (“good cholesterol”).• Weight loss, increased physical activity, and limiting sugar and refined carbohydrates are suggested as dietary strategies for reducing triglycerides. Omega 3 fatty acids may also be beneficial.4) A Desirable Blood Pressure• The AHA guidelines support the DASH diet and emphasize fruits, vegetables and low-fat dairy products to achieve normal blood pressure.• Moderate alcohol consumption for those who choose to drink (maximum 1 drink for women, 2 for men), weight loss, and reducing sodium intake to less than 2400 mg or 6 grams of salt is suggested to prevent and control high blood pressure. Note: salt restriction is the most important.• These lifestyle modifications should be used as initial therapy in early hypertension and as an adjunct to decrease the medication in others.Just the FAQs:QUESTION: How much fat am I?allowed?ANSWER: Refined fats and oils are high in calorie density and low in nutrients. Use them sparingly if you are trying to lose or maintain weight. Saturated fat should be limited to 10% or less of your calories if your LDL levels are normal, and if they are high then 7%?or less of your calories. Some fats are beneficial to your heart. These are called omega 3 fatty acids, and are found in cold-water fatty fish, including salmon, trout, herring, sardines and mackerel. They are also found in soyfoods, nuts, flax and canola oil.QUESTION: I want to lower my triglycerides; should I avoid carbohydrates?ANSWER: You should avoid sugar and refined carbohydrates such as baked goods, crackers and other items made with refined white flour if you want to lower your triglycerides. Replace these with plenty of whole grains, potatoes, yams, legumes, vegetables and fruits, since these items are high in fiber and low in caloric density, which helps with weight loss. Exercise is also important for lowering triglycerides.By Nancy Kennedy, MS, RD.