General Guidelines

The goals of a heart-healthy diet are to eats foods that help obtain or maintain healthy cholesterol and lipid levels -- to reduce overall levels and low-density lipoproteins (LDL) and to increase high-density lipoproteins (HDL). Reducing other lipids, such as triglycerides and lp(a) lipoproteins are also important. Any diet should also help keep blood pressure under control.

Fats and Oils

General Recommendations for Fat Intake.

 About two-thirds of cholesterol in the body does not come from cholesterol in food but is manufactured by the liver, its production stimulated by saturated fat. The dietary key to managing cholesterol, then, lies in understanding fats and oils. When it comes to studying the effects of fat on the body, however, the problem is compounded by its complex nature. All fats found in foods are made up of a mixture of three chemical building blocks: monounsaturated, polyunsaturated, and saturated fatty acids. Oils and fats are nearly always mixtures of all three fatty acids, but one type usually predominates. So, for example, although coconut oil is mostly saturated, it also contains small amounts of monounsaturated and polyunsaturated fatty acids. In addition, there are three chemical subgroups of polyunsaturated fatty acids: omega-3, omega-6, and omega-9 fatty acids. These subgroups are currently being heavily researched for their specific effects on health. In addition there are trans-fatty acids, which are products of food processing rather than naturally occurring fats.

Harmful Fats.

 Reducing consumption of saturated fats and trans-fatty acids is the first essential step in managing cholesterol levels through diet. Saturated fats are found predominantly in animal products, including meat and dairy products.

Trans-fatty acids are also dangerous for the heart, and in addition, they may pose a risk for certain cancers.

Beneficial Fats and Oils.

 It should be noted that some fat is essential for health and fat is essential for healthy development in children. Public attention has mainly focused on the possible benefits or hazards of monounsaturated and polyunsaturated fats. Polyunsaturated fats are found in safflower, sunflower, corn, cottonseed oils, and fish, while monounsaturated fats are mostly present in olive, canola, and peanut oils and in most nuts.

Three important fatty acids are omega-3, omega-6, and omega-9. Food oils often contain a combination of these building blocks, which may account for the mixed results observed in people consuming them.

• Omega-3 fatty acids: further categorized as alpha-linolenic acid (sources include canola oil, soybeans, flaxseed, olive oil, many nuts and seeds) and docosahexaenoic and eicosapentaneoic acids (sources are oily fish and breast milk). Studies have indicated that vegetable oils containing alpha-linolenic acids reduce triglycerides and are heart protective, although fish oils, which contain docosahexaenoic and eicosapentaenoic acids, do not have much effect. Fish itself, however, has other substances that appears to have many benefits (see also, Fish under Protein, below).
• Omega-6 fatty acids: further categorized as linoleic, or linolic, acid (sources are flaxseed, corn, soybean, and canola oil.) Many hydrogenated fats are made from oils rich in omega-6 fatty acids.
• Omega-9 fatty acids: (Source is olive oil).

Studies indicate that, in a healthy balance, all of these fatty acids are essential to life. Studies have found greater protection against heart disease from omega-6-oils than omega-3, but omega-6 is also associated with increased production of compounds called eicosanoids, which enhance tumor growth in animals. Both omega-3 and omega-9 fatty acids contain chemicals that block these eicosanoids.

Complex Carbohydrates and Fiber

Foods that are high in complex carbohydrates and fiber are as important as reducing harmful fats in maintaining a healthy diet.

Fresh Fruits and Vegetables. Regular consumption of fresh fruit and raw vegetables reduces deaths from stroke and coronary artery disease, may lower blood pressure, and may be protective against certain cancers.

Whole Grains, Nuts, and Fiber

. Dietary fiber is an important component in achieving a healthy cholesterol balance. One study indicated that people on a reduced-fat diet consuming 25 grams of fiber a day lowered their cholesterol by 13% compared to 9% in another group that consumed less fiber. In another study, more heart attacks and other heart diseases occurred in men who ate the least amount of fiber compared to those who ate the most. Fiber also helps weight reduction and may fights cancer.

Protein

Fish. A number of studies have reported that eating fish or shellfish at least once a week reduces the risk of sudden death from dangerous heart-rhythm abnormalities by more than one half. Oily fish, such as salmon, halibut, swordfish, and tuna, appear to be particularly beneficial.

Soy. Soy is an excellent food. It is rich in both soluble and insoluble fiber, omega-3 fatty acids, and provides all essential proteins. Soybeans also contain natural estrogens called phytoestrogens, which may have effects on lipid levels and also serve as antioxidants.

Meat. The fat content of meat varies depending on the type and cut. It is best to eat skinless chicken or turkey; the leanest cuts of pork (loin and tenderloin), however, are comparable to chicken in calories, fat, and cholesterol levels. It is best to avoid beef, which is not a necessary food. If it is impossible to refrain entirely from eating red meat, remember that the select grade has the least fat, and prime grade the most.

Sodium

Some sodium is essential to protect the heart, but most experts agree that most Americans consume far more than is necessary. Diets high in salt accelerate the increases in blood pressure that occur as people age. Simply eliminating table and cooking salt can be somewhat beneficial, and salt substitutes, such as Cardia, containing mixtures of potassium, sodium, and magnesium are now available. Cardia is costly, however, and because most (about 75%) of the salt in people's diets comes from processed or commercial foods, the benefits of table-salt substitutes are likely to be very modest.

Sugar

Sugar adds calories and increases blood glucose levels quickly. It provides no other nutrients. One study found that sugar was a risk factor for heart disease, possibly because sugar fuels obesity, which boosts very low density lipoproteins and triglycerides that are dangerous for the heart. Artificial sweeteners include saccharin, aspartame (Nutra-Sweet), and acesulfame K (Sweet One). Sucralose (Splenda), a new sweetener, may also prove to be a good alternative to sugar.