FN-301.

Clinical and Therapeutic Nutrition Topic-7

Heart Disease
❑ Heart
The heart is a muscular
organ in humans and others
animal, which pumps blood
through the blood vessels of
the circulatory system. Blood
provides the body with
oxygen, nutrients and
assists in the removal of
metabolic waste.

Location.
The heart is situated a little to the left, in the middle of the mediastinum, behind the
breastbone in the chest at the level of thoracic vertebrate T5 to T8. Diaphragm is
situated under the heart.
Description.
• Size. The heart in an adult measure about 12 centimeters.
In length 8 to 9 cm. In breath at the broadest part and 6cm in thickness.
• It's weight.
In the male varies from 280 to 340 grams.
In the female from 232 to 280 grams.
The heart continued to increase in weight and size up to an advanced period of life;
this increase is more marked in men than in women.
Walls of the heart.

The heart wall is made up of three

layers.
→ The inner endocardium.
→ Middle Myocardium.
→ And Outer Epicardium.
These are surrounded by a double
membrane SAC called the pericardium.

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FN-301.Clinical and Therapeutic Nutrition Topic-7

Cavities of heart.
The heart has four chambers,
2 upper atriums, the receiving
chamber and the two lower
ventricles.
1. Left atrium.
2. Right atrium.
3. Left ventricle.
4. Right ventricle.

Valves of the heart.

The four main valves in the heart

are.

The two atrioventricular valves

(AV), the mitral valves (bicuspids)
and the tricuspid valve which are
between the upper chambers,
(Atria) and the lower chambers
(Ventricles)

The two semilunar valves, the

aortic valve and the pulmonary
valve, are in the arteries leaving the
heart.

Types of blood vessels.

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Blood moves through many tubes called arteries and veins, which together are
called blood vessels.

→ Arteries carry blood away from the heart. The aorta is the largest artery.
→ Veins carry blood back to the heart and contain valves. The vena cava is the
largest vein.
→ Capillaries, exchange of water, oxygen, carbon dioxide and many other
nutrients, waste and chemical substances between blood.

❑ What is heart disease?

→ Coronary heart disease, often simply called heart disease, is the main form of
heart disease.
→ It is a disorder of the blood vessels of the heart that can lead to heart attack.
→ A heart attack happens when an artery becomes blocked, preventing oxygen
and nutrients from getting to the heart.
→ Heart disease is one of several cardiovascular diseases which are diseases of
the heart and blood vessels system.
→ Other cardiovascular diseases include stroke, high blood pressure, angina
(chest pain) and rheumatic heart disease.
What causes heart disease?
→ Smoking, including secondhand smoke.
→ High amounts of certain fats and
cholesterol in the blood.
→ High blood pressure.
→ High amounts of sugar in the blood due
to insulin resistance or diabetes
→ blood vessel inflammation.
→ Lack of exercise.
→ Overweight.
→ Family history.
→ Increasing age.

Symptoms of heart disease.

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FN-301.Clinical and Therapeutic Nutrition Topic-7

• Chest pain. (angina)

• Shortness of breath.
• Pain, numbness, weakness, or coldness in your legs or arms if the blood
vessels in those parts of your body are narrowed.
• Pain in the neck, jaw, throat, upper abdomen, or back.
• Fluttering in your chest.
• Slow heartbeat. (Bradycardia.)
• Chest pain or discomfort.
• Lightheadedness.
• Dizziness.
What are the risk factors of heart disease?
Important risk factors for heart disease that you can do something about are.
• High blood pressure.
• High blood cholesterol.
• Diabetes and
prediabetes.
• Smoking.
• Being overweight or
obese.
• Being physically inactive.
• Having a family history of
early heart disease.
• Unhealthy diet.
• Age (50 or older for
women).

Risk factors for developing heart disease include.

• Age. Ageing increases your risk of damage and narrowed arteries and
weakened are thickened heart muscle.
• Sex. Men are generally at greater risk of heart disease. However, women's
risk increases after menopause.
• Family history. A family history of heart disease increases your risk of
coronary artery disease, especially if a patient developed it at an early age
(Before age 55 for a male relative, such as your brother or father, and 65 for a
female relative such as your mother or sister.)
• Smoking. Nicotine constricts your blood vessels and carbon monoxide can
damage their inner lining, making them more susceptible to atherosclerosis.
Heart attacks are more common in smokers than in non-smokers.
• Poor diet. A diet that's high in fat, salt, sugar and cholesterol can contribute to
the development of heart disease.

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Foods that help prevent heart disease.

Things to remember.
• Diet is an important risk
factor in coronary heart
disease.

• Food related risk factors

include obesity, high blood
pressure, uncontrolled
diabetes and a diet high in
saturated fats.

• A low-saturated fat, high

fiber, high plant food diet,
can substantially reduce the
risk of developing heart
disease.
❑ Hypertension.
Blood pressure.
When the heart beats, it pumps blood around the body to give it the energy and
oxygen it needs. As the blood moves, it pushes against the sides of the blood
vessels. The strength of this push is blood pressure. The pressure which is exerted
by the blood upon the walls of the blood vessels and especially arteries, and that
varies with the muscular efficiency of the heart, the blood volume and viscosity, the
age and health of the individual, and the state of the vascular wall is referred to as
blood pressure.

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Blood pressure is the pressure of your blood on the walls of your arteries as your
heart pumps it around your body. It is a vital part of how your heart and circulation
works.
Classifications mainly there are two types of blood pressure.
• Systolic pressure. Blood pressure when the heart beats while pumping
blood.
• Diastolic pressure. Blood pressure when the heart is at rest between beats.
Normal range of blood pressure. Ideally, we should all have a blood pressure below
120 / 80. This is the ideal blood pressure for people wishing to have good health. At
this level, we have a much lower risk of heart disease or stroke.
Classification of blood pressure.
Blood pressure may be classified as
follows.
• Low blood pressure.
• Normal or ideal blood pressure.
• Pre high blood pressure.
• High blood pressure.

What is hypertension?
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term
medical condition in which the blood pressure in the arteries persistently elevated.
A well accepted definition of hypertension was suggested by Evan and Rose:
“Hypertension should be defined in terms of blood pressure level above which
investigation and treatment do good more than harm.”
Normal blood pressure at rest is within the range of 100 to 120 mmHg systolic and
60-80 mmHg diastolic. High blood pressure is present if the resting blood pressure is
persistently at or above 140/90 for most adults.

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High blood pressure or hypertension means that your blood pressure is consistently
higher than the recommended level. A blood pressure of 140/90 or higher is
considered high blood pressure. Both numbers are important. If one or both numbers
are usually high, you have high blood pressure.
Diagnosis.
As there are no symptoms. High blood pressure, (sometimes headache, nausea,
vomiting, dizziness, double vision, etc). So, we have to diagnosis it clinically. The
clinical process can be measured using a manual or automatic device.
A cuff is placed around your arm and pumped up to restrict the blood flow. The
pressure is then slowly released as your pulse is checked. Hearing how your pulse
beats after the cuff is released allows a measurement to be taken giving a blood
pressure reading. Before having your blood pressure taken. You should rest for at
least 5 minutes and empty your bladder.
To get accurate blood pressure reading, you should be sitting down with your back
supported and legs uncrossed and not talking when the reading is taken.
Causes of hypertension.
• Primary (essential) hypertension. For most adults, there's no identifiable
cause of high blood pressure. This type of high blood pressure, called primary
(essential) hypertension, tends to develop gradually over many years.
• Secondary hypertension. Some people have high blood pressure caused by
an underlying condition.
→ Obstructive sleep apnea.
→ Kidney problems.

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The exact causes of high blood pressure are not known, but several factors and
conditions may play a role in its development, including.
→ Smoking. → Genetics.
→ Being overweight or obese. → Family history of high blood
→ Lack of physical activity. pressure.
→ Too much salt in the diet. → Chronic kidney disease.
→ Too much alcohol consumption. → Adrenal and thyroid disorders.
→ Stress. → Sleep apnea.
→ Older age. → Medicine.

Symptoms of hypertension.

Risk factors for hypertension.

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Main complication of hypertension.

Hypertension places stress on several organs (called target organs), including the
kidneys, eyes and heart, causing them to deteriorate over time. High blood pressure
contributes to 75% of all strokes and heart attacks.

Treatments for hypertension.

Lifestyle changes are important for both treatment and prevention of high blood
pressure, and they can be as effective as drug treatment. These lifestyle changes
can also have wider benefits for heart health and overall health.
The lifestyle measures shown to reduce blood pressure and recommended by
experts include.
• Sodium restriction. Typical salt intake is between 9 and 12 grams a day, and
modest blood pressure reductions can be achieved even in people with
normal levels by lowering salt to around 5 grams a day, the greatest effects
are seen in people with hypertension.
• Moderation of alcohol consumption. Expert guidelines say moving from
moderate to excessive drinking is associated with both raised blood pressure
and with an increased risk of stroke.
• High consumption of vegetables and fruits and low fat. People with or at
risk of high blood pressure are advised to minimize intake of saturated fat and
total fat and to eat whole grain, high fiber foods, at least 300 grams of fruits
and vegetables a day, beans, pals and nuts, and omega-3 rich fish twice a
week.
• Reducing weight and maintaining it. Hypertension is closely correlated with
excess body weight, and weight reduction is followed by a fall in blood
pressure.
• Regular physical exercise. Guidelines say hypertensive patients should
participate in at least 30 minutes of moderate intensity dynamic aerobic
exercise (walking, jogging, cycling or swimming) 5 to 7 days a week.
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• Stress reduction. Avoiding sources of stress where possible and developing

healthy coping strategies is for managing unavoidable stress can help with
blood pressure control, especially as many people turn to alcohol, drug
smoking and unhealthy food or overeating to cope with stress.
• Quit smoking. It can also raise blood pressure, and because of its wider
effects on heart health and the rest of the body, giving up smoking is highly
recommended for people with high blood pressure.
Lifestyle modifications to manage hypertension.

Nutritional management.
• Energy. An obese person must be reduced to normal body weight with low
calorie diet. About 20kcal/kg of ideal body weight are prescribed for a
sedentary worker and 25 kcal/kg of body weight for moderately active worker,
alcohol consumption should be reduced.
• Protein. A diet of 60-gram protein is necessary to maintain proper nutrition. In
severe hypertension, protein restriction. to 20 gram as advocated by
Kempner may be necessary as a temporary measure since protein foods are
rich in sodium.
• Fat. As they are prone to atherosclerosis, it is advisable to avoid high intake
of animals and hydrogenated fat (Vegetable ghee, Margarine, vanaspati)
about 20 grams vegetable oil is permitted.
• Carbohydrate. Easily digestible carbohydrates are of great help in the
management of high blood pressure.

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• Fiber. A high fiber diet was associated with a significant reduction in blood
pressure levels constipated.
• Minerals. The micronutrients affecting blood pressure are sodium, potassium,
calcium and magnesium.
• Sodium. Increased intake of sodium in diet leads to increased intravascular
volume and thus increases cardiac output, elevating blood pressure. Also at
the cellular level, increased intracellular sodium is exchanged for increased
intracellular calcium with its potential effect of augmented vascular.

Flow chart that shows the relationship between salt and high blood pressure.

How to reduce or control high BP?

• Lose extra pounds and watch your waistline.
• Exercise regularly.
• Eat a healthy diet.
• Reduce sodium in your diet.
• Limit the amount of alcohol you drink.
• Quit smoking.
• Cutback of caffeine.
• Reduce your stress.
• Monitor your blood pressure at home and see your doctor regularly. he
Physical exercise reduces high BP.
• Exercise is good for the heart and circulation.
• Lowers blood pressure, reducing strain on the heart.
• Increases good HDL cholesterol that transports fat away from the arteries and
back to the liver for processing.
• May reduce levels of bad cholesterol (LDL) that can form fatty deposits in the
arteries and contribute to heart disease and high blood pressure.
• Improve circulation by preventing blood clots that can lead to heart attacks
and strokes and high blood pressure.
• Increases fat loss.
• Helps the weight loss.
• Builds muscle mass.

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• Exercise should be walking, swimming, running, biking, cycling, etc.

• Walking briskly for 30 minutes to 45 minutes, five or six days a week can.
Lower your blood pressure by up to 10 points.
• But must remember that you work hard enough to break into a sweat, but not
so hard that you become out of breath or unable to converse.
Blood pressure lowering Foods.
• Berries
Berries are a great source of antioxidants. Antioxidants help to protect our bodies
against free radicals. A research study performed in 2010 found that people who
incorporated berries into their diet had an 8% reduction in the risk of high blood
pressure. Add berries to your next breakfast smoothie, lunch salad, or dinner
dessert!
• Beet Juice
Beet juice is high in inorganic nitrates, and these can result in a positive effect on
your blood pressure level in as early as 24 hours. This happens so quickly because
nitrates work to relax blood vessels. Drinking beet juice might not be everyone’s
favorite, but including cucumber, apple, and carrots can help boost the flavor!
• Salmon
Salmon is a great fatty fish that has tons of omega-3 fats. Omega-3s have been
shown to offer heart benefits and help to reduce blood pressure by lowering
inflammation. Another bonus is that increasing your Omega-3s can also help to
lower your risk of hypertension. Salmon makes a yummy addition to your breakfast
bagel, lunch salad, or sautéed for dinner!
• Carrots
Carrots are rich in phenolic compounds which are found to reduce inflammation and
relax blood vessels. A study with over 2,000 people found that eating raw carrots
helped to lower the group’s blood pressure levels. Raw carrots can add a great
crunch to your salad or choose them as a healthy side with dressing!
• Leafy Greens
Like beets, leafy greens are high in nitrates. Researchers found that eating 1-2
servings of leafy greens can lower hypertension for up to 24 hours. These veggies
are also high in antioxidants, calcium, and potassium which all work to help with high
blood pressure. Add leafy greens to your breakfast omelet, lunch salad, or mixed in
with other veggies for your next dinner side!
Making the right dietary choices is worth it to protect our hearts and lower high blood
pressure. Eating the foods, we discussed today and mixing in other low-fat dairy
products can help to lower blood pressure by up to 11 mm Hg. We hope that if you’re
struggling with high blood pressure you can use this info to incorporate some healthy
ideas into your next meal plan!

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❑ Coronary heart disease.

Coronary heart disease (CHD) is when your coronary arteries, (the arteries that
supply your heart muscle with oxygen rich blood), become narrowed by a gradual
buildup of fatty material within the walls. The fatty deposits, called atheroma, are
made up of cholesterol and other waste substances.
Causes of coronary heart disease.
The buildup of atheroma on the walls of the coronary arteries makes the arteries
narrower, restricting the flow of blood to the heart muscle. This process is called
atherosclerosis. Your risk of developing atherosclerosis is significantly increased if
you.
→ Smoke.
→ Have high blood pressure hypertension.
→ Have a high blood cholesterol level.
→ Don't take regular exercise.
→ Have diabetes.
Risk factors of coronary heart disease.
→ Overweight or obese → High triglyceride.
→ Physical inactivity. → Age.
→ High stress. → Sex.
→ Sleep apnea. → High blood pressure.
→ High sensitivity C reactive → High blood cholesterol.
protein.

Atherosclerosis.
What is atherosclerosis?
Atherosclerosis is a disease in which
plaque builds up inside arteries.
Arteries are blood vessels that carry
oxygen rich blood to the heart and
other parts of the body.
Plaque is made up of fat,
cholesterol, calcium and other
substances found in the blood. Over
time Plug hardens and narrows
arteries. This limits the flow of
oxygen rich blood to organs and
other parts of the body.
Atherosclerosis can lead to serious
problem, including heart attack,
stroke and even death.

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Development of atherosclerosis.

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Mechanism of atherosclerosis.
• Atherosclerosis develops as a
chronic inflammatory response of
arterial walls to the endothelial
injury.
• It had a sclerotic is the
developmental process of
atheromatous plaques.
• It is characterized by. Modeling
of arteries leads to
subendothelial accumulation of
fatty substances called plaques.

Causes of atherosclerosis.
Atherosclerosis is caused by
macrophages, white blood cells, and
fat that accumulate in arteries - the
white blood cells are originally sent
by the body's immune system to
clean up LDL cholesterol pockets.

Certain factors that can damage the inner area of the artery (endothelium) and can
trigger atherosclerosis include.
→ High blood pressure.
→ High levels of cholesterol.
→ Smoking.
→ High levels of sugar in the blood.
Symptoms of atherosclerosis.
Most symptoms of atherosclerosis don't show until a blockage occurs.
Common symptoms include.
• Chest pain or angina.
• Pain in your leg, arm, and anywhere else that has a blocked artery.
• Shortness of breath.
• Fatigue.
• Confusion which occurs if the blockage affects circulation to your brain.
• Muscle weakness in your legs from lack of circulation.

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Complications.

• Coronary artery disease.

• Carotid artery disease.
• Peripheral artery disease.
• Aneurysm.
• Chronic kidney disease.

Diagnosis of atherosclerosis.
Depending on the result of the physical exam, your doctor may suggest one or more
diagnostic tests included.
→ Blood tests.
→ Doppler ultrasound.
→ Ankle branchial index.

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→ Electrocardiogram (ECG).
→ Stress test.
→ Cardiac catheterization and angiogram.
→ Other imaging tests.
Prevention of atherosclerosis.
Exercise. Exercise can help you lose weight if you are overweight or obese and
helps raise HDL and lower LDL cholesterol levels. Try to work up to 30 minutes of
moderate level activity four to six times a week.
Quit smoking. Working can damage blood vessels, reduce the flow of blood through
blood vessels and. Or your HDL cholesterol levels. Even exposure to secondhand
smoke can affect blood vessels and cholesterol. Talk to your doctor about
developing a plan to help you to stop smoking.

Some foods for atherosclerosis.

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Complication of atherosclerosis.
Stroke. A stroke occurs when an artery that carries blood to your brain becomes
blocked. This can cause temporary or permanent brain damage, and you may lose
your ability to see, speak, or move parts of your body.
Peripheral arterial disease (PAD). PAD occurs when plaque builds up in the
arteries that supply blood to your arms and legs. This can cause numbness, pain,
and possibly infection in your affected limbs.
❑ Heart attack.
What is a Heart Attack?
A heart attack is a serious medical emergency in which the supply of blood to the
heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can
seriously damage the heart muscle.
A heart attack is known medically as a myocardial infarction or MI.
In heart arteries due to formation of plaque blood circulation is stopped. This
situation is called a heart attack.
Causes of heart attack.
• Age. Risk increases when a man is • Heart surgery.
over 45 and women is over 55. • Hypertension, high blood
• Angina. pressure.
• High blood cholesterol levels. • Obesity, Overweight.
• Diabetes. • Physical inactivity.
• Genes. You can inherit a higher risk of • Previous heart attack.
heart attack. • Smoking.

Symptoms of heart attack.

Symptoms can include.
• Chest discomfort mild pain. • Dizziness.
• Coughing. • Dyspnea; shortness of breath.
• Nausea. • Face seems grey.
• Vomiting. • Restlessness.
• Crushing chest pain. • Shortness of breath.
• Pressure, lightness, pain, squeezing • Anxiety.
or aching in the chest or arms that • Sweating.
spread to the neck, jaw or back. • Pallor (pale face).

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Risk factors of heart attack.

• High blood pressure,

• diabetes mellitus,
• increasing age,
• high saturated fat,
• Cholesterol diet intake,
• high salt intake,
• Smoking.

Diagnosis of heart attack.

• Coronary angiography.
• Echocardiogram.
• Chest X-ray.
• Blood test.
• Electrocardiography; ECG.
Preventing a heart attack.
Making lifestyle changes is the
most effective way to prevent
having a heart attack or having
another heart attack.

There are three main steps you

can take to help prevent a heart
attack as well as stroke.
→ Eat a healthy, balanced
diet.
→ Avoid smoking.
→ Try to keep your blood
pressure at a healthy level.

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Complication of heart attack.

Heart Attack Complications are often related to the damage done to your heart
during a heart attack. This damage can lead to the following conditions.
• Abnormal heart rhythms (Arrythmias). If your heart muscle is damaged
from a heart attack, electrical "short-circuits" can develop, resulting in
abnormal heart rhythms, some of which can be serious, even fatal.

• Heart failure. The amount of damaged tissue in your heart may be so great
that the remaining heart muscle can't do an adequate job of pumping blood
out of your heart. Heart failure may be a temporary problem that goes away
after your heart, which has been stunned by a hear tattack, recovers.
However, it can also be a chronic condition resulting from extensive and
permanent damage to your heart following your heart attack.

• Heart rupture. Areas of heart muscle weakened by a heart attack can

rupture, leaving a hole in part of the heart. This rupture is often fatal.

• Valve problems. Heart valves damaged during a heart attack may develop
severe, life-threatening leakage problems.
Foods to love and foods to avoid for a heart healthy diet.

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❑ Stroke.
A stroke is a brain attack. It can happen
to anyone at any time. It occurs when
blood flow to an area of the brain is cut
off. When this happens, brain cells are
deprived of oxygen and begin to die.
When brain cells die during a stroke,
abilities controlled by that area of the
brain, such as memory and muscle
control, are lost.

Classification
Strokes can be classified as.
1. An ischemic stroke caused by a blocked artery.
2. Hemorrhagic stroke caused by bleeding in the brain.
3. Mini stroke.

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Symptoms of a stroke.
Signs and symptoms of a stroke may include.
• Sudden weakness,
• paralysis, or numbness of the face, arms, legs, especially of the body.
• Confusion,
• Trouble speaking or understanding speech.
• Trouble seeing in one or both eyes.
• Problems breathing.
Complication of stroke.
• Paralysis or loss of muscle movement.
• Difficulty talking or swallowing.
• Memory loss or thinking difficulties.
• Emotional problems,
• pain,
• change in behavior and self-care ability.
How to diagnosis a stroke?
Strokes happen fast and will often occur before an individual can be seen by a
doctor for a proper diagnosis.
The acronym F.A.S.T. is a way to remember the signs of stroke and can help identify
the onset of stroke more quickly.

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• Face drooping. If the

person tries to smile, does
one side of the face droop?
• Arm weakness if the person
tries to raise both. Their
arms Does one arm drift
downwards?
• Speech difficulty. If the
person tries to repeat a
simple phrase, is their
speech slurred or strange?
• Time.

Risk factors.

Preventing a stroke.
The best way to prevent a stroke is to address the underlying causes. This is best
done by living healthily, which means.
→ Eating a healthy diet.
→ Maintaining a healthy weight.
→ Exercise regularly.
→ Not smoking.
→ Avoiding alcohol or moderating consumption.

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❑ Dietary Management for heart disease.

• Reduce your heart disease risk with healthy eating
Eating a variety of foods is beneficial to our health and can help reduce our risk of
disease (including heart disease). Try to eat a wide variety of foods from each of the
5 food groups, in the amounts recommended. Not only does this help you maintain a
healthy and interesting diet, but it provides essential nutrients to the body.
The Heart Foundation recommends:
→ Plenty of vegetables, fruits and wholegrains.
→ A variety of healthy protein sources (especially fish and seafood), legumes
(such as beans and lentils), nuts and seeds. Smaller amounts of eggs and
lean poultry can also be included in a heart healthy diet. If choosing red meat,
make sure it is lean and limit it to one to 3 times a week.
→ Unflavored milk, yoghurt and cheese. Those with high blood cholesterol
should choose reduced fat varieties.
→ Healthy fat choices – nuts, seeds, avocados, olives and their oils for cooking.
→ Herbs and spices to flavor foods, instead of adding salt.
Also, be mindful on how much you are eating and whether you are filling up on
unhealthy foods. Portion sizes have increased over time and many of us are eating
more than we need which can lead to obesity and increase our risk of cardiovascular
disease.
Ideally, a healthy plate would include servings of – ¼ protein, ¼ carbohydrates
and ½ vegetables.

• Foods important for heart health

Although there is no ‘magic’ food to lower our risk of developing heart disease, there
is some evidence that some foods are important for heart health. These include:
→ Oily fish – such as mackerel, sardines, tuna and salmon which contain
omega-3 fatty acids. This type of fat has been shown to decrease triglycerides
(a type of fat) and increase HDL-cholesterol levels, improve blood vessel
elasticity and thin the blood, making it less likely to clot and block blood flow.
→ Some vegetables oils – such as corn, soy and safflower (which contain
omega-6 fatty acids), and those containing omega-3 fatty acids (such as
canola and olive oil). All of these can help to lower LDL cholesterol when used
instead of saturated fats such as butter.
→ Fruit and vegetables – fiber, potassium and other micronutrients (such as
antioxidants) in fruit and vegetables offer protection against heart disease.
They are also an important source of folate – which helps lower the blood
levels of the amino acid homocysteine, which appears to be linked to an
increased risk of heart disease.
→ Wholegrains – a diet high in fiber from wholegrain cereals is linked to
reduced LDL cholesterol and lowered heart disease risk. Foods with high

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levels of soluble fiber (for example, oats, legumes and barley) are great for
lowering total cholesterol levels.
→ Unrefined carbohydrate sources with a low glycaemic load – such as
wholegrain breads and cereals, legumes, certain types of rice and pasta, and
most fruits and vegetables also help to lower blood triglycerides and glucose
(sugar) levels, help manage diabetes and reduce heart disease risk.
→ Legumes, nuts and seeds – are good sources of plant proteins, fibre,
healthy fats and micronutrients to help lower your cardiovascular risk.
→ Tea – some research suggests antioxidants in tea can help prevent the build-
up of fatty deposits in the arteries. They may also act as an anti-blood clotting
agent and improve blood vessel dilation to allow increased blood flow.
→ Foods containing vitamin E – some studies indicate that vitamin E acts as
an antioxidant, helping to protect against LDL cholesterol.
Sources of vitamin E include – avocados, dark green vegetables, vegetable
oils and wholegrain products. Eat foods containing vitamin E rather than
supplements, which have not been shown to have the same protective
effects.
→ Garlic – a compound in fresh garlic (called allicin) has been found to lower
total and LDL cholesterol in the blood, thereby reducing the risk of heart
disease.
→ Foods enriched with plant sterols – a daily intake of 2 to 3 g of
phytosterols/stanols lowers LDL cholesterol levels by approximately 10% in
healthy people, and those with high cholesterol or diabetes. This equates to 2
to 3 serves of phytosterol-enriched foods like margarine spreads, yoghurts,
milk and breakfast cereals.
• How to reduce your risk of heart disease with healthy eating
Try these steps to reduce your risk of developing heart disease:
→ Limit fried fast food and processed foods.
→ Replace energy from saturated fats (such as butter, coconut oil and cream)
with healthy unsaturated fats from seeds and plants (such as extra virgin olive
oil, avocado, sunflower, canola, safflower, peanut, soybean and sesame) and
foods such as nuts, seeds, avocado, olives and soy.
→ Increase the amount and variety of plant foods – eat more vegetables, fruits
and wholegrain cereals.
→ Reduce intake of refined sources of carbohydrates with higher glycaemic
indices (including foods with added sugars).
→ Limit unprocessed red meats (such as beef, veal, mutton, lamb, pork,
kangaroo, rabbit, and other game meats) to a maximum of 350 g (cooked
weight) per week and avoid processed meat (such as sausages, ham, salami
and prosciutto).
→ Trim all visible fat from meat and remove skin from poultry.
→ Eat legumes regularly – like baked beans (reduced salt), soybeans, lentils and
tofu.
→ Snack on a handful of raw, unsalted nuts on most days of the week
(especially walnuts and almonds).

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→ Eat oily fish at least once per week.

→ Reduce your salt intake – avoid packaged and processed foods, limit fast
foods and salty foods. Replace salt at the table and in cooking, with herbs and
spices for flavor.
→ Check the sodium content of foods and choose the lowest sodium products.
→ If you have elevated cholesterol levels, switch to low-fat or non-fat dairy
products and have no more than 7 eggs per week.
→ If you drink alcohol, have no more than 2 standard drinks on any one day. A
high alcohol intake increases blood pressure and can increase triglycerides in
the blood.
• In a review of more than 600 studies assessing how dietary factors are
associated with coronary heart disease, certain diets and individual foods
notably popped out as key players in reducing the risk of coronary heart
disease. Of these, the Mediterranean diet, the “prudent” diet, and a high-
quality diet were considered beneficial.
→ The Mediterranean diet emphasizes a higher intake of vegetables, legumes,
fruits, nuts, whole grains, cheese or yogurt, fish, and monounsaturated fat
relative to saturated fat.
→ The “prudent” diet is characterized by a high intake of vegetables, fruit,
legumes, whole grains, and fish and other seafood.
→ A high-quality diet provides more nutrient density. Peanuts, known to the
culinary world as a nut but classified as a legume because of the way they
grow, fit in all these diets.

❑ Prudent Diet.

The “prudent” diet is characterized by a high intake of vegetables, fruit, legumes,

whole grains, and fish and other seafood.
Four principles were used to characterize and define a dietary pattern as a healthy or
prudent:
→ the avoidance of excess energy intake,
→ increased dietary fiber intake,
→ reduced total fat intake to approximately 30% of energy intake, and

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→ an increase in polyunsaturated fat consumption.

Importance:
A healthy or prudent diet is associated with reduced rates of a multitude of major
diseases, including heart attack, cancer, stroke, diabetes, and high blood pressure.
The Importance of Prudence:
Prudence, the ability to make good decisions or choices is one of the four cardinal
virtues. A prudent person takes the time to think of the consequences of their
actions. They will stop and ask themselves what the right and most loving thing is to
do.

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