Heart Healthy Diet
Heart Healthy Diet
Rose Marie Robertson, MD, FAHA, FACC, FESC (Chief Science Officer and Past President of the Board of American Heart Association) gives expert video advice on: Why is salt harmful for your heart?; Can an obese child or adolescent get heart disease? and more...
What is a "heart healthy diet"?
A heart healthy diet is one that's rich in fruits and vegetables, that has plenty of whole grains and high-fiber foods and that has protein - that includes omega-3 fatty acids (so fish as your protein source at least twice a week.) A heart healthy diet also has healthy fats and oils, not saturated fats and not trans-fat; we try to keep saturated fat to less than 7 percent of the calories and trans-fat to less than 10 percent of the calories, and encourage using unsaturated fats instead. That includes about 6 ounces of protein per day - that's really all we need to repair body tissues. A heart healthy diet is low in sodium, because higher sodium levels increase our chance of having high blood pressure, and is well-balanced with a large variety of foods to make sure that we get all of the vitamins and minerals and other substances that make a broadly varied diet healthier for us, than something that is focused on just a few separate foods.
Why is salt harmful for your heart?
There are several reasons why salt should be controlled in a heart-healthy diet. The most important probably has to do with blood pressure. A substantial proportion of people who either have high blood pressure or will get it are what we call salt sensitive. That is, their blood pressure will be higher if they eat a diet high in salt than it will be if they control salt. We think that people really don't need more than about 2.3 grams of sodium a day. That's about a teaspoon full of salt. When you figure sodium is in fact already present in a number of the packaged goods and prepared foods you may eat; that really leaves very little salt to actively sprinkle on things. So watching the salt in your diet and watching it in foods that you buy will surprise you if you haven't been counting those sodium milligrams already.
Why is saturated fat harmful for your heart?
Saturated fat is important to control, because if we eat a diet that's high in saturated fat, our LDL or "bad" cholesterol levels will rise. And if we don't control our saturated fat intake, we'll then have more cholesterol circulating in the blood where it can be taken up into artery walls and cause blockages in arteries that will gradually reduce blood flow to the heart, the brain, and other organs.
Why is portion control important for a healthy heart?
Portion control is really the keystone of a heart healthy diet. It's very important that over the course of a day we don't take in more calories than we burn. In fact, in this day and age, physical activity may in fact not be a part of many people's occupations. We tend to ride to work rather than to walk. We have in fact raised a generation of children who think that to do something you push a button. We push buttons on the computer. You don't dial the phone. It's a rare person who doesn't get upset when they lose the TV remote. So, we don't do much exercise and therefore we really can't take in more calories than we are able to burn. This means portion control is the way to handle that.
Why is fish important to my diet?
There's good evidence from a number of studies that suggests that making sure that we include fish in our diet--particularly oily fish--can reduce the risk of heart disease. We think that probably some of that effect comes from the Omega-3 fatty acids in fish. But actually, there may be multiple components, and so we would prefer, really, that people eat fish. Some people just won't eat fish, or can't eat fish. And in that case, using Omega-3 fatty acid supplements instead is a reasonable alternative. But since you can't be absolutely certain where the benefit comes from, actually having the fish in your diet is a good way to do it.
Is soy protein good for the heart?
The studies on soy protein have been very interesting. A number of years ago, there were some studies that suggested that there actually was a positive benefit of eating soy protein on reducing the risk for heart disease. Unfortunately, over the last five years or so, the studies that have been done to try to reproduce that have not come out with the same results. They haven't shown a positive benefit of soy protein for the heart. On the other hand, they certainly haven't shown harm, either. There's no question that using vegetable protein as opposed to animal protein lets you avoid a lot of saturated fat and cholesterol, which we know is good. We still think that soy protein is a great choice to make in your diet. Using vegetable oils and vegetable protein in your diet is beneficial to your heart because it displaces some of the things you might otherwise be eating.
What is "homocysteine", and how does it affect the heart?
Homocysteine is an amino acid that's found in the blood of people in various levels. When people have studied the levels of homocysteine and the likelihood of having coronary artery disease, they've found an association between the levels being elevated, and the likelihood of developing coronary artery disease. That wasn't entirely surprising because in circumstances where, through a genetic problem, the levels of homocysteine are very high, vascular disease is quite prominent. The hope arose that if we could reduce those levels of homocysteine, we might help prevent some of heart disease, and it's pretty ease to reduce it. Simply taking Folic Acid, a vitamin, helps us reduce homocysteine and can do so quite effectively. It's been a little disappointing, unfortunately, because reducing homocysteine levels with Folic Acid just hasn't shown any benefit. It's not that Folic Acid is not a useful thing - certainly all women of child bearing age ought to be taking Folic Acid if they might become pregnant because Folic Acid is very important in preventing birth defects. But taking Folic Acid with the thought that you are reducing coronary artery disease just doesn't have any science to back it up.
Why is a healthy diet important for my child's heart health?
Healthy lifestyle choices are equally important for children. In fact, perhaps more important because they have a longer life over which those healthy lifestyle choices will play out. So, it really is important to educate children about the importance of eating healthy foods, making the right choices, and being physically active enough. The same sort of heart-healthy diet that we eat for ourselves ought to be the one that we model to our children, so that they grow up with those choices being the things that they know, love and associate with the warmth, comfort and love of the home.
Can an obese child or adolescent get heart disease?
Not only can an obese child or adolescent get heart disease, they probably have it already. We know from studies that have been done looking at blood vessels and hearts of young people who have died from tragic events not related to their heart, but who have died from auto accidents and homicide where the heart was thought to be absolutely fine and the young person was thought to be healthy, that atherosclerosis, or hardening of the arteries, cholesterol deposits appear in young boys in this country in their teens and young women in their twenties. People we look at every day and never think they have atherosclerosis; they have hardening of the arteries. They already have coronary artery disease. So it's important as parents or as educators to be sure that we actually do think about that when we look at young people, and that we create for them an environment in which is easier to be healthy, to eat a healthy diet, to be certain that they get exercise. That this begins in the school and in the home, and that it begins now, because a generation of children is growing up with real time bombs ticking that will cause them huge difficulties when they reach their forties, fifties and sixties.