Nutrition and heart health

Atherosclerosis ("hardening of the arteries") is caused by a build-up of fat - mostly cholesterol - on the inside of blood vessels. This limits blood flow and makes the heart work harder.

1. Cholesterol is a waxy, fat-like substance that is produced by the liver.  Cholesterol is essential for life as it is used to make cell membranes and hormones.  Although the body needs cholesterol, too much in the blood increases the chance for heart disease.
2. There are two main types of cholesterol that make up your total blood cholesterol.  These are: 
   1. Low Density Lipoprotein or LDL cholesterol, carries cholesterol to the arteries and causes the narrowing or blocking of blood vessels. Remember "L" for Lousy! 
   2. High Density Lipoprotein or HDL cholesterol helps remove cholesterol from the arteries in the body and is thought to protect the heart. Remember "H" for Healthy!
3. Triglyceride is another type of fat in the blood that makes the blood thicker and increases the risk for it to clot. High triglycerides are often the result of excess fat, alcohol and sugar intake. They are also associated with excess weight or poorly controlled diabetes.

Limit your total fat intake and choose healthy fats more often to help improve blood cholesterol and maintain a healthy body weight. Remember, "low fat" does not mean "no fat"!

Fats to limit

• Saturated fats are found mostly in animal foods and are usually solid at room temperature. Saturated fats raise the level of cholesterol and triglycerides in the blood.
  • Sources: butter, lard, meat, poultry, 2% milk, whole milk and milk products, palm oil and coconut oil
  • Recommendation: Choose lean meat, skinless poultry, and fish more often.  Use lower fat dairy products.

• Trans Fat is formed by a process called "hydrogenation". These fats are worse than saturated fats because they raise LDL cholesterol, lower HDL cholesterol and significantly increase your risk of heart disease.
  • Sources: hard margarine, prepackaged foods made with hydrogenated vegetable oil and/or shortening, fast food items (e.g. French fries, hamburgers)
  • Recommendation: Use non-hydrogenated margarines.  When reading food labels, trans fat may appear as: (partially) hydrogenated oils or shortening.

• Cholesterol in the diet exerts some effect on blood cholesterol levels but saturated and trans fats are the real culprits. Limiting dietary cholesterol may be important for people who have hard-to-manage blood cholesterol levels.
  • Sources: All animal foods. The highest concentration is found in organ meats and egg yolks.
  • Recommendation: Limit your intake of cholesterol-rich foods.  (i.e. No more than 3 egg yolks per week).

Healthy fats (use in moderation)

Unsaturated Fats are found mainly in plant foods and are usually liquid at room temperature. These fats help to lower LDL cholesterol and raise HDL cholesterol in the blood.  There are two types:

• Monounsaturated fats
  • Sources: canola oil, peanut oil, olive oil, nuts, avocado and olives

• Polyunsaturated fats
  • Sources: safflower oil, sunflower oil, corn oil, soybean oil

• Recommendation:  Substitute saturated fats with more mono and polyunsaturated fats.

Omega-3 Fatty Acid is an essential fat that you must get from your diet. These fats can help lower triglycerides, raise HDL cholesterol, and improve elasticity of arteries.

• Sources: salmon, trout, sardines, mackerel, herring, tuna, ground flaxseed, walnuts, pumpkin seeds, wheat germ, soybean products, canola oil, omega-3 fortified products
• Recommendation: Try to include fish 2-3 times per week and/or have 1-2 tablespoons of ground flaxseed or walnuts per day.

Fibre is only found in plant products. Fibre slows digestion and gives a feeling of being full. There are two types of fibre: soluble fibre helps to lower LDL cholesterol, triglycerides, and total cholesterol. It also helps to control blood sugar levels and blood pressure. Insoluble fibre helps to relieve and prevent constipation.

Recommendations:  Try to eat 21-38 grams of fibre each day.  Add high fibre foods to your diet gradually, spread them throughout the day, and increase your water or fluid intake.  This will help to avoid gas and other discomfort.

Food sources of fibre

Soluble Fibre

• Psyllium products (e.g. All Bran Buds^®, All Bran Guardian^®, Metamucil^®)
• Legumes (e.g. dried beans, lentils, chickpeas)
• Oat products (e.g. oatbran, oatmeal)
• Barley
• Pectin-rich fruits (e.g. apples, pears, berries, citrus fruits)
• Some vegetables (e.g. artichoke, squash, corn, broccoli, carrots, potato with skin)
• Soybeans

Insoluble Fibre

• Wheat bran, whole grain cereals and breads
• Whole grain products (e.g. brown rice, couscous, whole-wheat or multi-grain pasta)
• Colourful whole fruits and vegetables (e.g. Dark leafy greens and yellow, orange, and red vegetables or fruit)

Blood Pressure & Salt

Blood pressure is the pressure of the blood in the arteries as the heart pumps it around the body. If you have high blood pressure, reducing your sodium* intake to no more than 1,500-2,300 mg/day may help control your blood pressure. One teaspoon of salt has 2,373 mg of sodium, so you should be limiting your salt intake to no more than the equivalent of 2/3 of a teaspoon from all sources daily.

*Sodium is a major component of salt.  

Tips for Reducing Sodium Intake

• A pinch of salt may be used in cooking
• Take the salt shaker off the table
• Try a blend of herbs and spices or use a salt-free product such as Mrs. Dash^®
• Replace garlic salt, onion salt, and celery salt with the fresh product or powder
• If Kosher meats are used, soak them in water and do not use salt in meal preparation
• Use fresh and home-prepared foods whenever possible

Limit

• Any foods that have been pickled, processed, cured, smoked, or salted, e.g. pickles, olives, smoked meats
• Baking soda, baking powder, canned vegetables, sauces, gravies, dressing, marinades

Avoid

• Sea salt, MSG, and brine
• Salt substitutes, such as "No Salt^®", "Nu-Salt^®", "Half Salt^®", unless approved by your physician or dietitian
• Foods that have visible salt, e.g. potato chips, salted nuts, salted pretzels, salted crackers

Enjoy a Variety of Foods
Eat a well-balanced diet according to Canada's Food Guide. The key to good nutrition is balance, variety and moderation. Give your body the best types of nutrients in appropriate portions, while making heart-healthy food choices. 

Emphasize vegetables and fruits, cereals, breads and other whole grain products
Certain types of fibre (found in psyllium, oats, barley, fruit, legumes, dried peas, beans and lentils) help to lower LDL cholesterol.

Choose low-fat dairy products, lean meats and food prepared with little or no fat
Reduce your total fat intake and substitute saturated fat with poly and mono unsaturated fats, and omega-3 fats. Bake, broil, steam, poach, grill or microwave foods instead of frying.  Trim all the fat and skin off meats.  Eat 2-3 servings of omega-3 rich fish per week.

Limit salt and sugar
A high salt diet may be associated with high blood pressure, which, in turn, increases the risk of heart disease. Avoid the salt shaker and limit processed, convenience and canned foods because of their high sodium content.  Check with your physician or dietitian regarding salt substitutes.

Foods high in sugar can contribute excess calories and may increase triglycerides. Limit foods such as sugar, jams, honey, syrups, and products containing honey, molasses, dextrose, sucrose, high fructose corn syrup (and other words ending in "-ose"), dextrins, and syrup.

Limit alcohol and caffeine
Alcohol provides calories without nutrients. Too much alcohol can cause weight gain, high blood pressure and high triglycerides. Check with your physician or dietitian regarding alcohol use.

Caffeine should be used in moderation. Caffeine is found in beverages such as coffee, tea, colas and foods that contain cocoa. Try to have less than 4 servings per day.  For example, 1 serving = 1 small coffee or tea, or 1 can of cola.  Choose decaffeinated beverages more often.

Achieve and maintain a healthy bodyweight by enjoying regular physical activity and healthy eating
Achieving a healthy weight has other benefits besides helping you to look and feel better! Fats in your blood, blood pressure, and diabetes control may be improved. Regular exercise, as approved by your physician, should be part of a healthy lifestyle. Make sure your heart, as well as your body, is fit. Follow Canada's Food Guide by eating the recommended amount and type of food each day to achieve and maintain a healthy bodyweight.