What type of diet causes heart disease?

FRUITS AND VEGETABLES

Fruits and vegetables are part of a heart-healthy diet. They are good sources of fiber, vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol.

Eat 5 or more servings of fruits and vegetables per day.

Get more fiber by eating whole fruits instead of drinking juice.

GRAINS

Choose whole-grain foods (such as whole-wheat bread, cereal, crackers, and pasta or brown rice) for at least half of your daily grain intake. Grain products provide fiber, vitamins, minerals, and complex carbohydrates. Eating too many grains, especially refined grain foods (such as white bread, pasta, and baked goods) can cause weight gain.

Limit high-fat baked goods such as butter rolls, cheese crackers, and croissants, and cream sauces for pasta. Avoid packaged snacks that contain partially hydrogenated oils or trans fats.

EATING HEALTHY PROTEIN

Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, B vitamins, iron, and other vitamins and minerals.

You should:

• Eat at least 2 servings of low-mercury fish per week.
• Cook by baking, broiling, roasting, steaming, boiling, or microwaving instead of deep frying.
• For the main entree, use less meat or have meatless meals a few times a week. Get protein from plant-based protein foods instead.

Milk and other dairy products are good sources of protein, calcium, the B vitamins niacin and riboflavin, and vitamins A and D.

FATS, OILS, AND CHOLESTEROL

Some types of fat are healthier than others. A diet high in saturated and trans fats causes cholesterol to build up in your arteries (blood vessels). This puts you at risk for heart attack, stroke, and other major health problems. Avoid or limit foods that are high in these fats. Polyunsaturated and monounsaturated fats that come from vegetable sources have many health benefits.

You should:

• Foods with a lot of saturated fats include animal products such as butter, cheese, whole milk, ice cream, sour cream, lard, and fatty meats such as bacon.
• Some vegetable oils (coconut, palm, and palm kernel oils) also contain saturated fats. These fats are solid at room temperature.
• Some vegetable oils (coconut, palm, and palm kernel oils) also contain saturated fats. These fats are solid at room temperature.
• Limit trans fats as much as possible by avoiding hydrogenated or partially-hydrogenated fats. These are often found in packaged snacks and solid margarine.

Think about the following when choosing a margarine:

• Choose soft margarine (tub or liquid) over harder stick forms.
• Choose margarines with liquid vegetable oil as the first ingredient. Even better, choose "light" margarines that list water as the first ingredient. These are even lower in saturated fat.
• Read the package label to choose a margarine that does not have trans fats.

Trans fatty acids are unhealthy fats that form when vegetable oil undergoes hydrogenation.

• Trans fats can raise LDL (bad) cholesterol level in your blood. They can also lower your HDL (good) cholesterol level.
• To avoid trans fats, limit fried foods, commercial baked goods (donuts, cookies, and crackers), and hard margarines.

OTHER TIPS TO KEEP YOUR HEART HEALTHY

You may find it helpful to talk to a dietitian about your eating choices. The American Heart Association is a good source of information on diet and heart disease. Balance the number of calories you eat with the number you use each day to maintain a healthy body weight. You can ask your doctor or dietitian to help you figure out a good number of calories for you.

Limit your intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that contain a lot of sugar.

The American Heart Association recommends that sodium intake be no more than 2,300 milligrams (about 1 teaspoon, or 5 mg) a day with an ideal limit of no more than 1,500 mg per day for most adults. Cut down on salt by reducing the amount of salt you add to food when eating and cooking. Also limit packaged foods that have salt added to them, such as canned soups and vegetables, cured meats, and some frozen meals. Always check the nutrition label for the sodium content per serving and be sure to pay attention to the number of servings per container. Season foods with lemon juice, fresh herbs or spices instead.

Foods with more than 300 mg of sodium per serving may not fit into a reduced sodium diet.

Exercise regularly. For example, walk for at least 30 minutes a day, in blocks of 10 minutes or longer. Try to move at least 30 minutes most, if not all, days of the week.

Limit the amount of alcohol you drink. Women should have no more than 1 alcoholic drink per day. Men should not have more than 2 alcoholic drinks each day. One drink is defined as 12 ounces [355 milliliters (mL)] of beer, 5 ounces (148 mL) of wine, or a 1 1/2-ounce (44 mL) shot of liquor.

Page 2

Cowley MA, Brown WA, Considine RV. Obesity: the problem and its management. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 26.

Jensen MD. Obesity. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 207.

Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-S138. PMID: 24222017 pubmed.ncbi.nlm.nih.gov/24222017/.

Semlitsch T, Stigler FL, Jeitler K, Horvath K, Siebenhofer A. Management of overweight and obesity in primary care - a systematic overview of international evidence-based guidelines. Obes Rev. 2019;20(9):1218-1230. PMID: 31286668 pubmed.ncbi.nlm.nih.gov/31286668/.

Page 3

Having obesity puts strain on your heart and can lead to serious health problems. These include:

HOW TO DETERMINE YOUR BMI

Your BMI estimates how much you should weigh based on your height.

There are many websites with calculators that give your BMI when you enter your weight and height.

You can also calculate it yourself:

• Multiply your weight in pounds by 703.
• Divide that answer by your height in inches.
• Divide that answer by your height in inches again.

For example, a woman who weighs 270 pounds (122 kilograms) and is 68 inches (172 centimeters) tall has a BMI of 41.0.

Use the chart below to see what category your BMI falls into, and whether you need to be concerned about your weight.

BMI is not always the best way to decide whether you need to lose weight. If you have more or less muscle than is normal, your BMI may not be a perfect measure of how much body fat you have:

• Body builders. Because muscle weighs more than fat, people who are very muscular may have a high BMI.
• Older people. In older adults it is often better to have a BMI between 25 and 27, rather than under 25. If you are older than 65, for example, a slightly higher BMI may help protect you from thinning of the bones (osteoporosis).
• Children. While many children have obesity, DO NOT use this BMI calculator for evaluating a child. Talk to your child's provider about the right weight for your child's age.

Providers use a few methods to decide whether you are overweight. Your provider may also take your waist circumference and waist-to-hip ratio into consideration.

Your BMI alone can't predict your health risk, but most experts say that a BMI greater than 30 (obesity) is unhealthy. No matter what your BMI is, exercise can help reduce your risk of developing heart disease and diabetes. Remember to always talk to your provider before starting an exercise program.

1) Joanna Kosinka / Unsplash, HotHi biscus / Thinkstock Photos, Wine Dharma / Unspash

2) Krasyuk / Thinkstock Photos

3) Delusi / Thinkstock Photos

4) Bhofack2 / Getty Images

5) Charles M. Cihon / ThinkstockPhotos

6) Maris Zemgalietis / Getty Images

7) Vitchakorn Koonyosying / Unsplash, Louise Lyshoj / Unsplash, Rawpixel / Unsplash

8) Igor Kell / Thinkstock Photos

9) Tsiomashko Denis / Thinkstock Photos

10) Ingram Publishing / Getty Images

11) Mermusta / Thinkstock Photos

12) Aleksandr Stennikov / Fotolia

13) PhanuwatNandee / Getty Images

14) WebMD

15) Elena Elisseeva / Getty Images

16) Vladimir Sretenovic / Thinkstock Photos

17) Roman Antonov / Getty Images

SOURCES:

Jo Ann Carson, PhD, past nutrition committee chair, American Heart Association; professor of clinical nutrition, University of Texas Southwestern Medical Center, Fort Worth.

American Heart Association: “Saturated Fat,” “Meat, Poultry, and Fish: Picking Healthy Proteins,” “Sugar 101,” “Triglycerides: Frequently Asked Questions,” “Are Some Breads Getting a Bad Rap?” “Alcohol and Heart Health,” “Oven-Fried Chicken with Roasted Potato Wedges,” “Healthy Swaps for Common Foods.”

News release, American Heart Association.

Harvard School of Public Health: “Health Risks and Disease Related to Salt and Sodium,” “Soft Drinks and Disease,” “The Great Muffin Makeover.”

News release, Harvard School of Public Health.

Harvard Medical School: “Sugary Drinks Seem to Raise Blood Pressure,” “Carbohydrates -- Good or Bad for You?” “Belly Fat Linked with Higher Heart Disease Risk,” “Simple Swaps to Eat Less Salt,” “Butter vs. Margarine,” “An Easy Way to Soup up Your Diet,” “Gaining Weight? Beware Potatoes -- Baked, Fried, or in Chips,” “Revamp Your Snacking Habits,” “Top 10 sources of calories in the U.S. diet,” “Types of Fat.”

Sodium Breakup: “America Has Some of the World’s Saltiest Pizza -- Here’s 5 Tips for a Healthier Slice.”

CDC: “Top 10 Sources of Sodium.”

The American Journal of Clinical Nutrition: “Fried Potato Consumption is Associated with Elevated Mortality: An 8-yr longitudinal cohort study.”

Journal of the American Heart Association: “Consumption of Fried Foods and risk of Heart Failure in the Physicians’ Health Study.”

Eatforhealth.gov.au: “Fat.”

University of California, San Francisco: “How Much is Too Much: The growing concern over too much added sugar in our diets.”