20 Nov 2014

Diet for Heart disease - A must read for every one

Coronary artery disease (Heart attack) is  a multi factorial disease. Here the strongest environmental factor is diet. Basic abnormality that lead to coronary artery disease is  is atherosclerosis. Major constituent of atherosclerosis is cholesterol esters,which  are carried by LDL (Law Density Lipoproteins ) in the blood. LDL cholesterol is affected by the type of  dietary fat.
Saturated fatty acid raise the blood cholesterol,while polyunsaturated fatty acid decreases the cholesterol. Cholesterol is found only in  animal food.

Following are the dietary recommendation in patients with coronary artery disease.
  • Balanced diet is recommended.
  • High fiber content (Complex carbohydrates) - Effect is determined by the type of dietary fiber. Soluble fibers such as pectin, guar and oat fibers can produce moderate reduction of cholesterol. Wheat fibers (wholemeal breads or bran) wont reduce the plasma cholesterol, but those who consume more wheat fibers and whole grain food the incidence of CAD  is decreased.
  • Weight reduction to achieve optimal BMI (Body Mass Index) - Overweight, especially abdominal obesity is an independent risk factor for CAD. Weight reduction will reduce the cholesterol.
  • More vegetables and fruits - Soya protein if included in the diet help to reduce the total and LDL cholesterol. Vegetables and fruits are law in fat and contain pectin other dietary fibers ,flavanoids and antioxidants. Five servings of different vegetables and fruit per day (400 g/day average weight)  is recommended.
  • Avoid excessive caffeine intake - Coffee contains small amounts of diterpenes (lipids), cafestol and kahweol - not caffeine - it raise plasma total and LDL cholesterol. Since the diterpenes are removed  filtered or instant coffee does not raise the cholesterol.
  • Avoid junk food.
  • Avoid  foods with high fat content especially MUFA, excess salt ,cholesterol.
  • Fish oil (omega 3 PUFA), garlic, plant sterols, antioxidants all help in reducing the cholesterol.
  • Salt (NaCl)   should be restricted to 6 gram/day for the general population this is more important for CAD  patients.
  • Fish  at least twice a week preferably fatty fish is recommended, it should not be fried in saturated fat. EPA (eicosapentanoic acid) help in reducing  CAD.
  • Alcohol one or two drinks per day may be beneficial in middle aged people at risk for CAD, because of complications of over intake not recommended in general population.
  • The following dietary components reduce the risk of coronary heart disease. Fruits and vegetables, cereal fiber,  PUFA, linolenic  acid, alcohol and fish, nuts, vitamin E, folate.
  1. BMI - Body mass index
  2. CAD - Coronary artery disease
  3. LDL - Law density lipoproteins
  4. MUFA - Monounsaturated fatty acids, plant-based fats found in avocado, nuts and seeds, oils, olives, and dark chocolate
  5. PUFA - Cutting off all vegetable oils except coconut oil, olive oil and palm oil. 

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