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Planning a heart healthy diet

General Principles: 1. 2. 3. 4. 5. Preferred diet is lacto-vegetarian Low in sodium, sugar, and calories Natural foods rich in high-quality fibre and nutrients - preferably organic foods Emphasis on whole grains, seeds (including nuts), fresh fruits, and vegetables Foods to be eliminated from the diet include white-flour products, sweets, canned foods, syrupy juices, soft drinks, squashes, hard-fats from animal sources butter and cream in particular Yoghurt/curds, and skimmed milk is OK and can be consumed within prescribed limits Tea and Coffee should be severely limited (1 cup a day max) or avoided totally. Those addicted to these beverages should be weaned away gradually Garlic and onions are excellent for the heart Nuts in general and walnuts, almonds, pistachios, pecans, and peanuts in particular, are good for the heart as they reduce LDL and help raise the levels of HDL. However do not consume more than a handful a day. You could even use them to garnish your oat porridge. Importantly, all nuts that you consume should be unsalted. Among grains Oats and barley are the gold standard as they contain soluble fibre. Other foods that contain soluble fibre include apples, pears, kidney beans, and prunes Among oils, olive oil and sesame (gingely) oil are heart healthy. Cold-pressed oils are preferable to heat-processed oils. Again oil should be limited to about 2 tablespoons a day Among fruits - fresh grapes, pineapples, oranges, apples, custard apples, pomegranates, and pears are heart healthy Tender-coconut water is a good heart tonic Amla (Indian gooseberry) is an excellent heart tonic Vegetables in general are rich in fibre and should be part of a heart healthy diet Important thumb rule: 75-85% of a days food should come from whole-grains, vegetables, and fruits

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Table 1: Foods to be avoided or severely limited Food substance Sodium (Salt) Remarks Limit intake to < 1,500 mg per day roughly 1 teaspoon or lesser What it means 1. No added salt 2. No biscuits, pastries, cakes, canned foods, savouries, chips, dips, sauces, ketchups, and processed foods 3. Check food labels for sodium content several processed, commercially available food substances contain hidden salt 1. No chocolates, sweets, toffees, and added refined sugar 2. Substitute honey for sugar (again limit to no more than teaspoon/day) honey is better than refined sugar

Sugar

Cut recommended sugar intake by 50-60% Recommended max sugar intake is 6 teaspoons/day, so aim for 2 teaspoons of sugar a day

Ramesh Venkatraman

Planning a heart healthy diet

Avoid all NSAIDS* (In general and particularly in Heart failure) Avoid completely 1. Paracetamol/Acetaminophen, Ibuprofen should be avoided by heart patients. If you have a headache use a balm or if you must consume a pain-killer, choose aspirin 1. Hydrogenated fats (Vanaspathi/Dalda) to be avoided completely 2. Packaged cookies, crackers, commercially prepared fried foods, chips, savouries, sweetmeats, potato crispies, finger-chips 1. Includes all of the above and rice (can be consumed in limited quantities), potatoes, pizzas, burgers, white bread, rolls, and all refined starches 2. Whole milk, butter, and fried foods

Drugs

Trans fats

Triglycerides

Avoid or limit intake to negligible quantities

*Non-steroidal anti-inflammatory drugs

Table 2: Natural foods that are "heart-healthy" Food substance Grapes and grape juice Benefits 1. Contain resveratrol known to preserve heart muscle flexibility 2. Reduces heart pain and palpitations 3. Helpful in reducing platelet aggregation and clots 4. Oxidises LDL (bad cholesterol) 1. Contain quercetin that is a natural anti-inflammatory which helps prevent blood clots 2. Rich in soluble fibre 1. Richest natural source of Vitamin-C 2. Heart tonic that tones up the heart muscle 1. Contain Lycopene a potent antioxidant and free radical scavenger 2. Promotes heart health 1. Contain good-fat (monounsaturated and polyunsaturated fats) 2. Enhance HDL (good cholesterol), reduce LDL 3. Reduce inflammation and blood clots 1. Reduces LDL 2. Onions like apples contain quercetin that is a natural antiinflammatory which helps prevent blood clots 3. Allicin in garlic is broken down into sulphur compounds which then react with RBC in blood to produce hydrogen sulphide which helps relax the blood vessels, thus keeping blood flowing freely in arteries 1. Rich source of vitamin-C 2. Improves blood flow to heart 3. Prevents pain due to angina 4. Beneficial in patients with ischaemic heart disease 1. Rich in polyphenol antioxidants 2. Reduce LDL, enhance HDL Caution: Pomegranate juice can (in some patients) interact with certain medicines such as warfarin, ACE-inhibitors check with your doctor before including it in your diet

Apples

Amla (Indian gooseberry) Tomatoes Almonds, walnuts, pistachios, pecans Onions and garlic

Pineapples

Pomegranates

Ramesh Venkatraman

Planning a heart healthy diet

1. Rich source of Vitamin-C and phytochemicals 2. Prevents LDL and enhances HDL 3. The phytochemical Hesperidin, a flavanone, improves blood vessel function and also lowers high blood pressure level

Oranges

A sample meal plan: On rising (optional) Fresh fruit juice of grapes, orange, or pineapple (without sugar, a teaspoon of honey may be added for taste) alternatively: warm water with a few drops lemon juice squeezed- in and a teaspoon of honey 2 slices of brown/whole-wheat bread or a bowl of oats, or 3 steamed idlies, or a bowl of vegetable upma or poha One apple, or a pear, a cup of grapes, or 5-6 slices of pineapple A cup of unsalted yoghurt or buttermilk or skimmed cows milk or soy milk A glass of coconut water Mixed salad of vegetables such as cabbage, carrots, tomatoes, onions, garlic and cucumber seasoned with olive or sesame oil (1 teaspoon) Two whole-wheat phulkas 1 bowl of vegetables 1 bowl of rice preferably fibre-rich red rice with sambar/rasam/vegetable stew (kootu) One cup of yoghurt/curd 1 cup herbal or green tea without milk and sugar a teaspoon of honey can be added for taste 2 whole wheat phulkas, or 3 steamed idlies, or a bowl of vegetable upma or poha One fruit A glass of unsalted butter milk

Breakfast

Mid-morning Lunch

Mid-afternoon/evening Dinner

Ramesh Venkatraman