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HEART GUIDELINES

Healthy dietary practices are based on one’s overall pattern of food intake over an extended period of time and not on the intake of a single meal. The goal should be to achieve and maintain a healthy eating pattern that includes foods from each of the major food groups. The suggested percentage of calories from each of the food groups are given in the table below:

Nutrient composition of a heart-healthy diet

NUTRIENT

Saturated fat

Polyunsaturated fat

Monounsaturated fat

Total fat

Carbohydrates

Fibre

Proteins

Cholesterol

Total calories

RECOMMENED INTAKE

Less than 7% of total calories

Upto 10% of total calories

Upto 20% of total calories

20%-30% of total calories

50%-60% of total calories

20-30 g/d

Approximately 15% of total calories

Less than 200 mg/d

Balance energy intake and expenditure to maintain desirable body weight/prevent weight gain

Principles of a heart-healthy diet

Choose a diet with plenty of vegetables and fruits

The diet should contain at least 5 servings of fruits and vegetables per day, both as meals and snacks. There are no restrictions on any type of fruits and vegetable (except for those with diabetes). Fruits and vegetables are high in nutrients and fiber and relatively low in calories, and can be consumed in large quantities. Fruit juices tend to be high in calories and lack fiber, and hence you should eat the fruit rather than have the juice.

Choose a diet low in saturated fat

There are three kinds of fat; saturated mono-unsaturated and poly-unsaturated. Saturated fat raises blood cholesterol more than other forms of fat. Reducing saturated fat to less than 10 percent of calories will help you lower your blood cholesterol level. Oil should be used sparingly for cooking. It is recommended that not more than 1 tbsp (1 tbsp = 3 tsp = 15 ml) be used per person per day. The oil selected should be low in saturated fat and should have a healthy mixture of monounsaturated and polyunsaturated fatty acids. Among the oils, groundnut, soybean, rice bran, mustard and sunflower are recommended. Olive oil is an excellent choice, but it is very expensive and its flavor may not be palatable to everyone.

Foods high in saturated fat include

  1. Red meat
  2. Whole milk and milk products
  3. Bakery products, such as muffins and cakes
  4. Ghee, vanaspati, coconut oil
  5. Butter, mayonnaise, cheese

Foods you can substitute with

FOOD

Whole eggs

Whole milk

Ice creams

Fried foods

Pulses

Coconut chutney

Cashew nuts

Mayonnaise based salad dressings

Red meat (mutton, beef, organ meat)

SUBSTITUTE

Egg whites

Skimmed milk / cows milk

Frozen fruit based desserts

Baked or steamed foods

Sprouts

Sambhar or coriander chutney

Almonds / walnuts

Yogurt based salad dressings

 

White meat (chicken and fish)

Choose a diet low in cholesterol

The body makes the cholesterol it requires. In addition, cholesterol is obtained from food. Dietary cholesterol comes only from animal sources such as egg yolks, meat (especially organ meats such as liver), poultry, fish, and milk products. Contrary to popular belief cholesterol is not present in vegetable oils. However, in addition to dietary cholesterol, the saturated fat that you consume is converted to cholesterol in the body, and should therefore be kept to a minimum. Choosing foods with less cholesterol and saturated fat will help lower your blood cholesterol levels

Foods high in cholesterol include

  1. Egg yolk
  2. Organ meat, like liver and kidney
  3. Red meat
  4. Shell fish, like prawns and crab
  5. Whole milk, cheese
Choose a diet high in grains and low in simple sugars

The diet should contain 4-6 servings per day of grain products, which provide complex carbohydrates, vitamins, minerals and fiber. Complex carbohydrates (like brown rice) are recommended over simple carbohydrates (like sugar). People tend to put on weight when they obtain their carbohydrates from simple sugars (like soft drinks) instead of complex carbohydrates. Grains, vegetables fruits legumes and nuts are good sources of fiber.

Eat Smaller, More Frequent Meals

Smaller meals help stave off feelings of starvation, which can lead to binge eating. It’s also an easy way to get fruits and vegetables into your diet.

Keep your food low in salt

The simplest way to avoid extra salt is to remove the salt-shaker from your dining table. Foods high in salt include:

    1. Pickles
    2. Papad
    3. Processed foods
    4. Baked beans
    5. Canned soups
HOW MUCH SHOULD YOU EAT??

It is important to match intake of energy (calories) to overall energy needs. There is no ‘magic formula’ for weight loss. Weight loss or gain is dependent on a simple mathematical equation.

CHANGE IN WEIGHT = CALORIES CONSUMED – CALORIES BURNED

We consume calories through the food we eat and burn the calories through activities of daily living, exercise, and through our metabolism. The basal metabolic caloric requirement can be calculated by multiplying your weight in kg by 20 cals.

In addition you need to add 20% of calories for a sedentary person (desk job); 50 % for a person who is moderately active; and 100% for a person who is very active (such as a laborer).

Example: for a 60 kg sedentary individual, the caloric requirement would be 60 x 20 = 1200 + 240 (20% of 1200) = 1440 cals.

This is the amount of calories a person would require to maintain their current weight. However, when BMI is excessive (>25 kg/m2-to calculate BMI, see article on risk factors for heart disease), caloric intake should be less than energy expended to reduce BMI. Diets for weight reduction should be limited in total calories, and should try and achieve a deficit of 500 to 1000 kcal a day. This will help achieve a weight loss of 0.5- 1 kg per week. The overall intake and health status should be considered while determining the amount of caloric deficit.

Caloric content of 20 most common Indian foods.

Products

Breakfast Items

Idli
Toast
Poha
Upma
Corn Flakes with milk

Main Meal Items

Rice
Chapati (with oil)
Dal
Mixed Vegetable
Chicken Tandoori

Snacks

Sandwich
Khakhra
Banana
Apple
Papaya

Beverages

Tea/Coffee
Milk (cow)

Miscellaneous

Kheer (rice)
Almonds
Alcohol (whisky, rum etc)

Amount

 

2 in no
2 slices
1 plate
1 plate
1 bowl (30 gms)

1 katori (30gm)
1 medium Size
1 Katori
1 katori
1 piece

1 in no
2 in no
1 in no
1 in no
100gm

1 cup
(200ml)

1 katori
4 in no
40ml

Calories

208
102
150
154
153

104
150
162
89
109

153
147
58
53
32

55
134

125
55
70