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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

    RECOMMENED INTAKE

    Saturated fat Less than 7% of total calories
    Polyunsaturated fat Upto 10% of total calories
    Monounsaturated fat Upto 20% of total calories
    Total fat 20%-30% of total calories
    Carbohydrates 50%-60% of total calories
    Fibre 20-30 g/d
    Proteins Approximately 15% of total calories
    Cholesterol Less than 200 mg/d
    Total calories 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

    SUBSTITUTE

    Whole eggs Egg whites
    Whole milk Skimmed milk / cows milk
    Ice creams Frozen fruit based desserts
    Fried foods Baked or steamed foods
    Pulses Sprouts
    Coconut chutney Sambhar or coriander chutney
    Cashew nuts Almonds / walnuts
    Mayonnaise based salad dressings Yogurt based salad dressings
    Red meat (mutton, beef, organ meat) 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

    Amount

    Calories

      Breakfast Items    
    1.
    2.
    3.
    4.
    5.
    Idli
    Toast
    Poha
    Upma
    Corn Flakes with milk
    2 in no
    2 slices
    1 plate
    1 plate
    1 bowl (30 gms)
    208
    102
    150
    154
    153
           

    6.
    7.
    8.
    9.
    10.
    Main Meal Items
    Rice
    Chapati (with oil)
    Dal
    Mixed Vegetable
    Chicken Tandoori

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

    104
    150
    162
    89
    109
           

    11.
    12.
    13.
    14.
    15.
    Snacks
    Sandwich
    Khakhra
    Banana
    Apple
    Papaya

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

    153
    147
    58
    53
    32
           

    16.
    17.
    Beverages
    Tea/Coffee
    Milk (cow)

    1 cup
    (200ml)

    55
    134
           

    18.
    19.
    20.
    Miscellaneous
    Kheer (rice)
    Almonds
    Alcohol (whisky, rum etc)

    1 katori
    4 in no
    40ml

    125
    55
    70

Is a registered society (NGO) which works to promote wellness, and has a mission to `STOP HEART ATTACK`. WARIS does awareness programs for public and for Doctors in this connection.

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