Heart disease is the major cause of death worldwide. It results from the lack of blood flow to the blood vessels surrounding the heart. The major cause of heart diseases are atherosclerosis and hypertension, both of which are greatly affected by diet. In atherosclerosis fatty material called plaque or atheroma is build up inside the arteries and as a result it narrows them.
Risk factors for coronary heart diseases
There are several risk factors which contribute to develop coronary heart diseases in later life. The primary prevention of coronary heart diseases involves the prevention and management of these risk factors in order to avoid heart problems. These risk factors are as follows
Cholesterol
Cholesterol is the type of fats found in blood. An elevated cholesterol level in blood increases the risk for heart diseases. Cholesterol is transported in the blood through the proteins called lipoproteins. The main lipoproteins are Low density lipoprotein ( LDL) and high density lipoprotein (HDL).
HDL is responsible for carrying cholesterol away from blood to the liver
LDL is responsible for carrying cholesterol to the blood.
A blood cholesterol level below 200 mg/dl and LDL cholesterol up to 100mg/dl is considered desirable. HDL levels should be kept higher in order to prevent heart diseases. The normal reading of HDL is 60 mg/dl or higher. A HDL level less than 40 mg/dl is a risk factor for heart disease.
Hypertension 
Hypertension is the major risk factor for heart diseases, stroke and heart failure. It contributes to disease development by causing injury to the blood vessels. Hypertension is defined as a blood pressure above 140/90 mmHg. Hypertension is frequently present with other risk factors including high cholesterol levels and obesity.
Smoking
Nicotine found in cigarettes are responsible for initiation and progression of plaque formation in blood vessels and increases the risk of heart diseases. Clinical studies reveal that smoking is also responsible for the decrease in HDL cholesterol up to 6-8mg/dL.
Diabetes 
Diabetes like hypertension is a disease as well as a risk factor of heart diseases. 80% of patients suffering from diabetes are likely to develop atherosclerosis and heart diseases. Heart diseases in patients with diabetes is attributed to other risk factors such as hypertension, obesity and high cholesterol levels.
Other factors which also contributes in developing heart diseases include
- Dietary trends
- Obesity
- Menopausal status
- Lack of physical activity
- Family history of premature congestive heart failure
- Age
Diet in heart diseases 
Clinical trial and experimental studies have shown that numerous dietary factors affects blood lipids levels, atherosclerosis and heart diseases . People who consume more saturated fatty acids are at higher risk of developing heart disease. A proper diet is essential for the prevention of heart diseases and treatment of risk factors responsible for heart disease.
Fats and lipids
Total fat intake is related to obesity which in turns may cause atherosclerosis in longer run. For patients with increased risk of heart diseases it is essential to limit dietary fat to less than 30 percent of total calories in which saturated fat should be less than 7 percent, trans fat less than 1 % and the rest should consist of unsaturated fats mainly polyunsaturated and monounsaturated fats. To achieve these recommendations it is essential to follow some tips:
- Avoid high fat content of mutton and beef. Use lean cut parts and remove extra fat.
- Always use skinless poultry
- High fat fish is rich in omega 3 and omega 6 and is good for heart.
- Consume low fat dairy products.
- Avoid margarine as it is rich in trans fatty acids.
Fibre
Soluble fibre found in fruits. vegetables , legumes and isapghol tend to lower the blood cholesterol levels and LDL. Whole grain cereals and legumes are strongly related to decrease risk of heart diseases. The recommended allowance for fibre is 30 grams of which approximately 6-10 grams should be from soluble fibre. This level is easy to attain if one consume 5 or more servings of fruits and vegetables and 6-8 servings of whole grains.
Nuts
Nuts are rich in unsaturated fatty acids and bio active compounds. Studies reveal that a small handful of nuts each day reduces the risk of developing heart diseases by lowering cholesterol and LDL levels in blood.
DASH Diet
DASH diet composed of fruits and vegetables, low fat dairy, chicken ,fish and low in salt tend to lower blood pressure and thus prevent heart diseases.
Dietary guidelines to prevent heart disease
- Eat more fruits and vegetables.
- Replace refined grains and consume more whole grains.
- Limit saturated fats.
- Chose low fat protein.
- Reduce salt in your diet.
- Limit sugar intake.
- Reduce portion size.
by
Aliya Waqas
Dietician daily 