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 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 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.
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 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
- Menopausal status
- Lack of physical activity
- Family history of premature congestive heart failure
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.
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 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 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.
Sodium is an important mineral needed by the body to work properly by controlling blood pressure and blood volume. It is also essential for the proper functioning of nerves and muscles in the body.
The recommended daily intake of sodium for different age groups is as follows Average sodium intake of a healthy adult should not exceed the maximum recommendation of 2300mg/day. However the average daily intake of sodium in a normal diet is far more than this.
Sources of sodium
The main source of sodium comes from the normal table salt, which is the main ingredient of every savoury. 1 tsp of table salt provide 2300 mg of sodium. Other sources of sodium include
- Natural sources such as meats , fishes, dairy and eggs.
- Foods in which salt is added during preparations and processing such as cheese, processed meats, tomatoes, salad dressings bread and cookies.
- Fast foods and foods prepared at restaurants.
- Baking soda and baking powder.
- Monosodium glutamate or Chinese salt
Effects of high sodium intake
Hypertension, stroke and heart diseases
The extra sodium in your body forces kidneys to hold more water to dilute the sodium which in turns increases the volume of blood in bloodstream . It then forces the heart to work more and put a lot of pressure on blood vessels. This extra works and pressure eventually results in stiffening of blood vessels resulting in high blood pressure, stroke and heart diseases.
High sodium intake results in increase calcium excretion . An increase loss of calcium via urine results in increased bone remodeling and bone loss which eventually results in weakening of bones and osteoporosis.
Kidneys are responsible to draw the extra fluids from the body through a process called osmosis. This process requires a balance of sodium and potassium to pull water from the bloodstream into the bladder. Eating salt raises sodium in the bloodstream which alters the balance and reduces the ability of kidneys to remove toxic substances out from the body, that in the long run causes damage to the kidneys.
Tips of reducing sodium intake
Almost 75% of the sodium comes from the packaged and processed foods available in the market. Following are some tips to reduce sodium intake .
- Try to avoid processed meats and packaged foods available in the market. Foods such as sausages, salami and ready made burger patties are rich in salt and should be taken with caution.
- Choose low salt condiments for example soya sauce, pickles and relishes. Read food label carefully to know the quantity of salt added in them.
- When using canned food items such as mushrooms, chickpeas and beans, wash them with running water before use.
- Try to use fresh vegetables as much as possible.
- Do not use monosodium glutamate (Chinese salt).
- Do not add salt when boiling rice , pasta or cereals.
- Use low salt instead of table salt as it contains potassium chloride which helps to lower the blood pressure. However this salt substitute is not advisable for patients with kidney diseases.
- Do not sprinkle extra salt from the top.
What is gout?
Gout is a disorder of purine metabolism which results in the accumulation of high levels of uric acid in blood. Uric acid are the waste products created after the breakdown of purines. The symptoms of gout are similar to arthritis but in this case crystals of uric acid are formed within the joint tissues which causes inflammation. Gout is generally associated with sudden onset of localized pain that begins from the toe and continues up the leg.
Gout mostly occurs after the age of 35 and is more common in males. Other factors which are normally associated with gouty conditions are
- Diet rich in fats and proteins and low in carbohydrates.
- Certain medicines such diuretics, aspirin, levodopa.
- Deficiency of enzymes responsible for purine metabolism.
Role of purine in gout
Uric acids are formed from the breakdown of purines in body. A diet low in purine along with medicines should be encouraged to reduce inflammation which occurs as a result of gout. Foods that are rich in purine and should be avoided are
- Organ meat such as liver, brains,kidney and heart.
- High fatty fishes such as sardines and roe
- Minced meat
Purine is the type of proteins that is present in some vegetables also and should be eaten in small amounts (Not more 1/2 cup of any purine rich vegetables is allowed in a day). Those vegetables are
Diet in Gout
Along with medicines , dietary modification is also essential to eliminate or inhibit uric acid synthesis, and reducing the recurring onsets of gout.
- Caloric restriction in case of being overweight . Because gout is more likely to develop if a person is obese. Also losing weight helps to relieve overall stress on joints.
- Excessive fluid intake (3L/day) should be encouraged in order to assist uric acid excretion.
- Gout diet should be high in complex carbohydrates ,low in saturated fats and moderate in protein to ensure uric acid excretion.
- Vitamin C may helps to lower uric acid levels. Take fruits and vegetables rich in vitamin C.
- Sodium bicarbonate or baking soda is highly alkaline and may help to lower uric acid in blood. But it is not advisable for patients with hypertension. 1/2 tsp of sodium bicarbonate in lemon juice helps to relieve gout symptoms.
Nutrition is mostly the favourite topic of discussion and these food myths are created either unintentionally based on personal experiences and word of mouth or intentionally as a marketing strategy in order to gain commercial benefits. Here we will discuss some of the popular beliefs about foods that are not true.
Apple and banana are rich in iron.
Apples and bananas are rich in iron as they turn brown when exposed to air. They turn brown because they contain an enzyme tyrosinase which when exposed to oxygen cause discolouration of fruits . The iron content of apple is 0.7 mg/100gm and banana is 0.4mg/100gm which is quite low as compared to other iron rich foods.
Hormones are injected in poultry.
Hormones are injected in poultry which is the main reason of early maturity or infertility, in girls, but the fact is hormones itself are far more expensive than chicken and it is not economical to give hormonal injections to chickens. Any hormones if present in food are denatured during cooking and in digestive track so there is no negative impact of eating poultry to the consumer.
Brown sugar and honey is better than sugar
Many people think that honey or brown sugar are better than sugar and can be taken if one is planning to restrict sugar in diet. However the only difference between them is the amount of micronutrients present. All three provide equal number of calories and there is not much difference in the reaction of these products in your body.
Eggs are bad for heart health
Eggs are rich in protein, fats, vitamins and minerals. One boiled egg contains about 5 gm of fat most of them are unsaturated . It also contains omega 3 fatty acids which is good for heart. As part of a healthy diet one can consume about 6 eggs in a week. Many people believe that cholesterol present in them may elevate blood cholesterol level. But the fact is ,cholesterol in egg has no effect on blood levels.
Egg whites are better than egg yolks
A popular belief is that egg yolks are harmful for elderly and young children,as they contain more fats and cholesterol than whites. However the truth is egg as whole is a combination of essential amino acids and fats and should be consumed regularly by all age groups. Also egg whites contains allergy causing amino acids and are not recommended for children before 10 months.
Carbohydrates from all sources makes you fat
One of the most common food myth is that all carbohydrates sources can lead to weight gain and obesity. This idea is mostly incorporated in minds by fad diet advocates who suggest to reduce carbohydrates to less than 50 grams per day. However the truth is carbohydrates should be consumed as the main source of energy . Carbohydrates is the form of energy that is present in all fruits and vegetables as well as in desserts and carbonated beverages, so choice of food is essential ,not restricting yourself to certain macronutrients.
Eating sugar can cause type 2 diabetes
Eating sugar does not directly cause elevated sugar levels in blood. It is a common misconception that a person who consume more sugar are more at risk of developing type 2 diabetes. Type 2 diabetes is a metabolic disorder in which many factors are involved which includes family history, obesity and lack of exercise and is not associated with consuming more sugars.
Supplement can cover all your nutrient needs
A healthy balanced diet is the best way to get all the vitamins and minerals needed to perform body functions. Vitamins and mineral supplements should only be used to cover any micronutrient deficiencies and when the diet is not adequate and lack of those nutrients.
Certain foods can detoxify your body from wastes.
Detoxification is the natural process constantly occurring in your body by liver and kidneys. No food has the ability to detoxify your body from wastes.