Meal Plan for Healthy Heart and Cardiovascular Disease Prevention

This information covers all nutritional aspects for maintaining a healthy heart and cardiovascular system. Both coronary artery disease (CAD – more commonly known as coronary heart disease (CHD)) and cerebral vascular accident (CVA – more commonly known as stroke) are types of cardiovascular disease (CVD) with similar nutritional risk factors as the processes by which they form are similar. The information provided here will help you improve your blood cholesterol level and reduce other risk factors which could lead to CVD.

The main points for CVD prevention and a healthy heart:

• Stop smoking
• Keep active and exercise regularly
• Get to a healthy weight and stay there
• Control your blood pressure
• Try to relax
• Don't drink too much alcohol
• Control your cholesterol level
• Eat a healthy diet
• Eat regular meals, and try to eat similar amounts of starchy carbohydrate foods each day. Make starchy food the main part of each meal
• Try to eat more high fibre foods. The fibre in pulses, fruit, vegetables, oats and whole grain products is particularly good
• Include plenty of fruit and vegetables in your meals. Have at least 5 servings a day
• Limit the amount of fried and fatty foods you eat
• Reduce your sugar intake by swapping high sugar foods for low sugar or sugar free alternatives
• Be careful not to use too much salt

Blood Cholesterol and Lipids
One of the principle risk factors for heart disease is having an unfavourable cholesterol level. However, this is not just a case of having a high cholesterol level as there are other blood lipids which are measured which also indicate risk of cardiovascular disease (CVD). The main ones we're concerned with are:

• Total cholesterol (TC): 3.6-6.5 mmol/l (139-251 mg/dl), though ideally it should be below 5.0 mmol/l (193 mg/dl)
  This is the total level of all cholesterol sub-fractions in the blood
• LDL cholesterol: <3.4 mmol/l (131 mg/dl)
  This is 'bad' cholesterol and this level should be low
• HDL cholesterol: >0.9 mmol/l (35 mg/dl)
  This is 'good' cholesterol as it signifies cholesterol which is going to be excreted; a higher level of HDLs indicates lower CVD risk
• Triglycerides (TG): 0.3-1.7 mmol/l (27-151 mg/dl)
  These fats signify what's been eaten and this level should be low

Fats in our Diet
Different types of fats that we consume in our diets can affect these different levels

• Saturated fats: These are mainly animal fats and we should be trying to reduce our intake. Although some saturated fat is acceptable, too much can contribute to an increase in total and LDL cholesterol.
• Omega-6 polyunsaturated fats: These are found in many nuts and seeds, sunflower and soya oil, as well as processed and junk foods and vegetable cooking oils. While it's essential that we include some omega-6 in our diet, too much can be a risk factor for heart disease.
• Omega-3 polyunsaturated fats: These are found in oily fish and flaxseeds/linseeds. These may offer some protection against CVD, so try to eat more. Consume oily fish at least 2-3 times per week, or if you're vegetarian, include ground linseeds or flaxseed oil regularly in your diet.
• Monounsaturated fats: Found in olive oils and rapeseed oils. These will help to lower LDL cholesterol level while keeping the good HDL levels high; include sources of these in your diet plan.
• Trans fats: These are hydrogenated oils used as ingredients in processed foods. They worsen your blood cholesterol profile, increase TGs and increase risk of heart disease.

Sugar
Sugary foods often contain few other nutrients; they are high in calories and therefore contribute to weight gain - empty calories. Many of us have excessively large intakes of sugar from confectionery and soft drinks, which can give unnaturally large rises in blood sugar levels before our body can bring them down. A high sugar intake can also contribute to raised triglyceride levels.

Cut down your sugar intake and replace with starchy carbohydrate foods like wholemeal bread, potatoes, rice, pasta and breakfast cereals. Alternative sweeteners can be useful if used in moderation, and try reduced sugar soft drinks.

Fibre and Whole Grains
A good fibre intake is important for everyone. Fibre helps digestion, weight control and cholesterol levels. There are two types of fibre:

• Insoluble fibre: found in wholemeal products, breakfast cereals, fruit and vegetables. This is helpful for weight control and bowel problems.
• Soluble fibre: found in oats, pulses and some fruits, which also helps weight control and digestion, but has the additional benefit of helping to reduce cholesterol.

High fibre foods are also full of vitamins and minerals and contain few calories, fat, sugar and salt. These foods are filling, so eating these will help stop us snacking on junk food in between meals. If you are increasing your intake of fibre, then make sure you're consuming plenty of fluid too.

It has also been shown that consuming whole grain products can reduce risk of heart disease. Include high fibre foods at each meal, and make a point of consuming whole grain products and soluble fibre sources regularly.

Fruit and Vegetables
Fruit and vegetables should be included as part of a healthy diet. Fruit is high in insoluble and soluble fibre, and contains antioxidants. Antioxidants can help prevent LDL cholesterol from sticking to artery walls. Aim to have at least 5 servings of fruit or vegetables a day and try to make sure your choices are of different colours. One fruit or vegetable serving is:

• 1 medium apple/pear/orange/peach
• 1 small banana
• ½ grapefruit
• 8-10 grapes/cherries
• 3 plums
• 2 satsumas
• 1 small glass fruit juice (unsweetened)
• 10 raisins/sultanas
• 1 small bowl tinned fruit in natural juice
• average portion of vegetables with a meal
• medium sized salad

Weight Control
If you need to lose weight do so, but do so sensibly and aim to keep the weight off. Being overweight can increase your total and LDL cholesterol and raises blood pressure. For suitable meal plans see:

Weight loss – males
Weight loss – females

Salt
Too much salt in our diet can be linked to a high blood pressure level. Use minimal salt on food and don't eat too many salty snacks.

Alcohol
Small amounts of alcohol may have some health benefits, but generally we consume too much. Alcohol adds a lot of calories so can be a problem especially if you are watching your weight. Alcohol also raises triglyceride levels, in some cases severely.

• If you drink a lot, cut down
• The odd social drink is not a problem, providing this not too often
• Have at least two alcohol-free days per week
• Alcohol is not necessary for good health but drinking can be enjoyable
• There is no recommended specific number of units, just enjoy the occasional drink
• If you're trying to lose weight, avoid alcohol

Example Meal Plan
The following example meal plan has been designed for an individual of regular body weight who wishes to reduce their risk of heart disease. If you have some risk factors for heart disease, including incidence of it in your family, then following some of this advice would be prudent. If you need to lose weight then adjust portions sizes accordingly.

Regular exercise or physical activity will also help to keep your heart healthy. Light cardiovascular exercise (e.g. running, cycling, stepper, cross-trainer, treadmill, etc) for 20 minutes 3-4 times per week will be a great start, as well as performing chores which are physical.

As with the other plans on this site, the one below it is merely a guide and needs to be adapted to suit an individual's own lifestyle, activity level, daily routine and nutritional requirements. Use this to give you an idea of what foods are good for improving your cholesterol and keeping your heart healthy, but don't forget to vary your food choices and to drink plenty of water through the day.