Heart Healthy Diet has an important role to play in the reduction of heart attacks and related problems. Many of us know this fact but since habits die hard, intake of such a diet remains poor and needs a lot of motivation.

It is, however, never too late to change and supplement the existing diet with food items which have been scientifically proven for their heart protecting properties.

Patients after getting a heart attack always come and ask the doctor regarding a healthy diet, and then follow it. While it is useful , at this stage it is now a secondary preventive measure. It has, however, its utility in preventing recurrences.

Making it as a part of our habit starting from early life is the key along with several other measures to prevent a heart attack and its aftermath. This is called primary prevention.

1. Eat more Vegetables and Fruits

Vegetables and fruits are good sources of vitamins, minerals and antioxidants. Many of these substances prevent deposition of bad cholesterol in arteries. Vegetables and fruits are also low in calories and rich in dietary fiber.

Eating more fruits and vegetables brings satiety and helps you to eat less high-fat foods, such as meat, cheese and snack foods.Keep vegetables washed and cut in a cool place or a refrigerator and cook them without deep frying with low salt and very few spices.

Keep fruit in a bowl in your kitchen and the rooms you sit in frequently so that you’ll remember to eat it. Choose recipes that have vegetables or fruits as the main ingredient, such as vegetable stir-fry or fresh fruit mixed into salads.

Consuming 5 to 6 servings of fruits or vegetables per day is highly recommended.

Vegetables and Fruits to be chosen: Fresh and seasonal fruits like apples, apricots, mangoes, peaches, cherry, pears, papaya, likewise green leafy vegetables, knol-khol, cabbage, cauliflower, eggplant, bhindi, gourd, turnips etc. Most of them are available in different seasons.

Canned fruits and pre-cooked preserved foods are not healthy and should be avoided. Likewise, fruit juices do not have the same protection as fresh fruits with all the fiber and natural vitamins intact To be avoided: Deep Fried vegetables, fruit salads in cream or heavy syrups

2. Select whole grains

Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. You can increase the number of whole grains in a heart-healthy diet by making simple substitutions for refined grain products Unpolished rice, whole wheat flour, barley, oatmeal, and flax seed.

The amount of rice eaten per day of course is very variable. In European or American food, it is not more than twice a week. But we in Kashmir as in various other parts of India take it twice every day. It is a major part of the meal. The quantity needs to be regulated. It should not exceed 100 to 150 grams per meal for one person.

Overweight persons and diabetics should not exceed 50 grams per meal. By far and large it should be an unpolished one. For wheat consumers 2 chapatis per meal made of whole wheat flour is recommended. Remember that it should be taken with plenty of vegetables, small servings of mutton or chicken and several servings of fruits per day.

The habit of taking bread from the baker which is usually made of Maida is also a causative factor for high triglycerides. While it is a tradition it should not be a daily routine. Homemade roti on a few days per week should be introduced.

One of the problems of very high triglycerides in the blood sample in our country men is the built-in habit of taking a very high carbohydrate diet. This also is a causative factor for high prevalence of diabetes in this part of the world, China included.

To be Avoided: Biscuits, muffins, cakes, white bread, white refined flour, Maida and products made from it

3. Limit unhealthy fats and cholesterol

High levels of blood cholesterol, especially bad cholesterol (LDL c) are important risk factors for heart attacks. It should be remembered that diet contributes only one third of the levels seen in blood on testing. Another major part comes from the liver.

The best way to reduce saturated fats is to limit the amount of solid fats like butter and ghee. It can also be reduced by trimming fat off the meat or choosing lean meats.

Chicken also has less saturated fat and the skin fat is mostly healthy fat (polyunsaturated and monounsaturated fats). Fish is always a better choice.Fats to choose: olive oil, mustard oil or canola oil, sunflower oil, safflower oil.

In our setting in the valley mustard oil which also is a part of our existing cooking medium should be the most preferred one. It is always better than safflower oil and sunflower oil.

Deep frying makes the oil bad so also the food items being cooked in it. The leftover of the oil after frying should be discarded. It is full of trans fatty acids and carbon products.To be avoided: Ghee, coconut oil, Palm oil, hydrogenated oils (vanaspati like “Dalda” vanaspati ghee)

4. Protein sources should have low-fat

Lean meat, poultry and fish, low-fat dairy products, and egg whites are some of the best sources of protein. But be careful to choose lower fat options, such as skimmed milk rather than whole milk.

Fish is another good alternative to high-fat meats and certain types of fish are rich in omega-3 fatty acids, which can lower blood fats called triglycerides. The highest amounts of omega-3 fatty acids are in cold-water fish, such as salmon, mackerel and herring.

Despite plenty of fish including trout being available the consumption in a typical Kashmiri diet is low. Likewise, the dried fish “Hogaad, Phaer etc” is no longer a popular food item and their sales are shrinking.

Legumes — beans, peas and lentils — are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting plant protein for animal protein will reduce fat and cholesterol intake.

Proteins to choose: Skimmed milk, yogurt or cheese made out of it. Egg white, fatty cold-water fish, Dals, and fat discarded meat)To be avoided: full cream milk, organ meats like liver, kidney, egg yolk, fatty meats, deep fried meat

5. Reduce the sodium/salt in your food

Eating a lot of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease.

Reducing sodium is an important part of a heart-healthy diet. Healthy adults have no more than 2.5 grams of sodium a day (about a teaspoon). Older People and those who have been diagnosed with high blood pressure, diabetes or chronic kidney disease should have no more than 1.5 grams of sodium a day.

Traditional tea with salt (noon chaay) is a source of high salt and should be taken only sparingly especially by the high-risk populations with high blood pressure and heart failure

6. Control the amount of food you eat

The amount of food is as important as what you eat? Overloading your plate, and eating until you feel stuffed can lead to eating more calories, fat and cholesterol than you should. The serving size should be small. Keep track of the number of servings you have. Meat, chicken or fish should not be more than 75 to 100 grams per meal.

Tail Piece:

Consumption of 5 to 6 servings of fresh seasonal fruits and vegetables per day leads to a marked reduction in vascular events when combined with regular exercise, cessation of smoking, keeping low blood cholesterol, blood pressure less than 140/90 mmHg, appropriate blood sugar control in diabetics, avoiding obesity and minimizing psychosocial stress.

Heart healthy Diet is an important and integral part of the “No Heart Attack Mission” of the Gauri Kaul foundation. Preventive health checkups and dietary counselling is an important component of the services rendered by the Gauri Heart Centre, Srinagar.

Prof Upendra Kaul, Founder Director Gauri Kaul Foundation