There has been a considerable enhancement in the richness of diet that our people have been taking over the years. This factor, combined with reluctance to exercise, the increased prevalence of diabetes, an increase in jobs that are deskbound, and the relative stress of modern urban living, has contributed to the wave of a swelling population of Indians affected with heart problems. All these factors put together lead to a possibility for Indians to have a very high incidence of heart diseases.

It has been estimated that Indians are nearly four times more susceptible to heart attacks than white Americans. According to the World Health Organization (WHO), 60 percent of the world's cardiac patients will be Indian by 2010.

Food is directly involved in many of the risk factors for coronary heart disease. Paying attention to what you eat is one of the most important preventative measures you can take. In addition to knowing which foods to eat, you'll also need to know how much you should eat. Overloading your plate, taking seconds and eating until you feel stuffed can lead to eating more calories, fat and cholesterol than you should.

What exactly is an overall healthy diet?

A well-rounded, nutrient-rich diet can help protect you from many diseases and health problems, including heart disease. But for many of us, trying to understand what constitutes good nutrition can be overwhelming. Here are the most important points to be considered.

Limit unhealthy fats and cholesterol.

Of the possible changes, limiting how much saturated and trans fat you eat is the most important step you can take to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.

Type of Fat Recommendation
Saturated Fat Less than 7 percent of your total daily calories.
Trans Fat Less than 1 percent of your total daily calories.
Cholesterol Less than 300 milligrams a day for healthy adults; less than 200 milligrams a day for adults with high levels of low-density lipoprotein (LDL), or "bad," cholesterol or those who are taking cholesterol-lowering medications.

Good fats for heart health

Rather than cutting all fat from your diet, it is better to replace the bad fats with good fats. Contrary to what many believe, not all fat is bad. Fats are necessary and vital for good health; the type of fat you consume is what is important.

The good fats for heart health are monounsaturated and polyunsaturated

Which reduce bad cholesterol levels and provide nutrients that help our cells function properly. Polyunsaturated fats include the Omega-3 and -6 fatty acids, which also benefit cardiovascular health. These are known as essential fatty acids (EFAs) because the body cannot manufacture them and they must be provided through the diet.

Easy sources of these good fats include nuts, seeds, fish, vegetable oils (especially olive oil) and avocados. Always use a variety of oils and in rotation so that you get the benefits of MUFA,omega-3 and omega-6 fatty acids. OILS to be used in rotation: Sunflower oil, mustard oil, ricebran oil, soyabean oil, groundnut oil, sesame oil.

Quantity: only 2 to 3 tsp per person per day

The bad fats are saturated fats, trans fats and damaged fats.

Saturated fats are found in butter, cheese, whole fat milk, red meat, organ meat, egg yolks.

Trans fats are found in many processed foods like cookies, crackers, fast food, some margarines, and in anything that contain partially hydrogenated oils, so read labels carefully and avoid deep fried fast foods.

The best way to reduce saturated and trans fats in your diet is to limit the amount of solid fats - butter, margarine and shortening - you add to food when cooking and serving. Use low-fat substitutions when possible for a heart-healthy diet. For example, use pudina chutney on your sandwiches instead of butter. You may also want to check the food labels of some cookies, crackers and chips. Many of these snacks - even those labeled "reduced fat" - may be made with oils containing trans fats. One clue that a food has some trans fat in it is the phrase "partially hydrogenated" in the ingredient list.

Choose low-fat protein sources.

Lean meat, poultry and fish, low-fat dairy products and egg whites are some of your best sources of protein. But be careful to choose lower fat options, such as skim milk rather than whole milk and skinless chicken breasts rather than fried chicken patties.

Fish is another good alternative to high-fat meats. Certain types of fish are heart healthy because they're rich in omega-3 fatty acids, which can lower blood fats called triglycerides and may reduce your risk of sudden cardiac death. You'll find the highest amounts of omega-3 fatty acids in cold-water fish, such as salmon, mackerel and herring. Other sources are flaxseed, walnuts, soybeans and canola oil. Legumes - beans, peas and lentils - also are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting soy protein for animal protein will reduce your fat and cholesterol intake.

Choose Avoid
Skim or low-fat (1 percent) milk Full-fat milk and other dairy products
Fat-free or low-fat dairy products, such as curds Organ meats, such as liver
Egg Whites Egg Yolks
Fish, like fatty, cold-water fish, salmon Fatty and marbled meats
Skinless Poultry Hot dogs and sausages
Legumes Fried, breaded or canned meats
Soybeans and soy products

Eat more vegetables and fruits.

Vegetables and fruits are good sources of vitamins and minerals; they are low in calories and rich in dietary fiber. A diet high in soluble fiber, the kind found in fruits and vegetables can help lower your cholesterol and reduce your risk of heart disease. Vegetables and fruits also contain substances found in plants that may help prevent cardiovascular disease. Eating more fruits and vegetables may help you eat less high-fat foods, such as meat, cheese and snack foods. Don't smother vegetables in butter, dressings, creamy sauces or other high-fat garnishes.

Choose Avoid
Fresh vegetables and fruits Vegetables with creamy sauces
Coconut Canned fruit packed in heavy syrup

Select whole grains

Whole grains are good sources of fiber and other nutrients. Whole grains are also a source of vitamins and minerals, such as thiamin, riboflavin, niacin, vitamin E, magnesium, phosphorus, selenium, zinc and iron. Various nutrients found in whole grains play a role in regulating blood pressure and heart health.

You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions. For example, choose breads made from 100 percent whole grain instead of those with refined white flour, whole-wheat pasta over regular pasta and brown rice instead of white rice. Select high-fiber cereals for breakfast, such as bran flakes, oats, or shredded wheat, instead of sugar-sweetened cereals. Select whole-wheat flour rather than white flour for making chapattis at home.

Another easy way to add whole grains to your diet is ground flaxseed. Flaxseeds are small brown seeds that are high in fiber and omega-3 fatty acids, which can lower your total blood cholesterol. Add ground flax seed to your salads or chapattis. Also a great way to increase the fiber content is to add two cups of wheat or oat bran to five cups of chapattis flour.

The importance of fiber to heart health

Diets high in fiber lower cholesterol levels and reduce the risk of heart disease. Fiber is classified as either insoluble fiber or soluble fiber depending on whether it dissolves in water. Soluble fiber is particularly important for lowering cholesterol since it binds with the cholesterol, enabling it to leave the body without getting reabsorbed back into the blood. Food sources high in heart-healthy soluble fiber include the following:

  • Oatmeal / oat bran
  • Legumes (chickpeas, northern beans, pinto beans, black, kidney, lima, navy)
  • Grapefruit, orange, blackberries, pear, figs, apple
  • Flax seeds
  • Psyllium husk

An average person only consumes around 15 grams of dietary fiber per day, falling short of the recommended daily intake of 38 grams for men and 25 grams for women under the age of 50.

Choose Avoid
Whole-wheat flour Doughnuts
Whole-grain bread, preferably 100 percent whole-wheat or 100 percent whole-grain bread Biscuits White breads
High-fiber cereal with 5 or more grams of fiber per serving Cakes
Brown rice Egg noodles
Whole-grain pasta Buttered popcorn
Oatmeal High-fat snack
Ground flaxseed Potato chips

Reduce the salt in your food.

Eating a lot of salt can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing the salt in your food is an important part of a heart-healthy diet. The American Heart Association recommends that healthy adults eat less than 2,300 milligrams of sodium a day (about a teaspoon).

Although reducing the amount of salt you add to food at the table or while cooking is a good first step, much of the salt you eat comes from canned or processed foods, like soups and frozen dinners. Eating fresh foods and making your own soups can reduce the amount of salt you eat.

Choose Avoid
Herbs and spices Table salt
Reduced-salt canned soups or prepared meals Canned soups and prepared foods,
Soy sauce

No Smoking, Less Alcohol

Studies have shown that both active and passive smokers are at risk of developing heart disease and lung cancer. So smokers, please stub it out completely. Moderate alcohol intake is said to be good for the heart according to certain studies, but too much raises risk of high BP and stroke. Moderate quantity means 1-2 drinks a week. Cigarette smoking has been associated with sudden cardiac death of all types in both men and women.

  • Smoking-related coronary heart disease may contribute to congestive heart failure. An estimated 4.6 million Americans have congestive heart failure and 43,000 die from it every year.
  • Smoking low-tar or low-nicotine cigarettes rather than regular cigarettes appears to have little effect on reducing the risk of coronary heart disease.

BMI and Exercise

BMI is "Body Mass Index". It tells you whether your body weight is appropriate for your height.

In Indians it is advisable that the BMI be not more than 22.9*

  • BMI = Weight in kilograms / (Height in meters) 2
  • Normal- 18 to 22.9
  • Overweight-23 to 29.9
  • Grade I obesity - 30 to 34.9
  • Grade II Obesity - 35 to 39.9
  • Grade III Obesity - 40 and above

Use the measuring tape more than the weighing scale. Also, check whether you are an "apple" or a "pear". Apple-shaped people tend to store excess body fat in their abdomen. Excess abdominal fat is thought to increase resistance to insulin, thereby increasing the risk of diabetes, which, in turn, raises cholesterol, and heart disease risk. But 30-40 minutes of brisk walking four to five times a week is required. This can reduce the risk of heart disease by 20%. Thus it is important to make time and include exercise in your daily routine.