With heart disease and its precursor metabolic syndrome on the rampage, urgent measures need to be taken to deal with it.
Coronary artery disease begins with atherosclerosis or hardening of arteries. The process begins when you’re young and can be well advanced by middle age. ‘Metabolic syndrome’ is a cluster of metabolic abnormalities that include abdominal obesity, high triglyceride levels, high cholesterol levels, low HDL (good cholesterol), pre-hypertension and pre-diabetes. The risk of cardiovascular disease can be reduced over 95 per cent by controlling excess body weight, large waist size, high blood pressure, high sugar and cholesterol levels. On an individual level, diet and exercise can help best.
Diet influences the course of heart disease by:
Maintain ideal body weight and Body Mass Index (BMI). For Asian populations, BMI guidelines are as under:
Manage waist and hip circumference: Waist circumference is an index of intra-abdominal fat mass and total body fat. A measurement of less than 80 cms for women and less than 90 cms for men is considered acceptable for Asians. A waist to hip ratio of >0.85 in women or >0.9 in men reflects abdominal obesity and increased risk for associated health problems.
Control cholesterol: Special foods that help lower the blood cholesterol include barley, oats, oat bran, legumes, psyllum (isabgol), green tea, garlic, soy, alfa-alfa, fenugreek seeds (methi).
Maintain blood pressure: The levels around 120 mm Hg systolic and 80 mm Hg diastolic. The best known approach is the DASH diet – a diet low in salt, fat, saturated fat, cholesterol and rich in fruits, vegetables and low-fat dairy products. Reduce inflammation: Inflammation has an important role in the genesis of cardiovascular disease. Obesity, diabetes and metabolic syndrome are associated with high inflammatory markers. Foods found to reduce inflammation include complex carbohydrates (whole grains), good fats (PUFA, MUFA and a good n-6:n-3 fatty acids in the diet), protein (pulses, legumes, lean meat, dairy products) and vitamins and minerals (fruits and vegetables), along with regular physical activity and avoidance of smoking. Other important nutrients, which help fight inflammation include n-3 fatty acids, Omega-3 fats (fish oil), Vitamin E, Vitamin C, phytochemicals like flavonoids, catechins and phenols (citrus fruits, fruit juices, dried and fresh plums, raisins, eggplant, cereals, legumes, and oilseeds) and isoflavones (soyabeans and soy products such as tofu).
Decrease clotting properties of blood: Have foods rich in Omega-3 fats like soy, tofu, walnuts, fenugreek seeds, flaxseeds, canola oil, mustard oil and fatty fish. Garlic, kiwi and tomatoes also possess anti-clotting properties.
Influencing homocysteine (artery damaging amino acid) levels: Normal levels are below 10 micromol/litre in adults. People with levels above 12 have double the risk of heart attack. Foods rich in folic acid can prevent increase in homocysteine levels. These include spinach, leafy greens, broccoli, beans, peanuts, wheat germ, sunflower seeds, sprouts, pulses, cabbage, cauliflower; Vitamin B6 – whole grains, fish, poultry, meat including liver and kidneys, nuts, sunflower seeds, bananas; Vitamin B12 – low fat dairy, eggs, meat, poultry, fish etc; and omega-3 fatty acids. Preventive health is about inclusion of beneficial foods rather than simply avoiding harmful ones. The key to a good diet is to follow a well balanced diet with sound nutritional principles and to use some common sense, to get optimum nutrients.
Ensure the diet provides:
- Whole grains – coarse grains, wheat germ, oats, oat bran, barley, barley porridge, millets, wholegrain breads etc. Limit intake of refined flour, polished rice and sugary foods. Avoid added sugar in beverages.
- Adequate proteins from pulses, soy, poultry or fatty fish. Adding 25 gms of soyabean to diet lowers cholesterol levels by 12 to 15 per cent. Eat a variety of fish and prefer fatty fish as it is rich in Omega-3 fats.
- Good fats from cold pressed oils like mustard, olive, sesame, rice bran oil. Choose a variety of vegetable oils as cooking medium.
- At least 15-20 gms of nuts & seeds (almonds, flax seeds, fenugreek seeds, pumpkin seeds, watermelon seeds, cucumber seeds)
- Avoid hydrogenated fats found in hydrogenated margarines, vanaspati, deep fried food and commercially prepared bakery products.
- Low fat dairy (milk, curd, cottage cheese, soya milk).
- Brightly coloured fruits and vegetables and pectin rich vegetables like bottle gourd (lauki), lady’s finger and pumpkin.
Supplements must be taken under the guidance of a qualified nutritionist or physician. Eat heartily, even small changes in diet can make huge differences to your health.