Jan 15, 2006 Table of Contents

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Information from Your Family Doctor

Keeping Your Heart Healthy Through Good Nutrition and Exercise

Am Fam Physician. 2006 Jan 15;73(2):265-268.

See related article on nutritional assessment for cardiovascular disease.

You can do a lot to reduce your risk of heart disease by eating right and exercising. Here are some tips on what to eat and what to stay away from. At the end, you will find some advice on exercise. This should start you on your way to a healthier heart.

TABLE 1

Breads, cereals, rice, and pasta: six or more servings per day

Foods to eat

Breads with at least 2 grams of fiber per serving (examples: whole grain bread, English muffins, bagels, buns, corn and flour tortillas)

Oat, wheat, corn, and multigrain cereals with at least 5 grams of fiber per serving

Whole wheat pasta

Brown rice

Low-fat animal crackers, graham crackers, soda crackers, bread sticks, melba toast, and other crackers that have all of the following:

Less than 2 grams of fat per serving

At least 1 gram of fiber per serving

No hydrogenated oil

Homemade baked goods made with unsaturated oil, skim or 1 percent milk, and egg substitute (examples: quick breads, biscuits, cornbread, muffins, bran muffins, pancakes, waffles)

Foods to avoid

Breads with fat, butter, or eggs listed as one of the first ingredients (examples: croissants, tortillas made with added fats)

Granola made with partially hydrogenated oil

White pasta

White rice

High-fat crackers and those made with partially hydrogenated oil

Commercially baked pastries, biscuits

Dairy products and dairy substitutes: three servings (each 1 cup) per day

Foods to eat

Skim milk, thick skim milk, 1 percent milk, buttermilk

Soy or rice drinks

Low-fat cheese with less than 3 grams of fat per serving, including natural cheese, processed cheese, and nondairy cheese such as soy cheese

Low-fat, nonfat, and dry-curd cottage cheese with less than 2 percent fat

Low-fat or nonfat coffee creamer and sour cream (read the label, and avoid if sugar is one of the first three ingredients)

Foods to avoid

Whole milk, 2 percent milk

Yogurt and yogurt drinks made with whole milk

Regular cheeses (examples: American, blue, Brie, cheddar, Colby, Edam, Monterey Jack, part-skim mozzarella, Parmesan, Neufchâtel cheeses)

Regular cottage cheese

Cream, half and half, whipping cream, regular nondairy creamer or flavored creamer, whipped topping, sour cream

Eggs and egg substitutes: no more than two egg yolks per week (four if eggs have added omega-3 fats)

Foods to eat

Egg whites (two whites can substituted for one whole egg in recipes), cholesterol-free egg substitute

Foods to avoid

Egg yolks (more than two per week; this includes eggs used in cooking and baking)

Fats and oils: no more than 6 teaspoons per day

Foods to eat

Unsaturated oils: olive oil, canola oil, peanut oil, soybean oil

Spreads with little or no trans-fatty acids (some brand names: Smart Balance Omega Plus and original, Canola Harvest non-hydrogenated spread, others such as Benecol and Take Control)

Salad dressings made with unsaturated oil, or low- fat or nonfat varieties

Foods to avoid

Saturated oils: coconut oil, palm kernel oil, palm oil

Hydrogenated oils

Trans-fatty acids (partially hydrogenated oils)

Butter, lard, shortening, bacon fat, stick margarine, margarine with partially hydrogenated oil

Foods made with olestra (brand name: Olean) should be limited; may cause gastrointestinal symptoms and keep fat-soluble vitamins out of circulation

Fruits: 2 cups per day (about two regular-sized pieces of fruit)

Foods to eat

A variety of fruits; all fruits are allowed. Limit dried fruit to 1/2 cup.

Meat and meat substitutes: no more than 6 oz per day

Foods to eat

Lean cuts of well-trimmed beef, pork, lamb (examples: loin or round. Choose select grade, not prime or choice)

Fish or shellfish without butter

Processed meat prepared from lean meats (examples: lean ham, lean hot dogs, lean meat with soy protein added)

Poultry without skin

Tofu, tempeh, vegetable patties

Cooked dried or canned beans (legumes) and peas

Foods to avoid

Fatty cuts of beef, pork, and lamb; regular ground beef; spare ribs; organ meats

Fish or shellfish with butter or high-fat sauces

Nuts and seeds, including olives and avocados: 1/2 cup per day most days

Foods to eat

Seeds and nuts, including avocados, olives, natural peanut butter (no more than 2 tablespoons per day)

Foods to avoid

Coconut, peanut butter made with partially hydrogenated oil

Soups and other mixed dishes: Servings per day depend on ingredients

Foods to eat

Reduced-fat or low-fat soups

Soups with less than 600 mg sodium per serving (examples: chicken or beef noodle, minestrone, tomato, vegetable, potato soups)

Foods to avoid

Soups made with whole milk, cream, meat fat, poultry fat, or poultry skin

Soups with 600 mg or more sodium per serving

Sweets and desserts: If your triglyceride levels are above normal, avoid foods in this section. Otherwise, eat only small amounts.

Foods to eat

Syrup, turbinado sugar, honey, jam, preserves, fruit-flavored gelatin, sucralose (brand name: Splenda), aspartame (brand names: NutraSweet, Equal)

Dark chocolate

Low-fat and nonfat frozen yogurt, low-fat and nonfat ice cream, sherbet, sorbet, fruit ice, frozen ice pops (one brand: Popsicle)

Cookies, cake, pie, and pudding made with egg whites or egg substitute, skim milk or 1 percent milk, and unsaturated oil

Gingersnaps, fig and other fruit bar cookies, fat-free cookies, angel food cake, desserts with no more than 3 grams of fat per serving

Foods to avoid

Candy made with milk chocolate, chocolate, coconut oil, palm kernel oil, or palm oil

Milk chocolate

Regular ice cream and frozen treats made with regular ice cream

Commercially baked pies, cakes, doughnuts, high-fat cookies, cream pies

Baked goods made with partially hydrogenated oil.

Vegetables: at least three to five servings per day

Foods to eat

Fresh or frozen vegetables without added fat or salt

Vegetables stir fried with small amounts of unsaturated oil

Foods to avoid

Vegetables fried or cooked with butter, cheese, or cream sauce

Exercise

Recommended activities

Gardening, cleaning the house, walking, climbing stairs, playing with children, activities with friends and family, raking leaves, walking to the store, parking far away, dancing, shoveling snow, yoga

Cycling, hiking, racquetball, running, swimming, walking, weight training

Activities to avoid

Excessive inactivity

TABLE 1  

View Table

TABLE 1

Breads, cereals, rice, and pasta: six or more servings per day

Foods to eat

Breads with at least 2 grams of fiber per serving (examples: whole grain bread, English muffins, bagels, buns, corn and flour tortillas)

Oat, wheat, corn, and multigrain cereals with at least 5 grams of fiber per serving

Whole wheat pasta

Brown rice

Low-fat animal crackers, graham crackers, soda crackers, bread sticks, melba toast, and other crackers that have all of the following:

Less than 2 grams of fat per serving

At least 1 gram of fiber per serving

No hydrogenated oil

Homemade baked goods made with unsaturated oil, skim or 1 percent milk, and egg substitute (examples: quick breads, biscuits, cornbread, muffins, bran muffins, pancakes, waffles)

Foods to avoid

Breads with fat, butter, or eggs listed as one of the first ingredients (examples: croissants, tortillas made with added fats)

Granola made with partially hydrogenated oil

White pasta

White rice

High-fat crackers and those made with partially hydrogenated oil

Commercially baked pastries, biscuits

Dairy products and dairy substitutes: three servings (each 1 cup) per day

Foods to eat

Skim milk, thick skim milk, 1 percent milk, buttermilk

Soy or rice drinks

Low-fat cheese with less than 3 grams of fat per serving, including natural cheese, processed cheese, and nondairy cheese such as soy cheese

Low-fat, nonfat, and dry-curd cottage cheese with less than 2 percent fat

Low-fat or nonfat coffee creamer and sour cream (read the label, and avoid if sugar is one of the first three ingredients)

Foods to avoid

Whole milk, 2 percent milk

Yogurt and yogurt drinks made with whole milk

Regular cheeses (examples: American, blue, Brie, cheddar, Colby, Edam, Monterey Jack, part-skim mozzarella, Parmesan, Neufchâtel cheeses)

Regular cottage cheese

Cream, half and half, whipping cream, regular nondairy creamer or flavored creamer, whipped topping, sour cream

Eggs and egg substitutes: no more than two egg yolks per week (four if eggs have added omega-3 fats)

Foods to eat

Egg whites (two whites can substituted for one whole egg in recipes), cholesterol-free egg substitute

Foods to avoid

Egg yolks (more than two per week; this includes eggs used in cooking and baking)

Fats and oils: no more than 6 teaspoons per day

Foods to eat

Unsaturated oils: olive oil, canola oil, peanut oil, soybean oil

Spreads with little or no trans-fatty acids (some brand names: Smart Balance Omega Plus and original, Canola Harvest non-hydrogenated spread, others such as Benecol and Take Control)

Salad dressings made with unsaturated oil, or low- fat or nonfat varieties

Foods to avoid

Saturated oils: coconut oil, palm kernel oil, palm oil

Hydrogenated oils

Trans-fatty acids (partially hydrogenated oils)

Butter, lard, shortening, bacon fat, stick margarine, margarine with partially hydrogenated oil

Foods made with olestra (brand name: Olean) should be limited; may cause gastrointestinal symptoms and keep fat-soluble vitamins out of circulation

Fruits: 2 cups per day (about two regular-sized pieces of fruit)

Foods to eat

A variety of fruits; all fruits are allowed. Limit dried fruit to 1/2 cup.

Meat and meat substitutes: no more than 6 oz per day

Foods to eat

Lean cuts of well-trimmed beef, pork, lamb (examples: loin or round. Choose select grade, not prime or choice)

Fish or shellfish without butter

Processed meat prepared from lean meats (examples: lean ham, lean hot dogs, lean meat with soy protein added)

Poultry without skin

Tofu, tempeh, vegetable patties

Cooked dried or canned beans (legumes) and peas

Foods to avoid

Fatty cuts of beef, pork, and lamb; regular ground beef; spare ribs; organ meats

Fish or shellfish with butter or high-fat sauces

Nuts and seeds, including olives and avocados: 1/2 cup per day most days

Foods to eat

Seeds and nuts, including avocados, olives, natural peanut butter (no more than 2 tablespoons per day)

Foods to avoid

Coconut, peanut butter made with partially hydrogenated oil

Soups and other mixed dishes: Servings per day depend on ingredients

Foods to eat

Reduced-fat or low-fat soups

Soups with less than 600 mg sodium per serving (examples: chicken or beef noodle, minestrone, tomato, vegetable, potato soups)

Foods to avoid

Soups made with whole milk, cream, meat fat, poultry fat, or poultry skin

Soups with 600 mg or more sodium per serving

Sweets and desserts: If your triglyceride levels are above normal, avoid foods in this section. Otherwise, eat only small amounts.

Foods to eat

Syrup, turbinado sugar, honey, jam, preserves, fruit-flavored gelatin, sucralose (brand name: Splenda), aspartame (brand names: NutraSweet, Equal)

Dark chocolate

Low-fat and nonfat frozen yogurt, low-fat and nonfat ice cream, sherbet, sorbet, fruit ice, frozen ice pops (one brand: Popsicle)

Cookies, cake, pie, and pudding made with egg whites or egg substitute, skim milk or 1 percent milk, and unsaturated oil

Gingersnaps, fig and other fruit bar cookies, fat-free cookies, angel food cake, desserts with no more than 3 grams of fat per serving

Foods to avoid

Candy made with milk chocolate, chocolate, coconut oil, palm kernel oil, or palm oil

Milk chocolate

Regular ice cream and frozen treats made with regular ice cream

Commercially baked pies, cakes, doughnuts, high-fat cookies, cream pies

Baked goods made with partially hydrogenated oil.

Vegetables: at least three to five servings per day

Foods to eat

Fresh or frozen vegetables without added fat or salt

Vegetables stir fried with small amounts of unsaturated oil

Foods to avoid

Vegetables fried or cooked with butter, cheese, or cream sauce

Exercise

Recommended activities

Gardening, cleaning the house, walking, climbing stairs, playing with children, activities with friends and family, raking leaves, walking to the store, parking far away, dancing, shoveling snow, yoga

Cycling, hiking, racquetball, running, swimming, walking, weight training

Activities to avoid

Excessive inactivity


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2006 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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