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Heart Health: Nutrition Guidelines for Heart and Blood Vessel Disease (189)

Heart Health: Nutrition Guidelines for Heart and Blood Vessel Disease (189) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition

189

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Nutrition Guidelines for Heart and Blood Vessel Disease

Many factors affect your chances of getting heart and blood vessel disease. Some of these risk factors can’t be
changed (family history, age and gender). Yet, by watching what you eat, you can improve your blood fat
levels, control your weight and reduce high blood pressure.

By making wise food choices, you can lessen your risk of stroke (caused by blockages in the arteries that lead to
the brain), heart attack (caused by blockages in the arteries around the heart) and peripheral vascular disease
(caused by blockages in arteries in the legs).

Risk Factors of Heart and Blood Vessel Disease
ξ High LDL (low-density lipoprotein) or low HDL (high-density lipoprotein) cholesterol levels
ξ Family history of heart disease, stroke or peripheral vascular disease
ξ Tobacco use
ξ High blood pressure
ξ Diabetes
ξ Obesity
ξ Inactive lifestyle
ξ Male gender
ξ Age
ξ Smoking

Blood Fats
Fat is an important part of the blood. It is a major source of energy for muscles. It helps transport vitamins
throughout your body. Fat is also needed to make certain body tissues.

Even so, some blood fats can lead to a type of heart and blood vessel disease called atherosclerosis. This
disease is a buildup of cholesterol, calcium, and blood clotting factors in blood vessels. This buildup limits
blood flow, which can increase the risk of a heart attack, stroke, leg pain or other problems.

Blood Fat Levels
The guidelines below applies to adults 20 years and older. All values are in milligrams/deciliter.
Optimal Normal High
Total Cholesterol Less than 160 Less than 200 200 or greater
LDL Cholesterol for people without
heart disease

Less than 100 Less than 130 130 or greater
LDL Cholesterol for people with
heart disease

Less than 70 Less than 100 100 or greater
Triglycerides Less than 100 Less than 150 150 or greater
HDL Cholesterol
Men
Women

-

45 or greater
55 or greater

-

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Your Blood Fat Levels
Total Cholesterol
LDL
Triglycerides
HDL


What Do These Levels Mean?
Cholesterol is a substance found in all cells. It is needed for many body functions. Lipoproteins are particles
that carry cholesterol and other fats throughout the blood stream. Two important types of lipoproteins are LDL
(low-density lipoprotein) and HDL (high-density lipoprotein).

High LDL levels increase the risk of heart and blood vessel disease. LDL cholesterol can collect in the arteries.
This is why it is called “bad cholesterol.”

HDL removes extra cholesterol from your blood stream. This protects you from heart and blood vessel disease.
For this reason, HDL is often called “good cholesterol.”

Triglycerides are fats found in your food. Your liver can make them from excess calories, alcohol and sugars
in your diet. They are also found in body fat. When triglycerides levels are high, HDL levels tend to be low.

Fat in Your Diet
Although some fat is needed for good health, most Americans eat too much fat. If fat intake is lowered it can
help lower blood cholesterol levels and aid in weight loss. To reduce the amount of fat in your diet, eat less of:
ξ Fatty meats
ξ Fried foods
ξ Whole milk dairy products and cheese
ξ Added fats such as salad dressing, margarine, oil, or mayonnaise

Learn more about the different types of fats below.

Saturated fats are hard or semi-solid at room temperature. These fats tend to raise blood cholesterol levels and
therefore should be controlled in your diet. These types of fats are found in animal fats (meat fat, milk fat,
butter) and tropical oils (palm and coconut oil).

Trans fats are made when liquid vegetable oils are hardened to make shortening or margarine. They act like
saturated fat by raising your cholesterol. You can check food labels to help you avoid trans fats.

Unsaturated fats are mostly liquid at room temperature. They lower LDL cholesterol and should be included
in your diet. They may be used instead of saturated fats. Unsaturated fats contain the same number of calories
as saturated fat.
ξ Monounsaturated fats are found mainly in olive oil, canola oil, peanut oil, sesame oil, nuts, avocado
and olives.
ξ Polyunsaturated fats are found in corn, soybean, safflower, sunflower and cottonseed oils. Omega-3
fatty acids found in fish (salmon, mackerel, herring, and sardines) as well as flax seed, walnuts are
also polyunsaturated fats. Include fish 2-3 times per week in your diet. If unsaturated oils have been
hardened or hydrogenated (made into trans fats), they should be avoided.


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Cholesterol is found in all foods from animals, such as meat, eggs, and milk. Cholesterol should be limited to
300 milligrams per day for the general public and 200 milligrams per day for people with heart disease or high
cholesterol. Plants foods (fruits, vegetables, vegetable oils, grains, beans, nuts, peanut butter, and other plant
products) do not contain cholesterol. Your body can make all the cholesterol it needs, so you don't need to
consume any cholesterol. It is okay to include up to one egg daily. Eating foods high in saturated fats increases
blood cholesterol levels more than eating cholesterol rich foods.

Choose healthier types of fat. Eat less saturated fats and no trans fat. Replace animal fats with plant fats.

Saturated fats, eat less:
ξ Fatty meat: brats, hot dogs,
sausage
ξ Cheese, butter, 2% and
whole milk, cream, ice
cream, cream cheese
ξ Candy bars, chocolate,
desserts, cookies
ξ Fast food: tacos, fried
chicken sandwiches,
cheeseburgers, French
fries, biscuits, pot pie
Trans fats, avoid:
ξ Partially hydrogenated
vegetable oils
ξ Stick margarine
ξ Doughnuts, pastries
ξ Some boxed crackers and
cookies
ξ Some muffin and pancake
mixes
Unsaturated fats, eat more:
and in place of saturated and
trans fats:
ξ Vegetable oils
ξ Nuts and Nut Butters
ξ Avocado, Seeds, Olives
ξ Fatty Fish: salmon, tuna,
herring, sardines,
anchovies

Sodium and Blood Pressure
Sodium is mostly found in salt (sodium chloride). A low-sodium diet is used for the prevention and treatment
of high blood pressure. When you consume large amounts of salt, your body may retain fluid. This increases
pressure on your arteries. Excess salt in the diet can also make it harder for high blood pressure medicines to
work. People with high blood pressure, African Americans, and those who are 50 years or older should limit
their sodium to 1,500 mg per day. The goal for other Americans is 2300 mg of sodium per day or less.

To reduce your sodium intake (often needed for persons with high blood pressure):

ξ Remove the salt shaker from your table.
ξ Try cooking with half as much salt as in the past or do not add any salt when you are cooking.
ξ Avoid high-sodium processed foods.
ξ Use herbs and spices for flavor instead of salt.
ξ Make low-sodium choices when eating out.
ξ To learn more about the Dietary Approaches to Stop Hypertension (DASH) eating plan, visit
http://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf

Fiber
Fiber is the indigestible portion of the plant foods we eat. Eating 20-30 grams of dietary fiber per day (with a
focus on soluble fiber) can help to reduce LDL by 5-15%. Soluble fiber is found in fruits and vegetables,
barley, corn, dried peas and beans, and oats.

To increase your fiber intake:
ξ Use more fruits and vegetables (aim for at least 4-5 cups per day).
ξ Use whole grain breads and cereals. Include those with oats and barley.
ξ Plan meatless meals once a week or more, using navy beans, kidney beans, pinto beans, garbanzo beans,
lentils, or split peas as a protein source.

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Exercise
Exercise strengthens your heart, raises your HDL, lowers your triglycerides and helps with weight control. It
can include aerobic activities like jogging, fitness walking (2.5 to 3.5 mph), biking, aerobic dancing, swimming,
cross-country skiing, and rowing. It can also include routine daily movement like taking the stairs, mowing the
lawn and washing windows. Experts suggest at least 150 minutes of exercise per week. If exercise is used as a
means for weight control, aim to exercise 4 to 5 days per week (at least 30 minutes each day) to increase the
amount of calories you burn.

How Should I Change my Diet?
Diet Guidelines
If you follow the food guidelines in this handout, your total fat, saturated fat, and trans fat intake should meet
recommended goals. You do not need to count fat grams, but some people find it helpful to keep track. As a
guideline:
ξ Total fat amounts: up to 60 grams/day women and up to 75 grams/day men
ξ Saturated fat amounts: up to 15 grams per day for men and women


ChooseMyPlate provides guidelines that help consumers make better
food choices. The ChooseMyPlate food guide recommends you find a
balance between food and physical activity by staying within your calorie
needs.

To find the amounts of food that are right for you, go to
www.ChooseMyPlate.gov




A Mediterranean diet may be best for preventing heart and blood vessel disease. This eating pattern includes
about 30% of the calories as fat, with saturated and trans fats less than 7%. Most of the fat should come from
monounsaturated fat (olive oil, canola oil, nuts and avocados). Cheese and meat are only eaten in small
amounts. Fruits, vegetables, whole grains, fish and vegetable proteins (legumes and nuts) make up most of the
diet. This diet is higher in unsaturated fats so portions may need to be reduced to prevent weight gain.




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Heart Healthy Eating
Sample Daily Menu

Breakfast
1 cup cooked oatmeal,
sprinkle with 1 tablespoon
chopped walnuts
Cinnamon on cereal
1 banana
1 cup 1% or fat-free milk

Lunch
1 cup low-fat (1% or lower)
plain yogurt
1/2 cup peach halves
2 Rye-Krisp crackers with
½ cup tuna (mixed with a little
mayonnaise or lemon juice)
1 cup raw broccoli and
cauliflower
Sparkling water

Dinner
Grilled turkey burger (4
ounces) with a whole-grain
bun
1 cup green beans
2 cups mixed salad greens
with 2 tablespoons low-fat
salad dressing
1 small orange

Snack
¼ cup nuts
1 small apple

Snack
1 cup 1% or fat-free milk
1 slice whole grain toast with
peanut butter (2 tsp)

This menu provides about 1800 calories, 215 grams carbohydrate (28 g fiber), 62 grams fat (10 grams saturated
fat), 93 grams protein (48% carbohydrate, 20% protein, 32% fat).

Food Guidelines
Follow these guidelines to reduce your intake of fat, saturated fat, cholesterol, and calories. Choose
“recommended” items most often and use “not recommended” items sparingly. A  indicates items high in
sodium. Avoid these foods if you are trying to control your salt intake.

Milk and Dairy Products

Recommended Not Recommended

Skim milk, 1% milk Whole/2% milk
Low fat/non-fat cream substitutes Full-fat, natural cheese
Evaporated skim milk Processed cheese
Low fat, part skim cheese: Ice cream
Mozzarella (part skim) Frozen custard
Farmer’s cheese Sour cream
Part-skim or non-fat ricotta Cream, half & half
Reduced fat cheese (5 gms fat per ounce or
less)
Non-dairy creamers (if made with coconut or
palm oil)
Low fat/non-fat cottage cheese Cream cheese
Low fat/non-fat yogurt
Low fat/non-fat sour cream
Low fat/non-fat cream cheese
Low fat/non-fat frozen yogurt
Sherbet
Low fat/non-fat ice cream
Soy milk (calcium fortified)


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Breads, Cereals & Grains

Recommended Low Fat but High Sodium
foods
Not Recommended

Whole grain breads
English muffins
Whole grain bagels
Cereals, especially whole grain
Pancakes, waffles (with 5 grams fat
or less)
Rice cakes
Pita Bread
Tortilla, corn or flour
Rice, barley, quinoa or bulgur
Pasta, especially whole grain
Graham crackers
Soda crackers  Doughnuts and other fried breads
Croissants
Crescent rolls
Sweet rolls
Muffins or biscuits made with
saturated fats
Crackers with more than 2 gm fat per
serving
Chow mein noodles, ramen noodles
with palm oil
Granola (unless lower than 2 grams
of fat/serving)
Rice/noodle mixes  (unless fat is
omitted)
Crackers  (with 2 grams of fat
or less per serving)









Protein Foods

Recommended Low Fat but High Sodium
foods
Not Recommended

Lean beef – Top sirloin, tenderloin,
top loin, round, ground round, rump,
arm, flank.
Lean pork – loin chop, tenderloin
Game – venison, rabbit
Poultry – chicken (skinless) turkey
(skinless)
Low fat/fat-free hot dogs
Fish, all types
Shrimp (limit to 4 ounces per week)
Egg white/egg substitute
Peanut butter
Dried or canned beans, split peas,
lentils
Textured vegetable protein
Tofu

Lean pork –ham
Low fat TV dinners/frozen
entrees  (Healthy Choice )
Low fat turkey bacon or
sausage
Low fat turkey luncheon meats
(3 grams fat or less per ounce)

Turkey/chicken bratwurst
Vegetarian burgers or sausage
 (made of soy)
Low fat creamed soups
Fatty beef – regular hamburger, T-
bone, prime rib, ribs, porterhouse
Fatty pork – spare ribs, sausage,
bacon
Fatty poultry – poultry skin, duck,
goose, self-basting turkeys
Luncheon meats/cold cuts with
more than 3 grams of fat per ounce
Hot dogs
Bratwurst 
Deep-fried meats and seafood
Egg yolk (limit to 4 per week)
Creamed soups





Limit meat, poultry and low-fat cheese intake to a total of 6 ounces per day. One 3-ounce serving is about the
size of a deck of cards. Choose meats that are lean ‘select’ cuts rather than ‘prime/choice’ cuts. Trim visible fat
before cooking. Prepare by baking, roasting, broiling or grilling to reduce fat content. Try meatless meals 1 to
2 times per week to further lower fat intake and increase fiber.





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Vegetables & Fruits – at least 4-5 cups per day

Recommended Low Fat but High Sodium
foods
Not Recommended

Fresh, frozen, dried, or canned fruits
Fruit juices (limit quantity to control
Canned vegetables or vegetable
juices
Fried, deep-fried, creamed or au
gratin vegetables
calories and sugar)
Fresh or frozen vegetables
Pickles 
Sauerkraut 
Coconut and coconut milk in large
quantities
Avocado Olives  Frozen vegetables in sauces or
cheese

Fats
Recommended Low Fat but High Sodium
foods
Not Recommended

Vegetable oil-based spreads
Liquid vegetable oils- canola, olive,
peanut, or sesame oil, sunflower,
safflower, corn, soybean or
cottonseed oil
Mayonnaise and sandwich spreads
(reduced calorie)
Nuts and seeds in moderate amounts
Salad dressings  (reduced
calorie)
Margarine with hydrogenated oil as
primary ingredient (most stick types)
Butter
Lard
Cream cheese
Hardened or hydrogenated vegetable
shortening
Coconut and palm oil
Regular gravy
Bleu cheese salad dressing 

The recommended fats should be used only in small amounts to control calories.

Snacks and Desserts

Recommended Low Fat but High Sodium
foods
Not Recommended

Fruit
Angel food cake
Puddings from skim milk
Cocoa powder, small amounts dark
chocolate
Cakes and cookies made with oil and
egg whites
Low fat, high fiber granola and
breakfast bars
Baked potato or corn chips
Popcorn with little or no added fat
Sherbet, fruit ices, Popsicles, sorbet
Low fat ice cream or frozen yogurt
Vanilla wafers, graham crackers,
ginger snaps
Hard candy, licorice, jelly beans
(small amounts)
Jelly, jam, honey, syrups (small
amounts)
Pretzels  Regular tortilla, potato and corn
chips
Candy bars
Cakes and cookies made with
hardened fat and egg yolks
Pies, pastry
Frosted or chocolate-covered
granola bar
Ice cream








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Cut down on added sugars. Although sugar does not increase cholesterol levels, amounts should be controlled
for persons who are overweight. Persons with diabetes or high triglycerides should eat fewer servings of sugar
and sweets. Snacks and desserts can lead to weight gain. Try to eat them in small servings or less often if you
are overweight.

Resources
Cookbooks
The Road to a Healthy Heart Runs through the Kitchen, by Joe and Bernie Piscatella, Workman Publishing,
2006.

The New American Heart Association Cookbook, 8th Edition, Random House, 2010.

American Heart Association Low-Fat, Low-Cholesterol Cookbook, 3rd Edition, Random House. 2005.

American Heart Association Quick and Easy Cookbook, Random House, 2010

American Heart Association The Diabetes and Heart Healthy Cookbook,Random House, 2004.

The Complete Idiots Guide to the Mediterranean Diet, Penguin Publishing, 2010

The New Mediterranean Diet Cookbook, Bantam, 2009

Eat, Drink and Weigh Less, by Mollie Katzen and Walter Willet, Hyperion, 2006.

How to Cook Everything Vegetarian: Simple Meatless Recipes for Great Food by Mark Bittman and Alan
Witschonke, 2007

The Complete Idiot's Guide to Vegan Living by Beverly Lynn Bennett and Ray Sammartano, 2005

Vegetarian Times Complete Cookbook by Vegetarian Times Magazine, 2005

Vegetarian Cooking for Everyone by Deborah Madison, 2007

Web Sites
National Cholesterol Education Program, Live Healthier, Live Longer
http://www.nhlbi.nih.gov/chd/

American Dietetic Association
http://www.eatright.org

Cooking Light Magazine
http://www.cookinglight.com

Eating Well Magazine
http://www.eatingwell.com

American Heart Association
www.americanheart.org

American Heart Association recipes
http://www.deliciousdecisions.org

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DASH (Dietary Approaches to Stop Hypertension) Diet
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/

National Stroke Association
http://www.stroke.org

Heart Decision
www.heartdecision.org


Teach Back:
What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?


Questions
If you are a UW Health patient and have more questions, please contact UW Health at one of the phone
numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can
be reached: (608) 890-5500. Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608)
287-2770.























Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If
this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be
used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your
doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright 5/2017
University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department
and the Department of Nursing. HF#189