Cardiovascular Disease and Food

If you have high cholesterol also see healthy eating for high cholesterol.

To Lower LDL ‘bad’ cholesterol
– Decrease total fats in diet
– Decrease cholesterol in diet
– Increase essential fatty acids
– Increase fibre (especially oats and psyllium husk)
– Increase complex carbohydrates
– Decrease caffeine and nicotine
– Supplement nutrients: Vitamin B3, B6, B12, C; chromium; EPA & GLA; garlic; red rice yeast.

To Increase HDL ‘good’ cholesterol
– Get regular aerobic exercise
– Do not smoke
– Decrease body weight
– Supplement nutrients: essential fatty acids; niacin; EPA, fibre and L-carnitine.

Risks of CVD include high blood pressure, high cholesterol (especially high LDL levels), high triglyceride levels, and obesity, as well as some cases of diabetes. High fat consumption, low fibre intake, high cholesterol and excess sodium intake are influential nutritional risks. Non-diet risks include smoking, stress and lack of exercise. Proper diet alone can decrease cholesterol levels by 30% or more. It is clear that a diet high in saturated fats and cholesterol leads to increased blood cholesterol levels and increased atherosclerosis. It takes dedication, and sometimes a complete lifestyle change, to make these changes.

The primary dietary focus for preventing CVD is reducing fat intake. The diet should be low in fat and particularly low in:
– saturated fats (especially animal fats, including dairy)
– hydrogenated/partially hydrogenated fats (margarine and most packaged refined foods), and
– poor quality oils, especially when heated in cooking.

Fat intake should be reduced to a maximum of 20% of total calories. This is not easy because it includes all fried foods, meats,dairy products, eggs, nuts, and seeds, which also clearly reduces protein intake. Supplementing with essential fatty acids,and using good-quality cold-pressed vegetable oils (poly/monounsaturated); and avoidance of many of the less healthy fats is best, such as refined cooking oils and hydrogenated fats like margarine.

Particularly helpful oils are contained in deep sea cold water fish such as salmon, tuna, mackerel, sardines, and herring. These contain EPA (eicosapentaenoic acid) and DHA (dicosahexaenoic acid), which have a positive effect on lowering cholesterol and triglycerides. Consuming these oily fish two or three times a week has been proven be beneficial.

To prevent atherosclerosis, a diet low in cholesterol and high in fibre is recommended. Fibre reduces CVD risk by binding cholesterol and fats and passing them out of the body, therefore reducing their absorption and subsequently decreasing blood cholesterol and LDL. Increased fibre levels can also help to reduce blood pressure levels. Oats has been shown to help reduce cholestrol levels, and reduce weight in those who suffer from obesity.

In addition, a low-salt and low-sugar diet is also suggested. Excess sugar causes an increase in calories, weight, and blood fats, and is a direct risk factor in CVD. More complex carbohydrates, including whole grain and vegetable foods, are important for CVD prevention.

Dietary Suggestions to Reduce CVD Risk
– Eat more fruits and vegetables, and leave skin on.
– Eat more whole grains, legumes and beans.
– Fat intake no more than 25% of the diet.
– Reduce cholesterol intake to less than 300 mg per day.
– Reduce consumption of eggs to about three per week.
– Minimise use of whole milk and dairy products.
– Avoid red meats, eliminate all cured/processed meats, chicken can be eaten occassionally but without skin.
– Eat more deep sea cold water fish.
– Use fresh, cold-pressed oils, such as olive or flaxseed, to provide the essential fatty acids, and do not heat oils.
– Replace snacks with low fat foods such as corn thins, rice cakes, Finn crisp or ryvita.
– Add oat bran to cereals and use whole grain cereals in place of sugary ones, such as oats.
– Substitute ice-cream for fruit juice ices.
– Use low-fat cheeses such as cottage cheese or ricotta.
– Increase salads in summer and veggie soups in winter.
– Consume cookies and treats with no saturated fats and lower/no sugar content, sweeteners can include dried fruit, xylitol or stevia, or fruit-juice-sweetened sweets.
– Include garlic in your food, it has a cholesterol lowering effect, as do onions, ginger and cayenne pepper.
– Soybeans and soy products such as tofu, tempeh, miso and soy lecithin may have a positive effect on cholesterol and atherosclerosis; and are low in fat and high in protein.
– Millet and buckwheat, okra, asparagus, apples and bananas, red rice yeast, and flaxseed (linseed) oil may reduce cholesterol.
– Ground flaxseeds are a good source of soluble fibre and essential oils and may help reduce blood fat levels and fatty deposits.

Vegetarian Diet

Vegetarian diets typically lack protein, iron, calcium, zinc, vitamin B12, and possibly vitamin D, but are high in fibre, complex carbohydrates, and nutrient rich. If the vegetarian diet is composed mainly of whole grains, legumes, beans, vegetables, fruits, nuts and seeds then it will provide all the nutrients a vegetarian needs.

Vegetarians who include eggs and milk products in their diet can meet most nutrient requirements, especially protein. The protein of whole grains, legumes, seeds, nuts and vegetables can provide adequate amounts of all the amino acids, but should be combined appropriately in order to obtain a complete protein. Please see protein combining for more information. 50 g of protein should be consumed daily. Milk, cheese, butter and eggs are complete proteins so can be consumed alone.

Those who do not eat meat should pay close attention to their iron intake, especially women who are in their menstruating years. The iron in legumes, cereals, fortified cereals and whole grains is not readily absorbed. Iron absorption is enhanced by vitamin C. Requirements are 15 – 20 mg per day. Other sources are: dried beans, dried fruit, spinach, chard, beet greens, blackstrap molasses, prunes and legumes. Cooking in iron cookware increases iron intake. For further reading click on the following links iron deficiency or sources of iron.

Vegetarians who do not consume eggs and milk products are at risk of deficiency. Calcium is especially important for children and post-menopausal women. Calcium is found in nuts, broccoli, tofu, soybeans, molasses, all dairy products, seeds especially sesame seeds, tahini is a high source of calcium. Calcium fortified soy milk can help to increase levels. Sources of calcium contains more information on calcium absorbtion and foods.

Meat is one of the riches sources of zinc, and unfermented soy products can interfere with zinc absorption, hence vegetarians are often low in zinc. Requirements per day are 20 – 25 mg. It becomes necessary for vegetarians to consume a variety of nutrient dense foods rich in zinc such as legumes, e.g. black eyed peas, pinto beans and kidney beans. Zinc can also be found in pumpkin and sunflower seeds, mushrooms, fermented soy products, and eggs also see sources of zinc .

Vitamin B12
Vitamin B12 is mainly found in animal products, so is present in dairy products and eggs. Some plant foods contain traces of B12 but usually as a B12 analogue that cannot be absorbed by the body, so supplementation may be necessary. Tempeh, miso and brewers yeast contain small amounts of B12, and some seaweeds such as kombu, wakame, kelp, alaria, dulse and nori, and spirulina, chlorella and wild blue green algae (these also have a high amino acid profile, that is – a high protein content).

Vitamin D
This is not such a problem in South Africa because we have adequate sunshine, exposure to sunlight helps the synthesis of vitamin D in our bodies. Vitamin D may be lacking in climates where there is less sunshine. If you are vegetarian and do not like the sun then you may well be deficient as the most common food sources are contained in animal products, click on the following link sources of vitamin D for some options.