Can what we eat contribute to a healthy heart? Can our diet support heart health after a heart attack? If you've asked yourself these questions, read on. The foods you eat can be a part of a heart healthy lifestyle, if you make some smart choices and stick with them. That's the topic of my
Today Show segment about diet and heart disease.
Click to watch the segment
What we eat can make a difference in heart health – both positive and negative. That said, while diet can influence heart health, it’s only one of the important factors involved in the variety of illnesses we commonly think about related to the catch-all term “heart health” – which include
high blood pressure, stroke, heart attack, atherosclerosis (plaque-clogged arteries), and high cholesterol. Genetics (family predisposition), physical activity, stress management, and smoking are all important contributors as well.
I'd love to hear what you think about nutritional contributions to heart health.
How does healthy eating fit into your lifestyle? Do you think the other factors are more important (like exercise and stress management)???
The lifelong goal is to
seek a stable weight AND a heart healthy lifestyle – from childhood on. For many women (and men!), healthy eating and weight maintenance have come at the expense of caring for other family members. So many people approaching age 40 or older consume diets contributing to
high cholesterol and
artery-clogging, have a
lack of physical activity, can’t manage
stress, and
smoke. Oftentimes, a heart attack is the unexpected outcome of poor diet, genetic tendencies, and inactivity (people often know their lifestyles are not heart healthy, but don’t know what to do!). This occurs after years of poor eating habits – not the occasional piece of cheesecake!
Food is not medicine, and will not replace medical care for the treatment of heart disease. Healthy eating can help lower the risk of heart disease for many people, if done consistently over time.
While we hope that the “wake up call” of eating for a healthy heart does NOT come after a heart attack, there are thousands of people needing this information. In reality, the diet to lower risk factors to prevent a heart attack is just about the same as the best diet to consume after heart attack.
So, what to eat for a healthy heart? I have an easy plan that starts with what I call the
“3 Cs”, all supported my recent medical studies:
Calorie Counting; Cholesterol/Saturated Fat Reductions; and
Compliance.
Calorie Counting: Maintain a stable weight, or lose weight if you’re willing to. Even not gaining is a help. If you monitor calories, you’ll naturally lower your fat intake as well. Plus, you won’t tend to consume to much of “heart healthy” foods that are highly caloric – like nuts and olive oil.
Cholesterol/Saturated Fat Reductions: Cholesterol comes from two sources: the diet and our own livers, that make it. We can’t control the amount of cholesterol our livers produce (that’s genetic), but we CAN
limit the cholesterol we eat in foods. While reductions in dietary cholesterol and saturated fat (artery-clogging) can often help lower blood cholesterol, and limit plaque formation, it is not always the case, and medications must often be used when lifestyle alone is insufficient. Cholesterol is a waxy, fatty substance that our bodies need a small amount of. Saturated fats come from animal fats (in contrast to vegetable fats), and contribute to plaque formation. This is a big area of improvement for many people – and the single biggest area of focus when it comes to heart health.
Compliance: While we use the word diet, that’s really wrong – because you can always go “off” a diet, but I like the term lifestyle, because that indicates “forever”. For the diet changes to have any influence on long term heart-health, it must be done DAILY, not “when I remember”. This is the hardest part of the heart-healthy diet for many.
There are two very similar eating plans: The American Heart Association’s TLC (Therapeutic Lifestyle Changes is the gold standard, while some studies have compared this with the Mediterranian-style diet (the main difference here is that there’s almost no red meat), and found similar effects.
HERE IS THE SIMPLE LIST OF FOOD GROUPS TO CONSUME: 
Generous fruits and vegetables (all colors) Healthy Fats: fish, nuts, olive/canola oil
Protein: LEAN meat, fish, poultry Fish (2 x/wk; skinless white meat poultry, very lean cuts of meat, including red meat; limited amounts of nuts, soy proteins
Fiber rich starches (20-25 grams/day); up to 4 whole eggs a week (whites ok)
Not fat or lowfat dairy products REQUIREMENTS: Total Calories (vary): To maintain: Take your present weight, multiply by 12- a rough idea…., so, 150 pound person needs 1800 cal; a 200 pounder is 2400 cal).
The calorie distribution is an example of someone who needs 1800 calories/day.
Total Fat: 25% - 35% of calories (450 - 600 calories per day)
Protein: about 15% (270 calories per day)
Carbohydrates (fiber rich): 50% - 60% of calories (900 – 1100 per day)
This means fruits, veggies, and starchy CHO – like bread, rice, potatoes, cereals
Cholesterol: Less than 200 mg per day (if no heart disease, or heart attack, this is 300 mg per day).
If the total fat intake for the day is 25% - 35% of calories, it can be divided into the following calories: best rule of thumb, keep saturated as low as possible…
Fat is broken down into saturated (bad) and unsaturated (good). Within the healthy, unsaturated group there is “mono” and “poly”
Saturated: less than 7% of daily calories (125 calories or less)
(This is 10% of calories if no heart disease: 180 calories)
Monounsaturated (like olive oil): up to 20% of calories (up to 360 calories daily)
Polyunsaturated: up to 10% of calories (180 calories)
An important reference point: a tablespoon of ALL fat has about 120 calories!
What about salt intake? 2500 mg or less per day (heart healthy) is the goal; 2000 mg or less per day with heart disease (check with your doctor!).
Other dietary strategies which might be helpful: Plant stanols (or sterols) can be included, at 2 grams per day. These are often found in functional foods like PROMISE active yogurt (nothing to do with dairy, but 2 grams plant stanols); Cocoa Via chocolate bars; Benecol margarine.
A final thought on red wine and chocolate, that always come up in discussions of heart healthy eating. While these products do have antioxidants, so do many other foods. I suggest using these foods as part of your daily indulgence calories - 100-200 calories daily - which is part of a deprivation-free lifestyle. Use these "free" 200 calories wisely. If you like chocolate, go for it. A glass of wine, fine! Don't start eating candy or drinking alcohol is you don't already do it, for the perceived health benefit. It's just not true!
Your thoughts on this?
译文:
合理饮食铸就健康心脏
我们吃什么能够让心脏健康？ 我们日常的饮食能让我们“受伤”的心恢复健康吗？如果你曾经问过自己这些问题，那么请继续读下去。你的日常饮食是让你拥有健康心脏的生活方式的一部分，如果你已经做出了些明智的选择，那么坚持下去。日常饮食与心脏病，这就是我要在今天的今日秀探讨的主题。
什么食物会对我们的心脏健康产生影响？不论是积极的或是消极的影响。尽管饮食会影响心脏的健康，但它只是我们通常认为会涉及各种影响心脏健康的疾病的重要因素之一，这些疾病通常包括高血压、中风、心脏病、动脉硬化症（斑块动脉堵塞）和高胆固醇。遗传学（家庭遗传），体育运动，压力管理和吸烟同样也是影响心脏健康的重要因素。
我想知道你们如何看待营养物质对心脏健康的影响。健康的饮食如何融入你的生活方式？你是否认为其他的因素更为重要，比如锻炼和压力管理？
从孩提时代开始，我们的终生目标便是保持稳定的体重和一种心脏健康的生活方式。对需对人来说，健康饮食以及保持体重已经成为照顾家庭成员开支的一部分。因此，有许多接近四十岁或更年长的人，他们缺少体育锻炼，不能成功的应付压力，还有抽烟的习惯，他们追求健康的饮食，希望以此缓解高血压和动脉堵塞。不良的饮食、遗传和缺乏锻炼常造引发心脏病。（人们常知道自己的生活方式不健康，但却不知道该如何去做）。长年不良的饮食习惯常造成这些疾病，所以别再想偶尔来片奶酪蛋糕了。
然而食物不是药物，也不能代替治疗疾病的医疗护理。但对许多人来说，长期坚持健康的饮食有助于降低患心脏病的风险。
然而我们并不希望人们在患上心脏病后才意识到健康饮食的重要，成千上万的人需要知道这些相关的信息。事实上，通过健康饮食来降低患病风险与在患病后通过饮食来调理同样重要。
那么，到底要吃什么才能拥有健康的心脏？根据我最近的医学研究，我提出了个简单的计划，我称它为“3C”计划。“3C”是计算卡路里（Calorie Counting）、降低胆固醇/和脂肪（Cholesterol/Saturated Fat Reductions）和长期坚持（Compliance）。
计算卡路里：如果你想保持稳定的体重或是减肥，或者只是不想增重。如果你注意摄入的卡路里，你很自然的也会降低你摄入的脂肪。此外，你也不会吃太多高卡路里的“心脏健康”食物，比如坚果和橄榄油。
降低胆固醇/和脂肪：胆固醇主要来源我们的饮食和我们肝脏自身。我们无法控制我们的肝脏产生的胆固醇数量（这由基因决定），但我们能限制我们从食物中获取的胆固醇数量。我们从日常饮食中摄取的胆固醇和饱和脂肪（动脉堵塞）数量降低，有助减小血液中胆固醇含量，并且限制血小板的形成。但情况并非总是如此，单凭生活方式控制胆固醇/饱和脂肪数量时。就有必要借助药物。胆固醇是一种蜡色的，脂肪类的物质，我们的身体对它的需求量很小。饱和脂肪来自动物油脂（与植物油脂相反）能促进血小板的形成。这是许多人都有待改进的领域，同时也是在心脏健康方面最应该关注的领域。
长期坚持：当我们用饮食这个词来指厂时间的饮食习惯时，其实是错的。因为你总是能改变一种饮食习惯。而我更愿意用生活方式这个词，因为它意味着“永远”。暂时性饮食的改变对长期的心脏健康不会有什么；影响，它必须是每天都坚持的，而不是在你想起时才那么做。对许多人来说，这是最难的一部分。
有两种非常相似的饮食计划：由美国心脏协会的TLC（Therapeutic Lifestyle Changes治疗性生活形态改变）和地中海式饮食(the Mediterranian-style diet)，前者与后者最大的差别在于后者不包含红肉（牛羊肉等），一些研究发现两者有相似的功效。
以下是一些推荐的食物清单
丰富的水果和蔬菜（所有颜色）的植物脂肪；鱼、坚果、橄榄和菜子油蛋白质；瘦肉、家禽和鱼（2 x/wk；去皮白肉（指禽类的胸部和翅膀等处的肉），瘦肉，包括红肉;少量的坚果，富含纤维的淀粉（20-25 克/天）；每周四个蛋（蛋白也可以），脱脂或低脂的乳制品。
要求：
总卡路里量：粗略的计算方法是把自身体重乘以12，例如，一个150磅的人每天需要1800卡路里，一个200磅的人则需要2400卡路里。
总脂肪：25%-35%的卡路里（450-600卡路里每天）
碳水化合物（富含纤维）：50%-60%的卡路里（900-1100卡路里每天），水果、蔬菜和淀粉，如面包，大米，土豆，谷类。
胆固醇：少于200毫克每天（如过没有心脏病，则是300毫克每天）
脂肪被分解成饱和脂肪（有害）和不饱和脂肪（有益）。健康状态下，不饱和脂肪有一般不饱和和多不饱和两种。
饱和脂肪：每天少于7%卡路里（125卡路里或更少）。（若没有心脏病，则是10%，180卡路里）
一般不饱和脂肪（如橄榄油）：总计达20%卡路里（每天360卡路里）
一个重要的控制点是一大汤匙的脂肪大约是120卡路里！
那么食物包含的盐分又有什么要求?对于想要达到心脏健康的人来说，其目标应该是2500毫克每天或更少。对于有心脏病的人来说，每天应为2000毫克或更少。
一些其他可能有帮助的建议：
摄入植物甾烷醇(或是植物甾醇)每天2克。在些功能性的食物中常能发现它们，如PROMISE牌的酸奶（它和乳制品没什么关系，但能为你提供植物甾烷醇）、可可维亚牌（Cocoa Via）的巧克力棒和贝尼科尔牌（Benecol ）黄油。
最后是红酒和巧克力，对于它们在心脏健康饮食中的作用总是引起争议。然而，这些食物的确含有抗氧化剂，但其他食物也一样。 我建议把这些食物为日常生活中额外卡路里的来源，每天摄入100-200卡路里，作为一种拘束的生活方式的一部分。但是要明智的利用这200卡路里。如果你喜巧克力，那么去吃吧。一杯红酒也不错。但以为了健康这个理由开始吃糖果或喝酒，这不是真的。
你怎么看呢？