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Ask The Expert: Heart-Healthy Diets

February 14, 2019

Bijal Dave, MD is a family physician specializing in diet-oriented treatment of chronic diseases and a medical staff member at Atlantic Health System's Hackettstown Medical Center and Newton Medical Center.

What are good dietary choices for my heart?

Despite major advances in medical therapies for reducing cardiovascular (CV) events, diet and lifestyle changes remain the most effective ways to reduce the burden of cardiovascular disease (CVD) in the general public. Unfortunately, current dietary patterns, along with decreasing physical activity, have led to epidemics in obesity and diabetes, both major risk factors for heart disease. A majority of the research has focused on individual nutrients, but it has become increasingly clear that overall healthy eating patterns ensure adequate nutrient intake and energy balance.

  • Sodium: The evidence is strong and consistent that reducing sodium intake lowers blood pressure in men and women and across a spectrum of ages and ethnicities. The recommendation for lower sodium targets (≤2400 or ≤1500 mg/day) applies to more than two-thirds of the US adult population who have pre-hypertension or hypertension.

  • Oily Fish: Multiple observational studies have consistently documented the association between fish intake and decreased risk of CVD. The American Heart Association (AHA) recommends that individuals without coronary heart disease (CHD) consume fish at least twice a week, specifically oily fish such as tuna, mackerel, trout, or salmon. For patients with CHD, a total of 1 gram daily of long-chain omega-3 fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), had been suggested, through the consumption of oily fish and/or supplements.

  • Fiber: Increased total dietary fiber consumption has been associated with a reduced risk of CHD and coronary death in observational studies. Soluble or viscous fiber found in oats, barley, flax, psyllium, beans, peas, and nuts can modestly lower LDL-C levels by increasing short-chain fatty acid synthesis, thus reducing endogenous cholesterol synthesis, and by increasing bile acid production. Insoluble fiber found in whole wheat, whole grains, green beans, and leafy vegetables can enhance satiety and slow gastric emptying. 

  • Alcohol: While alcohol use is not encouraged, for those currently consuming alcohol, the AHA recommends limiting its intake to two servings per day in men and one serving per day in women. One serving equates to one-half ounce of alcohol, which is the content of one 12-ounce bottle of beer, a 4-ounce glass of wine, and a 1-1/2 ounce shot of 80-proof spirits. Epidemiologic data suggest that this quantity of alcohol may be associated with a lowered risk of CVD, but whether or not initiating consumption of alcohol in those who have abstained will lower CVD events is unknown.