Heart Health: Standard American Diet vs. Cardiac Diet

Most of the recognized risk factors for coronary heart disease are influenced by the Western diet or standard American diet.

What’s wrong with the typical American diet?

The typical American diet contributes not only to atherosclerosis but also to many other health problems, including obesity, high blood pressure, stroke, breast and colon cancer, diabetes, gallstones, constipation problems, and diet-related diseases.

Foods to eat

Enjoyment of the food we eat is still compatible with self-discipline. Moderation rather than elimination is always the guiding principle.

You can eat the following foods on a cardiac diet:

  • Cereals and wholegrain foods, such as whole-grain, millet, barley, whole wheat bread, quinoa, brown rice, oat.
  • Vegetables and fruits, such as broccoli, curly kale, blueberry, orange, avocados, apple, carrot, banana.
  • Fish with the most lifesaving omega-3 fatty acids, such as salmon, herring, sardine, Atlantic mackerel, trout.
  • Soluble fiber foods, such as oat bran, barley, beans, lentils, peas, nuts and seeds.
  • Low-fat dairy foods in moderate amounts, such as low-fat milk, low-fat cottage cheese, and low-fat plain yogurt.
  • Polyunsaturated fats in small amounts, such as tahini, linseed (flaxseed), chia seeds, soybean, sunflower, safflower, and canola oil.

What is a cardiac diet?

Dietary guidelines

Eliminating fatty foods from the diet makes room for healthy carbohydrates such as bread, cereals, pasta, rice, legumes, fruit and vegetables. Many of these are high in fiber which can help lower cholesterol.

Here are 10 dietary guidelines for a balanced cardiac diet:

1. Eat a variety of foods each day

Different types of food are necessary to supply the main nutrients required for good health. No single food contains all these materials.

2. Prevent and control obesity

Obesity increases the risk of heart disease, high blood pressure, and diabetes. Reducing excess fats, alcohol and sugar and increasing physical activity will help to bring down your weight. Eat less, rather than cutting out whole categories of food.

3. Eat less fat

Excess fats in the diet may contribute to obesity, high blood cholesterol levels, heart disease, and certain cancers. Choose lean meats, low-fat dairy products and use low-fat cooking methods. Use butter, margarine, cream, and oils sparingly.

4. Eat less sugar

High sugar intake is associated with obesity and tooth decay. Sugars, whether white, brown, raw or glucose, are solely an energy source and their nutrient content is negligible.

5. Limit alcohol intake

Excessive alcohol contributes to the health, social and nutritional problems of many people. Low nutritional status results when habitual drinking interferes with good eating habits.

6. Eat more fruit, vegetables, and cereals

Constipation, diverticular disease, and other constipation-related ailments are linked with a lack of dietary fiber (found only in plant foods). Bread, wholegrain cereals, fruit, and vegetables provide necessary dietary fiber and a variety of nutrients. They are best for replacing foods high in fat and sugar.

7. Eat less salt

Sodium from excessive use of table salt and salty processed foods may contribute to high blood pressure. Reducing excess sodium intake from an early age may help to control hypertension. Salt should not be added to food prepared for infants.

8. Enjoy water

People drink large amounts of soft drinks and alcohol, which may contribute to obesity and/or dental caries. Where possible, quench your thirst with water. Use water rather than sweetened syrups and beverages for infants and children.

9. Use lean meats, chicken and fish

Remove all visible fat before cooking. Avoid sausages, luncheon meats, and salami-type meats. Replace some meats with beans, peas, and lentils several times a week.

10. Use methods that require minimal fat or oil

Grilling, baking, braising, steaming, boiling or pressure cooking. Use recipes requiring only moderate amounts of fat.

Dietary fiber and heart health
Dietary fiber is fast becoming recognized as an important protective component of our diet.

Why are fruits and vegetables good for your heart?

Vegetables and fruits contain fiber and substances that can make your heart stronger.

The fiber in the diet could well influence the risk of heart disease because of its effects on blood cholesterol levels, obesity, and diabetes.

Fiber foods, such as potatoes, vegetables, and fruit contain few calories for their large volume. Not only are such foods bulk-forming and filling, but the extra chewing required before swallowing tends to lessen the amount of food eaten.

For example, one large, fresh apple would fill most people, yet the juice from two or three apples is quickly swallowed without chewing and is not filling.

Furthermore, when fiber foods replace foods with high fat or sugar content there is a significant saving in calories. Indeed, one study showed that men, given 10 large potatoes to eat each day, and being allowed whatever other food they fancied, were able to lose weight because they didn’t want much else.

Additionally, fiber can physically interfere with the complete digestion and absorption of fats and other nutrients in the intestines. This small wastage of energy could be significant over a period in helping to control weight.


Understanding fats, cholesterol, and your heart

Fats and carbohydrates are made up of the same elements — carbon, hydrogen, and oxygen.

All fats are a concentrated energy store and fuel for exercise, containing more energy per gram of weight than carbohydrates.

This is good because fats give your body a huge energy reserve for when you need to keep on going, but the downside is that it takes a lot of work to use up fat tissue when you want to reduce your body-fat levels.

Saturated fats

Saturated fats are the biggest culprits for raising cholesterol and should be avoided where possible.

Meat fat, full-cream dairy products and many processed foods such as pastries and biscuits are full of them. Vegetable fats and oils used in processed foods or commercial cooking are usually saturated fats.

Mono-unsaturated fats and polyunsaturated fats

Mono-unsaturated fats and polyunsaturated fats can be found in some oils and kinds of margarine, nuts and seeds. Neither raise cholesterol levels and they can help lower them if your meals are low in saturated fat. They are, however, high in calories.


Cholesterol is just another form of fat in your body.

Cholesterol is called a derived fat because it is not usually used as fuel for exercise, but is derived from simple fats already in the body or, less importantly, derived from food in the diet.

Cholesterols are used in creating the structure of the membrane around every cell in your body and in the manufacture of the sex hormones estrogen, progesterone and testosterone.

Cholesterol is carried around in the blood by a little protein that acts as a prime mover to shift a trailer of fats to wherever it is needed, unload it, and then head back to the liver for another load of fat.

These combinations of fats (lipids) and proteins are commonly called lipoproteins.

Low-density lipoproteins (LDLs)

Low-density lipoproteins (LDLs) are slack and tend to park themselves when they are not needed.

When they park themselves on the walls of arteries they are called plaque and can stack up and eventually block off the artery. This process is called arteriosclerosis, or hardening and narrowing of the arteries. Arteriosclerosis is a major, cause of cardiovascular disease.

Bits of plaque can break off from, a large blood vessel, get pushed through the arteries by a surge of blood, and then jam, inside a smaller blood vessel. The tissues served by that blood vessel will die without a supply of energy and nutrients.

If LDL blocks up the arteries serving the heart muscle, then that part of the heart dies. If it is dead, it cannot contract. If your heart stops contracting, you die.

Storing fat in the blood vessels where it is easily accessed when needed seemed like a good idea when fat in the diet was scarce, but now that our diet is high in fat, these lipoproteins can build-up to the point where the narrowing of the arteries and veins due to plaque formation will lead to an increase in blood pressure.

High-density lipoproteins (HDLs)

High-density lipoproteins (HDLs) are supercharged and tear around the body carrying cholesterol to wherever it is needed. HDLs are so keen that they will even pick up cholesterol from lazy low-density lipoproteins (LDLs).

HDL in the body is good because it goes around scraping plaque off the walls of blood vessels, heart, brain, and body, and protects the body against cardiovascular disease. LDL is bad as it goes around gumming up the cardiovascular system.

HDL loses ground to LDL as you age, and you get a higher amount of cholesterol as well as a higher ratio of LDL. Total cholesterol peaks at about the age of 55, but then declines as you get older.

Regular physical exercise and low-fat diet

People who are serious about exercise and have a low-fat diet may seem to have a high cholesterol count because exercise may increase the total cholesterol count in their blood, but regular exercisers have mostly the good guys, the HDLs.

If you ever have a cholesterol count done, you should insist that you have an HDL and LDL count done as well. If you have high HDL and low LDL then you have a lower risk of cardiovascular disease.

As little as 20 minutes of walking three times a week has been shown to improve the cholesterol HDL/LDL ratio.

The make-up of your diet is as important as exercise for keeping your cholesterol HDL/LDL ratio down. As a general rule, you should keep fat to less than 30 percent of total calorie intake.

Any fat can be converted to cholesterol by your liver, so be wary of food that states “no cholesterol” on the label. If it is high in fat it will most probably end up clogging up your arteries.

Make your mind up. Make little lifestyle changes to diet and exercise. Exercise regularly as you get older, as exercise offers some protection against increasing levels of low-density cholesterols.

Heart-healthy cooking

How to make foods heart-friendly

The major indicator of heart disease is cholesterol, particularly bad cholesterol, called low-density lipoprotein (LDL). These healthy cooking methods can lower the bad cholesterol in food.

Spaghetti sauce

After cooking mince until all the red color is gone, pour the contents of the frying pan into a colander and drain off all the fat. Continue with your regular recipe.

Soups, stews, and casseroles

Prepare these dishes a day ahead of time. Refrigerate overnight. Skim off the fat that rises to the top. If you want to thicken them with flour or cornstarch, wait until the fat is removed.


Invest in a non-stick frying pan, in which you can saute with much less oil. Instead of butter, substitute cooking oil. In rare cases when the flavor of butter is indispensable (for mushrooms, for instance) add a teaspoonful of butter to the salad oil. That way you get the flavor without most of the cholesterol.


There are many kinds of cheese made with skim milk, including mozzarella and a Norwegian cheese called Jarlsberg. You don’t have to stop serving lasagna, for instance; just substitute skim-milk mozzarella and leave out the ricotta cheese. In parts of northern Italy, very little cheese is used in lasagna; instead, the cooks use a cream sauce that can be made successfully with skim milk.


Rich chocolate is taboo, but cocoa is all right and can be substituted in many recipes. Three tablespoons of cocoa are the equivalent of an ounce of baking chocolate.

Bacon and salt pork

Many cooks depend heavily on pork products for flavoring vegetables. If you are one of them add imitation bacon bits after the vegetable is cooked. These bacon bits are also good in salads. A little wine is a good low-cholesterol way to add flavor to stew, casseroles, and sauces. Always simmer the sauce long enough to get rid of the alcoholic taste.

Patients with cardiovascular disease will be told they need to eat a low-salt diet for improving their health.

Low salt diet for heart patients

People like salt and eat foods high in salt. But salt makes congestive heart disease (heart failure) worse or may contribute to bringing it on.

In heart failure, the heart is over-worked perhaps because of high blood pressure or earlier heart damage. Salt promotes watery swellings in the body and the heart has to work even harder.

Salt is both the oldest and most popular of all condiments and is employed in virtually every form of food processing, from canning to ice-cream making.

We do not need to add extra salt at the table, yet we go on salting what is put before us. We salt salt-cured meats and salt-saturated vegetables and most of us consume five or six times as much salt as our bodies need.

In such quantities salt masks, rather than enhances, the flavor of what we eat. This served a very special purpose centuries ago, when much meat was rank, but it defeats the purpose of consuming foods at their peak.

The taste of fried foods is particularly enhanced by salt, and if you can make them less appetizing by not salting them – and so eat fewer chips or deep-fried fish pieces – you will be doing yourself a favor.

Sugar and Cardiovascular Disease

How does sugar affect the heart?

Eating too much sugar is a well-known cause of premature heart attacks and sudden death. It can also elevate the cholesterol (another blood fat) level with similar consequences.

Excess refined sugars may contribute to heart disease, as it can be concentrated into small amounts of food and drinks which require little chewing. This makes it easy to consume excessive energy unintentionally and become overweight.

Refined sugar does make you fat faster than many other foods, even those high in natural sugars, fats, and calories. This is because refined sugar is the only nutritionally “pure” staple in our diet; it contains nothing but calories in the form of simple carbohydrates, whereas all other foods, including complex carbohydrates, contain traces of other nutrients.

Sugar, like salt, is an acquired taste. We consume more of it than we need, having acquired our sweet tooth as infants, when first introduced to solid food. Habits so deeply ingrained are all but impossible to reverse, but an adult can wean himself or herself from over-dependence on sugar. (Some sugar is essential to the diet).

Any diet high in fruits and vegetables will not only be low in calories but also in refined sugars. Most nutritional quackery and dietary foolishness center around the sugar content of cakes and sweets, cordials and snack foods. These things were once considered no more than “extras” to a balanced meal, but have gradually replaced fruits and vegetables, whole grains and fiber in the Western diet.

People’s notions about the relative merits of such foods tend to be strongly influenced by what they have seen and read. They extol the “natural” qualities of brown sugar, unaware that it is 99 percent refined, one step removed from the white table sugar they hold in contempt. And they praise the virtues of honey, an “organic” sweetener indistinguishable from refined sugar in the body and just as liable as sugar to cause tooth decay.

The key to a balanced heart-healthy diet

A cardiac diet, also known as a heart-healthy diet, concentrates on eating heart-healthy foods and reducing foods rich in energy, saturated fats, cholesterol, salt, and refined sugar.

One Response

  1. How do you know when your cholesterol level is too high?

    You might start getting chest pains – because the heart muscle is being starved of oxygen. This is angina pectoris, often picked up in a routine blood test.

    Your doctor will suggest the course to follow. Often people with a family history of heart conditions are asked by the family doctor to undergo tests to check blood cholesterol levels.

    If you simply want to avoid risk of heart disease you can plan your menus to avoid undesirable foods.

    Substitute polyunsaturated margarine for butter, skim milk for full cream milk, seed oils for dripping or olive oil.

    Saturated fats are present in meats like bacon, lamb, pork – where fat is evenly distributed and cannot be removed e.g. rolled roast, T-bone steak, loin and shoulder chops, liver, kidney, brain, tripe, and sausage meats. Avoid these foods: eggs, dairy foods (only in moderation), milk-based sauces, creamed foods, gravies, puddings, and gooey sweet concoctions.

    Stick to boiling, grilling, stewing, rather than frying and baking.

    Eat plenty of fish (as long as it’s not fried in butter), poultry, veal, lean cuts of beef (rump, fillet, round, and topside), fresh fruits and vegetables and salads without mayonnaise. French dressing made with seed oils is acceptable. At first glance it seems that you will never again enjoy the pleasures of the table but there are plenty of low-fat gourmet recipes to delight any epicurean.

    One important thing to remember is this: It isn’t enough to substitute polyunsaturated margarine for butter and to cut out cheese and eggs and think you’ve done your bit.

    You must look at the whole diet. This involves a closer look at your total diet – carbohydrates and calorie intake as well.

    The main thing is to have a balanced diet – a plan that cuts total fats down by one quarter, replaces part of your saturated fats with polyunsaturated fats, reduces cholesterol intake to a minimum, and keeps calories down.

    Your doctor may also prescribe drugs to help you win the cholesterol battle.

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