Features July 2015 Issue

Learn the Answers to 4 Common Heart-Healthy Diet Questions

Eating right for cardiovascular health means understanding the role of carbohydrates, fruits, vegetables, whole grains, salt, sugar, alcohol and more in your diet.

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The basics of a heart-healthy diet are pretty well established: Follow the DASH or Mediterranean-style eating plans that focus on fruits, vegetables, whole grains and lean proteins:

Simple, right? Well, not exactly. The more you pay attention to how the foods you eat and the liquids you drink affect your heart health, the more questions emerge.

What follows are four common questions that relate to heart health and some of the various factors that can impact it negatively or posivitely. Issues like weight management, sodium, sugar and diabetes, nutritional balance and alcohol will be covered.

And the person to answer these questions is Julia Zumpano, RD, LD, a registered dietitian with the Preventive Cardiology & Rehabilitation Section at Cleveland Clinic.

1. Are three square meals a day better than several smaller meals?

Zumpano says the best approach is the one that is most conducive to your lifestyle.

“Either is fine, in my opinion,” she says. “If you find yourself overeating at meal time, then I think adding healthy snacks would be a good idea to help offset your hunger. Then decrease the portions a bit at your next meal.”

The key, though, is to make sure those snacks or mini-meals are healthy.

“If you find yourself snacking on empty calories or low-nutritious foods, like chips, snack foods, cookies, etc., then cut them out. They’re doing more harm than good. Replace them with fresh fruit, nuts, low-sugar and low-fat yogurt, veggies and hummus and that sort of thing. Eating throughout the day is fine as long as you are eating nutrient-dense foods, as opposed to empty calories.”

There are two other issues to consider. One is that if you are actively trying to lose weight, watching your calorie intake throughout the day—even from nutritious foods—is important. A handful of almonds is okay. An entire jar of almonds in one day is too much.

Also, if you have diabetes and must be aware of the carbohydrates in your meals and snacks, consult with a dietitian who is also a certfied diabetes educator to best manage your food consumption.

2.  Which is worse for heart health: salt or sugar?

“Both... equally bad,” Zumpano says.

She adds that it depends on the individual and that person’s particular health issues.

“If you have uncontrolled high blood pressure or heart failure, then salt is a larger threat,” she explains.

But Zumpano notes that recent research continues to show that sugar and foods that break down into sugar (high-carbohydrate foods) contribute to worsening risk factors associated with heart disease. These include obesity, greater waist circumference, diabetes, elevated glucose and triglycerides, and higher blood pressure due to weight gain.

The bottom line is that a diet low in added sodium and added sugars is always better for your heart and weight than a diet with high-sodium and sugary foods. If high blood pressure is a concern, be sure to talk with your doctor about any dietary restrictions you should observe.

Likewise, if weight management is a concern, stay clear of added sugars.

3. What’s the latest on alcohol and heart health?

As with sugar and salt, a little alcohol is usually okay, but too much presents health risks.

“The general recommendation is that one to two drinks per day is safe for heart health,” Zumpano says. “Preferably, it should be wine, due to its proven positive benefits on HDL and blood pressure. Avoid beer and spirits and mixed drinks that can be high in calories and carbohydrates.”

She adds that it’s also quite important to pay attention to medication recommendations on alcohol.

“If you’re taking a medication, such as a blood thinner, that advises against alcohol, do not drink,” Zumpano says. “Always ask your doctor if it’s safe to drink alcohol.”

Remember that alcohol acts as a diuretic, so if you take diuretics for blood pressure, be especially mindful of alcohol.

She adds that if you are overweight or obese, have diabetes, elevated triglycerides or blood sugar, it is advisable for you to avoid alcohol. Zumpano also notes that if you don’t currently drink, there’s no evidence to suggest that starting to drink will improve your heart health. And if you have experience with substance abuse, then by all means don’t start drinking in order to obtain the mild benefits of alcohol, especially wine.

It’s also worth noting that as we age, our bodies don’t metabolize alcohol the same way as they did when we were younger. That means that the amount of alcohol you could tolerate easily and safely when you were younger may cause problems today.

4. Are carbohydrates really the bad guys?

In an era of high-protein diets, carbohydrates have become dietary demons in some ways. A carb is anything that breaks down into glucose in the bloodstream.

But Zumpano says that rather than look at all carbs the same, distinguish between complex and simple carbohydrates. Simple carbs are those broken down quickly by the body, and include sodas, candy, jellies, table sugar and maple syrup.

“Complex carbs provide fiber and some protein that slows down the rate at which glucose is broken down and used by the body,” she explains. “They also fill you up faster and longer, which helps you eat less. Choose complex carbs, especially ones with soluble fiber, which has been proven to lower cholesterol.”

These foods include oats, oat bran, brown rice, barley, beans, lentils, split peas, bananas, apples and pears (the soft parts), Brussels sprouts, root vegetables (sweet potatoes, eggplant), and green vegetables.

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