What you eat can help keep your heart beating strong—or lead to overweight, high blood pressure, and high blood cholesterol, three key factors that increase the risk of developing heart disease.

Overweight and obesity pose major health risks. First, they increase the risk of heart disease. Second, they make you more likely to develop other factors that also increase that risk. For instance, overweight and obesity increase your chance of developing high blood pressure and high blood cholesterol (see following sections), and diabetes—all major risk factors for heart disease.

So it’s important to stay at a healthy weight. There’s no gimmick to achieving this goal. The amount of calories you take in through your diet should not exceed the amount you expend through body metabolism and physical activities. If you eat more calories than you use up, you’ll gain weight. But, even a small decrease in calories eaten can help keep you from gaining weight.

If you are overweight, losing just 10 percent of your current weight helps to lower your risk of heart disease. If you can’t lose extra weight just yet, then try not to gain more.

Here are a few tips to help you keep your weight in check:

• Watch out for portion size. It’s not just what you eat, but how much.
• Choose fewer high-fat foods. These often have more calories than the same amount of other foods
• But be careful of “lowfat” foods. They aren’t always low in calories. Sometimes, extra sugars are added to lowfat items, such as desserts. They can be just as high in calories as regular versions.
• Be physically active—if you are, you’ve got a good chance of keeping your calorie equation in balance.

Also called hypertension, this condition puts you at risk for heart disease and stroke. Diet plays a big role in your chance of developing high blood pressure. Following an eating plan low in saturated fat and cholesterol, and moderate in total fat is important for heart health generally and may help prevent or control high blood pressure. A key ingredient of this plan should be reducing your intake of salt (sodium chloride) and other forms of sodium.

Only small amounts of salt occur naturally in foods. Instead, most of the salt Americans consume is added during food processing, in preparation at home, or in a restaurant. By cutting back on salt, you’ll probably lessen your taste for it over time.

Try to consume no more than 6 grams (about 1 teaspoon) of table salt a day. That equals 2.4 grams (2,400 milligrams) of sodium a day. Studies such as the Dietary Approaches to Stop Hypertension trial, or DASH, show that persons with or at an increased risk of developing high blood pressure can help control or prevent the condition by further reducing table salt—to 4 grams (or 2/3 teaspoon) a day. That equals 1.5 grams (1,500 milligrams) of sodium a day. Both totals include ALL salt and sodium consumed—that used in cooking and at the table, as well as in prepared foods.

Fat and cholesterol in the diet can raise the level of cholesterol in the blood—and that can lead to atherosclerosis, a type of “hardening of the arteries.” In atherosclerosis, cholesterol, fat, and other substances build up in artery walls. As the process continues, arteries, including those to the heart, may narrow, reducing blood flow. Saturated fat raises blood cholesterol more than anything else in the diet.

Help reduce your fat intake by looking for lowfat or fat free dairy products and other fat free items—but, again, keep an eye on the products’ calorie content so you don’t gain weight.

Some foods can actually help to lower blood cholesterol. This includes foods with soluble (also called viscous) fiber. Soluble fiber is found in cereal grains, fruits, vegetables, and legumes (which include beans, peas, and lentils).

Other food products also help lower blood cholesterol: These products contain plant stanols or plant sterols. These include cholesterol-lowering margarines. Plant stanols and sterols are noted on product food labels.

If you’ve got a heart, heart disease could be your problem. Heart disease affects women just as much as it does men. But everyone can take steps to reduce their chance of developing the disease.

How? By preventing or controlling behaviors and conditions known to increase its risk. They’re called “risk factors,” and there are two types—those you can change and those you can’t. Luckily, most of them can be changed. These are smoking, high blood pressure, high blood cholesterol, overweight/obesity, physical inactivity, and diabetes.

Those you can’t alter are your age (45 or older for men; 55 or older for women) and having a family history of early heart disease (a father or brother diagnosed before age 55, or a mother or sister diagnosed before age 65).

Start now to improve your heart-health profile. For instance, following a heart healthy eating plan helps prevent or control high blood pressure, high blood cholesterol, overweight, and diabetes. Here are some other steps you can take to help protect your heart health:

• Stop smoking. If you can’t quit the first time, keep trying.
• Lower high blood pressure. Have your blood pressure checked regularly (once every 2 years if it is normal, more often if it is not).
  Also, maintain a healthy weight and limit your intake of alcoholic beverages—to one drink a day for women and two for men.
• Reduce high blood cholesterol. Maintain a healthy weight and get your cholesterol level checked once every 5 years (more often, if needed). The test measures the level of cholesterol circulating in the bloodstream.
• Aim for a healthy weight. To lose weight and keep it off, adopt a lifestyle that combines sensible eating with regular physical activity.
• Be physically active. Do at least 30 minutes of a moderate-intensity physical activity, such as brisk walking, on most and preferably all days of the week.
• Prevent or manage diabetes. The steps that lower your risk of heart disease also reduce your chance of developing diabetes. If you already have diabetes, be sure to manage it.

Eating well means enjoying a variety of food—and so does eating to stay well. Variety matters because no food has all the nutrients and other substances needed by your heart—and the rest of your body. So be sure to follow a well-balanced eating plan.

The nutrient list that accompanies the recipes in this collection can help you keep your diet in balance. The list gives nutrients vital for good heart health. Use the list to aim for the recommended daily total intakes of those nutrients.

The recommended daily intakes for healthy adults are given below. Your needs may differ from these if you are overweight or have heart disease, high blood pressure, high cholesterol, diabetes, or another condition. If you do, check with your doctor or a dietitian to find out what intakes are best for you.

• Calories ..............Consume enough to stay at a healthy weight

A calorie is a unit of energy, not a nutrient. The amount that’s best for you depends largely on your height and weight. You’ll also need to consider whether or not you have to lose pounds.

Other factors that affect your calorie needs include how physically active you are and your age. Physical activity helps burn calories, while middle-aged and older adults tend to need fewer calories than younger persons.

Typical daily intakes are:

1,600 calories—For young children (ages 2-6), women, and some older adults

2,200 calories—For older children, teenage girls, active women, and most men

2,800 calories—For teenage boys and active men

• Total fat .............No more than 30 percent of daily calories
• Saturated fat ......Less than 10 percent of daily calories
• Cholesterol .........Less than 300 milligrams per day
• Fiber ..................25–30 grams per day
• Protein ...............10–35 percent of daily calories
• Carbohydrates....45–65 percent of daily calories
• Sodium ...............No more than 2,400 milligrams per day

To calculate percent of daily calories, it’s important to know that protein and carbohydrate have 4 calories per gram, while fat has 9 calories per gram. So, for example, if you eat 2,000 calories a day, your daily total intakes should be: no more than 67 grams of total fat, 22 grams or less of saturated fat, and 225–325 grams of carbohydrates. For the other nutrients, have no more than the maximums listed above.

However, try to remember that the goal is to build a nutritious pattern from nutritious meals. Not every dish needs to be low in fat or calories. Keep your sights set on an overall healthy pattern.

When it comes to heart health, size matters. It’s very easy to “eat with your eyes” and misjudge what equals a portion. That makes it just as easy to pile on unwanted pounds. So be sure you eat a sensible portion size. The recipes in this collection are designed to give you a satisfying portion.

• Nutrition and Your Health: Dietary Guidelines for Americans—See “A Pyramid of Healthy Foods”. The section gives the portion sizes used in this healthy eating plan.
• Nutrition Facts Label—The section tells how to read these labels, which give calorie and nutrient contents per serving. Products often are sold as single portions but actually contain more than one serving. For instance, a small bag of pretzels may be sold as one portion but contain two servings. Be especially careful of portion size when choosing high-calorie items.

Shopping for the right food item can be dizzying. Shelves are packed with different brands, some with special health claims.

There’s a surefire way to pick out the best item: Read its Nutrition Facts Label. This label gives you x-ray eyes. It tells you nutritional value and number of servings in an item.

The label has another asset too—the Percent Daily Value listing. This tells you how much each serving of the item supplies of the day’s recommended intake for total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fiber, vitamins A and C, calcium, and iron. Not bad.

Use the Nutrition Facts Label to compare foods. As a guide, if you want to consume more of a nutrient (such as fiber), try to choose foods with a higher Percent Daily Value; to consume less of a nutrient (such as saturated fat, cholesterol, or sodium), choose foods with a lower Percent Daily Value. Try the "5–20" guide—an easy way to use the Percent Daily Value to compare the nutrients in similar foods. So, for nutrients you want to get less of, look for a Percent Daily Value of 5 or less; for nutrients you want to have more of, look for a Percent Daily Value of 20 or more.

Also get in the habit of checking an item’s ingredient list. It will tell you what’s in the food—including any added nutrients, fats, or sugars. Ingredients are listed in descending order of amount by weight.

See the Box below for information on how to decipher the special content claims on food labels.

One of the best ways to find heart healthy products is to check food labels. Here are some terms to look for when choosing lowsodium, lowfat, and low-calorie items:

PHRASE	WHAT IT MEANS
FOR SODIUM
Sodium free or salt free	Less than 5 milligrams per serving
Very low sodium	35 milligrams or less per serving
Low sodium	140 milligrams or less per serving
Low sodium meal	140 milligrams or less per 31/2 ounces (100 grams)
Reduced or less sodium	At least 25 percent less sodium than the regular version
Light in sodium	Half the sodium of the regular version
Unsalted or no salt added	No salt added
FOR FATS
Fat free	Less than 0.5 grams per serving
Low saturated fat	1 gram or less per serving
Lowfat	3 grams or less per serving
Reduced fat	At least 25 percent less fat than the regular version
Light in fat	Half the fat of the regular version
FOR CALORIES
Calorie free	Less than 5 calories per serving
Low calorie	40 calories or less per serving
Reduced or less calories	At least 25 percent fewer calories than the regular version
Light or lite	Half the fat or a third of the calories of the regular version

If you’re searching for a healthy overall eating plan, you’ve come to the right page. The Federal Government has created a pyramid to good health—in fact, it’s called the “Food Guide Pyramid.”

The idea is that the base of the pyramid forms the foundation for good nutrition and the foods you should eat most often. As you go up the pyramid, you eat less of the major food groups represented. Putting all the pyramid’s groups together assures you a well-rounded diet. The pyramid’s also designed to encourage you to choose a variety of foods from within the groups.

The pyramid is shown above, along with the recommended daily servings. More information about the servings appears below.

There’s one more piece of vital information you need to follow the pyramid, and that’s what counts as a serving. Here are some examples of one serving of each of the pyramid’s building blocks:

• Bread, Cereal, Rice, and Pasta (Grains Group)—especially whole grain
  1 slice bread
  About 1 cup of ready-to-eat cereal
  ½ cup of cooked cereal, rice, or pasta
  
• Vegetable Group
  1 cup of raw leafy vegetables
  ½ cup of other vegetables—cooked or raw
  ¾ cup of vegetable juice
  
• Fruit Group
  1 medium apple, banana, orange, pear
  ½ cup of chopped, cooked, or canned fruit
  ¾ cup of fruit juice
  
• Milk, Yogurt, and Cheese (Milk Group)—preferably fat free or lowfat
  1 cup of milk or yogurt
  1½ ounces of natural cheese (such as Cheddar)
  2 ounces of processed cheese (such as American)
  
• Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts (Meat and Beans Group)—preferably lean or lowfat
  2–3 ounces of cooked lean meat, poultry, or fish
  ½ cup of cooked dry beans or ½ cup of tofu—these count as 1 ounce of lean meat
  
  (Note: Dry beans, peas, and lentils can be counted as servings in either the meat and beans group or the vegetable group. As a vegetable, ½ cup of cooked, dry beans counts as one serving.
  As a meat substitute, 1 cup of cooked, dry beans counts as one serving—2 ounces of meat.)
  2½–ounce soyburger or 1 egg counts as 1 ounce of lean meat 2 tablespoons of peanut butter or 1/3 cup of nuts counts as 1 ounce of meat

Eating heart healthy meals doesn’t mean giving up some of those too-rich favorite family recipes. With a few changes, you can keep the heart and add the health. Here’s how:

• Cook with lowfat (1 percent fat) or fat free dry or evaporated milk, instead of whole milk or cream.
• Instead of sour cream, blend 1 cup lowfat, unsalted cottage cheese with 1 tablespoon fat free milk and 2 tablespoons lemon juice, or substitute plain, fat free or lowfat yogurt or sour cream.

• Use a variety of herbs and spices in place of salt.
• Use low-sodium bouillon and broths, instead of regular bouillons and broths.
• Use a small amount of skinless smoked turkey breast, instead of fatback to lower fat content but keep taste.
• Use skinless chicken thighs, instead of neck bones.

• Use cooking oil spray to lower fat and calories.
• Use a small amount of vegetable oil, instead of lard, butter, or other fats that are hard at room temperature.
• In general, diet margarines are not well suited for baking. Instead, to cut saturated fat, use regular soft margarine made with vegetable oil.
• Choose margarine that lists liquid vegetable oil as the first ingredient on the food label.

• In baking or cooking, use 3 egg whites and 1 egg yolk, instead of 2 whole eggs, or 2 egg whites or 1/4 cup of egg substitute, instead of 1 whole egg.

• Choose a lean cut of meat and remove any visible fat.
• Remove skin from chicken and other poultry before cooking.

• In salads and sandwiches, use fat free or lowfat dressing, yogurt, or mayonnaise, instead of regular versions.
• To make a salad dressing, use equal parts water and vinegar, and half as much oil.
• Garnish salads with fruits and vegetables.

• Remove fat from homemade broths, soups, and stews by preparing them ahead and chilling them. Before reheating the dish, lift off the hardened fat that formed at the surface. If you don’t have time to chill the dish, then float a few ice cubes on the surface of the warm liquid to harden the fat. Then, remove and discard the fat.
• Use cooking spray, water, or stock to sauté onion for flavoring stews, soups, and sauces.

• To make muffins, quick breads, and biscuits, use no more than 1–2 tablespoons of fat for each cup of flour.
• When making muffins or quick breads, use three ripe, very well-mashed bananas, instead of 1/2 cup butter or oil. Or, substitute a cup of applesauce for a cup of butter, margarine, oil, or shortening—you’ll get less saturated fat and fewer calories.

• To make a pie crust, use only 1/2 cup margarine for every 2 cups flour.
• For chocolate desserts, use 3 tablespoons of cocoa, instead of 1 ounce of baking chocolate. If fat is needed to replace that in chocolate, add 1 tablespoon or less of vegetable oil.
• To make cakes and soft-drop cookies, use no more than 2 tablespoons of fat for each cup of flour.

Less fat? Less salt? How can you do that and get more taste? Easy. Flavor with spices and herbs.

Beef .....................Bay leaf, marjoram, nutmeg, onion, pepper, sage, thyme

Lamb...................Curry powder, garlic, rosemary, mint

Pork.....................Garlic, onion, sage, pepper, oregano

Vea ......................Bay leaf, curry powder, ginger, marjoram, oregano

Chicken ..............Ginger, marjoram, oregano, paprika, poultry seasoning, rosemary, sage, tarragon

Fish......................Curry powder, dill, dry mustard, lemon juice, marjoram, paprika, pepper

Carrots ................Cinnamon, cloves, marjoram, nutmeg, rosemary, sage

Corn....................Cumin, curry powder, onion, paprika, parsley

Green beans .......Dill, curry powder, lemon juice, marjoram, oregano, tarragon, thyme

Greens.................Onion, pepper

Peas .....................Ginger, marjoram, onion, parsley, sage

Potatoes ..............Dill, garlic, onion, paprika, parsley, sage

Summer squash..Cloves, curry powder, marjoram, nutmeg, rosemary, sage

Winter squash....Cinnamon, ginger, nutmeg, onion

Tomatoes ............Basil, bay leaf, dill, marjoram, onion, oregano, parsley, pepper

That it? You say you still have questions? Thought so. Here are a few quick facts and tips on fiber, fat, and sodium.

You’ve probably heard that it’s good to eat plenty of fiber. But what is fiber, and why is it important for your heart?

Fiber comes from plants. Since your body can’t really digest fiber or absorb it into your bloodstream, it’s not nourished by it. That means, technically speaking, fiber isn’t a “nutrient.” But it’s vital for good health.

First, fiber can help reduce your risk of heart disease. Second, it’s also good for the digestive tract and overall health. And, as a bonus, eating lots of fiber helps you feel full on fewer calories, which makes it ideal if you’re trying to lose weight.

There are two main types of fiber—soluble (also called “viscous”) and insoluble. While both have health benefits, only soluble fiber reduces the risk of heart disease.

The difference between the types is how they go through the digestive track. Soluble fiber mixes with liquid and binds to fatty substances to help remove them from the body. Soluble fiber thus helps to lower cholesterol levels—thereby reducing the risk of heart disease. Good sources of soluble fiber are whole oats, barley, fruits, vegetables, and legumes (which include beans, peas, and lentils).

Insoluble fiber goes through the digestive tract largely undissolved. Also called “roughage,” insoluble fiber helps the colon function properly. Good sources of insoluble fiber are whole-grain foods (such as wheat and corn bran), fruits (such as apples and pears with the skins), vegetables (such as green beans, cauliflower, and potatoes with the skins), and legumes.

As you can see, many foods have both soluble and insoluble fiber. As a rule, fruits have more soluble fiber and vegetables more insoluble fiber.

You should try to eat 25–30 grams of total fiber each day. That should include at least 5–10 grams daily of soluble fiber.

Here’s a more complete list of good sources of soluble fiber:

• Whole grain cereals and seeds — barley; oatmeal; oatbran; and psyllium seeds (ground)
• Fruits —apples (with the skin); bananas; blackberries; citrus (such as oranges and grapefruits); nectarines; peaches; pears; plums; and prunes
• Legumes —black, kidney, lima, navy, northern, and pinto beans; yellow, green, and orange lentils; and chickpeas and black-eyed peas
• Vegetables —broccoli; brussels sprouts; and carrots

Fat is a nutrient that helps the body function in various ways: For example, it supplies the body with energy. It also helps other nutrients work and, when it becomes fatty tissue, it protects organs and provides insulation, keeping you warm. But the body only needs small amounts of fat. Too much fat can have bad effects, including turning into unwanted excess pounds and increasing cholesterol in the bloodstream.

There are different types of fat, and they have different effects on your risk of heart disease. Knowing which fat does what can help you choose healthier foods.

• Total fat. This is the sum of saturated, monounsaturated, and polyunsaturated fats and trans fatty acids in food. Foods have a varying mix of these three types.


• Saturated fat. This fat is usually solid at room and refrigerator temperatures. It is found in greatest amounts in foods from animals, such as fatty cuts of meat, poultry with the skin, whole-milk dairy products, lard, and some vegetable oils, including coconut and palm oils. Saturated fat increases cholesterol in the blood more than anything else in the diet. Keep your intake of saturated fat low.


• Unsaturated fat. This fat is usually liquid at room and refrigerator temperatures. Unsaturated fats occur in vegetable oils, most nuts, olives, avocados, and fatty fish, such as salmon.
  
  There are types of unsaturated fat—monounsaturated and polyunsaturated. When used instead of saturated fat, monounsaturated and polyunsaturated fats help lower blood cholesterol levels. Monounsaturated fat is found in greatest amounts in foods from plants, including olive, canola, sunflower, and peanut oils. Polyunsaturated fat is found in greatest amounts in foods from plants, including safflower, sunflower, corn, soybean, and cottonseed oils, and many kinds of nuts. A type of polyunsaturated fat is called omega-3 fatty acids, which are being studied to see if they help guard against heart disease. Good sources of omega-3 fatty acids are some fish, such as salmon, tuna, and mackerel.
  
  Use moderate amounts of food high in unsaturated fats, taking care to avoid excess calories.


• Trans fatty acids. Foods high in trans fatty acids tend to raise blood cholesterol. These foods include those high in partially hydrogenated vegetable oils, such as many hard margarines and shortenings. Foods with a high amount of these ingredients include some commercially fried foods and some bakery goods.

The Box below can help you choose foods lower in fat.

Each day, aim for intakes of less than 10 percent of calories from saturated fat and no more than 30 percent of calories from total fat. Those are the recommended daily intakes for healthy adults.

Here are some examples of the maximum amount of fat you should consume:

If you consume:	Calories a Day	Eat no nore than:	Saturated Fat	Total Fat
	1,200		13 grams	40 grams
	1,600		18 grams	53 grams
	2,000*		22 grams	67 grams
	2,200		24 grams	73 grams
	2,500*		28 grams	83 grams
	2,800		31 grams	93 grams

* Percent Daily Values on Nutrition Facts Labels are based on a 2,000 calorie diet. Values for 2,000 and 2,500 calories are rounded to the nearest 5 grams to be consistent with the Nutrients Facts Label.

Definitely. Here’s a guide to the lower-fat cuts:

Beef .....................Top round, eye of round, round steak, rump roast, sirloin tip, short loin, strip steak lean, lean and extra lean ground beef

Pork.....................Tenderloin, sirloin roast or chop, center cut loin chops

Lamb...................Foreshank, leg roast, leg chop, loin chop

You’re in luck. There’s a host of lowfat cooking methods. Try these—but remember not to add butter or high-fat sauces:

• Bake
• Broil
• Microwave
• Roast
• Steam
• Poach
• Lightly stir fry or sauté in cooking spray, small amount of vegetable oil, or reduced sodium broth
• Grill seafood, chicken, or vegetables

Most Americans eat too much salt (sodium chloride). You can help protect yourself against high blood pressure—and so heart disease and stroke—by reducing the amount of salt and other forms of sodium in your diet. Try to consume no more than 2,400 milligrams of sodium a day—or, if you can, 1,500 milligrams a day. That includes all the salt and sodium in your diet, whether added at the table or in cooking, or already in processed foods.

Here are some tips on ways you can reduce your intake of salt and sodium:

• Use reduced sodium or no salt added products. For example, choose low- or reduced-sodium, or no salt added versions of foods and condiments when available.
• Buy fresh, frozen, or canned “with no salt added” vegetables.
• Use fresh poultry, fish, and lean meat, rather than canned, smoked, or processed types.
• Choose ready-to-eat breakfast cereals that are lower in sodium.
• Limit cured foods (such as bacon and ham), foods packed in brine (such as pickles, pickled vegetables, olives, and sauerkraut), and condiments (such as MSG, horseradish, catsup, and barbecue sauce). Limit even lower sodium versions of soy sauce and teriyaki sauce—treat these condiments as you do table salt.
• Be spicy instead of salty. In cooking and at the table, flavor foods with herbs, spices, lemon, lime, vinegar, or salt-free seasoning blends.
• Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes, which usually have added salt.
• Choose “convenience” foods that are lower in sodium. Cut back on frozen dinners, mixed dishes such as pizza, packaged mixes, canned soups or broths, and salad dressings—these often have a lot of sodium.
• Rinse canned foods, such as tuna, to remove some sodium.