If you've recently survived a heart attack or had cardiac surgery, you may feel overwhelmed with questions about recovery—especially regarding your diet. Hope and help are on the way: We've asked four heart-health experts to weigh in on your most pressing post-illness questions. Find out what to eat, what to avoid, and where to go from here.
Which foods will help heal and protect my heart?
Good news: You can enjoy plenty of delicious foods, especially fruits, vegetables, and whole grains. "Highly pigmented, organic fruits and vegetables are best," says Decker Weiss, NMD, FASA, a naturopathic cardiologist at the Arizona Heart Hospital in Phoenix. He particularly recommends dark leafy greens, carrots, beets, and berries because "the antioxidants, beta-carotene, and bioflavonoids in these foods prevent cholesterol from oxidizing and causing further damage to the heart." According to a recent study, eating five or more fruits and vegetables every day can reduce cardiovascular disease risk by up to 72 percent, with an astonishing 10 percent risk reduction for every piece of fruit eaten daily (Nutrition Journal, 2003, vol. 2, no. 2).
Add high-fiber foods to your grocery list, too. "Fiber absorbs bile, clears toxins, and can lower [bad] LDL and raise [good] HDL cholesterol," says Weiss. He suggests stocking your pantry with beans and legumes, which are rich in fiber, low in fat, and cholesterol free.
Tofu and other soyfoods are also cardiac friendly because soy's isoflavones inhibit atherosclerosis (hardening of the arteries), improve vascular function, and lower cholesterol and triglycerides (Journal of Nutrition, 2000, vol. 130, no. 3). And you can still enjoy certain oils, especially olive, canola, soybean, flaxseed, and hemp oils, which contain beneficial fatty acids; research indicates that canola and soybean oils, in particular, help lower cholesterol (American Journal of Clinical Nutrition, 2002, vol. 75, no. 2).
What about fish?
Definitely eat fish—particularly omega-3–rich fish such as lake trout, herring, sardines, albacore tuna, and salmon—says Alice H. Lichtenstein, DSc, professor at the Friedman School of Nutrition at Tufts University. The fatty acids in fish decrease lesion formation, inflammation, platelet aggregation, and triglyceride levels.
"Those who don't consume two fish meals per week may want to ask their health care provider about taking 1 gram of fish oil per day," Lichtenstein recommends. In one study of more than 11,000 heart attack survivors, daily supplements equivalent to one fatty-fish meal reduced the risk of sudden cardiac death (Lancet, 1999, vol. 354, no. 9177). Researchers believe that consuming fish-oil fats helps stabilize heart muscle cells, making them more resistant to arrhythmia.
Which foods should I avoid from now on?
Sharply reduce intake of saturated and trans fats, says M. Laurel Cutlip, RD, LDN, author of The Cardiac Recovery Cookbook (Hatherleigh Press, 2005). These fats raise blood cholesterol and contribute to atherosclerosis. Avoid "fatty meats, whole-milk products, processed foods such as bakery items, hard margarines, shortenings, and lard," says Cutlip.
Do I have to worry about sodium?
"That depends," says New York City–based cardiologist Will Grossman, MD, FACC. "Not everyone who has cardiac problems needs to restrict sodium, but those who have high blood pressure, congestive heart failure, or a severely damaged heart should be especially vigilant." Reducing sodium reduces blood pressure, which helps lower heart attack and stroke risk. To go salt-free, season your food with chopped fresh or dried herbs, spices, lemon juice and zest, or high-quality flavored vinegars.
Can I continue to drink alcohol?
Yes, in moderation. Alcohol can raise HDL (good) cholesterol levels, says Grossman, which have a protective effect on the heart. Moderate alcohol consumption has been shown to reduce heart attack risk, peripheral vascular disease, and sudden cardiac death, and it inhibits the formation of dangerous arterial blood clots. "Up to two drinks per day for a male or one for a female is fine," says Lichtenstein. "This isn't a recommendation to start drinking but to provide limits for those who already do." The alcohol in wine, beer, and spirits is equally effective, but red wine contains added antioxidant benefits.
Can I continue to eat out?
Yes, with caveats. After a heart attack or surgery, you need to become selective and assertive when dining out, says Lichtenstein. "Identify restaurants that will accommodate special requests, such as making fish or chicken baked or broiled, without added sauces, salt, or saturated fats." Make eating out the exception, not a routine, says Cutlip. "Even when choosing wisely, large portion sizes can tip your saturated fat and sodium scale for the day."
I haven't suffered a heart attack or heart surgery, but I have a family history of heart disease. Do these recommendations apply to me?
"Yes," says Grossman. "The recommendations are basically the same whether you have experienced a cardiac event yourself or have a family history of heart disease before age 50."
Cheryl Sternman Rule covers trends in food and nutrition from San Jose, California. Her last piece for Delicious Living was "Great Grains" in November 2005.