DIETARY MANAGEMENT - LOW FAT DIET
Objectives of dietary management include
1. Maximum rest for the heart
2. Maintenance of good nutrition
Principles of Diet
Low calorie, low fat diet particularly low in saturated fat, low in cholesterol, high in poly unsaturated fatty acids (PUFA), low carbohydrate and normal protein, minerals and vitamins are suggested. High fiber is recommended.
Increased body weight increases the workload of the heart. Reduction in body weight and blood lipids is accomplished by lowering calorie intake and substituting PUFA for saturated fats. Normal weight is maintained when energy intake and output are equal. Regular exercise is essential.
Dietary fat is the single most important factor requiring adjustment in prevention and control.
Dietary fat should be restricted to 30 percent of the total calories. Severe restriction results in mental and physical depression. The content of saturated fat should be less than 10 percent of calories and polyunsaturated fat should not exceed 10 percent of calories. The proportion of saturated to monounsaturated to polyunsaturated fat should be 1:1:1. Saturated fatty acids appear to enhance the risk of CHD.
Mono unsaturated fatty acids reduce plasma cholesterol levels and increase HDL cholesterol levels. This is present in groundnut oil and olive oil.
Omega - 6 - PUFA found in seed oil and chicken fats lower plasma cholesterol levels and if necessary, small amount can be included.
Omega - 3 PUFA fatty acids found in fish, lower triglycerides and reduce risk of CHD. Consumption of 100 to 200 g of fish 2-3 times a week helps prevent heart disease. Trans fatty acids found in shortenings and spreads (due to hydrogenation of oil) produces an increase in LDL cholesterol (bad cholesterol) and decrease in HDL cholesterol (good cholesterol) and thus raises blood cholesterol levels.
Dietary cholesterol intake should be less than 300 mg / day. Fat calories should be replaced by complex carbohydrates like bread, cereals, legumes, vegetables and fruits. Diary products should not be eliminated since they are a rich source of calcium. Low fat or non fat dairy products should be eaten.
1. A multivitamin pill with B-complex and several minerals, containing about 5 times the recommended dietary allowances should be taken once in a day on reducing diets.
2. Tea/Coffee to be taken without sugar.
3. Cooking oil not to exceed 15 g.
4. Vegetarian diets have their own advantages. It is low in calories, fat and cholesterol. It has a high PUFA to saturated fat (P/S) ratio and provides adequate fiber. A ratio of 0.5 or over is satisfactory.
Carbohydrates : Carbohydrate intake is restricted as total caloric intake is restricted. Complex carbohydrate intake is recommended in place of sucrose. By reducing the sugar intake, the serum triglycerides decrease.
Protein, Vitamins and Minerals : Normal allowances are
Sodium : Sodium is restricted if there is hypertension.
Meal and Exercise : Three or four smaller meals are suggested instead of two big meals. Evening meals must be eaten two hours before bed. Regular exercise is necessary to reduce pressure.
Functional Foods : A functional food is any food that has a positive effect on a person's health, physical performance or state of mind. Foods rich in antioxidants, hypocholesterolenic agents and phytochemicals protect from CHD.
Vitamin C and b carotene are antioxidants. Citrus fruits are a good source of vitamin C. Green leafy vegetables and yellow orange coloured vegetables are a good source of carotenoids.
Garlic is hypocholesterolemic and one clove of garlic per day is sufficient to reduce cholesterol. High fibre also reduces cholesterol. Pectin in apples is effective in reducing cholesterol.
Guargum extracted from cluster beans, oats, turmeric, onion, garlic and fenugreek have hypocholesterolemic effect. Legumes and vegetables lower serum triglyceide levels.