Healthy Eating Plans for People with Heart Disease
Although there is no one typical Mediterranean Diet, many of the fundamentals of Mediterranean dietary patterns are in line with the American Heart Association's (AHA) Eating Plan for Healthy Americans, recommended for the general public. For those who are at high risk for heart disease or who already have heart disease, the AHA refined this plan further into what they call the "Therapeutic Lifestyle Change Diet" (TLC), which integrates guidelines from the National Cholesterol Education Program.104
Therapeutic Lifestyle Change Diet
The TLC Diet recommends focusing on foods low in saturated fat (which often are also low in cholesterol) such as fruits, vegetables, whole grains, low-fat or fat-free dairy products and lean cuts of meat. Avoid fatty meat and poultry with the skin. The TLC Diet recommends the following combination of nutrients for patients at high risk or who have known heart disease104:
| Recommended Intake as a Percent of Total Calories |
| Nutrient |
Intake |
| Total Fat1 |
25% - 35% |
| Saturated |
Less than 7% |
| Polyunsaturated |
Up to 10% |
| Monounsaturated |
Up to 20% |
| Carbohydrates |
50% - 60% of total calories |
| Protein |
Approximately 15% |
| Dietary Cholesterol |
Less than 200 mg per day |
| Total Calories3 |
Balance energy intake and expenditure to maintain desirable body weight and prevent weight gain |
Source: American Heart Association104
- 1. The 25-35% fat recommendation allows for increased intake of unsaturated fat in place of carbohydrates in people with the metabolic syndrome or diabetes.
- 2. Carbohydrates should come mainly from foods rich in complex carbohydrates. These include grains (especially whole grains), fruits and vegetables.
- 3. Daily energy expenditure should include at least moderate physical activity (contributing about 200 Kcal a day).
How do these guidelines translate into actual meals? Below is an overview of the recommended servings from each food group, as well as some serving suggestions from the TLC plan:
| Food Group |
Number of Daily Servings |
Serving Size Examples |
| Fruits |
2-4 |
1 piece of fruit, ½ cup diced fruit or ¾ cup fruit juice |
| Vegetables |
3-5 |
1 cup leafy or raw vegetables, ½ cup cooked vegetables or ¾ cup vegetable juice |
| Grains |
6-11 |
1 slice of bread, 1 ounce dry cereal or ½ cup cooked pasta |
| Low-fat dairy |
2-3 |
1 cup skim milk, 1 cup yogurt or 1 ounce fat-free cheese |
| Protein |
Varies (up to 5 ounces a day of lean meat, poultry and fish, egg whites or egg substitutes are unlimited) |
Substitute ½ cup dry beans, peas or tofu for 1 ounce meat |
| Fats and oils |
6-8 |
1 teaspoon soft margarine or vegetable oil, 1 tablespoon salad dressing or 1 ounce nuts |
Source: National Heart, Lung and Blood Institute10
To calculate the estimated amount of calories, grams of saturated fat and total fat to help you achieve a balanced eating plan and lower your cholesterol through the TLC Diet, visit: .
The DASH Diet
The Dietary Approaches to Stop Hypertension (DASH) eating plan was developed jointly by the U.S. Department of Health and Human Services, the National Institutes of Health (NIH) and the National Heart, Lung and Blood Institute, and has been proven in NIH studies to lower blood pressure, critical for heart disease patients. The DASH diet involves eating more fruits and vegetables, and low-fat or non-fat dairy foods.105 Also essential to the plan is reduced consumption of salt. The DASH diet recommends the following:
| Type of Food |
Daily Servings |
Serving Size Examples |
| Grains |
6-8 |
1 slice bread
1 oz dry cereal
½ cup cooked rice, pasta or cereal |
| Vegetables |
4-5 |
1 cup raw leafy vegetable
½ cup cut-up raw or cooked vegetable
½ cup vegetable juice |
| Fruits |
4-5 |
1 medium fruit
¼ cup dried fruit
½ cup fresh, frozen or canned fruit
½ cup fruit juice |
| Fat-free or low-fat milk, milk products |
2-3 |
1 cup milk or yogurt
1 ½ oz cheese |
| Lean meats, fish, poultry |
6 or less |
1 oz cooked meats, poultry or fish
1 egg |
| Nuts, seeds and legumes |
4-5 per week |
1/3 cup or 1 ½ oz nuts
2 Tbsp peanut butter
2 Tbsp or ½ oz seeds
½ cup cooked legumes (dry beans and peas) |
| Fats and oils |
2-3 |
1 tsp soft margarine
1 tsp vegetable oil
1 Tbsp mayonnaise
2 Tbsp salad dressing |
| Sweets and added sugars |
5 or less per week |
1 Tbsp sugar
1 Tbsp jelly or jam
½ cup sorbet |
Source: National Heart, Lung, and Blood Institute106
The Whole Truth about Grains
It's nearly impossible to walk down the aisle of any supermarket without seeing breakfast cereals, flour, breads, pastas, breadcrumbs and the like all advertising the fact that they are made from whole grains. But what are the benefits of eating whole grains?
According to a recent study, researchers led by Dr. Philip B. Mellen of Wake Forest University said that they have confirmed a definite connection between eating whole grains and the risk of heart disease.
The study found that on average, people who ate two and a half servings of whole grains a day had 21 percent lower risk of developing heart disease then those who ate one fifth of a serving.107
So, next time you make yourself a sandwich, swap the white bread for grain bread. It can do you a whole lot of good!
Eating Fish Helps Your Heart
Fruit, vegetables and grains aren't the only foods that can protect your heart. Studies have shown that omega-3 fatty acids found in fish can protect against coronary artery disease.108 These acids are thought to help lower triglycerides, the body's chemical form of fat, and reduce the risk of sudden cardiac death. Fish that are rich in omega-3 fatty acids are cold water fish such as salmon, mackerel and herring. Omega-3s are also found in flaxseeds, walnuts, soybeans and canola oil.109 Fish oil can also be obtained through supplements. However, some supplements, including fish oil, may cause side effects alone or in combination with prescription medications so it is important to speak with your healthcare professional before starting a supplement regimen.
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