Weight: Maintain an appropriate body weight. Obesity is associated with number of health problems. A strong correlation exists between body weight and blood pressure. Obesity makes it easier for genetic abnormalities to manifest themselves.
2. Total fat: Reduce total fat intake in the diet to less than 30 per cent of total calories. Cook with little or no fat. Avoid frying foods. Instead stir-fry, broil, microwave, broil, roast or steam your food. Use more vegetables and fruits.
3. Saturated fats: Reduce saturated fats to less than 10 per cent of total calories. Reduction of saturated fat in the diet also reduces total cholesterol. Tropical oils like coconut, palm, kernel, ghee (clarified butter) are very high in saturated fat. They are frequently used in commercially prepared crackers, snacks and Indians sweets.
It is important to read labels before buying your favourite snacks. Hydrogenated oils (margarine etc) should be limited in the diet. The hydrogenation process saturates fats and changes their chemical structure and this tends to raise total blood cholesterol. Substitute liquid oils for solid shortening in cooking.
4. Polyunsaturated fats: They should comprise up to 10 per cent of total calories. Rich sources of these oils include safflower, sesame, sunflower, corn and soybean. These oils can help lower blood cholesterol levels.
5. Mono-unsaturated fats: They should comprise up to 15 per cent of total calories. Rich sources of these fats are olive, canola, peanut and avocado. Studies have shown that monounsaturated oils help reduce cholesterol levels.
6. Cholesterol: Cholesterol intake should be less than 300 milligrams per day. A normal adult manufactures about 1,000 milligrams a day. The remaining cholesterol comes from animal food sources. The body needs small amounts of cholesterol for cell membranes and some hormones. Saturated fats and dietary cholesterol raise blood cholesterol levels.
The American Heart Association has developed two plans for people who have high cholesterol levels.
The Step One Diet is for healthy people whose cholesterol levels are slightly high (it restricted total fat to no more than 30 per cent of total calories, saturated fat to no more than 10 per cent of total calories, and cholesterol to less than 300 mg/day. Intended as the starting point for patients who had high cholesterol levels).
Step Two Diet further reduces saturated fat to seven per cent of calories and dietary cholesterol to less than 200 mg a day (intended for people who had already achieved Step I goals or for patients with a high-risk cholesterol level, 240 mg/dL or higher, or who had had a heart attack).
7. Less carbs: Reduce simple carbohydrates (sugars) to 10 to 15 per cent of total calories. These include rich desserts and cookies.
8. High fibre: Increase complex carbohydrates to 50 to 60 per cent of total calories. Some water-soluble dietary fibres such as oat bran, pectin (found in apples, oranges, and grapefruit), and guar gum (found in beans, peas, and lentils) have a cholesterol lowering effect. Water insoluble fibres, such as wheat bran do not have this property.
High fibre diet can also be helpful in losing weight. At the Bariatric Clinic at Howard University, we have been using high fibre diets in the treatment of obesity. Patients on these diets lose significant weight. Fibre slows the absorption of food and this gives a feeling of fullness. The best way to increase fibre in the diet is to eat fruits, especially apples, oranges and grapefruit. Oat bran, beans, peas, and lentils are also effective.
The diet of most South Asians includes lentils. They can improve their diet by not using saturated fats in lentils and eating more fruits and vegetables. Another way they can increase fibre content is by adding oat bran flour to their chappatis. It is recommended that the diet should include 20 to 30 grams of fibre per day. It is important to increase water intake with high fibre intake.
9. Salt: The American Heart Association recommends that healthy adults not consume more than 2,400 mg of sodium per day. Some people with high blood pressure need to reduce their salt intake further. One teaspoon of salt contains 2,000 mg of sodium. Canned, precooked foods, pickles, salted nuts, prepared soups and desserts are very rich in sodium.
10. Alcohol: A number of studies have shown that alcohol raises HDL cholesterol (good cholesterol) levels. Some studies have shown that this increase is mainly in HDL, rather than DL (the protective component of HDL cholesterol). Therefore, it is recommended that if you don't drink, don't start because the benefits are negligible. If you do drink, limit your take to two drinks a day (one ounce ethanol) of wine, beer or liquor.
11. Do not smoke: Cigarettes greatly increases an individual's chances of developing heart disease. Smoking decreases HDL cholesterol (good cholesterol) and is associated with the development of arteriosclerosis.
12. Exercise: Regular physical activity reduces the risk of cardiovascular disease. It increases HDL levels, lowers triglyceride levels, improves glucose tolerance, reduces high blood pressure, controls weight, and lessens depression. The amount and intensity of exercise varies with different individuals.
An individualized exercise program should be developed in consultation with your physician. In healthy individuals, an exercise program of moderate intensity (eg brisk walking) thirty to forty-five minutes a day five days a week is recommended.
13. Stress: A number of studies have shown that stress increases LDL cholesterol (bad cholesterol). It is recommended that you keep your stress levels low by minimizing frustrating and angry situations and making time for pleasurable activities. Mediation can be very helpful in reducing stress as mentioned earlier in the book.
Earlier feature: Healthcare goes five-star in India
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