Heart-Healthy Diet: Limit Sodium, Problem Fats, and Energy-Dense Foods

By James M. Rippe

Another aspect of heart-healthy nutrition is making food choices that limit intakes of certain ingredients that can work against heart health. The most important things to limit are sodium (salt), saturated fats and trans fats, and energy-dense foods that provide energy (calories) but relatively few nutrients.

Use less salt and choose prepared foods with less salt

Guidelines currently recommend that adults in general should consume less than 2,300 milligrams of sodium daily, about 1 teaspoon of table salt (sodium chloride). The recommendation is less than 1,500 milligrams daily (just over a half teaspoon salt) for adults 51 and older, individuals of African American heritage, and anyone with high blood pressure, diabetes, or a diagnosis of heart disease.

On average, most American adults consume about twice the recommended amount. Many prepared and convenience foods have high levels of sodium — take a glance at the labels. The same goes for restaurant offerings, whether they’re fast food or haute cuisine.

The major reason to limit salt/sodium intake has to do with its association with high blood pressure. In societies where less sodium is consumed, the incidence of high blood pressure is dramatically lower than it is in the U.S. If people with hypertension pay more attention to strict limitations on salt consumption and control their weight, many can manage blood pressure without medications.

Consume fewer foods with saturated fats and avoid trans fats

Eating too much saturated fat, especially trans fat, contributes to elevated total cholesterol and LDL cholesterol (the bad kind), which have clear links to developing atherosclerosis, including that of coronary heart disease. Saturated fat also is linked to diabetes and colon cancer. Here’s what you need to know:

  • Saturated fats (SFA) typically come from animal sources, such as fat in meat and poultry and butterfat in dairy products; some fats from tropical plants, such as cocoa butter, palm oil, and coconut oil, also are saturated. Saturated fats typically are solid at room temperature. Good ways to lower your intake of saturated fats are to substitute healthy fats, trim all visible fat from meat, and eat nonfat or low-fat dairy products.

  • Trans fat is a saturated fat that is made by adding hydrogen to vegetable oil, turning it into a solid. Hydrogenation makes the oil stable and helps prevent it from going rancid; that’s why trans fats are used in many manufactured foods.

    Vegetable shortening and stick margarine are two examples of trans fats. Trans fat, which is labeled as hydrogenated or partially hydrogenated vegetable oil, raises unhealthy LDL cholesterol and may lower healthy HDL cholesterol. Avoid trans fat entirely if possible.

From a dietary point of view, the first line of therapy for elevated cholesterol is lowering your intake of saturated fats and trans fats. Although dietary cholesterol is not as big an influence on blood cholesterol as saturated fat and trans fat, limiting the amount of cholesterol you eat is still important, particularly if you have diabetes.

Cholesterol is found in animal foods. The recommended daily intake level is 300 milligrams. To put this in perspective, note that the yolk of an average egg contains 215 mg of cholesterol. Egg whites, on the other hand, are cholesterol-free.

Choose foods to moderate your intake of energy-dense foods

Who doesn’t like a little something sweet or a savory snack? Unfortunately, most Americans consume far too many empty calories in the form of cookies, ice cream, candy, soft drinks and other sweet treats or savory snacks. (The intake of highly refined carbohydrates has also been linked to increased levels of small dense LDL cholesterol.)

So think about these possible choices: One average candy bar or one half-cup serving of a premium ice cream contains about 275 to 300 calories (much of which is sugar and fat). For the same number of calories, you can eat two to three bananas, pears, or apples; or three to four peaches, apricots, or plums; an entire cantaloupe; a big wedge of watermelon; or a quart-and-a-half of strawberries.

Or you could eat a whole bowl of air-popped or microwaved low-fat, whole-grain popcorn. You no doubt get the drift. Plenty of good-for-you treats are available. Go ahead and enjoy the occasional ice cream, candy. or soda, but for everyday eating, think in terms of “more is less” — more fruit (more nutrition) is less caloric intake.

If you consume alcohol, do so in moderation

From a cardiovascular point of view, alcohol consumption is a complex issue. Moderate alcohol consumption actually has been shown to lower the risk of heart attack. Yet alcohol also is loaded with calories and may, therefore, contribute to weight gain. Furthermore, excessive alcohol consumption actually carries with it the cardiovascular risk of increasing blood pressure and acting in adverse ways on the cardiac muscle itself.

Research and debate continue about the complex mechanisms (including genetic links) and pathways through which alcohol appears to benefit heart health. Debate also continues about which type of alcohol (wine, beer, spirits) may hold the advantage, although red wine in particular has received a lot of study.

Moderate alcohol consumption generally is defined as no more than one drink daily for women and two drinks for men. One drink equals a 1.5 shot of distilled spirits, 5 ounces of wine, or 12 ounces of beer. Higher levels of alcohol consumption carry unacceptable health risks.