American Heart Association for Cardiovascular Disease Risk Reduction

Diet and Lifestyle Goals

  • Consume an overall healthy diet.
  • Aim for a healthy body weight.
  • Aim for recommended levels of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.
  • Aim for a normal blood pressure.
  • Aim for a normal blood glucose level.
  • Be physically active.
  • Avoid use of and exposure to tobacco products.

Diet and Lifestyle Recommendations

  • Balance calorie intake and physical activity to achieve or maintain a healthy body weight.
  • Consume a diet rich in vegetables and fruits.
  • Consume whole-grain, high fiber foods.
  • Consume fish, especially oily fish, at least twice a week.
  • Limit your intake of saturated fat to <7% of energy, trans fat to <1% of energy, and cholesterol to <300 mg per day by:
  • Choosing lean meats and vegetable alternatives
  • Selecting fat-free (skim), 1%-fat, and low-fat dairy products
  • Minimizing intake of partially hydrogenated fats.
  • Minimize your intake of beverages and foods with added sugars.
  • Choose and prepare foods with little or no salt.
  • If you consume alcohol, do so in moderation.
  • When you eat food that is prepared outside the home, follow the AHA Diet and Lifestyle Recommendations.

For more about food's functional benefits for heart health, refer to "Phytonutrients—a 'Crop'for Good Health" in chapter 4, "Functional Foods; A New Wave" in chapter 9, and "FunctionalFoods: What Does Research Say?" in the Appendices.

Triglycerides: Another Health Issue

High blood triglycerides get much less attention than cholesterol, yet they're significantly linked to heart disease. As with cholesterol, high blood triglyceride levels don't mean you'll develop heart disease, but the chance goes up if you have other risk factors.

Triglycerides are the main form of fat in foods, whether they're saturated, polyunsaturated, or mono-unsaturated. Once consumed, your liver processes them. Excess calories from any source—carbohydrates, proteins, or fats—change to triglycerides for storage as body fat. Alcohol also can boost the liver's production of triglycerides.

Your blood triglyceride level normally goes up after eating. Things that can increase triglyceride levels include: overweight, physical inactivity, cigarette smoking, excessive alcohol use, a very-high-carbohydrate diet, certain diseases and drugs, and genetic disorders.

Because of the risk for heart disease, the National Heart, Lung, and Blood Institute recommends treating people with borderline-high and high triglyceride levels. If your blood triglyceride level consistently exceeds normal, weight control, physical activity, and

Source: American Heart Association, 2006.

*The AHA's advice parallels the Dietary Guidelines for Americans, 2005, from the U.S. Department of Health and Human Services and the U.S. Department of Agriculture (see chapter 1).

perhaps medication may bring it down. (Normal is below 150mg/dL.) In fact, the advice for lowering total blood cholesterol levels also applies to reducing triglyceride levels. Of importance:

  • Maintain or improve your weight. Weight loss alone may significantly lower triglyceride levels.
  • Live an active lifestyle. Regular physical activity can lower triglyceride levels and raise HDL cholesterol.
  • Go easy on sugary foods.
  • If you drink alcoholic beverages, consume just moderate amounts or skip them entirely. Check with your doctor and a registered dietitian.
  • Eat fatty fish, such as salmon, since their omega-3 fatty acids may help lower triglycerides. Refer to page 285 for advice on fatty fish and food safety.

screenings at a mall or a health fair? As an initial screening, these finger stick tests for cholesterol may be good indicators. If your cholesterol number is borderline high or high—or if you have other risk factors for heart disease—have it rechecked with your healthcare provider. A finger stick screening may be less accurate than a blood test done in your doctor's office or a health center.

For a complete picture, you need a blood test called a lipoprotein profile: LDL, total, and HDL cholesterol levels as well as blood triglycerides. Triglyceride levels are especially important if you have other risk factors—for example, high total blood cholesterol; two or more risk factors for heart disease, such as smoking and obesity; or health problems related to triglycerides, such as diabetes, high blood pressure, obesity,

Strive for Desirable Blood Lipid Levels

To lower your heart disease risk, strive to keep your blood lipid levels at desirable levels for life. If you don't know your blood cholesterol and triglyceride numbers, check soon. Then act on the results!

Total Cholesterol

  • Less than 200 mg/dL
  • 200-239 mg/dL
  • 240 mg/dL and above

LDL Cholesterol (lower is better)

  • Less than 100 mg/dL
  • 100-129 mg/dL
  • 130-159 mg/dL
  • 160-189 mg/dL
  • 190 mg/dL and above Triglyceride
  • Less than 150 mg/dL
  • 150-199 mg/dL
  • 200 or more HDL Cholesterol
  • Less than 40 mg/dL
  • 40-59 mg/dL
  • 60 mg/dL or more

Desirable Borderline high High

Optimal

Near optimal/above optimal

Borderline high

High

Very high Normal

Borderline high High

A major risk factor for heart disease

The higher, the better Considered protective against heart disease

Source: National Heart, Lung, and Blood Institute, National Institutes of Health (2006).

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