Hypertension, cholesterol, diabetes, and obesity—these are all drivers for heart disease, the leading cause of death in the United States. Treating each individually often means seeing multiple specialists. But one thing is clear: If you reduce excess body fat with a healthy lifestyle, your cholesterol, blood pressure, and risk for diabetes or prediabetes will likely drop, and so will your risk for heart disease.
Jeffrey I. Mechanick, MD
In this Q&A, Jeffrey I. Mechanick, MD, Professor of Medicine and Medical Director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Fuster Heart Hospital, explains how adopting a healthy eating pattern, rather than restrictive or fad dieting, can reduce your risk for heart disease and other chronic illnesses.
How do I know if I am at risk for heart disease?
Your body mass index (BMI) should be 18.5 to 24.9 (for Asian Americans, a healthy BMI is 18.5 to 22.9). Keep in mind that for some people, such as those who are more muscular or have a lot of swelling, BMI may not be accurate. Your goal should not be to lose weight but to be healthy and enjoy your life. Instead of going on a diet or eliminating certain foods or food groups, focus on developing a healthy eating pattern.
What is a healthy eating pattern?
First, do not think about a single food as being good or bad. Rather, consider how the pattern of foods you eat over the course of 24 hours—the total aggregate of the foods and the nutrients that are in them—are affecting your risk for heart disease. A healthy eating pattern is one that reduces your risk.
How do I develop a healthy eating pattern?
Here is what I often tell my patients:
- An ideal plate is a healthy food plate, the majority of which should consist of hi-fiber plants.
- If you include meat, make sure it is lean meat.
- Keep in mind that quantity (portion size) is not as important as the quality of the food (whole, high-fiber foods).
- Try to get in at least five to seven servings of fresh fruits and vegetables (one serving fits in the palm of your hand), as well as beans, lentils, nuts, and whole grains, every day.
- Include a good quality protein—such as poultry, fish, or vegetable protein such as beans and lentils—with every meal.
- Avoid processed foods, and eat treats only on occasion.
- Instead of baked goods, have whole grain breads or even Ezekiel breads, which are made out of sprouts and lentils (this will help you transition your eating pattern to those healthier whole grains).
- Limit alcohol as much as you can—no amount is considered healthy.
- Do not skip meals.
If you’re having trouble, seek out a professional, such your primary care physician, heart specialist, or registered dietitian, who can help structure an eating pattern for you to achieve a healthy weight.
What should I look for in food labels?
Look for foods that are high in fiber but lower in calories, fat, sodium, and simple sugars. Be aware that these numbers are often listed on Nutrition Facts labels as “per serving” and not per the total amount in the food product.
Dietary fiber: The more fiber, the better. Both soluble and insoluble fiber are good for gut health and decrease your risk for chronic diseases, such as heart disease and cancer. Fiber also decreases appetite and helps you feel full, so you are not as tempted to snack on high-calorie foods.
Sodium: The official recommendations are to have only about two grams of sodium a day—roughly one teaspoon of table salt per day. If you are already at risk for heart disease, you may need to limit sodium even more.
Saturated fat, trans fats, and simple sugars: While the data on how much saturated fat is safe is unclear, you should stick to foods that have little to no saturated fat. Avoid trans fats and simple sugars—again, you can find the amount on the Nutrition Facts labels of packaged foods or just by looking up information online.
What should I look for in restaurant menus?
Here’s a trick I give my patients: Don’t ask for the menu. Research the restaurant online at a time when you’re not hungry (such as after a meal at home) and decide what you will eat before you go, or ask the server about specific items they might have—the fish of the day, lean proteins that are cooked without sauces, salads and raw or steamed vegetables, plant-based entrees and side dishes, and even berries for dessert. This way, you won’t be tempted by the less healthy options on the menu or enticing specials.
Will dietary supplements reduce my risk for heart disease?
There is really no need to take dietary supplements unless there is a medical reason. If you are following a healthy eating pattern, you will reduce your risk for deficiencies. If you have any question or doubt, definitely discuss it with your physician.
What else will help me reduce my risk for heart disease?
Get sufficient amounts of physical activity, including a mix of aerobic exercise and strength training, especially progressive resistance training. Sleep a minimum of seven hours a night. Do not smoke or do drugs, and reduce stress as much as possible. If you are overly worried or struggle with addiction, don’t delay—seek help from a mental health professional or counselor.