FIRST PRINCIPLE : To maintain an Ideal Body Weight. Obesity is an independent risk factor for Coronary Heart disease. An important recommendation, therefore, is to reduce caloric intake to achieve weight reduction. Weight reduction would lower the LDL cholesterol, reduce plasma triglyceride and raise HDL levels. To reduce weight, one should choose the right type of food and perform exercises to burn off excessive calories.

SECOND PRINCIPLE : To reduce Fat. The total fat intake in cardiac patients should not exceed 20 percent of the caloric intake. A higher intake of fat leads to deposition of fat in blood vessels of the heart-atherosclerosis. This leads to blockage of arteries of the heart, making it difficult for the heart to function properly and can lead to a heart attack.

SATURATED FATS - are those, which are hard or solid at room temperature. Certain fats like whole milk, butter, cream, ice cream, khoya, cheese, ghee, vanaspati, palm oil, and coconut oil contain high proportion of saturated fatty acid which increase the blood cholesterol levels, and therefore these foods should be avoided.

POLYUNSATURATED FATS - are those, which are liquid at room temperature. They are found in many oilseeds and nuts except coconut. These are also to be consumed in restricted amounts.

MONOSATURATED FATS - these are present in groundnut oil, olive oil and peanut oil. These have a neutral effect on blood lipid levels.

CHOLESTEROL - This is a type of fat present only in animal foods and is present in liver, kidney, shell fish, egg yolk, brain, prawns, and shrimps, dairy products such as butter, whole milk and cream. It is not found in vegetables, fruits, cereals, pulses, and vegetable oils.

THIRD PRINCIPLE : Reduce the consumption of sugar. Intake of refine sugar in the form of sucrose, sweets, and desserts should be reduced, as they give no nutritional value other than a source of energy. Foods such as chocolate, rich desserts, jams, jaggery, honey and cold drinks should be avoided.

FOURTH PRINCIPLE : Increase intake of complex carbohydrates. The indigestible carbohydrates and related polymers come under the category of dietary fibre. An example of insoluble fibre is cellulose, found in wheat chapatis, whole wheat bread, bajra, jawar, etc. These complex carbohydrates are essential for weight control as they provide satisfaction without producing excessive calories. Another type of carbohydrate is soluble fibre, which helps to reduce cholesterol and triglyceride levels, and stabilizes blood sugar levels. They are present in pulses such as beans, peas, dhals, guar gum and fruits such as apples, sapola etc.

FIFTH PRINCIPLE : Consume more of vegetable protein than animal protein. The richest sources of vegetable protein are legumes, grains, nuts, lentils, peas, soyabeans, kidney beans, etc. All these legumes can be a healthy substitution for animal proteins, since many animal proteins contain more fats, most of which are saturated. In vegetable proteins, carbohydrates provide most of the calories.

SIXTH PRINCIPLE : Consume less salt. The principal problem from excessive dietary salt is high blood pressure. Excessive consumption of salt retains fluids, thereby loading the heart and the kidneys. To reduce salt intake, avoid consumption of salty foods such as papad, pickles, chutneys and canned foods and make use of herbs, spices, lemon juice and vinegar instead of salt.

Dr. Ashok H. Punjabi
M.D. (Medicine), D.M. (Cardiology)

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