If you follow nutrition in the news, there are many evolving messages about how to eat to prevent heart disease. Nutrition research, like any research, changes over time. This article will explain past thinking about fat and its role in heart health and review current recommended patterns of eating.
Questions about the fat we eat became popular in the late 1950s, when a researcher found that certain ways of eating affect heart disease. He discovered that people with higher cholesterol levels had higher rates of heart disease. Scientists then found that a higher saturated fat intake was also linked to heart disease risk; this started people thinking that if they reduced fat and dietary cholesterol intake, it would reduce their risk of heart disease.
Health organizations like the American Heart Association developed dietary recommendations for reducing fat intake in the late 1950s. By the 1960s and 1970s, people were encouraged to replace saturated fat with polyunsaturated fat, to help reduce blood cholesterol levels. In the 1970s, they were also advised to reduce foods rich in cholesterol, like egg yolks and shrimp. However, further research found that these fat recommendations did not have an impact on reducing deaths from heart disease.
In the 1980s and 1990s, other foods in the diet besides fat were scrutinized like vegetables, fruit, nuts and fish. Researchers also studied the role of dietary fibre. Research showed these foods had a bigger impact on heart disease risk than fat alone.
What is the current healthy eating guidance for heart disease? Some health organizations still recommend limiting dietary cholesterol for those who have a high level of blood cholesterol, but research is finding that dietary cholesterol has little impact on blood cholesterol. The appropriate message is to choose healthy fats, with a bigger emphasis on eating foods that help protect against heart disease. Here are some tips for heart-healthy eating:
- Eat lots of vegetables and fruit. Aim for seven to 10 servings each day. Include dark green and orange vegetables like spinach and carrots.
- Choose higher-fibre foods and whole grains, including foods like amaranth, barley, buckwheat, bulgur, cracked wheat, millet, oats, wild or brown rice.
- Eat fish at least twice a week. Fish containing heart-healthy fats (omega-3 fats) include salmon, sardines, herring, mackerel, trout and tuna.
- Reduce consumption of added sugar by limiting sweet desserts, and drinks with added sugar such as regular soft drinks, sweetened coffee and teas, juices and fruit-flavoured drinks.
- Choose and prepare foods with little or no added salt. Limit salty foods like pickles, crackers, snack foods, deli meats, canned and dry soup.
- Limit saturated fat by using lower-fat dairy products (skim or one per cent milk), leaner meats or dried peas, beans and tofu.
- Include small amounts of healthy fats (two to three tablespoons or 30-45 millilitres) every day such as:
- Olive, canola, peanut and sunflower oils
- Soft margarine with zero grams of trans fat
- Ground flax, chia or hemp seeds
- Nuts like walnuts, almonds, pecans or pistachios
Remember that fat is only part of the picture when choosing foods for heart health. Include a variety of healthy foods and reduce foods that increase heart disease risk.
Karol Sekulic is a registered dietitian with Alberta Health Services who has expertise and interest in the areas of weight management, nutrition and communications.