Dietary Management Of Coronary Heart Disease !

Dietary Management Of Coronary Heart Disease. 

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Dietary Management of Coronary Heart Disease: 

Dietary management of coronary heart disease has several phases. During the acute phase of illness (myocardial infarction or congestive heart failure) the patient is generally hospitalised. The diet is given to the patient under the supervision of trained dietitians. The dietary management of coronary heart disease from the point of the following individuals:

 (a) those individuals who are at risk of developing CHD (prevention of development of disease) .

(b) those who already have some manifestations like atherosclerosis or angina pectoris.

 (c) those who have recovered from the acute phase of illness (i.e., myocardia! infarction or congestive heart failure) 

(1) Main Principles of Treatment : 

The main principles for prevention of CHD are: 

• to keep fat and cholesterol levels in the blood in normal limits .

• to prevent clinical manifestations like angina pectoris, myocardial infarction or congestive heart failure. 

(2) Modifications in Nutrient Needs : 

The following modifications in requirement of various nutrients need to be made: 

Energy :

 Energy restriction is needed in case of obese individuals. Energy intake should be just enough to maintain ideal body weight. If the person is of normal weight, energy intake should be according to recommended dietary intakes for energy. If the person is obese or overweight suitable modifications are to be made under the supervision of a dietitian or physician. 

Protein : 

The recommended dietary intake of I g protein/kg body weight is suitable for these patients. Fat : As fat and fat-rich foods have a direct connection with heart disease. one has to carefully monitor the intake of fat by the patient. Normally not more than 10 to 15 g (2 to 3 tsp) of visible fat in the form of cooking oils should be allowed. In addition, restriction of other fat-rich foods (especially foods containing saturated fatty acids and cholesterol is essential). 

Vitamins and Minerals: 

Vitamins and minerals should be present in adequate amounts according to recommended dietary intakes. Particular care has to be taken with regard to fat-soluble vitamins (because of fat-restricted diets). 

(3) Dietary Modifications : 

The main crux of dietary management is to provide a fat controlled and energy restricted diet to the patient. The following points summarise the major changes to be made in the diet.

 (i) Energy restriction :

 The following modifications are need to be made: 

• Cut down the intake of total food. · Avoid consumption of fat-rich foods. 

• Give cereals in moderation Cut down intake of refined cereals, encourage use of whole grain cereals. 

* Give more of pulses especially the whole pulses. Other body-building foods like milk and milk products and nesh foods have to be given by taking their fat content into consideration. 

• Increase the intake of fruits and vegetables (especially fibrous ones). 

• Cut down the intake of sugar and other sweeteners.

 (ii) Fat restriction :

 As we can see, fat control is the major aspect in the changes suggested above. To achieve reduction in fat intake :

 (i)Reduce the intake of fats and oils. 

(ii) Replace saturated fats like gher, hydrogenated fats, butter with unsaturated fats like groundnut oil, soya oil, safflower oil. 

(iii) Oils like mustard oil and coconut oil have more saturated fatty acids than unsaturated fatty acids. Their use should be limited. 

iv) Use low fat milk or toned milk instead of whole milk Whole Milk can be RIven after removing the fat or cream (which comes on top after boiling).

 (v) Give eggs in moderation. If possible not more than one egg should be given to the patient (or otherwise, it should be given after removing the yolk portion of it). 

(vi) Avoid giving fat-rich portions of flesh foods. Select lean cuts of meat. Trim visible fat from it before cooking.

 (vii) Use roasting, baking, boiling and steaming as methods of cooking instead of frying (both shallow and deep frying).

 (vii) Don't give nuts like groundnuts, cashewnuts, walnuts etc. They are rich in fat. 

(ix) Avoid giving other fat-rich desserts and fried snacks like cakes, pastries.

 Sodium restriction : 

As we have read that hypertension or high blood pressure is one of the risk factors of CHD, sodium intake influences blood pressure. Thus, high intake of sodium indirectly becomes a risk factor for CHD also.Those individuals who have hypertension or their family members are suffering from hypertension ,should keep a check on intake of sodium ( common salt).