Ischemic Heart Disease and Diet Management

Ischemic heart disease

Ischaemic (or ischemic) heart disease is a disease characterized by reduced blood supply to the heart. It is the most common cause of death in most western countries. Ischaemia means a "reduced blood supply".

The coronary arteries supply blood to the heart muscle and no alternative blood supply exists, so a blockage in the coronary arteries reduces the supply of blood to heart muscle. Most ischaemic heart disease is caused by atherosclerosis, usually present even when the artery lumens appear normal by angiography.

Initially there is sudden severe narrowing or closure of either the large coronary arteries and/or of coronary artery end branches by debris showering downstream in the flowing blood. It is usually felt as angina, especially if a large area is affected. The narrowing or closure is predominantly caused by the covering of atheromatous plaques within the wall of the artery rupturing, in turn leading to a heart attack (Heart attacks caused by just artery narrowing are rare).

Causes

Ischemic heart disease is typically caused by a heart attack or coronary artery disease. Risk factors for these conditions include:

·         Family history of coronary heart disease

·         High blood pressure, also known as

·         Hypertension

·         High cholesterol

·         Obesity

·         Diabetes mellitus

·         End-stage kidney disease

·         Amyloidosis, a condition in which abnormal proteins build up in your tissues and organs, including blood vessels

·         Sedentary lifestyle

·         History of smoking tobacco

·         Alcohol or drug abuse

 Read also: Coronary Heart Disease And Diet Management

Signs and Symptoms

It’s possible to have early-stage heart disease with no symptoms. If blood flow becomes impaired due to coronary artery disease, you may experience:

·         Extreme fatigue

·         Shortness of breath

·         Dizziness , lightheadedness , or fainting

·         Chest pain and pressure, known as angina

·         Heart palpitations

·         Swelling in your legs and feet, known as

·         Edema

·         Swelling in your abdomen

·         Cough or congestion, caused by fluid in your lungs

·         Difficulty sleeping

·         Weight gain

If you develop these symptoms, seek medical care immediately.

Diagnosis

If your doctor suspects you have IC, expect to be referred to a heart specialist, also known as a cardiologist. They will take your medical history and perform a physical examination, and they likely will order further tests to develop their diagnosis.

For example, they may order:

·         Blood tests to measure the level of cholesterols and triglycerides in your blood

·         Imaging tests, such as an X-ray , CT scan, or MRI

·         An echocardiogram to evaluate your heart anatomy and function using ultrasound waves

·         An electrocardiogram (ECG or EKG) to record electrical activity in your heart

·         A stress test to monitor your heart’s ability when it’s made to work harder

·         Cardiac catheterization, in which a coronary angiogram is done to check for narrowing inside your arteries

·         Myocardial biopsy to collect and analyze a small tissue sample from your heart muscle

Food indication

1. Control your portion size

How much you eat is just as important as what you eat. Overloading your plate, taking seconds and eating until you feel stuffed can lead to eating more calories than you should. Portions served in restaurants are often more than anyone needs.

Use a small plate or bowl to help control your portions. Eat larger portions of low-calorie, nutrient-rich foods, such as fruits and vegetables, and smaller portions of high-calorie, high-sodium foods, such as refined, processed or fast foods. This strategy can shape up your diet as well as your heart and waistline.

Keep track of the number of servings you eat. The recommended number of servings per food group may vary depending on the specific diet or guidelines you're following. A serving size is a specific amount of food, defined by common measurements such as cups, ounces or pieces. For example, one serving of pasta is about 1/3 to 1/2 cup, or about the size of a hockey puck. A serving of meat, fish or chicken is about 2 to 3 ounces, or about the size and thickness of a deck of cards. Judging serving size is a learned skill. You may need to use measuring cups and spoons or a scale until you're comfortable with your judgment.

2. Eat more vegetables and fruits

Vegetables and fruits are good sources of vitamins and minerals. Vegetables and fruits are also low in calories and rich in dietary fiber. Vegetables and fruits, like other plants or plant-based foods, contain substances that may help prevent cardiovascular disease. Eating more fruits and vegetables may help you cut back on higher calorie foods, such as meat, cheese and snack foods.

Featuring vegetables and fruits in your diet can be easy. Keep vegetables washed and cut in your refrigerator for quick snacks. Keep fruit in a bowl in your kitchen so that you'll remember to eat it. Choose recipes that have vegetables or fruits as the main ingredients, such as vegetable stir-fry or fresh fruit mixed into salads.

Fruits and vegetables to choose

·         Fresh or frozen vegetables and fruits

·         Low-sodium canned vegetables

·         Canned fruit packed in juice or water Coconut

Fruits and vegetables to limit

·         Vegetables with creamy sauces

·         Fried or breaded vegetables

·         Canned fruit packed in heavy syrup

·         Frozen fruit with sugar added

3. Select whole grains

Whole grains are good sources of fiber and other nutrients that play a role in regulating blood pressure and heart health. You can increase the amount of whole grains in a heart-healthy diet by making simple substitutions for refined grain products. Or be adventuresome and try a new whole grain, such as whole-grain farro, quinoa or barley.

Grain products to choose

·         Whole-wheat flour

·         Whole-grain bread, preferably 100% whole-wheat bread or 100% whole-grain bread

·         High-fiber cereal with 5 g or more fiber in a serving

·         Whole grains such as brown rice, barley and buckwheat (kasha)

·         Whole-grain pasta

·         Oatmeal (steel-cut or regular) White, refined flour

·         White bread

·         Muffins

Grain products to limit or avoid

·         Frozen waffles

·         Corn bread

·         Doughnuts

·         Biscuits

·         Quick breads

·         Cakes

·         Pies

·         Egg noodles

·         Buttered popcorn

·         High-fat snack crackers

4. Limit unhealthy fats

Limiting how much saturated and trans fats you eat is an important step to reduce your blood cholesterol and lower your risk of coronary artery disease. A high blood cholesterol level can lead to a buildup of plaques in your arteries, called atherosclerosis, which can increase your risk of heart attack and stroke.

The American Heart Association offers these guidelines for how much fat to include in a heart-healthy diet:

Type of fat Recommendation

Saturated fat No more than 5 to 6% of your total daily calories, or no more than 11 to 13g of saturated fat if you follow a 2,000-calorie-a-day diet

Trans fat Avoid

You can reduce the amount of saturated fat in your diet by trimming fat off your meat or choosing lean meats with less than 10 percent fat. You can also add less butter, margarine and shortening when cooking and serving.

You can also use low-fat substitutions when possible for a heart-healthy diet. For example, top your baked potato with low-sodium salsa or low-fat yogurt rather than butter, or use sliced whole fruit or low-sugar fruit spread on your toast instead of margarine.

You may also want to check the food labels of some cookies, cakes, frostings, crackers and chips. Some of these — even those labeled "reduced fat" — may be made with oils containing trans fats. One clue that a food has some trans fat in it is the phrase "partially hydrogenated" in the ingredient list.

When you do use fats, choose monounsaturated fats, such as olive oil or canola oil. Polyunsaturated fats, found in certain fish, avocados, nuts and seeds, also are good choices for a heart-healthy diet. When used in place of saturated fat, monounsaturated and polyunsaturated fats may help lower your total blood cholesterol. But moderation is essential. All types of fat are high in calories.

An easy way to add healthy fat (and fiber) to your diet is ground flaxseed. Flaxseeds are small brown seeds that are high in fiber and omega-3 fatty acids. Some studies have found that flaxseeds may help lower cholesterol in some people, but more research is needed. You can grind the seeds in a coffee grinder or food processor and stir a teaspoon of them into yogurt, applesauce or hot cereal.

Also Read: What You Should Know About Cholesterol

Fats to choose

·         Olive oil

·         Canola oil

·         Vegetable and nut oils

Fats to limit

·         Margarine, trans fat free

·         Cholesterol-lowering margarine, such as Benecol, Promise Activ or Smart Balance

·         Nuts, seeds

·         Avocados Butter

·         Lard

·         Bacon fat

·         Gravy

·         Cream sauce

·         Nondairy creamers

·         Hydrogenated margarine and shortening

·         Cocoa butter, found in chocolate

·         Coconut, palm, cottonseed and palm-kernel oils

5. Choose low-fat protein sources

Lean meat, poultry and fish, low-fat dairy products, and eggs are some of your best sources of protein. But be careful to choose lower fat options, such as skim milk rather than whole milk and skinless chicken breasts rather than fried chicken patties.

Fish is another good alternative to high-fat meats. And certain types of fish are rich in omega-3 fatty acids, which can lower blood fats called triglycerides. You'll find the highest amounts of omega-3 fatty acids in cold-water fish, such as salmon, mackerel and herring. Other sources are flaxseed, walnuts, soybeans and canola oil.

Legumes — beans, peas and lentils — also are good sources of protein and contain less fat and no cholesterol, making them good substitutes for meat. Substituting plant protein for animal protein — for example, a soy or bean burger for a hamburger — will reduce your fat and cholesterol intake and increase your fiber intake.

 

Proteins to choose Proteins to limit or avoid

·         Low-fat dairy products, such as skim or low-fat (1%) milk, yogurt and cheese

·         Eggs

·         Fish, especially fatty, cold-water fish, such as salmon

·         Skinless poultry

·         Legumes

·         Soybeans and soy products, such as soy burgers and tofu

·         Lean ground meats Full-fat milk and other dairy products

·         Organ meats, such as liver

·         Fatty and marbled meats

·         Spareribs

·         Hot dogs and sausages

·         Bacon

·         Fried or breaded meats

6. Reduce the sodium in your food

Eating a lot of sodium can contribute to high blood pressure, a risk factor for cardiovascular disease. Reducing sodium is an important part of a heart-healthy diet. The American Heart Association recommends that:

·         Healthy adults have no more than 2,300 milligrams (mg) of sodium a day (about a teaspoon of salt)

·         Most adults ideally have no more than 1,500 mg of sodium a day

Although reducing the amount of salt you add to food at the table or while cooking is a good first step, much of the salt you eat comes from canned or processed foods, such as soups, baked goods and frozen dinners. Eating fresh foods and making your own soups and stews can reduce the amount of salt you eat.

If you like the convenience of canned soups and prepared meals, look for ones with reduced sodium. Be wary of foods that claim to be lower in sodium because they are seasoned with sea salt instead of regular table salt — sea salt has the same nutritional value as regular salt.

 

Prognosis

Age. Your risk of heart disease increases as you get older. Men age 45 and older and women age 55 and older have a greater risk.

Gender. Some risk factors may affect heart disease risk differently in women than in men. For example, estrogen provides women some protection against heart disease, but diabetes raises the risk of heart disease more in women than in men.

Race or ethnicity. Certain groups have higher risks than others. African Americans are more likely than whites to have heart disease, while Hispanic Americans are less likely to have it. Some Asian groups, such as East Asians, have lower rates, but South Asians have higher rates.

Family history. You have a greater risk if you have a close family member who had heart disease at an early age.

Prevention

·         Control your blood pressure. High blood pressure is a major risk factor for heart disease. It is important to get your blood pressure checked regularly - at least once a year for most adults, and more often if you have high blood pressure. Take steps, including lifestyle changes, to prevent or control high blood pressure.

·         Keep your cholesterol and triglyceride levels under control. High levels of cholesterol can clog your arteries and raise your risk of coronary artery disease and heart attack.

·         Lifestyle changes and medicines (if needed) can lower your cholesterol.

·         Triglycerides are another type of fat in the blood. High levels of triglycerides may also raise the risk of coronary artery disease, especially in women.

·         Stay at a healthy weight. Being overweight or having obesity can increase your risk for heart disease. This is mostly because they are linked to other heart disease risk factors, including high blood cholesterol and triglyceride levels, high blood pressure, and diabetes. Controlling your weight can lower these risks.

·         Eat a healthy diet. Try to limit saturated fats, foods high in sodium, and added sugars. Eat plenty of fresh fruit, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure and cholesterol, two things that can lower your risk of heart disease.