Eating Well for Your Heart

by Cam Patterson, M.D.
February 2009

I was in Japan recently, and I was struck by how rarely I saw obese people while I was there. This is dramatically different from the situation here, and in fact the prevalence of obesity is reaching epidemic proportions in the United States?—? 60% of Americans are overweight and over one in four of us are clinically obese.

So many health problems are caused or aggravated by obesity including diabetes, kidney disease, and even cancer. But being obese is especially bad for the heart. So let’s talk about eating with your heart in mind.

I know what you’re thinking, that food is one of the great pleasures in life. I agree! I also think that eating well and healthy eating can be one and the same. Let’s go back to the Japanese for a second. It’s a fantastic place to visit if you enjoy food. They have wonderful noodle and rice dishes, all kinds of seafood, some of the best beef in the world, and of course sushi, which I could eat at every meal. When I think of good food and healthy eating habits, I also think of the Mediterranean countries, with their pastas, great sauces and breads, and rich olive oil for flavor.

In both of these societies, people are eating with gusto, yet obesity is rare and heart disease is much less common than in the United States. I have learned a lot about how to eat in a heart-healthy fashion from observing how people eat in Mediterranean and Japanese cultures.

When I talk to my patients about healthy eating, the first lesson I pass on is that the only way to eat right is to make healthy eating part of their lifestyle. Unhealthy eating behaviors punctuated by risky diets form a vicious cycle. It is so much more healthy and fun to develop eating habits that you can adopt for the long term to keep fit and protect your heart.

After that, I tell my patients that all eating can be divided into two categories, what goes on at mealtime and what happens in between. Snacking is probably the biggest driver of obesity in our society: it is really hard to become obese if you don’t snack.

If you can totally cut out snacks from your diet, that is great, but few of us can totally resist this temptation. The next step then is to figure out when those hunger pangs are prone to strike. Do you crave something sweet in mid-morning, or reach for potato chips late in the afternoon? If this is the case, the key is to have something available that is good for you and that won’t rack up the calories, fat, and salt that are so bad for your body. Fruit and unsalted nuts are my favorite recommendations here. Keep some dried fruits or nuts in your desk at work and some fresh fruit in the kitchen, and go to these rather than to the vending machine when you can’t deny the hunger pangs between meals.

While we are talking about between meal eating, let me say something about sodas. They are so bad for you, empty calories and zero nutrition. I can’t say enough good things about drinking lots of water as a thirst-quenching, appetite-suppressing, tres fashionable habit.

At mealtime, the first rule is portion control. Most of the time, it isn’t what you eat but how much of it. A good rule of thumb is a cup of vegetables per serving and 4 ounces of meat. It sounds too simple, but research shows that smaller plates and bowls help to keep serving sizes under control.

The second rule at mealtime is to avoid typical fast food restaurants. It is so hard to make a burger and French fries healthy. It is getting easier to find fast, healthy sandwiches and salads. Make the extra effort.

Beyond these simple rules, remember that it is easy to eat well and eat healthy at the same time. Pastas and rice can be great for you as long as you mind the portion-control rule. Try to eat seafood a couple of times a week. Seafood is low in fat (if not fried) and some fish oils such as sardines and salmon are higher in the kind of fat that can help reduce your cholesterol levels. I think there is a pretty neat relationship between how spicy food is and how good it is for you: a lot of the spiciest dishes are full of vegetables. And olive oil is such a great addition to the diet. Use it to cook with, or as a replacement for butter.

The last tip I give my patients is a great, completely free resource I’ve found on the internet. It’s called Dr. Gourmet (drgourmet.com). As the name suggests, this is a Web site about food and it has been developed by a physician in New Orleans with all kinds of heart-healthy recipes and tips about healthy eating. Dr. Gourmet and I agree about one thing: Eating healthy can be fun.

Cam Patterson, MD, is chief of cardiology for the University of North Carolina at Chapel Hill School of Medicine, UNC Hospitals, and the UNC Health Care System.