If you are suffering from coronary heart disease, the American Heart Association (AHA) recommends the Therapeutic Lifestyle Changes, or TLC, program, which includes diet, physical activity and weight management. According to the National Institute of Health (NIH), the TLC program improves cholesterol levels and helps control other heart disease risk factors such as high blood pressure, being overweight, diabetes and the formation of blood clots. The TLC diet recommendations are to decrease saturated fat to less than 7 percent of your daily calories, decrease cholesterol to less than 200 mg per day, limit total fat to 25 to 35 percent of your daily calories; lose 10 lb. if overweight, add 5 to 10 g soluble fiber daily and add 2 g of plant sterols or stanols per day. The AHA also recommends limiting sodium to 1500 mg per day.
Breads, Cereals and Grains
Breads, cereals and grains are usually high in complex carbohydrates and fiber but low in saturated fat, cholesterol and total fat, according to the NIH. It is advisable to eat 6 or more servings a day of whole-grain breads and cereals, pasta, rice, potatoes or low-fat crackers. Of these, the AHA recommends at least three 1-oz. servings of fiber-rich whole grains. Barley, oats and psyllium are especially good sources of soluble fiber, which helps reduce heart disease risk by blocking cholesterol and fats from being absorbed from the intestines into the bloodstream.
Vegetables and Legumes
Vegetables and legumes, or dry beans and peas, are important sources of vitamins, antioxidants, fiber and other nutrients. Aim for 3 to 5 servings a day. Broccoli, Brussels sprouts, carrots, dry beans, peas and soy products, such as tofu and miso, are good sources of soluble fiber. Legumes are also a good source of plant protein and can be used as a substitute for meat. Choose fresh, frozen or canned vegetables without added fat, sauces or salt.
Fruits
Fruits are also important sources of vitamins, antioxidants, fiber and other nutrients, according to the NIH. Aim for 2 to 4 servings a day. Some specially-labeled orange juices contain plant stanols or sterols, which help block the absorption of cholesterol from the digestive tract, helping to lower LDL, or "bad," cholesterol without affecting HDL, or "good," cholesterol. According to the NIH, adding 2 g daily of plant stanols or sterols can reduce LDL by 5 to 15 percent. Apples, bananas, berries, citrus fruits, nectarines, peaches, pears, plums and prunes are high in soluble fiber. Look for fresh, frozen, canned or dried fruits without added sugar.
Dairy Products
The TLC diet recommends 2 to 3 daily servings of fat free or 1 percent milk dairy products. These provide calcium and protein, but with little or no saturated fat. Choose fat-free or low-fat milk, buttermilk, yogurt, sour cream or cream cheese. Look for low-fat cheese with no more than 3 g fat per ounce. Calcium from dairy products is helpful in managing weight and blood pressure.
Eggs
Because egg yolks are high in dietary cholesterol, the TLC diet recommends limiting yolks to 2 or fewer per week, including yolks in baked goods and in cooked or processed foods. Egg whites or egg substitutes have no cholesterol and fewer calories than whole eggs and can be used as desired. Use egg whites or egg substitutes in cooking or baking to limit cholesterol and fat.
Meat, Poultry and Fish
It is best to limit your intake of meat, poultry and fish to 5 oz. or less a day. To reduce saturated fat intake, choose lean cuts of meat, fish, and white meat poultry without the skin. Trim fat before cooking. Lean cuts of beef include loin and round. For pork, look for center and loin cuts. Choose extra lean ground meats. Look for cold cuts made with lean meat or soy protein, but limit processed meats to no more than 2 servings a week; they tend to be high in sodium. To limit cholesterol, strictly limit organ meats and eat shrimp only occasionally. The AHA recommends including at least two 3.5-oz. servings of a fatty fish like salmon, tuna or mackerel each week. These contain heart-protective omega-3 fatty acids.
Fats and Oils
Daily servings of fats and oils depend on your calorie level. All fats are calorie dense, so limiting fat can help with weight control. Choose heart-healthy unsaturated vegetable oils --- canola, corn, olive, safflower or soybean. Look for soft or liquid margarines or vegetable oil spreads; the first ingredient on the label should be unsaturated liquid vegetable oil, not hydrogenated oil. TLC recommends products that are labeled "low-saturated fat" and contain no more than 1 g saturated fat per serving. Walnuts, canola and soybean oils and flaxseed are good sources of omega-3s. Also, some specially-labeled margarines contain stanols or sterols.
