Numerous studies have shown that nutrition is one of the most important factors in the development of coronary artery disease (CAD) that are susceptible to influence. A healthy .

The role of nutrition in cardiovascular disease

Numerous studies have shown that nutrition is one of the most important factors in the development of coronary artery disease (CAD) that are susceptible to influence. A healthy lifestyle (not smoking, coping with stress, an increase in physical exercise) and an appropriate diet can be crucial factors in reducing the risk of atherosclerosis either developing or worsening. Some of the food categories that play an important part in arteriosclerosis are explained in the following.

Fats and oils: The type and quantity of fats consumed affect the blood cholesterol and triglyceride concentrations. An important principle is therefore to eat a low-fat diet (not more than 25-30 % of the total energy supplied by fats). A reduction in fat intake at the same time contributes to the loss of any excess weight. In particular, animal fats and high-fat animal foods should be restricted, because these contain predominantly saturated fatty acids, which increase the blood cholesterol. Vegetable fats such as coconut fat, palm fat and hardened fats ("shortening") should also be avoided, because they often contain trans-fatty acids. Preferably you should use vegetable oils with a high proportion of monounsaturated fatty acids (olive oil and rapeseed oil).

Fish: The recommended low-fat diet does not involve limiting high-fat fish such as salmon, tuna, mackerel and herring. The plentiful amounts of omega-3 fatty acids contained in these fish help to protect blood vessels - they exert a beneficial effect on fat metabolism and may have anti-inflammatory and anticoagulant effects. These types of fish should therefore be eaten regularly.

Fruit, vegetables and wholemeal cereals: A plentiful consumption of these is particularly important. They ensure the supply of dietary fibre, minerals, vitamins and secondary vegetable substances. Dietary fibre helps to lower a high cholesterol level. Antioxidant vitamins (betacarotene, vitamin E, vitamin C) protect the fats in the body against oxidation, which is deleterious to health. Folic acid - a B-vitamin - can lower an increased homocysteine concentration in the blood, which is also considered to be a risk factor for atherosclerosis.

Alcohol: Many studies indicate that light consumption of alcohol (e.g. up to two glasses of a red wine per day) can lower the CAD risk. However, since alcohol also encourages weight gain and other health risks, the consumption of alcohol cannot be encouraged.

Garlic: It has been suggested for a long time that garlic can protect the blood vessels. However, further research still needs to be done in this area.

Further preventive measures:

• Give up smoking
• Take more physical exercise (brisk walking once a day for 30 minutes, cycling, gardenwork) - see also "Exercise Programs - a Primer"
• Reduce stress

Dietary recommendations for cardiovascular problems

Many factors affect our dietary behaviour: individual needs and desires, our day-to-day condition, the social environment, the food currently on offer, advertising etc. The following recommendations ensure a balanced and varied diet that provides an adequate intake of energy, nutrients and protective substances and thus a healthy approach to nutrition. The figures quoted are intended for the "average person", i.e. for adults who engage in normal physical activities and thus have an average energy and nutrient requirement. The figures would vary for other groups (such as children and adolescents, top athletes, pregnant women etc.). The quantities and portions given are likewise average values; they cannot be adhered to precisely every day. Those passages that appear in italics are particularly important for persons with cardiovascular problems. Also included here are the dietary recommendations for lowering cholesterol (marked with *) and for lowering blood pressure (marked with °), because not only are these major risk factors, but cholesterol and blood pressure are also often raised in cardiovascular diseases.

Fats and oils:
Use 2 teaspoonfuls (10 g) per day of vegetable oil with a high content of monounsaturated fatty acids (e.g. olive oil, rapeseed oil), unheated, e.g. for salad dressings.
Use not more than 2 teaspoonfuls (10 g) of cooking fat or oil per day, e.g. peanut oil or olive oil, for the preparation of meals.
Do not eat more than 2 teaspoonfuls (10 g) of spreading butter or margarine per day on bread. Do not eat more than one high-fat meal per day, such as deep-fried or breaded food, cheese dishes, fried potato, sausage, cream sauce, puff pastry, cakes, chocolate, etc.
Do not use hardened cooking fats. Cut down heavily on products with hardened fats (e.g. ready-to-eat products, cakes).*

Sweets/snacks:
Eat these in moderation - avoid high-fat sweets, salted nuts and salted snacks.* °

Meat, fish, and eggs:
Do not eat more than one portion of meat, as low fat as possible*, 2 - 4 times a week (1 portion = 80 - 120 g); more is unnecessary, less is no problem.
Cut down heavily on the consumption of salted meats such as ham, sausage, or bacon.° Avoid offal (liver, kidneys, tripe, sweetbreads).*
Plan to eat 2 portions of fish a week (1 portion = 100 - 120 g), preferably fatty fish such as mackerel, herring, tuna, and salmon.*
Eat not more than 1 - 3 eggs a week*, including processed eggs e.g. in cakes and pastries, soufflés or cream desserts.

Pulses, pulse products:
Eat 1 - 2 portions of lentils, chickpeas, kidney beans (1 portion = 40 - 60 g, dry weight) and tofu (1 portion = 100 - 120 g) per week.

Milk and dairy products:
Consume 2 - 3 portions of dairy products a day (1 portion = 2 dl milk or 1 cup of yogurt or 30 g of hard cheese or 60 g of soft cheese). Choose low-fat and fat-reduced products.*

Cereal products and potatoes:
Eat at least 3 portions of carbohydrate-rich foods per day (e.g. bread, potatoes, rice, cereal, pasta, etc.), preferably wholemeal products. The size of the portion depends on the degree of physical activity the person engages in. Ensure that low-fat methods of preparation are used.*

Fruit:
Eat 2 - 3 portions of fruit per day (1 portion = 1 apple, 1 banana, 3 plums or a dish of berries), ideally raw.

Vegetables:
Eat 3 - 4 portions of vegetable per day, at least one of them raw, e.g. as a dip or a mixed salad (1 portion = 100 g raw or 150 - 200 g cooked vegetable, 50 g lettuce or 100 g mixed salad).

Beverages and alcoholic drinks:
Drink at least 1.5 litres of liquid per day, preferably unsweetened and alcohol-free beverages. Low-sodium mineral water is especially suitable.°
Alcohol: Do not drink any more than one glass of wine or beer per day. Coffee: Preferably filtered coffee.

Cardiovascular disease - chief points to note:

• Lose any excess weight
• Eat low-fat food
• Eat plenty of fruit, vegetables and wholemeal products
• Take regular physically exercise
• Stop smoking