1. DIET IN
CARDIOVASCULAR
DISEASES
PRESENTED BY
Ms. Aishwarya Sanjay subhekar
MPH(N),
GMC nagpur

2. PRINCIPLES
 Dietary management
It is first line tresatment for patient with high blood cholesterol level. low calorie, low fat perticularly
low saturated fat, low cholesterol, high in PUFA with omega -6 to omega- 3, low carbohydrate and
normal protein , minerals and vitamins are suggested. High fiber diet with increase amount of
antioxidant is also recomemended.
OBJECTIVES
• Maximum rest to the heart
• Maintainance of good nutrition
• Acceptability of the programme
 Drugs
 Exercise
 Smoking cessation
 Stress management

3.  Total energy : Those patient whose weight at desirable level are
permitted a maintenance level of calories during covalencence and their
return to activity. The total calories should be restricted so as to reduce
the weight to the expected normal for the height, age and sex. usually a
1000 to 1200 calorie diet is suitable for an obese patient in bed.
 Carbohydrates : Only complex carbohydrate should be included in the
diet. by restricting carbohydrate intake, serum triglyceride level can be
controlled. carbohydrate intake should be limited to 60 % of total energy
in patient with metabolic syndrome.
 Protein, Vitamin and Minerals : Normal allowances are recommended.
animal proteins are not suggesgted for an atherosclerotic patient.
since total fat, animal fat, organ meat, eggs and sea food are restricted.
vitamin A deficiency may occur. therefore supplement vitamin A is
essential.
Niacin (B3) increases HDL cholesterol level while lowering the level
of LDL cholesterol, triglycerides and lipoprotein. it decreases the coronary
risk.
vitamin B6, B12 and folic acid (B9) supplementation dcreases the risk
of cardiovascular disease related to homocysteine risk factor.

4.  vitamin C is maintaining the structure of blood vessels and
antioxidant effect prevent the tissue damage that leads to CHD.
cholesterol is converted to cholic acid by ascorbic acid. 200 -300 mg of
vitamin C reduces cholesterol.
 Sodium is restricted when their is hypertension. WHO recommend
6 g of salt from mixed food sources per day for a normal person.
Potassium helps to maintain cell fluid balance and play a role in
muscle contraction. low lewel of this mineral have associate with high
blood pressure. Magnesium help muscles relax, affects the muscle tone
of blood vessels and keep heart rythem steady and decrease incidence
of CHD and low levels have been correlated with high blood pressure
angina.
 Fluid : the restriction of fluid is not required as long as sodium is not
restricted.
 Low glycemic foods : Low GI diet may preserve HDL cholesterol and
thus have a potentially positive effect in reducing CHD level.

5. FAT
 PUFA : Omega 3 & Omega 6 fatty acid, It promot esterification of colesterol and make
into easily utilisable form. It prevent thrombus formation. It decrease the tendency of
blood platelet clot. PUFA decrease the synthesis of the precursor of VLDL which are
associated with an incresed incidence of CHD. PUFA decrease the production of LDL
and triglycerides. Fish are good sourse of omega- 3 fatty acid specialy fatty fish such as
salmon. consumption of 100 - 200 g of fish two or three times a week help to prevent
heart disease (NIN hydrabad, 1992). vegetable substances such as mustard oil, flax seed
oil, canola oil, soybeen oil and walnuts are good source of omega- 3 fatty acid
 MUFA : Uncontrolled peroxidation of PUFA in cell membrane my lead to cellular
damage while maintainance of balance with MUFA is condacive to maintain cell
function. it decrease the risk of coronary heart disease. mediterrean style diet that
focuses on fruits, vegetables, legumes and grain and only small portion of meat product
has beneficial effects.
 Saturated fatty acids : SFA raise the level of LDL and total blood cholesterol level.
both of these effects increase the risk of CHD.

6.  Trans fatty acid : it also increase LDL and lipoprotein level, thus
raising the risk of CHD. meat, dairy products and hydrogenated
fats (vanaspati ghee).
 Cholesterol : Cholesterole level of diet should not exceed 300 mg.
Liver synthesis as much as 2 g of cholesterol per day. If
cholesterrol level are above 260 mg/ dl, it is impossible to bring
about a drop, by diet alone. cholesterole content of animal foods.
no vegetable substance contains cholesterol.
 Blended oil : Use of more than one source of oil gives an
additional advantage of providing greater variety of minor
components present in oils which may enhance their antioxidant
properties. government of india has permitted admixture of any
two edible vegetable oil.

7. FUNCTIONAL FOODS FOR CHD
A functional food is any food that has a positive effect on a person’s health, physical performance or
state of mind . it reduses risk of chronic diseases, food rich in antioxidant including vitamin C, E, and
beta-carotene have potencial health benefits of reducing CVD, and protect from CHD.
 Vitamin E & C & Carotenoids and B- carotene : It is an antioxidant property. this may work
synergetically in preventing cellular oxidation. fruits and vegetable are good soures of anthocyanins,
vitamin C, Beta- carotene and dietary fiber which are all cardio protective. guvava, red grapes and
pomegranate have maximum antioxidant properties. green leafy and cruciferous vegetables contain
nutrients and phytochemicals that protect the heart.
 Selenium : selenium is essential for the production of glutathion peroxidase, enzyme that catalyses
the breakdown of hyperoxides. seafood, kidney and liver are good sourse of selenium. low intake of
selenium in urban south indians contribute to development of coronary heart disease. selenium in
south indian vegetarian diet can be enhanced by substituting polished rice, wheate and finger millet.

8.  Soya protein : soya protein reduces the plasma total cholesterol concentration in hyper-
cholesterolemic subjects. soya protein sources include soya milk, tofu, soya sauce, isolated textured
soya protein supplements. the current recommendations to consume 25 g/day soya protein as a mean
of reducing CVD risk is not feasible.
 Fruit and vegetables : flavonols, powerful health giving chemicals which can protect against heart
disease are found in wines, fruits and vegetable.small cherry tomatoes and red onions are good source
of flavonol.
 Garlic : One half or one clove of garlic per day is sufficient to reduce cholesterol level. garlic is also
valuabe for hypertensive patients. Deordarised garlic preperation is also effective.
 Nuts : A growing body of scientific evidence suggests potencial beneficial effects from the ingestion of
three nuts such as pecans, walnut and almond. magnesium and copper present in nuts may protect
against CHD. almond is the best source of vitamin E and 70% offat in almonds is MUFA. It also help
to reduse cholesterol.

9.  Beans : the components of beans that decrese cardiovascular disease are
soluble fiber, phytosterols, magnesium, potassium, copper and folate. greater
consumption of legumes was linked to a lower incidence of hypertension.
 Yogurt and milk tea : synthesis of cholesterol is reduced when yogurt and
milk are consumed. casein and calcium have hypocholestrolemic effect.
 High fiber : High fiber in diet reduse the cholesterol. lower the risk of blood
clot formation and MI. sources are raw vegetable and fresh fruits, whole grain
cereals and pulses.

10. HYPERTENSION
 Salt restrictions : tips to reduse salt in diet, avoid and restrict below followings
1. Processed food
2. Table salt
3. Ajinomoto
4. Baking powder
5. Salt preserved food
6. Hard water
7. Ketchup and souce
8. Cheese , butter
9. Frozen peas
10. Ready made soups
11. Backed food

11. Diet suggested by DASH
DIETARY APPROACHES TO STOP HYPERTENSION
FOOD GROUPS DASH (SERVINGS)
• Grain
• Vegetable
• Fruit
• Low fat milk
• Lean meat
(7-8 servings)
(4-5 servings)
(4-5 servings)
(2-3servings)
(2 or less)

12. Reference
 Book Ditetics, author B shrilakshmi, page no. 320.
 American heart association dietary
guidelines.https://www.ahajournals.org/doi/10.1161/CIR.0000000000001031
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798927/.

13. Thank you !
Any Questions ?