Food for heart patients




Patient Perspective Paper 1

These notes are a personal view on food issues, following two meetings that we have had with dieticians in JRH. Some years ago we met James Doering and more recently we heard a fascinating talk by Susie Fellows. There is a wealth of information and comment on this subject around, of course, some informed and some mischievous. BHF publish a relevant booklet. I must emphasise once again that notes such as these are very much my personal interpretation and I apologise but take no responsibility for any inaccuracy.



The Eatwell plate. See the menu on the left for a copy. This classic diagram breaks food down into various categories and then highlights how much of each one should eat in a day (or week).

The first third is

Fruit and vegetables. The recommendation for 5 units a day is vital. “1 unit” is approximately 2-3 tablespoons of vegetables, 1 dessert bowl of salad, 1 fruit, a cupful of smaller fruits, glass of fruit juice (not more than one). Recent thinking now talks about 9 units a day. Fruit juices should be taken in moderation. 1 unit is about 150 ml. Cranberry juice is incompatible with warfarin. Grapefruit juice does not mix with statins and possibly some other drugs. Fruit and vegetables are a source of fibre,

The second third is:

Starchy carbohydrates. These are an essential source of energy, B vitamins and fibre so moderate amounts of these should be eaten at each meal. Vegetables such potato, butternut squash, parsnip, swede, celeriac would be classed as starchy and would in this section.

Bread. Granary bread is the best (mind any dickey teeth!). Failing that wholemeal bread is better than white bread. Brown bread is coloured white bread. One of our members pointed out that white bread is recommended for diabetics.

Cholesterol. A blanket figure is not particularly helpful but it is often used. Total blood number should be less than 5.0. Less than 4.0 for more severe cases of heart disease. There is good and bad cholesterol. Eggs, liver and shellfish have natural cholesterol but this has little effect on blood cholesterol. It is thought that soluble fibre may help lower cholesterol. They work by forming a gel during digestion so trapping the dietary cholesterol particles and so inhibits its absorption. Foods rich is soluble fibre are oat bran, barley, nuts, seeds, beans, lentils, peas and some fruit and vegetables.

The remaining third of the plate is made up of:

Milk and milk derivatives and Meat/Fish alternatives. 2-3 units of calcium rich foods should be eaten each day and 2-3 units of protein-rich foods should be eaten each day. The former are rich in calcium and meat and fish are an important source of protein. Much of the food in these two sections contain fats and this is not good news. However fish is an important source of omega-3.

Fats. The key is to eat less fat. Monounsaturated fats are better than the others. Olive oil is particularly recommended and better than other monounsaturated fats like flora and sunflower oil. One member stated that he used olive oil exclusively in all eating and cooking and there is evidence that a product like Flora pro-active does help to control cholesterol. Rape seed oil is rich in monounsaturated fat. Transfats, which used to be in a lot of commercial hard fats are not recommended but they are still widely found in baked goods. Saturated fats like butter and cheese should only be eaten sparingly. If a product is marked “low fat”, the fat content should be less than 15%.

Cheese. The maximums (per week) are:
Fish. White fish has very low fat content. Eat 2-3 portions of oily fish per week (such as fresh or tinned mackerel, salmon, pilchards, sardines) to increase intake of Omega 3. Walnuts, pumpkin seeds and soya oil are also sources of omega-3. Tinned tuna does not have Omega 3.

Meat. Meat is high in saturated fat. Processed meat such as sausages and pies have a particularly high content. White meat (eg Chicken) is probably better than red meat. If you wish to eat the latter, make it lean.

Alcohol. The official recommendation is to only drink a maximum of 2-3 units a day over a 5 day week (i.e. include two “free” days). If you are at a party, have you tried alternating your alcoholic and non-alcoholic drinks? Alcohol has high caloric value – i.e. it puts on weight. However many believe that a little is probably good for you. There are no real differences between types of drink though red wine does contain valuable anti-oxidants.

Salt. Reduce salt intake. Processed foods, some cereals (eg Allbran), smoked fish, ready meals, many crisps and nuts contain a lot of salt. Use little or no salt in cooking (don’t watch Masterchef on the TV then!!). Keep the salt cellar off the table.

Nuts. Nuts (low or nil salt) are good for you. They do however have high calorific value.

Food labelling. Keep an eye on those labels. Some examples are shown below. Remember many foods contain natural sugar or fat. Be careful of labels that say “no added sugar” or “unsweetened”, “Low fat” is different to “reduced fat”. Beware of the words “Light” and “Lite”. An iniquitous one is a deliberate misleading use of the terms: “flavoured”, “flavour”, “concentrated” and “natural”. A “sodium” figure is not the same as the “salt” figure. Control of portion size is of course vital in a policy of sensible eating. All figures are per 100g.


What about the other portion on the Eatwell plate? You will notice that I have ignored the “naughty foods” – high in fat and sugar such as pasties, chips, confectionery, chocolate, the demon drink, cakes and biscuits, pastries, iced buns, full fat cream, that Cotswold Cream tea. The Eatwell plate has about 8% of these – i.e. it makes the assumption that we are allowed a little of these.

How much? – that is the question.

Geoff Shaw.

GCS/12.01.12