Heart Healthy Diet: Low Fat, Low Cholesterol, Low Sodium Diet

Heart Healthy Diet: Low Fat, Low
Cholesterol, Low Sodium Diet
Purpose of the diet
•
Control and / or decrease levels of cholesterol in your blood.
•
Control and / or decrease blood pressure and / or fluid retention.

Cholesterol
This fat-like substance is necessary for good health. However, high levels in the
blood can cause heart and blood vessel diseases. Our bodies make cholesterol. We
also get it from eating foods from animals (meats, milk, eggs, cheese, butter).
Foods from plants (fruits, vegetables, grains) do not contain cholesterol.

Saturated fats
These fats are generally solid at room temperature. They tend to increase blood
cholesterol levels.

Trans fatty acids
These are fats that can raise cholesterol levels like saturated fat does. Trans fats
are usually listed as partially hydrogenated oils.

Polyunsaturated and monounsaturated fats
These fats are generally liquid at room temperature. Some can lower blood
cholesterol levels.

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Learn more about your health care.



© Copyright, (2000 - 9/30/2010) Department of Nutrition Services, The
Ohio State University Medical Center - Upon request all patient
education handouts are available in other formats for people with
special hearing, vision and language needs, call (614) 293-3191.

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How can I lower my blood cholesterol level?
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Decrease total fat intake, especially saturated and trans fats.
Saturated fats are mainly in animal foods. Trans fats come mostly from
partially hydrogenated plant oils. Foods that may contain trans fats include
store bought baked goods, non-dairy whipped toppings, cream substitutes,
some crackers and cookies, and many deep fried foods. To check for trans fats
in a food, look for any oil that is “partially hydrogenated” in the ingredients on
food labels. If a food has less than half a gram of trans fat per serving, the food
manufacturer can list “zero grams of trans fat” on the food label, so it is best to
check the ingredients for partially hydrogenated oils.
•
Limit high cholesterol foods.
Egg yolks, fatty meats, organ meats, butter, whole milk and other high fat dairy
products are high cholesterol foods.
•
Substitute monounsaturated fat or polyunsaturated fat for saturated fat in
your diet.
Monounsaturated fats include olive oil, peanut oil and canola oil. Safflower,
corn and sunflower oils, and most margarines and salad dressings are examples
of polyunsaturated fats. Also, fish has a higher content of polyunsaturated fat
than red meat.
A special note on fish:
Many fish are low fat. Some fish that have a higher fat content such as
salmon are high in a kind of fat called omega 3 fatty acids. This type of fat
has been shown to be very heart healthy. It is recommended to eat fish three
times a week for this reason. One caution: consider how you prepare it so
that you don’t add large amounts of undesired fats. Baking, broiling,
grilling or poaching fish is best.

What is sodium?
Sodium is a mineral that is necessary for good health and is present in all foods.
Most people eat more sodium than they need. If the body cannot get rid of the
extra sodium, fluid builds up. Extra fluid increases the work of the heart and
kidneys, and may increase blood pressure. Eating less sodium may help control
these problems. You will sometimes see the term sodium abbreviated "Na", as in
NaCl (Sodium Chloride) which is table salt. The recommended sodium intake per
day for most people is no more than 2300 milligrams (mg). Your doctor or
dietitian may have you consume less sodium depending on your health.

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Sodium Guidelines
To choose foods that are healthier for you, look for these labels:
•
Sodium-free – less than 5 milligrams of sodium per serving
•
Very low-sodium – 35 milligrams or less per serving
•
Low-sodium – 140 milligrams or less per serving
•
Reduced sodium – usual sodium level is reduced by 25 percent
•
Unsalted, no salt added or without added salt – made without the salt, but
still has the sodium that's a natural part of the food

Know Your Salt
When you are on a No Salt Added diet, even a small amount of salt has a lot of
sodium in it.
Amount of Sodium in Salt
¼ teaspoon salt
600 milligrams of sodium
½ teaspoon salt
1,200 milligrams of sodium
¾ teaspoon salt
1,800 milligrams of sodium
1 teaspoon salt
2,300 milligrams of sodium
1 teaspoon baking soda
1,000 milligrams of sodium

How can I limit sodium?
To control sodium in your diet, you need to:
•
Limit salt since it is the major source of sodium in our diets.
Do not add salt to food at the table.
•
Avoid food where large amounts of salt and / or sodium have been added.
This includes frozen dinners, cured meats and lunchmeats, pickles, potato
chips, sauerkraut, processed cheese foods and most canned products such as
soup, vegetables and pasta sauces.
•
Use herbs and spices to help flavor foods.

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If you are overweight:
If you are at your ideal body weight, it is important that you avoid any weight
gain. If you are overweight, weight loss can be helpful in lowering your
cholesterol and blood pressure. To lose weight, you will need to decrease the
number of calories you eat. The diet changes used to control cholesterol are
helpful in controlling calories as well.
To control your weight:
•
Limit the total amount of fat in your diet.
Avoid fried foods and limit fats, even healthier high fat foods such as
margarine, vegetable oils and salad dressings. Although monounsaturated and
polyunsaturated fats are a better choice, these fats should also be used in
moderation because all sources of fat are equally high in calories.
•
Keep serving sizes moderate.
Keep in mind that all foods have calories, so avoid large amounts and second
helpings. Portion control is very important in maintaining or losing weight.
•
Satisfy your appetite.
Raw vegetables, sugar free soda pops, water and other calorie free beverages
can help satisfy your appetite. Pick caffeine free beverages as your doctor or
dietitian directs.
•
Do not skip meals.

This often leads to overeating at the next meal.
•
If you have diabetes, eat to control your blood sugar levels.
Limiting total calories and high amounts of carbohydrates can help keep your
blood sugar levels in control.
•
Be as active as possible.
Being active will help you lose weight, because your body burns stored
calories. If your activity is restricted, non-strenuous activities may be used.
Check with your doctor before starting any exercise program.

A Summary of Diet Changes
•
Decrease total fat intake, especially saturated and trans fats.
•
Limit high cholesterol foods.
•
Avoid using salt and eating foods high in salt.
•
Control and/or lose body weight.
•
Maintain a balanced diet.

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Guidelines for Meal Planning
Meat and Meat Substitutes
Use:
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Chicken, turkey (remove skin)
•
Fish, canned tuna or salmon (packed in water), shell fish. Shrimp and crayfish
are higher in cholesterol than other fish but lower in fat and cholesterol than
most meats and poultry.
•
Lean beef, fresh pork, veal or lamb, (trim all fat). Limit to 3 servings (3 oz
each) a week. These are considered "Red Meats." Leanest cuts include beef
round, sirloin, loin, rump or pork tenderloin, sirloin, or loin roast.
•
Dried beans and peas (cook without adding meat fat)
•
Low-cholesterol eggs or egg whites
•
Vegetable patties (watch for high sodium)
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Casseroles and mixed dishes made with allowed ingredients
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Tofu

Avoid Using:
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Fatty, well marbled meats, poultry skin
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Sausage, wieners, lunch meats
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Cured meats such as ham, corned beef, pastrami, salami, pepperoni
•
Regular frozen TV dinners and entrees, pot pies, canned or packaged entrees
(such as Hamburger Helper), frozen or store made pizza
•
Restaurant prepared Chinese, Italian or Mexican foods

Limit:
•
Egg yolks - The American Heart Association no longer makes
recommendations on how many egg yolks to eat or not to eat. A good, general
guideline is to eat no more than 1 egg yolk a day, up to 5 total a week. There is
no restriction on egg whites (including those used in baking and cooking).
•
Peanut butter (one tablespoon once or twice per week if you are trying to lose
weight)
•
Liver (one 3-ounce serving per week as a substitute for one egg yolk)

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Tips:
•
Since poultry and fish are generally lower in fat than red meats (beef, pork,
lamb), include these more often at meals.
•
Preparation: bake, broil, boil, grill, roast, or pan broil without adding fat. (Use
a non-stick skillet or vegetable spray, such as Pam.)
•
If a frozen TV dinner is eaten on occasion, choose one that has no more than
600 mg sodium and 10 grams fat.
•
Consider having fish and vegetarian meals more often.

Milk and Dairy Products
Use:
•
Skim or 1% milk
•
Fat free and low-fat yogurt. Choose "lite" versions if trying to lose weight.
•
Homemade cocoa or chocolate milk made from skim milk
•
Instant cocoa made with skim milk powder
•
Low-fat or fat-free sour cream
•
Low-fat buttermilk
•
Low-fat or fat-free cottage cheese or ricotta cheese
•
Low-fat or low-cholesterol cheeses
•
Reduced-fat or fat-free cream cheese
•
Low-fat soy milk

Avoid Using:
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2% and Whole Milk
•
Buttermilk, chocolate milk or cocoa made from whole milk
•
Instant cocoa mixes with palm or coconut oil or butterfat added
•
Yogurt made with whole milk
•
Cream, half and half, sour cream, whipped cream, non-dairy or frozen whipped
toppings
•
Processed cheeses and cheese foods that have more than 5 grams fat per
serving.
•
Natural cheese made with whole milk or cream

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Breads and Starches
Use:
•
Whole grain or enriched breads and cereals, bagels, English muffins
•
Melba toast, matzo, unsalted top saltines, graham crackers, rye wafers, low salt
crackers
•
Homemade stuffing or dressing prepared with recommended ingredients and
not cooked inside the poultry cavity (bake in separate dish)
•
Homemade biscuits, muffins, pancakes, waffles, cornbread made with allowed
ingredients. Egg substitutes can be used instead of whole eggs in these
products.
•
Spaghetti, noodles, macaroni, rice, tortillas (whole wheat are best)
•
Salt-free pretzels; salt-free, air-popped popcorn; reduced fat microwave
popcorn. Limit fat free potato chips to a 1 oz. serving per day.
•
Baked goods (cookies, cakes, etc.) made with allowed ingredients. If you have
diabetes, these foods should be consumed in very moderate amounts.

Avoid Using:
•
Commercially prepared biscuits, muffins, pancakes, waffles, cornbread,
donuts, sweet rolls, coffee cakes, packaged nut breads, cakes, pies, cookies.
•
Egg noodles, packaged breading and stuffing mixes, seasoned rice mixes, soy
meat extenders, and any mix that comes out of a box. (These are usually very
high in sodium.)
•
Salted crackers, corn chips, potato chips, pretzels

Vegetables and Fruits
Use:
•
All raw or fresh cooked vegetables, plain frozen vegetables, or salt-free canned
vegetables; all fresh, frozen, dried or canned fruits; preferably packed in
natural juice or water.
•
Canned tomato puree and tomato paste may be used in recipes but do not add
salt.
•
Homemade tomato sauce without added salt, or store bought low sodium
sauce.
•
Frozen French fries. Do not add salt. Bake, rather than fry them.
•
Pan fried potatoes in minimum amount of polyunsaturated or monounsaturated
oil (vegetable, canola or olive oil).
•
All fruit juices and salt-free vegetable juices.

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Avoid Using:
•
Sauerkraut
•
Vegetables cooked with meat fat (such as greens)
•
Frozen vegetables in cream, cheese, or butter sauce
•
Pickled vegetables
•
Packaged potato mixes (escalloped, au gratin)
•
Regular canned vegetables (if used on occasion, drain & rinse vegetables, and
cook in fresh water)
•
Regular V-8 or tomato juice

Limit:
•
Regular tomato sauce (2 cup per day)
•
Reduced sodium tomato juice (like V-8)

Tips:
If you are trying to lose weight, raw vegetables and fresh fruits are low in calories
and make satisfactory snacks.

Fats and Oils
Use:
•
Liquid vegetable oils: canola, olive, safflower, corn, sunflower, soy,
cottonseed, peanut
•
Soft tub margarines that list "liquid vegetable oil" or water as the first
ingredient. Use "squeeze" or spray margarines for the least amount of saturated
fats.
•
Low-fat or fat-free mayonnaise or salad dressing
•
Homemade sauces made with allowed ingredients

Avoid Using:
•
Coconut oil, palm oil, partially hydrogenated oils and products using these oils
•
Tartar sauce
•
Butter, lard, salt pork, bacon, meat fat, sour cream, gravy (mixes, canned, or
made from meat drippings), cream and cheese sauces

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•
Margarine which list "partially hydrogenated vegetable oil" as the first
ingredient
•
Salad dressings: Roquefort or Bleu cheese, any containing cheese or sour
cream, creamy varieties, store bought slaw dressing, real mayonnaise

Limit:
•
All nuts if you are monitoring or trying to lose weight. Limit nuts to a small
handful (about 15 nuts) a day. Salt free nuts are best.

Miscellaneous
Use:
•
Homemade soups made with recommended ingredients; salt-free canned, broth
based soups; salt-free bouillon. When making soups from meat broth, cool
broth in refrigerator until fat rises to the top and hardens. Remove fat, and then
add vegetables.

Avoid Using:
•
Regular canned, frozen or instant soups; bouillon cubes or granules
•
Soups made with ham or ham bones
•
Soups served in restaurants, unless advertised as low fat, low salt

Snacks, Sweets, Desserts and Beverages
If you have diabetes, limit foods with large amounts of sugar. If your doctor tells
you to limit your fluids, check with him or her on what your limit is. One cup of
fluid equals 8 ounces. Anything liquid at room temperature is a fluid including ice
cream, jell-o, soup and popsicles.

Use:
•
Unsalted popcorn, unsalted pretzels
•
Regular or sugar-free gum and mints, sugar, brown sugar, molasses, honey,
syrups, fructose, gum drops, hard candy
•
Regular or sugar-free soda pop, Gatorade, canned sweetened fruit drinks,
Kool-Aid, decaffeinated coffee, tea, iced tea
•
Homemade cakes, cookies and pies in moderation, made with recommended
oils and margarine.
•
Ice milk, low-fat frozen yogurt, sherbet, sorbet, popsicles in moderation
•
Pudding made from skim or 1% milk

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Avoid Using:
•
Salted popcorn, potato chips, corn chips, pretzels and other salted and/or deep
fried snack foods
•
Chocolate, candy bars
•
Store bought pies, cakes and cookies, cake mixes, pie crusts, canned puddings
and pie fillings

Condiments
Use:
•
Mrs. Dash
•
Vinegar, lemon juice, garlic, garlic powder, onion powder, herbs and spices,
salt substitute
•
Horseradish
•
Catsup and mustard (No more than 2 tablespoons per day because of sodium
content)

Avoid Using:
•
Meat tenderizer, monosodium glutamate (MSG), seasoned salt, onion salt,
celery salt, Morton Lite Salt, sea salt, spice blends which contain salt,
seasoning mixes
•
Baking powder, baking soda (use as an ingredient for baking only)
•
Chili sauce, soy sauce, steak sauces, BBQ sauce, Worcestershire sauce,
cooking wine, cooking sherry
•
Dill pickles, sweet pickles, pickle relish, olives, imitation bacon bits

Other tips
•
Read all labels.
Avoid products which contain shortening, vegetable shortening, partially
hydrogenated vegetable oils, lard, butter, beef suet, animal or chicken fat,
bacon, cream, salt and monosodium glutamate (MSG).
•
Check all medicines with your doctor.
Commonly used medicines for indigestion which are high in sodium include
Alka Seltzer, Bromo Seltzer, Rolaids, some laxatives, pain relievers, antibiotics
and cough medicines.

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