Director, Health Promotion and Disease Prevention Directorate, Charmaine Gauci serves up some food for thought. Here are her suggestions for the right diet to maintain a healthy heart.

Heart disease is the number-one killer in many developed countries, including Malta. The good news is that we can reduce heart disease by promoting a healthy lifestyle.

If we search ‘healthy lifestyle’ online, we come up with a multitude of websites with information... some good and some that may not be so good.

Getting information from credible sources is very important. We need information that is based on evidence because it could help us make smart choices that will benefit our long-term heart health.

The American Heart Association has defined what it means to have ideal cardiovascular health, identifying seven health and behaviour factors that impact health and quality of life.

We know that even simple, small changes can make a big difference in living a better life.

Known as Life’s Simple 7, these steps can help add years to your life:

1. don’t smoke;
2. maintain a healthy weight;
3. engage in regular physical activity;
4. eat a healthy diet;
5. manage blood pressure;
6. take charge of cholesterol; and
7. keep your blood sugar, or glucose, at healthy levels.

Researchers found the risk of heart disease was 42 per cent higher among people who regularly ate processed meats such as hot dogs, ham and processed deli meats

As part of a healthy diet, an adult consuming 2,000 calories daily should aim for:

Vegetables and fruits, which are good sources of vitamins and minerals, low in calories and rich in dietary fibre. Eating more fruits and vegetables may help you eat less high-fat foods, such as meat, cheese and snack foods.

Some vegetables, for example spinach, are packed with heart-enhancing nutrients, including lutein (a carotenoid), B-complex vitamins, folate, magnesium, potassium, calcium and fibre.

These substances, found in plants, may help prevent cardiovascular disease.

To get the most out of every vegetable you eat, follow these serving suggestions:

• Fruits and vegetables – eat at least 4.5 cups a day

Choose vegetables of different colours for maximum nutrition. Eat fresh or cooked tomato products every week. Add onions and garlic to your meals; an average of 1⁄4 cup of onions and one clove of garlic per day lowers cholesterol, some studies say. Steaming vegetables rather than boiling them preserves nutrients.

• Fish (preferably oily fish) – at least two 3.5-ounce servings a week

Salmon is a top food for heart health; it is rich in the omega-3s EPA and DHA. Omega-3s may lower risk of rhythm disorders of the heart and reduce blood pressure. Salmon also lowers blood triglycerides and reduces inflammation

• Fibre-rich whole grains – at least three one-ounce-equivalent servings a day

Barley, which is whole grain, can be used instead of rice with dinner or simmer barley into soups and stews. The fibre in barley can help lower cholesterol levels and may lower blood glucose levels as well. Oats in all forms can help your heart by lowering LDL, the bad cholesterol.

• Sodium – fewer than 1,500mg a day

A number of studies show that blood pressure rises with increasing amounts of sodium in the diet, and that sodium reduction lowers cardiovascular disease and death rates over the long term.

• Sugar-sweetened beverages – no more than 450 calories (36 ounces) a week

Water is the best choice for quenching your thirst. Some beverages should be limited or consumed in moderation, including diet drinks, fruit juice and milk. Alcohol in moderation can be healthy for some people, but not everyone. Avoid sugary drinks like soda, sports beverages and energy drinks.

• Other dietary measures

Nuts, legumes and seeds: at least four servings a week. For example, black beans are packed with heart-healthy nutrients, including folate, antioxidants, magnesium and fibre, which help control both cholesterol and blood sugar levels. A small handful of walnuts (1.5 ounces) a day may lower cholesterol and reduce inflammation in the arteries of the heart. Walnuts are packed with omega-3s, monounsaturated fats and fibre. The benefits especially come when walnuts replace bad fats, like those in chips and cookies.

Processed meats: no more than two servings a week. Researchers found that the risk of heart disease was 42 per cent higher among people who regularly ate processed meats – those that were preserved by smoking, curing, salting or with the addition of chemical preservatives – such as hot dogs, ham and processed deli meats. In addition, studies also found a 19 per cent higher risk of type 2 diabetes among processed-meat eaters.

Saturated fat: less than seven per cent of total energy intake. Extra virgin olive oil, made from the first press of olives, is especially rich in heart-healthy antioxidants called polyphenols, as well as healthy monounsaturated fats. When olive oil replaces saturated fat (like butter), it can help lower cholesterol levels.

Nutrients in heart-healthy foods

• Phytoestrogens are substances in plants (like flaxseed) that have a weak estrogen-like action in the body. Studies suggest that flaxseed lowers the risk of blood clots, stroke and cardiac arrhythmias. It may also help lower total and LDL ‘bad’ cholesterol and triglycerides, and even blood pressure.

• Phytosterols are plant sterols that chemically resemble cholesterol – and seem to reduce blood cholesterol. All nuts and seeds, including wheat germ, have phytosterols.

• Carotenoids are heart-protective antioxidants in many colourful fruits and veggies. Alpha-carotene, beta-carotene, lutein and lycopene are carotenoids.

• Polyphenols are another set of anti-oxidants that protect blood vessels, lower blood pressure, reduce LDL ‘bad’ cholesterol. Flavonoid polyphenols include catechins, flavonones, flavonols, isoflavones, reservatrol and anthocyanins. Non-flavonoid polyphenols include ellagic acid (found in all types of berries).

• Omega-3 fatty acids (found in fatty fish like salmon) and alpha-linolenic fatty acids (found in plant foods like walnuts) help boost the immune system, reduce blood clots and protect against heart attacks. They also increase good HDL levels, lower triglyceride levels, protect arteries from plaque build-up, are anti-inflammatories and lower blood pressure.

• B-complex vitamins, like vitamin B12 (folate) and vitamin B6, protect against blood clots and atherosclerosis, or hardening of the arteries. Niacin (vitamin B3) helps increase HDL ‘good’ cholesterol.

• Vitamins C and E are antioxidants that protect cells from free radical damage.

• Magnesium, potassium and calcium help lower blood pressure. Fibre-rich foods help lower cholesterol levels.