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Dietary Guidelines

Reduce your risk of heart attack & stroke 

Healthy food habits can help you reduce three of the major risk factors for heart attack:  high blood cholesterol, high blood pressure and excess body weight. They will also help reduce your risk of stroke, because heart disease and high blood pressure are major risk factors for stroke.

The American Heart Association Eating Plan for Healthy Americans is based on these new dietary guidelines, released in October 2000:

  • Eat a variety of fruits and vegetables. Choose 5 or more servings per day.
  • Eat a variety of grain products, including whole grains. Choose 6 or more servings per day.
  • Include fat-free and low-fat mild products, fish, legumes (beans), skinless poultry and lean meats.
  • Choose fats and oils with 2 grams or less saturated fat per tablespoon, such as liquid and tub margarines, canola oil and olive oil.
  • Balance the number of calories you eat with the number you use each day. (To find that number, multiply the number of pounds you weigh now by 15 calories. This represents the average number of calories used in one day if you are moderately active. If you get very little exercise, multiply your weight by 13 instead of 15. Less active people burn fewer calories.)
  • Maintain a level of physical activity that keeps you fit and matches the number of calories you eat. Walk or do other activities for at least 30 minutes on most days. To lose weight, do enough activity to use up more calories than you eat every day.
  • Limit your intake of foods high in calories and low in nutrition, including foods like soft drinks and candy that have a lot of sugars.
  • Limit foods high in saturated fats, trans fat and/or cholesterol, such as all-fat milk products, fatty meats, tropical oils, partially hydrogenated vegetable oils and egg yolks.  Instead choose foods low in saturated fats, trans fat and cholesterol from the first four points above.
  • Eat less than 6 grams of salt (sodium chloride) per day (2,400 milligrams of sodium).
  • Have no more than one alcoholic drink per day if you are a women and no more than two if you are a man.  "One drink" means it has no more than 4 ounce of pure alcohol.  Examples of one drink are 12 oz. of beer, 4 oz. of wine, 1 -1/2 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.

Following this eating plan will help you achieve and maintain a healthy eating pattern. The benefits of that include a healthy body weight, a desirable blood cholesterol level and a normal blood pressure. Every meal doesn't have to meet all the guidelines. It is important to apply the guidelines to your overall-eating pattern over at least several days. These guidelines may do more than improve your heart health.  They may reduce your risk for other chronic health problems, including type 2 diabetes, osteoporosis (bone loss) and some forms of cancer.

Meats, Poultry & Fish

Servings per day:
No more than 6 oz. cooked lean meat, poultry and fish

Serving size:
3 oz. cooked (4 oz. raw) lean meat, poultry or fish

Here are some examples to help you judge serving size of meat, poultry and fish.
A 3-ounce portion equals:

  • The size of a deck of cards
  • 2 thin slices of lean roast beef (each slice 3" x 3" x 1/4")
  • 1/4 of a chicken, breast or a chicken leg with thigh (without skin)
  • 3/4 cup of flaked fish

Choose fish, shellfish, skinless poultry (e.g. chicken, Cornish hen or turkey), or up to 6 ounces (cooked weight) trimmed lean meats per day.

Eat at least 2 servings of baked or grilled fish each week.

Instead of frying, prepare meats by baking, broiling, roasting, microwaving or stir-frying. Pour off the fat after browning meats.

One-cup serving of cooked beans, peas or lentils - or 3 ounces of soybean curd (tofu) or peanut butter - can replace a 3-ounce serving of meat, poultry or fish.

Organ meats are very high in cholesterol. However, liver is rich in iron and vitamins. A small serving (3 ounces) is OK about once a month.

Choose from:

  • Fish and shellfish: Shrimp and crayfish are higher in cholesterol than most types of fish, but lower in saturated fat and total fat than most meats and poultry.
  • Fish such as mackerel, lake trout, herring, sardines, albacore tuna and salmon are high in omega-3 fatty acids.
  • Chicken, Cornish hen and turkey (without skin); ground turkey
  • Lean beef (round, sirloin, chuck, loin). Buy "choice" or "select" grades of beef rather
    than "prime." Choose cuts of meat that have the least amount of visible fats.
  • Lean or extra lean ground beef (no more than 15% fat).
  • Lean veal (except commercially ground).
  • Lean ham, pork (tenderloin, loin chop). Ham and Canadian bacon are higher in sodium (salt) than other meats.
  • Lean lamb (leg, arm, loin).
  • Lean cuts of emu, buffalo and ostrich. These are very low in total fat, saturated fat, cholesterol and sodium.
  • Wild game (rabbit, pheasant, venison, wild duck without skin). These usually have less fat than animals raised for market (duck, goose).
  • Processed sandwich meats (low-fat turkey, chicken, turkey ham, turkey pastrami or lean boiled ham). Check the amount of sodium; some have 25% or more of the recommended daily limit.

Breads, Cereals, Pasta, and Starchy Vegetables

Servings per day:
6 or more

Serving size:
1 slice of bread
1/4 cup nugget or bud-type cereal
1/2 cup hot cereal
1 cup flaked cereal
1 cup cooked rice or pasta
1/4 to 1/2 cup starchy vegetables
1 cup low-fat soup

Choose from:

  • Breads and rolls
    • wheat, rye, raisin or white bread
    • english muffins
    • frankfurter and hamburger buns
    • water (not egg) bagels
    • pita bread
    • tortillas (not fried)
  • Crackers and snacks - Many kinds of crackers and snacks are now available with no added salt or unsalted tops. Some are high in saturated fatty acids, so read labels.
    • animal, graham, rye crackers
    • soda, saltine, oyster crackers
    • matzo
    • fig bar, ginger snap, molasses cookies
    • bread sticks, melba toast
    • crusts, flat bread
    • pretzels (unsalted)
    • popcorn (see "Fats and Oils" for preparation)
  • Quick breads - If you use any egg yolks in cooking quick breads, be sure to count them in your daily allowance. Homemade using margarine or oils low in saturated fatty acids, skim or 1 % fat milk, and egg whites or egg substitutes (or egg yolks counted in your daily limits).
    • biscuits
    • muffins
    • cornbread
    • fruit breads
    • soft rolls
    • pancakes
    • French toast
    • waffles
  • Hot or cold cereals - Cereals, pasta and rice cooked without salt are lower in sodium than instant or ready-to-eat types of these foods.
    • all kinds (granola-type may be high in fat or saturated fatty acids)
  • Rice and pasta
    • all kinds (pasta made without egg yolks)
  • Starchy vegetables
    • potatoes
    • corn
    • lima beans
    • green peas
    • winter squash
    • yams
    • sweet potatoes
  • Soups - Most soups are high in sodium and some are high in fat. Read labels and choose those low in sodium and fat. You can also make your own to control both sodium and fat.
    • chicken noodle
    • minestrone
    • tomato-based
    • seafood
    • onion
    • chowders split pea

Eggs

Servings per week:
Egg whites are not limited

  • Eggs have a high cholesterol content (213 mg per yolk). You should keep track of how many eggs
    you use in order to limit your cholesterol intake to less than 300mgm per day. Be sure to count any egg yolks used in cooking and in store-bought foods in your total for the week.
  • Use two whites, or one egg white plus 2 teaspoons of unsaturated oil, in place of one whole egg in cooking. You can also use cholesterol-free commercial egg substitutes.
  • Eat only cooked (not raw) eggs and egg whites.

Fruits and Vegetables

Servings per day:
5 or more - Be sure to include fruits and vegetables rich in Vitamin C and Vitamin A.

Serving Size:
1 medium sized piece of fruit
1/2 cup dried fruit or vegetable juice
1/2 - 1 cup cooked or raw vegetables

Choose from:

  • all fresh, frozen, canned or dried vegetables and fruits except coconut.
  • count olives and avocados as fats.
  • starchy vegetables are listed with Breads, Cereals, Pasta and Starchy Vegetables because they are similar in calories per serving to the other foods in that group.

Shopping and preparation tips:

  • Check labels for the sodium content of canned vegetables and soups. Buy those with low amounts
  • Steaming and microwaving vegetables are ideal ways to prepare them.
  • When cooking, use sparingly fats and oils low in saturated fats. (See Fats & Oils)
  • Fresh or canned fruit, gelatin containing fruit and dried fruit are good choices for a low-fat dessert.
  • If you need more iron, eat more iron-rich green leafy vegetables. These include spinach;
    peas, beans (fresh or dried), dried fruits and whole-grain enriched cereals. Your body can
    use the iron these foods provide if you eat them along with a good source of vitamin C.
  • For snacks, eat raw vegetables.

Milk and Cheese Products

Servings per day:
2 for children 1 to 3 years old
2 or more for children 4 to 8 years old
3 for adults 19 to 50 years old
4 for children and teenagers 9 to 18 years old and 51 years or older
3-4 for women who are pregnant or breast-feeding

Serving size:
1 cup fat-free or 1/2% or 1% fat-free milk
1 cup nonfat or low-fat yogurt
1 oz. low-fat cheese
1/2 cup cottage cheese

Choose from:

  • Milk products with 0-1% fat
  • 1/2 - 1% low-fat, light or "little fat" milk
  • Nonfat or low-fat dry milk powder
  • Evaporated skim milk
  • Buttermilk made from skim or 1/2%  or 1% fat milk
  • Fat-free or low-fat yogurt
  • Frozen fat-free or low-fat yogurt
  • Drinks made with fat-free or 1% fat milk and cocoa (or other low-fat drink powders)
  • Low-fat cheeses (dry-curd or low-fat, cottage cheese, low-fat natural cheeses or processed cheeses made with nonfat or low-fat milk with no more than 3 grams of fat per ounce and no more than 2 grams of saturated fat per ounce)
  • Fat-free or low-fat ice cream (no more than 3 grams of fat per 1/2 cup serving)
  • Fat-free, low fat and l/2% fat and 1% fat milk all provides slightly more nutrients than whole milk and 2% fat milk. They are much lower in fat, saturated fat, cholesterol and calories. (If you are used to whole milk products, you may find it easier to taper off slowly. Try 1% low fat first, and then change to 1/2% low-fat.  Soon you will be able to switch to fat-free milk with no trouble)

The servings per day of milk products are higher to reflect revised recommendations for calcium intake - 1,000 milligrams for all adults until age of 50; 1,200 milligrams at age of 50 and older. For vitamin D, the revised recommendations are 400 I.U.s (International Units) for everyone age 51 and older; 600 I.U.s for age 71 and older.

Fats and Oils

Servings per day:
No more than a total of 5-8 teaspoon servings depending on your caloric needs. Limit to 5 teaspoons or equivalent if you're trying to lose weight.

Serving size:
1 teaspoon vegetable oil or regular margarine
2 teaspoons diet margarine
1 tablespoon salad dressing
2 teaspoons mayonnaise or peanut butter
1 tablespoon seeds or nuts
1/8 medium avocado
10 small or 5 large olives

Choose from:
Vegetable oils and margarines with liquid vegetable oil as the first listed ingredients and no more than 2 grams of saturated fatty acids per tablespoon - canola, corn, olive, safflower, sesame, soybean, sunflower.

Salad dressings and mayonnaise with no more than 1 gram of saturated fatty acids per
tablespoon.

  • Use fats and oils sparingly - and use the ones lowest in saturated fatty acids and cholesterol.
  • Use hydrogenated shortenings sparingly and choose those made from vegetable fat. They are lower in saturated fatty acids than those made from animal/vegetable fat blends.
  • Use cooking styles that add little or no fat to food, and ask for them when eating out.
  • Remember to count the "hidden fat" in bakery and snack foods as well as the fats used in cooking and on vegetables and breads.
  • Remember that although coconut oil, palm oil and palm kernel oil are vegetable oils and have no cholesterol, they are high in saturated fatty acids.
  • Read food labels carefully.

Carbohydrates and Sugars

Carbohydrate intake should be 55-60% of your calories.
It is better to eat more complex carbohydrates - vegetables, fruits and grains - than simple carbohydrates found in sugars. Complex carbohydrates add more fiber, vitamins and minerals to the diet than foods high in refined sugars. Foods high in complex carbohydrates are usually low in calories, saturated fats and cholesterol.

The American Heart Association recommends 25-30 grams of fiber per day.

What foods are sources of complex carbohydrates?

  • Starches - Flour, bread, rice, corn, oats, barley, potatoes, legumes, fruits, and vegetables.
  • Fiber - Insoluble: whole-wheat breads and cereals, wheat bran, cabbage, beets, carrots, Brussels sprouts, turnips, cauliflower and apple skin.
  • Fiber - Soluble: oat bran, oats, legumes, citrus fruits, strawberries, apple pulp, psyllium, rice bran and barley.

Which foods are sources of simple carbohydrates?
Sucrose - Table sugar, brown sugar, confectioner’s sugar, raw sugar and turbinado
Glucose - Dextrose, corn syrup and glucose syrup
Fructose - Fruits, vegetables and honey
High fructose corn syrup -- Liquid sweeteners that contain 42-90 percent fructose.
Honey - Made up of glucose, fructose and water
Sugar alcohols -- Sorbitol, mannitol, xylitol
Lactose - Milk and milk products
Maltose, dextrose - cereals and some baked goods

Desserts, Snacks and Beverages

Desserts

Choose:

  • Desserts low in saturated fatty acids, cholesterol and calories. For special treat, share a dessert portion with someone.
  • Fruit - fresh, frozen, canned or dried
  • Low-fat yogurt with fruit
  • Crackers and cookies
  • Angel food cake
  • Frozen fat-free, low fat or nonfat yogurt
  • Low-fat ice cream with no more than 3 grams of fat per 1/2 cup
  • Flavored gelatin
  • Water ices, sherbets or sorbets