Q: What are the basic tenets of a heart-healthy diet?
A: I once had a patient who had a history of heart disease in his family. When he first came to see me, he was in his late 20s. He knew that having heart disease in his family put him at higher risk for it later in life. He told me he had decided to do something to protect himself: He had consulted a cardiologist.
As for his lifestyle, he had done nothing. Zip. Nada. Hadn't changed his diet and never exercised.
Of course he had heard ("ad nauseam," he said) advice from his doctor and from people (like me) who write about a healthy lifestyle.
"I first heard that stuff from my kindergarten teacher," he said, "and I've been hearing it ever since." But he thought it was all sanctimonious preaching.
It's not sanctimonious preaching; it's solid science. There are thousands of studies, involving hundreds of thousands of people, whose diets and health histories have been cataloged over (collectively) millions of years.
What do those studies say? A heart-healthy diet may reduce your risk of a heart attack by 73 percent compared to a typical American diet of meat, cheese and high-fat desserts.
What do I mean by "heart-healthy diet"? Here are the basics:
Watch your fats: Eliminate trans fats from your diet. Limit saturated fat.
Choose whole grains: Replace refined carbohydrates (such as white bread and white rice) with whole-grain varieties.
Eat meat sparingly: Relegate meat to a minor part of your diet. Avoid fatty cuts of beef, pork and lamb. Instead, choose lean meats, or substitute fish or skinless white-meat poultry.
Opt for low-fat dairy products: Avoid dairy foods that contain whole milk or cream.
Choose healthy cooking oils: Use liquid cooking oils rather than butter or margarine. Good choices include canola, sunflower, safflower, corn, soybean, olive and peanut oils.
Reduce Dietary Cholesterol: Strive to eat less than 200 mg of dietary cholesterol a day. (On my website, AskDoctorK.com, I've put a table listing the amount of cholesterol in several common foods.)
Eat more fiber: Emphasize foods that are low in calories and high in fiber, such as fruits and vegetables, whole-grain products and legumes (dried beans and peas). Eat more water-soluble fiber, such as that found in oat bran and fruits.
Go for nuts: Nuts are associated with a lower risk of heart disease. But they have lots of calories, so watch your portions.
Add fish to your diet: Oily fish such as mackerel and salmon contain heart-healthy omega-3 and omega-6 fatty acids.
Reduce salt intake: High-salt diets increase your risk of high blood pressure, a major risk factor for cardiovascular disease.
Drink alcohol only in moderation: That means no more than one drink a day for women, and one or two drinks a day for men.
If you want to reduce your risk of heart disease by over 70 percent, this is how to do it. I finally convinced my patient of this, and he is a trim and healthy 80-year-old today.
• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com.