Diet taboos for coronary heart disease

There are no foods that patients with coronary heart disease must not eat. What they really need to strictly avoid are long-term diets high in oil, salt and sugar, overeating, and large amounts of irritating/exciting foods in a short period of time. The core of all taboos is "control the amount and frequency" rather than banning certain types of food across the board.

Many people who have just been diagnosed with coronary heart disease or have had a stent, the first thing they do is search for "what should not be eaten with coronary heart disease" and then make a long blacklist. They dare not touch eggs, dare not eat meat, and even eat a fruit and have to repeatedly check the glycemic index. I have been in the cardiovascular department for almost ten years, and I have met too many patients who have gone to such extremes. The most exaggerated case is that last year there was a 62-year-old Aunt Zhang. She did not eat a single bite of red meat for half a year after the stent surgery. She ate boiled cabbage with multi-grain rice every day. When she finally came for a review, her hemoglobin was only 90g/L. She was severely anemic, which put a heavier burden on the blood supply to the heart.

Regarding the dietary taboos of coronary heart disease, there has been a lot of controversy in the academic community. Take the egg yolk that everyone is most concerned about. A few years ago, it was said that patients with coronary heart disease must not touch egg yolk for fear that high cholesterol content will aggravate blood vessel stenosis. Now the latest "Dietary Guidelines for Chinese Patients with Cardiovascular Disease" have already adjusted Recommendation: As long as your low-density lipoprotein is controlled within the target value, it is absolutely fine to eat 3-4 whole eggs a week. Only patients with familial hypercholesterolemia or long-term blood lipids that cannot be controlled need to appropriately reduce the intake of egg yolks. There is really no need to beat them to death with a stick.

Don’t think that using less salt in cooking means you have met the salt control standards. Most people have stepped on the trap of invisible salt. There used to be an old man who usually put half a spoonful of salt in his dishes. His blood pressure kept rising and falling. After asking for a long time, I found out that he drank porridge with a piece of fermented bean curd every morning. A piece of fermented bean curd of about 10g contains 5g of salt, which directly accounts for 10% of the average daily dose. The recommended daily salt intake for most people is half, not to mention that there is a lot of sodium hidden in the noodles, sliced bread, salad dressing, and even soda crackers that we usually eat. For patients with heart failure, the daily salt intake must be reduced to less than 3g. If you are not careful, it will exceed the standard.

Let’s talk about the issue of oil. Many people think that animal oil should not be touched, and vegetable oil can be used for cooking. I have seen many people pour half a plate of olive oil when mixing cold dishes, thinking that it is healthy to eat more oil. However, no matter whether it is animal oil or vegetable oil, the calories are the same. It is best not to use more than 20g of oil in a day, which is about the amount of two ordinary white porcelain spoons. Eating too much will increase blood lipids and accelerate the growth of blood vessel plaques. Of course, it doesn’t mean that you can’t eat fat meat at all. When I follow up with discharged patients during holidays, I will also say that if you really want to eat two pieces of pork belly or braised pork belly, it’s okay. Just eat one or two pieces to satisfy your craving. In the next one or two meals, eat more fresh vegetables and less oil and salt to make up for it. There is really no need to be so anxious that you can’t sleep just because you eat a piece of meat. The negative impact of mood swings on the heart is much greater than that of fat.

There is another minefield that many people ignore: drinking a large amount of stimulating drinks in a short period of time, such as strong tea, espresso coffee, alcohol, and functional drinks that young people love to drink. Last year, a 32-year-old young man was admitted to the emergency department. He had just had a stent placed for three months. He drank two or three cans of energy drinks every day for a week to stay up late for a project. When he finally came for a review due to chest tightness, his heart rate soared to 120 beats/min, and his cardiac enzymes were abnormal. Of course, that doesn’t mean you can’t drink coffee at all. Many studies now show that drinking a cup of light coffee every day and controlling the caffeine intake within 200mg has a protective effect on cardiovascular disease. The key is not to drink too strong, and don’t drink too much at one time.

Oh, by the way, I really need to mention overeating. Every Spring Festival emergency department receives more than a dozen patients with angina pectoris caused by eating too much at family dinners. If you think about it, if you eat too much high-fat and oily food at once, the blood will be concentrated in the gastrointestinal tract to digest the food, and the blood supply to the heart itself will be reduced. If the blood vessels themselves are narrowed, wouldn't it be easy to cause problems?

In fact, after all, there are so many black and white taboos on the diet for coronary heart disease. Instead of holding on to the blacklist every day and not daring to eat this or touch that, it is better to learn to "flexibly manage" your own diet. It doesn't matter if you are greedy for something "unhealthy" occasionally. As long as the long-term overall diet is light and balanced, it is much better than tabooing everything and ending up with malnutrition. If you are really not sure whether you can eat it, take your blood lipids, blood sugar, and blood pressure reports to a medical doctor or nutritionist. A tailor-made plan is much more reliable than the cookie-cutter list of taboos on the Internet.