Coronary heart disease is the abbreviation of coronary atherosclerotic heart disease, which refers to the heart disease caused by the blockage of coronary artery lumen due to atherosclerosis and the functional changes of coronary artery, resulting in myocardial ischemia and hypoxia, also known as ischemic cardiomyopathy. Because of its high morbidity and mortality, coronary heart disease is a serious threat to human health and is therefore called the “number one killer of human beings”. Coronary heart disease is a multi-causal disease, and the risk factors affecting its development are present in our daily life, including age and gender, smoking, alcohol consumption, hypertension, diabetes, obesity, hyperlipidemia, physical inactivity, mental stress, as well as genetic and environmental factors. Plaque formation and atherosclerosis in coronary arteries are formed gradually. In addition to heredity, we should control and improve our life habits as much as possible to reduce these risk factors in order to counteract or delay the occurrence of coronary artery blockage and reduce the occurrence of myocardial infarction. According to a large-scale population survey, coronary heart disease is related to nutritional imbalance, so reasonable dietary adjustment is an important measure to prevent and treat coronary heart disease. Here we talk about the risk factors of coronary heart disease related to diet, and talk about the diet health of coronary heart disease.
1.Actively control blood lipids
Although the pathogenesis of coronary heart disease is not completely clear, the results of several studies show that it is related to abnormal lipid metabolism and elevated cholesterol, and it is very important to actively control blood lipids and cooperate with reasonable lipid intake to prevent and treat the occurrence and development of atherosclerosis.
In general, the main components of lipids are triglycerides (TG) and cholesterol (Ch), and the cholesterol related to atherosclerosis is mainly high-density cholesterol (HDL-C) and low-density cholesterol (LDL-C). HDL-C is mainly used to transfer excess cholesterol from extrahepatic tissues to the liver for metabolism and prevent excessive steroid accumulation in tissues. The main role of HDL-C is to transport cholesterol from the liver to extrahepatic tissues to meet their cholesterol needs. However, LDL-C is viscous and has a slow flow rate, so it accumulates along the road from the liver to other organs and tends to stick to the walls of blood vessels, especially oxidized LDL-C, which can cause inflammatory reactions in the endothelium of blood vessels, prompting endothelial cells and macrophages to phagocytose lipids, and is the main culprit of atherosclerosis, which is often referred to as “bad cholesterol It is the main culprit of atherosclerosis, also known as “bad cholesterol”. Triglycerides are mainly composed of long-chain fatty acids and glycerol, and their main role is to participate in the body’s energy metabolism, which is the main energy storage bank of the body, but excessive triglycerides will cause changes in the function of fat cells and increase blood viscosity, promoting the formation of atheromatous plaques. Therefore, lowering LDL-C and TG becomes an important measure to prevent atherosclerosis. To reduce lipids we have to start from two sources of lipids, one is to control diet and the other is to reduce synthesis. Although statins and beta-lipid-lowering drugs have received good results in reducing LDL-C and TG synthesis, diet therapy is still the most important element in lipid-lowering process.
Cholesterol in nature mainly exists in animal foods, and foods with high cholesterol content mainly include: egg yolk, fish roe, crab yolk, animal brain, animal liver and kidney, etc.
Generally speaking, the cholesterol content of animal meat is higher than that of poultry, fatty meat is higher than that of lean meat, shellfish and mollusks are higher than that of fish in general, and the cholesterol content of egg yolk and fish roe animal innards is the highest. Since cholesterol is so harmful to the human body, so we can not eat it? In fact, cholesterol is an essential nutrient in the human body, involved in many chemical synthesis, if excessive avoidance of such foods, it is easy to cause imbalance in nutritional balance, leading to disease. Normal healthy people should consume 50-300mg of cholesterol daily (the high value is equivalent to the Ch content of 1 egg yolk), while coronary heart patients should be less than 200mg/day. In addition to reducing cholesterol intake, it is equally important to lower blood cholesterol by consuming foods that can lower cholesterol.
Studies have confirmed that hyper-TGemia is often associated with sLDL-C formation and reduced HDL-C.[3] Excessive intake of saturated fatty acids (SFA), trans fatty acids (widely found in margarine, bread, cookies, and oils heated at high temperatures for long periods of time), meat (especially fatty meats), and some vegetable oils (e.g., coconut oil, palm oil) can raise cholesterol and LDL-C levels. Unsaturated fatty acids can esterify cholesterol, lower blood cholesterol and triglycerides, and promote the metabolism of saturated fatty acids in the body to reduce and eliminate animal fats in food, so reducing dietary cholesterol and saturated fatty acid intake and appropriately increasing the intake of unsaturated fatty acids can effectively reduce the occurrence of hypercholesterolemia and cardiovascular diseases.
Reduce the absorption of cholesterol, affect the metabolism of cholesterol, promote the excretion of cholesterol, etc. to reduce the level of cholesterol in plasma; reduce the level of triglycerides in plasma by increasing the transition time of food in the intestine, delaying gastric emptying, slowing down or reducing the absorption of fat and other mechanisms; reduce the rate of glucose absorption so that blood sugar does not rise sharply after meals. Corn, millet, barley, oats, konjac, rice bran and wheat flour and other mixed grains, burdock, carrots, string beans, red beans, peas, potatoes and root vegetables such as kelp, wakame and seaweed, celery, corn, fungus, onions, mushrooms, apples, hawthorn, strawberries, soybean sprouts and other vegetables and fruits.
The Chinese Nutrition Society proposes the amount and range of dietary fiber intake for Chinese residents: low energy diet 1800 kcal for 25g/day; medium energy diet 2400 kcal for 30g/day; high energy diet 2800 kcal for 35g/day.
Vitamins C and E
Promote the excretion of cholesterol, prevent the deposition of cholesterol in the inner walls of arteries, and have antioxidant components that help reduce the harm of cholesterol to blood vessels.
Foods rich in VC: cherries, guava, red peppers, yellow peppers, persimmons, broccoli, strawberries, oranges, kale cauliflower, kiwifruit.
Foods rich in VE: soybean oil, sesame oil, peanut oil, millet, sunflower oil, cornmeal, cottonseed oil, spinach, salad oil, lean pork.
Adults must consume VC amount of 100mg/day and VE amount of 14mg/day.
Plant sterols
They can compete with cholesterol in the intestinal tract to reduce cholesterol absorption and effectively lower LDL in the blood without affecting HDL in the blood.
Vegetable oil: corn germ oil, sesame oil, canola oil, soybean oil, peanut oil, etc.
Legumes: black beans, green beans, tofu, soy milk, etc.
Cereals: purple rice, barley rice, buckwheat rice, barley, millet, corn, etc.
Vegetables and fruits: cauliflower, broccoli, oleander, oranges, tangerines, hawthorn, etc.
The daily vegetable oil intake is 25 grams.
Ensure at least three meals of beans per week, with an intake of 50 grams or more each time.
Adults consume 300~600 grams of cereals per day.
Eat 400~500 grams of vegetables and 100~200 grams of fruits every day.
Unsaturated fatty acids
Make cholesterol esterification, lower blood cholesterol and triglycerides; improve blood microcirculation, prevent fat deposits in the walls of blood vessels, inhibit the formation and development of atherosclerosis, and enhance the elasticity and toughness of blood vessels.
Vegetables: garlic, onion, scallion, cauliflower, leek, ginger, radish, tomato, winter melon, kelp, nori. Various mushrooms such as shiitake and flower mushrooms.
Legumes: soybeans, adzuki beans, mung beans, broad beans, peas, kidney beans, etc.
Vegetable oil: soybean oil, sunflower oil, corn oil, safflower oil, Inca fruit oil, tea oil, olive oil, canola oil, etc.
Fish: snapper and various sea fish, etc.
Fruits: vegetable fruit, hawthorn, orange, etc.
Milk: yogurt.
Nuts: sunflower seeds, sesame seeds, walnuts, almonds, etc.
The principle is low-fat diet, so that the proportion of fat only accounts for 15% to 25% of the total calories, and the optimal distribution ratio of saturated fat (meat, etc.), multiple non-saturated fat (vegetable oil, etc.) and single non-saturated fat (canola oil and olive oil, etc.) is 7:10:13. The calorie intake from saturated fat should be reduced to less than 7% of the total amount; the calorie intake from multiple non-saturated fat should be reduced to The calorie intake from saturated fat should be reduced to less than 7% of the total; the calorie intake from multiple unsaturated fats should be reduced to less than 10% of the total; the calorie intake from single unsaturated fat can be increased to more than 13% of the total.
Patients with hyperlipidemia, those who have developed atherosclerosis and complications (e.g., coronary heart disease, stroke, etc.), and those at high risk for risk factors are all suitable for a low-fat diet, even if their lipids are in the normal range.[5] The 2011 ESC/EAS lipid guidelines clearly state that the target LDL-C value for very high-risk patients needs to be controlled at 70 mg/dl ( 1.8 mmol/L) or less and/or a >50% decrease in LDL-C, while the LDL-C target values for high- and intermediate-risk groups are <100 mg/dl (2.5 mmol/L) and <115 mg/dl (3.0 mmol/L), respectively, even in patients with stable angina pectoris, whose LDL-C should reach 70 mg/dl (1.8
mmol/L) level or less.
2.Actively control blood pressure
Hypertension is a major risk factor for coronary heart disease and death. 1 in 5 adults in China suffer from hypertension, which shows that the incidence of hypertension in China is quite high, which is closely related to people’s dietary habits. 2011 hypertension prevention and treatment guidelines point out that sodium intake is positively correlated with blood pressure level and hypertension prevalence, while potassium intake is negatively correlated with blood pressure level. The correlation between dietary sodium/potassium ratio and blood pressure is even stronger. Diets high in sodium and low in potassium are the most important risk factors for the development of hypertension in most patients in China. In most areas of China, the per capita daily salt intake is more than 12-15 g, far exceeding the WHO recommended sodium intake of <6 g/day. Sodium salt can significantly increase the risk of hypertension and the development of hypertension, while potassium salt can counteract the effect of sodium salt to increase hypertension. Patients with hypertension and hypertension combined with coronary artery disease need to control sodium intake more strictly, which should be <3g/day.
Recommendations for dietary control of blood pressure.
Low sodium
Sodium intake <3g/d and foods with high salt content should also be avoided as much as possible, such as: 1. condiments - salt, soy sauce (3ml of soy sauce is equivalent to 1g of salt), MSG, black vinegar, ketchup, etc. 2. salt cured products - salted meat, pickles, kimchi, pickles, tofu milk, lo mein, etc. 3. preserved foods - sausage, ham, bacon, etc. 4. canned goods - vegetable cans, meat cans, etc., all with added salt preparations. 5. .Others - instant noodles, salted bread, etc.
Potassium-rich
In addition to consuming low sodium and high potassium salt, foods rich in potassium should also be consumed, such as beans, mushrooms black dates, almonds, walnuts, peanuts, potatoes, bamboo shoots, lean meat, fish, poultry, amaranth, rape, onions, bananas, dates, peaches, oranges, etc.
Calcium supplementation
Maintaining normal blood calcium levels can maintain the balance of calcium metabolism inside and outside smooth muscle cells, avoiding spasm of vascular smooth muscle, thus achieving the purpose of effectively preventing vascular sclerosis and lowering blood pressure, so you should eat more calcium-rich foods, such as soybeans, sunflower seeds, walnuts, milk, peanuts, fish and shrimp, red dates, fresh snow budding, garlic, purple cabbage, etc.
Calorie control
The diet should be arranged in small quantities and avoid overfilling. Patients with hypertension are often obese and must eat low-calorie food, with total calories controlled at about 8.36 MJ per day, 150-250 grams of staple food per day, with animal protein and vegetable protein accounting for 50% each. The calorie allocation of three meals for hypertensive patients should be 30% for breakfast, 40% for lunch and 30% for dinner.
Limit alcohol consumption
Long-term heavy alcohol consumption can lead to increased blood pressure, and limiting alcohol consumption can significantly reduce the risk of developing hypertension. Daily alcohol intake should not exceed 25 grams for men and 15 grams for women. It is not recommended that people with hypertension drink alcohol, but if they do, they should drink small amounts: less than 50ml of white wine, 100ml of wine (or rice wine) and 300ml of beer.
Fresh fruits and vegetables
Patients with hypertension eat 1 pound to 1 and a half pounds of fresh vegetables 2 to 3 fruits per day, for hypertensive patients with diabetes, under the premise of stable blood sugar control, you can choose low-sugar type or medium sugar-containing fruits, including watermelon, apples, kiwi, strawberries, pears, grapefruit, etc., eat 200 grams per day, as an additional meal.
Coarse fiber food
Coarse fiber foods include various kinds of grains, celery, leek, garlic, yellow cauliflower, parsley, green pepper, mao bean, wild rice, bamboo shoots, onion, mustard, apple, pear, grape, apricot, hawthorn, strawberry, olive, red date, corn, walnut, peanut, fungus, mushroom, mushroom, eggplant, kelp, nori, seaweed, etc.
In addition, because the diet of salt is very unpalatable, not easy to adhere to; as the saying goes, “light and tasteless”, in order to make hypertensive patients in the diet can adhere to salt reduction, is introduced to some salt reduction and salty measures, such as: adding vinegar to increase salt, with spicy condiments to increase the taste, with diluted soy sauce to preserve the taste of salt reduction, with milk to reduce salt to increase salt, light dishes as the main food to eat salt reduction, eat Reduce salt by eating baked foods.
Patients with hypertension, coronary heart disease, hypertension combined with coronary heart disease, high risk groups of hypertension should pay attention to blood pressure control, so that blood pressure control below 140/90mmHg.
3.Actively control blood sugar
Diabetes is another major risk factor of coronary atherosclerosis, and the incidence of coronary heart disease is higher in diabetic patients. And most of them are characterized by diffuse coronary lesions, multi-branch lesions, distal vascular lesions, small vessel lesions, poor circulation and other lesions, often accompanied by endothelial dysfunction, hypercoagulable state, and often have metabolic syndrome such as abnormal glucose metabolism, insulin resistance, abnormal lipid metabolism, etc. Therefore, controlling blood sugar means reducing the risk factors of coronary heart disease. [6] The goals of diabetic diet control are to make blood glucose close to or reach normal level, protect pancreatic B-cell function, increase insulin sensitivity, maintain or reach ideal body weight, make lipids close to or reach normal level, prevent and treat acute and chronic complications, improve overall body nutrition level, and enhance body resistance. Dietary control of blood glucose has some similarities with lipid and hypertension control, which can be matched with reference.
Suggestions for dietary control of blood sugar
Reasonable eating habits
Meals should be regular and quantitative, at least 3 meals/day, the ratio of 3 meals can be 1/3 each, or 1/5, 2/5, 2/5, for patients who inject insulin or prone to hypoglycemia and poorly controlled condition, 2 or 3 additional meals should be added between 3 regular meals, i.e., a part of food from 3 regular meals should be set aside for additional meals to prevent hypoglycemia. 3 meals should be evenly matched, each meal has Carbohydrates, fat and protein.
Carbohydrate
Carbohydrate energy supply should account for about 60% of the total caloric energy, the use of complex carbohydrates, control the intake of monosaccharides and disaccharides, it is best to use the slower absorption of polysaccharides, such as buckwheat, oats, oat, corn crumbs, potatoes, yams, pumpkin, potatoes, roots, etc., the main food should be coarse and fine grains with.
Food diversity
Generally eight categories of cereals, vegetables, fruits, soybeans, milk, lean meat, eggs, fats and oils. These eight categories should be eaten every day, each type of food selection 1 ~ 3 kinds.
Control total calories
25%-30% of the total calories should come from fat and oil, carbohydrate supply accounts for 55%-65% of the total calories, and protein is no more than 15% of the total calories. The caloric supply of diabetic patients should be maintained or slightly lower than the ideal weight, so whether they are obese or lean, they should control their weight within the ideal weight range.
The quality of protein is appropriate
Should be appropriate to increase plant protein, especially soy protein. High-quality protein accounts for 40% to 50%. Animal protein and vegetable protein each account for 50% of high-quality protein.
Eat more calcium-rich food
Human pancreatic beta cells need calcium ions to secrete insulin, and because diabetic patients urinate a lot, calcium excretion increases, so calcium-rich foods can increase insulin release.
High fiber food
It can promote gastrointestinal peristalsis, prevent constipation, and improve the glucose metabolism of diabetic cells, increase the sensitivity of insulin receptors to insulin, and promote the decrease of blood sugar. Such as: potatoes, apples, oats, bamboo shoots, guava, celery, shiitake mushrooms, etc.
Diabetic patients and people with reduced glucose tolerance should actively control blood glucose so that blood glucose is controlled at the target value. China’s type 2 diabetes control guidelines recommend the following blood glucose control targets: fasting blood glucose: 3.9C7.2 mmol/L, non-fasting blood glucose: _<10.0 mmol/L, glycosylated hemoglobin <7.0%.
In general, patients with coronary heart disease are often combined with high blood lipid, high blood pressure, high blood sugar, etc. Even if they are not combined with these diseases, they should pay attention to the “four low and two high” diet, i.e. low salt, low fat, low sugar, low calories, high vitamin and high fiber. On the other hand, patients with coronary heart disease should also pay attention to nutritional balance, not to overemphasize a certain aspect, and cause a new imbalance. The old saying “five grains for nourishment, five fruits for enrichment, five animals for benefit, five vegetables for help” is to warn people to pay attention to dietary balance and not to be partial. Coronary heart disease is a chronic pathogenesis, prevention and control of coronary heart disease is also a long-term persistent work of each coronary heart disease patients and high-risk groups, diet is the first measure, with the adjustment of biological clock, appropriate exercise, good attitude and drug treatment, etc., to minimize the risk factors of coronary heart disease, will reduce the incidence of coronary heart disease and its complications, improve the control rate, so, control the mouth in order to control the heart. The majority of coronary heart disease patients and high-risk groups should pay enough attention to it.