I. Knowledge of the disease
The etiology of coronary heart disease has not been completely clarified, and it is mostly thought to be related to the disorder of lipid metabolism in the body. Among the risk factors for the development of coronary heart disease, the most important ones are hypertension, hypercholesterolemia and smoking; followed by obesity, diabetes mellitus and psychoneurological factors; there are also some factors that cannot be changed, such as family genetic history, age and gender (male), etc. From the above factors, the onset of coronary heart disease has a direct or indirect relationship with dietary and nutritional factors, so pay attention to reasonable nutrition is one of the important measures to prevent and treat coronary heart disease.
We summarize 7 points: control calories, limit fat, moderate protein, light diet, eat protective food, sufficient vitamins, avoid smoking and alcohol, high fat and high cholesterol food.
The principles should be: low calorie, low fat, low cholesterol, low salt, high protein, high vitamin, high fiber, avoid stimulation, and eat less and more meals.
Second, dietary guidance
1. Control calories and maintain ideal weight. Eat less sweet food and pure sugar to reduce daily cholesterol intake. Cholesterol intake should not exceed 300mg/day, or less than 100mg/per kcal total calories. More aquatic fish can be used because of its excellent protein, easy to digest and absorb, and has a regulatory effect on blood lipids, which is more suitable for the characteristics of the elderly compared with animal meat food, and is beneficial to the prevention and treatment of coronary heart disease.
More beans and soy products should be used, which can ensure the supply of high-quality protein, but also to provide essential fatty acids, to avoid excessive intake of animal food saturated fatty acids and cholesterol, and soybeans also contain lecithin and inorganic salts, which is beneficial to the prevention and treatment of coronary heart disease. Eat more lean meat, fish, eggs, dairy, soybeans or soy products and fresh vegetables and fruits.
2, control the quality and quantity of fat intake. Dyslipidemia is the main risk factor for diabetes complicating macroangiopathy. And high blood fat, high blood sugar, high blood pressure, is the main risk factors of coronary heart disease. To prevent and control coronary heart disease, it is necessary to control blood lipids and reduce the occurrence of atherosclerosis. Dietary cholesterol content will have an impact on lipid metabolism in the body and should be properly controlled. The intake of fat should not exceed 30% of total calories, of which saturated fatty acids should be controlled to account for less than 10% of total calories. Minimize the use of animal offal (pig liver, kidney, brain, roe, etc.) squid, muffin egg, fatty meat, animal fat, butter, cream, whole milk, egg yolk, fatty pork, fatty lamb, fatty beef, butter, lard, butter, coconut oil, etc. Avoid foods containing high cholesterol. Some studies have shown that patients with coronary heart disease can eat egg yolks because they contain both high cholesterol and a large amount of phospholipids, the latter of which can counteract the former and have the effect of inhibiting cholesterol and softening blood vessels. Therefore, patients with coronary heart disease can eat one egg yolk every day, which is very beneficial to human health.
3.Control sugar intake. Carbohydrate is the body’s main source of caloric energy, carbohydrate intake is too much (in our people’s dietary structure is too much staple food), can cause heat into the super, in the body can also be converted into fat, causing obesity, and make the blood lipids rise. Research has proved that the role of carbohydrates in raising blood lipids, fructose is higher than sucrose, sucrose is higher than starch. To strictly control the total carbohydrate intake, especially the control of sugar intake, generally not more than 10% of the total calories is appropriate. Eat compound carbohydrates, and eat less or no simple carbohydrates such as sucrose or glucose.
4, appropriate to increase the intake of dietary fiber, to keep the stool smooth. Dietary fiber can adsorb cholesterol, prevent cholesterol from being absorbed by the body, and promote the discharge of bile acid from the feces to reduce the production of cholesterol in the body, so it can lower blood cholesterol. Therefore, in the diet to prevent and control coronary heart disease, there should be sufficient dietary fiber. If you are overweight (standard weight ± 5 kg is normal), you should further restrict the total calories or increase physical activity appropriately.
5.Advocate eating more fresh vegetables and fruits, consuming soybean products, and consuming liquid vegetable oil. Provide vitamin C, B vitamins and the right amount of dietary fiber. The benefits of eating more vegetables and fruits are that they can replenish the vitamins and inorganic salts needed in the body, but also to facilitate the stool, prevent constipation, vitamin C can promote the generation of cholesterol bile acid, which has the effect of lowering blood cholesterol; can also improve coronary circulation and protect the blood vessel wall. Nolic acid can dilate the peripheral blood vessels and prevent thrombosis; it can also reduce the level of triglycerides in the blood. Vitamin E has antioxidant effect, can prevent unsaturated fatty acid peroxidation, protect the heart muscle and improve myocardial hypoxia, prevent thrombosis. Vegetables are an indispensable food in human diet and are rich in vitamin classes. Such as vitamin C, inorganic salts, fiber and pectin. Where green vegetables or yellow vegetables and fruits contain more carotene, which has an antioxidant effect, vitamin C can affect myocardial metabolism, increase the toughness of blood vessels and make them more elastic, and large doses of vitamin C can make cholesterol oxidized to bile acid and excreted from the body. In addition white vegetables have high iron content, black series are rich in selenium, anthocyanins and trace elements can promote the digestive system and enhance hematopoiesis, red foods all contain beta carotene, and beta carotene together with other red pigments in red vegetables can increase the vitality of cells in the body’s resistance tissue, which is beneficial to the heart and small intestine. In addition, there are many pairs of vegetables with protective effect on the heart, such as onions, garlic, purple flowers, alfalfa, fungus, kelp, shiitake mushrooms, nori, etc.
6, to ensure the necessary supply of inorganic salts and trace elements. Iodine can inhibit the absorption of cholesterol by the intestines and reduce the deposition of cholesterol on the walls of blood vessels, so it can slow down or stop the development of atherosclerosis. Regular consumption of seafood rich in iodine, such as kelp, nori, can reduce the incidence of coronary heart disease. Dietary calcium, magnesium, potassium, sodium, copper, chromium, etc. are also related to the development of coronary heart disease.
7, reduce the intake of sodium, sodium promotes blood circulation, increase the volume of cardiac blood, directly increase the burden on the heart, for coronary heart patients with insufficient blood flow supply to the heart is not good. Control sodium intake if the body sodium intake is too much, water has to increase proportionally, the systemic blood volume also increased, directly increase the burden on the heart, often inducing angina or aggravate the degree of heart failure. Therefore, patients with coronary heart disease, in the diet must limit the intake of salt, using a low-sodium diet, generally not more than 5 g per day. if the patient appears generalized swelling, hepatomegaly, reduced urine volume, respiratory distress, can not lie down, indicating that heart failure has occurred, then the patient should be given a salt-free diet, while strictly control the amount of water, to be improved, and then gradually return to normal diet and water intake.
8, a small number of meals, do not overeat, dinner should not be too full, the best way to use regular, quantitative and small meals. It is best to eat 4 to 5 meals a day, each meal eat eight minutes full, if each meal is too full, so that the stomach cavity is too large, often in a state of tension, it will affect the diaphragm activity. Do not overeat, otherwise it is easy to induce angina or the occurrence of myocardial infarction.
9, quit smoking and limit alcohol. Cigarettes contain nicotine can cause vasoconstriction, which increases blood pressure, increases heart rate, increases myocardial oxygen consumption, reduces heart function, increases the burden on the diseased heart, and is one of the common factors that trigger angina pectoris. Cigarettes can damage the endothelium of blood vessels, leading to thrombosis. Therefore, patients with coronary heart disease are advised to strictly prohibit smoking. Alcohol accelerates the heart rate and can aggravate myocardial hypoxia. Alcohol contains alcohol, which excites the brain and has the effect of promoting blood circulation and helping digestion. If the blood pressure is not high without liver disease and ulcer disease, you can drink a small amount of wine (<30g of alcohol) every morning and evening, which is beneficial to the recovery of coronary heart disease.
In summary, suitable food choices for patients with coronary artery disease are.
(1) Carbohydrates (such as japonica rice, millet, corn), beans and soybean products that contain more fiber.
(2) Fresh vegetables and fruits rich in vitamin C and vitamin P (such as chard, rape, tomatoes, dates, oranges, lemons).
(3) foods containing more vitamin E (such as yogurt, egg whites, deep-sea fish) and high-protein, low-fat foods (lean pork, beef), etc.
Recent studies have shown that volatile oil contained in onion and garlic can prevent coronary heart disease and should also be consumed appropriately. There are also some foods that have a lipid-lowering effect and can be used as adjunctive therapy. Selectable foods such as: fresh mushrooms, yellow croaker, leeks, celery, eggplant, black fungus, walnuts, oats, corn, buckwheat, soybeans, peanuts, barley, black rice, tea, yeast, brown sugar water, mung bean soup; onions, garlic, purple flowers, fungus, kelp, shiitake mushrooms, purple cabbage, eggplant, mushrooms, algae, melon, radish, honey, hawthorn, goldenrod, mung bean sprouts, lentils.
For patients with coronary heart disease, limit salt and do not forget to supplement potassium. Eat more potassium-rich foods such as beans and their products, potatoes, nori, kelp, shiitake mushrooms, mushrooms, yams, spring bamboo shoots, winter bamboo shoots, fungus, buckwheat, and bananas and watermelon. To moderate sodium and protect the heart muscle cells. Eat more foods that can lower blood fat such as milk, goat’s milk, soybeans, adzuki beans, mung beans, fava beans, peas, lentils, kidney beans, bean sprouts, carrots, cauliflower, leeks, garlic, onions, onions, ginger, tomatoes, fresh mushrooms, purple cabbage, fish, citrus, apples, hawthorn, etc.
Coronary heart disease diet recommended food of fruits – hawthorn, citrus, pomegranate, grapes, apples. Eating vegetables and fruits is better for the heart. Fruits and cereals like fiber is sufficient, and fruits have the additional advantage that vitamins and trace elements are also sufficient. The most recent studies have found that fiber intake from cereals and fruits is most effective in reducing the risk of death from coronary heart disease, but there is little association between fiber intake from vegetables and coronary heart disease incidence and mortality. The above-mentioned fruits are all fruits that have a special effect on blood stasis and prevention of atherosclerosis.
Recommended foods for coronary heart disease diet of meat – sea fish, fatty fish, fish scales, salmon, lean meat. Heart disease patients diet in the consumption of meat when the sea fish is the most appropriate. Fish is rich in magnesium, which has a good protective effect on the cardiovascular system and is conducive to the prevention of hypertension, myocardial infarction and other cardiovascular diseases. Sea fish is the best.
Coronary heart disease diet recommended food of nuts – goji berries, hazelnuts, pine nuts, pistachios, almonds. Nuts it has a high nutritional value, is a good food to prevent heart disease. Rich in monounsaturated fatty acids and plant sterols, help reduce the human blood “bad cholesterol” (low-density cholesterol). And there are many nuts, such as pecans, walnuts, almonds, peanuts, etc. contain ellagic acid, can inhibit the growth of cancer cells. Nuts also contain a variety of health benefits of vitamin E, B complex and minerals, vitamin E is a well-known antioxidant, can prevent cell aging.
Foods that should be eaten sparingly or not are.
(1) foods high in fat: such as fatty meats.
(2) Foods high in cholesterol: such as animal offal, pork skin, crab meat, full-fat dairy, bacon and snails and squid in aquatic products.
(3) Foods with high sugar content and high calorie content: such as ice cream, chocolate, cream, sucrose, honey, etc. (4) Stimulating foods:such as chili, pepper, mustard, white wine, strong tea, etc. Finally, the intake of salt should also be appropriately limited to less than 5g per day
① animal fats, such as lard, butter, mutton fat, chicken fat, etc.
②Fatty meat, including fatty meat from pigs, cattle and sheep.
③ brain, bone marrow, offal, egg yolk, fish roe.
④ mollusks and shellfish.
⑤ sugar, alcohol, tobacco, chocolate, etc.
Coronary heart disease contraindicated food.
1, sheep marrow: because of the high cholesterol content in the brain marrow of sheep, should not eat more often to avoid aggravating the disease.
2, fatty meat: easy to make the body fat excess animal accumulation, blood lipid elevation, leading to atherosclerosis.
3, pig liver: contains cholesterol more than three times higher than that of pork fat, should not eat more, so as not to aggravate the disease.
4, pig kidney: contains high cholesterol, where suffering from cardiovascular disease, one of the avoid eating pig kidney, so as not to aggravate the disease.
5, duck eggs: contains a large amount of cholesterol (especially the yolk), is no exception, so one of the atherosclerosis should be avoided, will aggravate coronary heart disease and atherosclerosis.
6, goose meat: goose meat, goose eggs are big hair food, are high fat and high cholesterol food, so, where atherosclerosis should be avoided;.
7, liquor, beer, smoking, coffee are aggravating the disease.
Third, drug guidance
Patients with hypertension and coronary heart disease need to take long-term medication. Follow the doctor’s instructions not to arbitrarily stop or increase or decrease, in the process of medication, learn to self-monitoring, such as the use of anticoagulant aspirin, should be taken with warm water after meals, gum bleeding, vomiting, black stool and skin bleeding spots immediately stop; use diuretics, pay attention to the amount of urine, abnormalities at any time to seek medical advice. When you go out, you should carry nitroglycerin with you, and when you are at home, you should put it in an easily accessible place and position it, and your family should know about it, so that you can get it in time when you have an attack; β-blockers and calcium channel blockers together will have the danger of heart suppression, learn to measure your pulse, and if your pulse is less than 60 times/min, you should suspend taking the medicine and go to the hospital.
Fourth, activity in rest guidance
Middle-aged and elderly people have increased intake and reduced energy consumption, which can easily cause obesity and another cause of coronary heart disease. According to the patient’s physical condition and endurance, you can choose activities such as walking, jogging, cycling and tai chi. Try it at first and slowly increase the amount of exercise. Generally, after 5~15 minutes of activity, the heart rate should not exceed 100 beats per minute. The amount of exercise varies from person to person, step by step, and persistently. This exercise can not only improve physical fitness, increase exercise endurance, but also change the original condition of the heart, while contributing to weight loss, lowering fat, lowering blood pressure. Participate in appropriate physical work and sports activities, such as walking, playing tai chi, doing radio exercises, etc.
Bed rest is required for one week in the acute stage, the purpose of which is to reduce the oxygen consumption of the heart muscle and prevent the aggravation of the disease. The importance of bed rest should be emphasized even more for those who do not have severe pain when myocardial infarction occurs. Maintain a certain daily sleep routine, exclude distractions, rest at ease, and ensure that the surrounding environment is quiet, comfortable and ventilated during sleep.
V. Life guidance
1, keep the patient’s stool smooth: acute bed rest bed when the stool is forbidden to force too hard, you can routinely give the patient laxative to prevent the force and induced myocardial infarction. In addition, daily diet with more coarse fiber. If the patient is in the chronic phase emphasizes appropriate daily light exercise to increase bowel movement and facilitate defecation.
2, establish a good lifestyle: maintain optimism, avoid excitement. Pay attention to the regularity of life, relax the spirit, happy life, keep the mood calm. Pay attention to maintenance, with the weather changes in time to increase and reduce clothing, cold days pay attention to warmth to avoid cold wind stimulation.
3, alert to unexplained pain: coronary heart disease to angina type, myocardial infarction type is the most common. Angina is often manifested as crushing pain in the upper part of the sternum, tightness, choking sensation and chest pain gradually aggravated, and several minutes to reach a climax and other symptoms; myocardial infarction is caused by a sharp reduction or interruption of coronary blood supply, so that the corresponding myocardium severe and persistent acute ischemia.