Nutrition After a Cardiovascular Event

What’s Best and Why?

In this edition of Patient Pulse, we’re pleased to welcome Dr. Sara Folta for a discussion on nutrition after a cardiovascular event. Dr. Folta is an Associate Professor and Associate Dean for Diversity and Inclusion at the Friedman School of Nutrition Science and Policy at Tufts University. Her research interests focus on community-based strategies for improving diet, physical activity, and weight. A major line of her research involves community-based interventions to improve heart health among women. 

In this webinar, Dr. Folta addresses:

• The evidence around which eating patterns work to prevent cardiovascular events

• What the recommended eating patterns actually look like

• Practical strategies to shift your eating pattern

• Eating on a budget

Key Takeaways

• The DASH and Mediterranean diets are proven heart-healthy eating patterns.

• To make sustainable changes to your eating habits, choose one change to focus on first, such as “I will add a serving of vegetables to each meal for the next 3 weeks.”

• Assess, revise, and reassess your goals and eating patterns over time to see if they’re working for you.

• Practice CART to maximize your food budget:

  • Cook more, coupons, canned and frozen foods (be mindful of sodium), cut the amount of olive oil you use to save money (or use canola oil)

  • Avoid ready-to-eat and highly processed foods

  • Recipes and menu planning

  • Try to go meatless

Overview: Dr. Folta discusses the best eating patterns for preventing cardiovascular events based on current scientific evidence. The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets have shown the most promise for primary and secondary prevention [1, 2]. These diets emphasize vegetables, fruits, whole grains, nuts, legumes, moderate amounts of fish, and low-fat dairy while minimizing red and processed meats, refined grains, and added sugars. The Tufts-developed HEART acronym summarizes these key components: Heap on vegetables and fruits, Emphasize the right fats, Accentuate whole grains, Revere dairy in moderation, and Target heart-healthy proteins [3]. Popular diets like Keto and Paleo, while having some positive aspects, often eliminate beneficial food groups and can be difficult to sustain, expensive, and potentially harmful [4, 5]. Making gradual, achievable changes using SMART goals is the most effective approach to long-term dietary modifications [6]. Strategies for eating heart-healthy on a budget include using canned or frozen seafood and produce, planning meals around sales and coupons, and incorporating more plant-based foods [7].

Key Points:

1. The Mediterranean and DASH diets, which emphasize vegetables, fruits, whole grains, nuts, legumes, moderate fish, and low-fat dairy, have the most evidence for cardiovascular event prevention [1, 2].

2. The Tufts-developed HEART acronym summarizes key components of a heart-healthy diet: Heap on vegetables and fruits, Emphasize the right fats, Accentuate whole grains, Revere dairy in moderation, and Target heart-healthy proteins [3].

3. Popular diets like Keto and Paleo often eliminate beneficial food groups, can be difficult to sustain, expensive, and potentially harmful due to nutrient deficiencies or health risks [4, 5].

4. Gradual, achievable dietary changes using SMART goals are most effective for long-term success [6].

5. Strategies for eating heart-healthy on a budget include using canned or frozen seafood and produce, planning meals around sales and coupons, and incorporating more plant-based foods [7].

References:

1. Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M. I., Corella, D., Arós, F., ... & Martínez-González, M. A. (2018). Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. New England Journal of Medicine, 378(25), e34. https://doi.org/10.1056/NEJMoa1800389

2. Siervo, M., Lara, J., Chowdhury, S., Ashor, A., Oggioni, C., & Mathers, J. C. (2015). Effects of the Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a systematic review and meta-analysis. British Journal of Nutrition, 113(1), 1-15. https://doi.org/10.1017/S0007114514003341

3. Tufts University. (n.d.). Eating by Heart. Retrieved April 19, 2023, from https://hnrca.tufts.edu/flipbook/eating-by-heart/

4. Seidelmann, S. B., Claggett, B., Cheng, S., Henglin, M., Shah, A., Steffen, L. M., ... & Solomon, S. D. (2018). Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet Public Health, 3(9), e419-e428. https://doi.org/10.1016/S2468-2667(18)30135-X

5. Genoni, A., Lyons-Wall, P., Lo, J., & Devine, A. (2016). Cardiovascular, metabolic effects and dietary composition of ad-libitum Paleolithic vs. Australian guide to healthy eating diets: a 4-week randomised trial. Nutrients, 8(5), 314. https://doi.org/10.3390/nu8050314

6. Bovend'Eerdt, T. J., Botell, R. E., & Wade, D. T. (2009). Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide. Clinical Rehabilitation, 23(4), 352-361. https://doi.org/10.1177/0269215508101741

7. Monsivais, P., Aggarwal, A., & Drewnowski, A. (2011). Following federal guidelines to increase nutrient consumption may lead to higher food costs for consumers. Health Affairs, 30(8), 1471-1477. https://doi.org/10.1377/hlthaff.2010.1273