Risk Factors for Heart Disease

Heart disease includes coronary artery disease, which involves damage to the arteries. It also includes congestive heart failure and other heart issues. The coronary arteries provide the oxygen your heart needs to pump blood to the rest of your body.

A risk factor is something that increases your chance of having a disease. Risk factors such as smoking or high cholesterol levels can damage arteries. You can’t control some heart risk factors. These include your age or having a family history of heart disease. But there are many heart risk factors you can control. This can reduce your risk for heart disease.

Unhealthy cholesterol levels

Cholesterol is a fatlike substance in your blood. It can build up along the artery walls. This is called plaque. Over time, plaque narrows the arteries. This reduces blood flow to your heart or brain. If a blood clot forms or a piece of plaque breaks off, it can block the artery. This can cause a heart attack or stroke. Your risk for heart disease goes up if you have high levels of LDL ("bad") cholesterol. Or if you have high levels of triglycerides. This is another fatty substance that can build up. You’re also at risk if you have low HDL ("good") cholesterol. HDL helps clear the bad cholesterol away. You're at risk if you have any of these: 

• HDL cholesterol of 40 mg/dL or lower

• LDL cholesterol of 100 mg/dL or higher

• Triglycerides of 150 mg/dL or higher

Unhealthy diet

Diets high in saturated fats, trans fats, and cholesterol have been linked to heart disease and coronary artery disease. By cutting back on saturated fat and trans fat, you can lower your LDL ("bad") cholesterol and triglyceride levels. LDL is one of the main substances that causes heart attacks. Stay away from most trans fatty acids by eating less of these foods:

• Margarine

• Cookies

• Crackers

• French fries

• Doughnuts

• Other snack foods that have partially hydrogenated oils

Replace less healthy foods by eating a diet with a lot of:

• Fruits

• Legumes

• Vegetables

• Whole grains

• Nuts

• Lean fish or lean animal protein

Drinking too much alcohol also raises the risk for heart disease. It can raise blood pressure levels. And it raises triglyceride levels.

Smoking

This is the most important risk factor you can change. You’re at risk if you use any kind of tobacco or nicotine. This includes:

• Cigarettes

• E-cigarettes

• Chew tobacco

• Cigars

• Pipe

If you smoke, it's never too late to help your heart. Ask your healthcare provider about nicotine replacement products and smoking-cessation support. Quitting smoking is the single biggest way to reduce your risk for coronary artery disease.

High blood pressure

High blood pressure occurs when blood pushes too hard against artery walls. This damages the artery walls. Scar tissue forms as it heals. This makes the arteries stiff and weak. Plaque sticks to the scarred tissue. This narrows and hardens the arteries. High blood pressure also makes your heart work harder to get blood out to the body. It raises your risk for heart attack and especially stroke. The brain tissue is very sensitive to high blood pressure damage. You're at risk if your blood pressure is 120/80 or higher. Experts now label blood pressure between 130 to 139/80 to 89 as stage 1 hypertension.

Chronic kidney disease

Chronic kidney disease is another cardiac risk factor. Talk with your healthcare provider about ways to control kidney disease if you have it.

Negative emotions

Chronic stress, pent-up anger, and other negative emotions have been linked to heart disease. This is because stress increases the levels of a hormone that raises the demand on your heart. Over time, these emotions could raise your heart disease risk.

Metabolic syndrome

This is caused by a mix of certain risk factors. It puts you at extra high risk for heart disease, stroke, and diabetes. You have metabolic syndrome if you have 3 or more of these:

• Low HDL cholesterol

• High triglycerides

• High blood pressure

• High blood sugar

• Extra weight around the waist

Diabetes

Diabetes occurs when you have high levels of sugar (glucose) in your blood. This can damage arteries if not kept under control. Having diabetes also makes you more likely to have a silent heart attack—one without any symptoms.

The A1C test is a common blood test that diagnoses type 1 and type 2 diabetes. It can also check how well you are managing diabetes. If your A1C level is between 5.7 and 6.4, you have prediabetes. Once your A1C reaches 6.5, you have diabetes. Your healthcare provider will help you figure out what your A1C should be. Your target number will depend on your age, general health, and other factors. Your treatment plan may need changes if your current number is too high.

Extra weight

Extra weight makes other risk factors, such as diabetes, more likely. Extra weight around the waist or stomach increases your heart disease risk the most.

You're at risk if your:

• Waist measures more than 35 inches (women) or 40 inches (men)

• Body mass index (BMI) is higher than 25

Lack of physical activity

Experts recommend at least 150 minutes of moderate-intensity physical activity per week for substantial health benefits. You're at risk if you exercise less than 30 minutes per day, on fewer than 5 days a week.

When you’re not active, you’re more likely to develop diabetes, high blood pressure, high cholesterol levels, and extra weight.

Most people with heart disease have more than one risk factor. As your number of risk factors increases, so does your risk for heart disease and coronary artery disease. Talk with your healthcare provider about your heart risk factors. Find out how you can improve them or remove them completely.

Discharge Instructions for Heart Attack

You have had a heart attack (acute myocardial infarction). A heart attack occurs when a vessel that sends blood to your heart suddenly becomes blocked. This causes your heart not to work as well as it should. Follow these guidelines for home care and lifestyle changes.

At home

• Check that you have a list of all the medicines you take. Take your medicines exactly as directed. Make sure you've been given instructions about your medicines and how to take them. Make sure you have a pharmacy so you can get the prescription filled. Don’t skip doses. Talk with your healthcare provider if your medicines aren't working for you. Together you can come up with another treatment plan.

• Remember that recovery after a heart attack takes time. Plan to take it easy for at least 4 to 6 weeks while you recover. Then return to normal activity when your doctor says it’s OK.

• Ask your doctor about joining a heart rehab program. This can help strengthen your heart and lungs and give you more energy and confidence.

• Tell your doctor if you are feeling depressed. Feelings of sadness are common after a heart attack. But it's important to speak to someone or seek counseling if you are feeling overwhelmed by these feelings. These feelings most often pass within a month.

• Call 911 right away if you have chest pain or pain that goes to your shoulder, neck, or back.  Don't drive yourself to the hospital.

• Ask your family members to learn CPR. This is an important skill that can save lives when it's needed.

• Learn to take your own blood pressure and pulse. Keep a record of your results. Ask your doctor when you should seek emergency medical attention. They will tell you which blood pressure reading is dangerous.

Lifestyle changes

Your heart attack was likely caused by heart disease. Your healthcare provider will work with you to make changes to your lifestyle. This will help the heart disease from getting worse. These changes will most likely be a combination of diet and exercise.

Diet

Your healthcare provider will tell you what changes you need to make to your diet. You may need to see a registered dietitian for help with these diet changes. These changes may include:

• Cutting back on how much fat and cholesterol you eat

• Cutting back on how much salt (sodium) you eat, especially if you have high blood pressure

• Eating more fresh vegetables and fruits

• Eating lean proteins such as fish, poultry, beans, and peas, and eating less red meat and processed meats

• Using low-fat dairy products

• Using vegetable and nut oils in limited amounts

• Limiting how many sweets and processed foods such as chips, cookies, and baked goods you eat

• Limiting how often you eat out. And when you do eat out, making better food choices.

• Not eating fried or greasy foods, or foods high in saturated fat

Exercise

Your healthcare provider may tell you to get more exercise if you haven't been physically active. Depending on your case, your provider may recommend an exercise program that is best for you. Warm up 5 to 10 minutes before exercising and cool down 5 to 10 minutes after exercising.

The cardiac rehab program

Ask your healthcare provider about a cardiac rehab program. Cardiac rehabilitation is a medically supervised program to help people who have heart disease. It's designed to improve heart recovery and your ability to function. It also helps prepare you for activities of daily living. People in this program may have recently had a heart attack or heart surgery. It may ease your symptoms and improve your sense of well-being. Your cardiac rehab program is designed to meet your needs. It's overseen by a cardiac doctor and a team of cardiac health providers. Your program may last from 6 weeks to up to a year.

The goal of cardiac rehab is to help ease your symptoms and make your heart as healthy as possible. Your program may include:

• Exercise program. This makes you more fit, and helps your heart work better.

• Classes to help you change your lifestyle and habits.  For example, classes and support to help you quit smoking. Or you may take a nutrition class to learn how to eat better.

• Stress management. You will learn how to manage stress to lower your anxiety.

• Counseling. This will help you learn about your specific condition and how to live with it.

• Occupational therapy. This is to help you get ready to go back to work or to manage normal activities of daily living.

Other changes

Your healthcare provider may also recommend that you:

• Lose weight. If you are overweight or obese, your provider will work with you to lose extra pounds. Making diet changes and getting more exercise can help. A good goal is to lose your 10% of your body weight in one year.

• Stop smoking. Sign up for a stop-smoking program to make it more likely for you to quit for good. You can join a stop-smoking support group. Or ask your doctor about nicotine replacement products or medicines to help you quit.

• Learn to manage stress. Stress management techniques to help you deal with stress in your home and work life. This will help you feel better emotionally and ease the strain on your heart.

• Control other conditions. If you have diabetes, high blood pressure, kidney disease, or high cholesterol, your provider will work with you to control these diseases. All of these are risk factors for heart attacks.

Follow-up

Check that you have the details about all of your medical appointments once you leave the hospital. Or make a follow-up appointment as directed.

Call 911

Call 911 right away if you have:

• Chest pain or pain that goes to your neck, jaw, back, or shoulder

• New shortness of breath

When to call your healthcare provider

Call your healthcare provider right away if you have:

• Lightheadedness, dizziness, or fainting

• Feeling of irregular heartbeat or fast pulse

Heart Disease Education

• The heart beats 60 to 100 times per minute, 24 hours a day. This equals almost 100,000 times a day. It pumps blood with oxygen and nutrients to the tissues and organs of the body. But the heart is a muscle and needs its own supply of blood. Blood flow to the heart is supplied by the coronary arteries. Coronary artery disease (atherosclerosis) is a result of cholesterol, saturated fat, and calcium deposits (plaques) that build up inside the walls. This causes inflammation within the coronary arteries. These plaques narrow the artery and reduce blood flow to the heart muscle. The reduction in blood flow to the heart muscle decreases oxygen supply to the heart. If the narrowing is significant enough, the oxygen supply to 1 or more regions of the heart can be temporarily or permanently shut down. Sometimes the plaque can burst open (rupture), exposing the materials in the plaque to the bloodstream. This can lead to a blood clot suddenly forming on top of the plaque that interrupts blood flow to the heart muscle. This can cause chest pain (angina) and possibly death of heart tissue (heart attack).

• Types of chest pain

• Angina is the name for pain in the heart muscle. Angina is a warning sign of serious heart disease. When untreated, it can lead to a heart attack, also known as acute myocardial infarction, or AMI. Angina occurs when there is not enough blood and oxygen flowing to the heart for the amount of work it is doing. This most often happens during physical exertion, when the heart is working hardest. It is usually relieved by rest or nitroglycerin. Angina may also occur after a large meal, when extra blood is sent to the digestive organs and less goes to the heart. In the case of advanced or unstable heart disease, angina can occur at rest or awaken you from sleep. Angina usually lasts from a few minutes up to 20 minutes or more. When treated early, the effects of angina can be reversed without permanent damage to the heart. Angina is a serious condition and needs to be evaluated by a medical professional immediately.

• There are 2 types of angina—stable and unstable:

• Stable angina. This often occurs with a predictable level of activity. Being stable, its character, severity, and occurrence don't change much over time. It often starts with activity and resolves with rest or taking your medicine as instructed by your healthcare provider. The symptoms usually don't last long.

• Unstable angina. This changes or gets worse over time. It is different from whatever you are used to. It may feel different or worse, begin without cause, occur with exercise or exertion, wake you up from sleep, and last longer. It may not respond in the same way as it does when you take your usual medicines for an attack. This type of angina can be a warning sign of an impending heart attack. 

• A heart attack is often the result of a blood clot that suddenly forms in a coronary artery that has been narrowed with plaque. When this occurs, blood flow may be cut off to a part of the heart muscle, causing the cells to die. This weakens the pumping action of the heart, which affects the delivery of blood to all the other organs in the body, including the brain. If not treated immediately, this damage will become permanent. The earlier that treatment is given, the better chance that the heart muscle can be saved.

• The pain you feel with angina and a heart attack may have a similar quality. However, it is usually different in intensity and duration. Here are some typical descriptions of a heart attack:

• It's most often felt as a squeezing, crushing, pressure-like sensation in the center of the chest.

• It's sometimes described as “something heavy sitting on my chest.”

• It may feel more like a bad case of indigestion.

• The pain may spread from the chest to the arm, shoulder, throat, or jaw.

• Sometimes the pain isn't felt in the chest at all, but only in the arm, shoulder, throat, or jaw.

• There may also be nausea, vomiting, dizziness or light-headedness, sweating, and trouble breathing.

• Unexplained weakness

• You may not be able to tell the difference between "bad" angina and a heart attack at home. Get help if your symptoms are different than usual. Don't be in denial or just try to tough it out.

• Call 911

• It's important to call 911. This is the fastest and safest way to get to the ER. Don't delay. You may be having a heart attack. The paramedics can also start treatment on the way to the hospital. This saves valuable time for your heart.

• Call 911 right away if any of these occur:

• The angina gets worse

• The angina continues after taking a nitroglycerin tablet or using nitroglycerin spray

• The angina stops and returns

• Other reasons to call 911

• Don't wait until symptoms become severe to call 911. Other reasons to call 911 include:

• Trouble breathing

• Feeling lightheaded, faint, or dizzy

• Rapid heartbeat

• Slower than usual heart rate compared to your normal

• Angina with weakness, dizziness, fainting, heavy sweating, nausea, or vomiting

• Extreme drowsiness, confusion

• Weakness of an arm or leg or 1 side of the face

• Trouble with speech or vision

• After you call 911

• After you call 911:

• Take a second nitroglycerin tablet or spray unless instructed otherwise. When repeating doses, sit down, if possible, because it can make you feel lightheaded or dizzy.

• Wait another 5 minutes. If the angina still doesn't go away, take a third nitroglycerin tablet or spray. Don't take more than 3 tablets or sprays within 15 minutes.

• Stay on the phone with 911 for more instructions.

• Note: Your healthcare provider may give you slightly different instructions than those above. If so, follow them carefully.

• When to get medical care

• Remember, the signs and symptoms of a heart attack are not always like they are on TV. Sometimes, they are not so obvious. You may only feel weak, or just not right. If it is not clear or if you have any doubt, call for advice.

• Get help if there's a change in the type of pain, if it feels different, or if your symptoms are mild.

• Don't drive yourself. Have someone else drive you. If no one can drive, call 911.

• Don't delay. Fast diagnosis and treatment can prevent or limit the amount of heart damage during a heart attack.

• Don't go to your healthcare provider's office or a clinic. They may not be able to provide all the testing and treatment required for this condition.

• If your provider has given you medicine to take when symptoms occur, take them. But don't delay getting help trying to locate medicines.

• What happens in the emergency room (ER)

• The emergency room (ER) is connected to your local emergency medical system (EMS) through 911. That's why during a cardiac emergency, calling 911 is the fastest way to get help. The goal of the ER is to quickly screen, evaluate, and treat people.

• Once you're there, an electrocardiogram (ECG) will be done. Often this will be done by paramedics who will send it to the hospital even before you get to the ER. Blood samples may be taken. These look for the presence of heart enzymes that leak from damaged heart cells and show if a heart attack is occurring. You'll often be evaluated by a heart specialist (cardiologist) who decides the best course of action. In the case of severe angina or early heart attack, and depending on the circumstances, powerful clot-busting medicines can be used to dissolve blood clots in the coronary artery.

• In most cases, you may be taken to a cardiac catheterization lab for emergency angiography and coronary intervention. During this procedure, a long, thin, plastic tube (catheter) is put in an artery in your groin or arm. It's threaded through the blood vessel to the blockage. Blood flow will be evaluated. If a significant blockage is seen, a balloon and metal mesh coil (stent) may be inserted. This is done to open the artery and restore blood flow. 

• Risk factors for heart disease

• Some risk factors for heart disease can be modified. Others can't be changed, such as your family history. Many risk factors work by either directly or indirectly damaging the blood vessels of the heart, or by increasing the risk of forming blood or cholesterol clots, which then clog up and block the arteries.

• Examples of physical lifestyle risk factors:

• Cigarette smoking or tobacco use

• High blood pressure

• High blood cholesterol

• Use of stimulant drugs such as cocaine, crack, and methamphetamine

• Eating high-fat, high-cholesterol foods

• Diabetes

• Overweight and obesity, which increases the risk for diabetes and high blood pressure

• Lack of regular physical activity 

• Examples of emotional lifestyle factors:

• Chronic high stress levels release stress hormones. These raise blood pressure and cholesterol levels and make blood clot more easily.

• Held-in anger, hostile or cynical attitude

• Social and emotional isolation, lack of intimacy

• Loss of relationship

• Depression

• Other factors that increase the risk of heart attack that you can't control:

• Age. The older you get beyond 40, the greater your risk is of significant coronary artery disease.

• Gender. More men than women get heart disease. But after menopause, a woman's risk of heart disease dramatically increases.

• Family history. If your mother, father, brother, or sister has coronary artery disease, your risk of having it is higher than a person your age without this family history.

• What you can do to decrease your risk

• To reduce your risk for heart disease:

• Get regular checkups with your healthcare provider.

• Take your medicines for blood pressure, cholesterol, or diabetes as directed.

• Watch your diet. Eat a heart-healthy diet, choosing fresh foods, less salt, cholesterol, and fat.

• Stop smoking. Get help if needed.

• Stop using illegal drugs.

• Get regular exercise.

• Manage stress.

• Ask your provider if they advise behavioral counseling to promote a healthy diet and physical activity.

Taking Your Medicines After a Heart Attack

You'll likely need to take several types of medicines after a heart attack. You may wonder: Do I really need to take so many medicines? The answer is yes. Medicine can be a vital part of healing. They can also help prevent another heart attack in the future. Be sure to take all medicines as directed.

Getting started

• Keep a list of all your medicines. Know what they are, what they do, what happens if you don't take them, and how to take them. Keep that list with you at all times.

• Know what side effects to expect. If a side effect bothers you, doesn't go away, or gets worse, call your healthcare provider.

• Ask your provider or pharmacist about possible interactions between medicines. Check before taking any over-the-counter medicine, herbs, or supplements.

• Try to get all prescriptions filled at the same pharmacy. This will help reduce the risk of interactions between medicines.

• Talk to your provider if you have any concerns about the cost of medicines. A lot of pharmacies offer free or low-cost prescriptions for generic medicines. It's important that you take all of them or find alternatives if you can't afford them.

Types of medicines

• Antiplatelet and anticoagulant medicines. These help prevent blood clots.

• ACE inhibitors or ARBs (angiotensin receptor blockers) . These help control blood pressure and reduce heart strain and weakening of the heart muscle. They also help with heart remodeling and lowers risk for future heart attack.

• Statins. These help reduce cholesterol levels.

• Beta blockers. These help slow the heart rate and lower blood pressure. They can also help the heart pump more effectively.

• Nitroglycerin. This helps reduce the heart's workload and improves blood flow through the heart.

Hints for taking medicines

• Use a pillbox to store all the pills you need for the week.

• To be sure you don't skip or repeat a dose, write down when you take your medicine.

• Consider downloading a medicine app to your smartphone.

• Don't stop taking your medicines. This can be dangerous to your heart.

• Be sure to refill a prescription before it runs out.

• Take your medicines at the same time every day.

• Be sure your healthcare provider knows all your medicines you are taking. This includes over-the-counter medicines and supplements.

• Talk with your healthcare provider about your medicines and possible side effects. Let your provider know if you have any side effects. They may change the dosage or schedule to reduce effects. Your feedback will help the healthcare provider find the best medicine plan for you.

Medicines for related conditions

• Blood pressure medicines. High blood pressure is one of the most serious risks for heart attack. Medicine is likely needed to help manage this problem. It might take time to find the best medicine for you. For best results, follow these tips:

• Don't stop taking high blood pressure medicine suddenly. This can make your blood pressure shoot up quickly.

• Keep in mind that medicine works best when you're also eating heart-healthy foods, limiting sodium (salt), and getting regular exercise.

• Diabetes or high cholesterol medicine.  If healthy eating and physical activity aren't enough to manage these conditions, your healthcare provider may prescribe medicines to treat them. Be sure to take them as directed

How to Quit Smoking

Smoking is a hard habit to break. About half of all people who've ever smoked have been able to quit. Most people who still smoke want to quit. Here are some of the best ways to stop smoking.

Keep in mind how quitting can help your health

The health benefits of quitting start right away. They keep improving the longer you go without smoking. Knowing this can help inspire you to stay on track. These benefits occur at any age. Quitting is a good choice whether you are 17 or 70. Some of the health benefits after your last cigarette include:

• After 20 minutes:  Your blood pressure and pulse return to normal.

• After 8 hours: Your oxygen levels return to normal.

• After 2 days: Your ability to smell and taste start to get better as damaged nerves regrow.

• After 2 to 3 weeks: Your circulation and lung function get better.

• After 1 to 9 months: You have less coughing, congestion, and shortness of breath. You feel less tired.

• After 1 year: Your risk of heart attack goes down by 50%.

• After 5 years: Your risk of lung cancer goes down by 50%. Your risk of stroke becomes the same as a nonsmoker’s.

What about going cold turkey?

You may have heard about quitting "cold turkey." This means stopping all at once. Going cold turkey is an option. But it's not the most successful way to quit smoking. Trying to cut back slowly often doesn't work as well either. This may be because it continues the habit of smoking. You may also inhale more smoke while smoking fewer cigarettes. This leads to the same amount of nicotine in your body.

But quitting cold turkey or cutting back slowly aren't your only choices. Using tobacco cessation medicines with behavioral counseling may be a better choice to help you succeed. Talk with your provider about your choices for support while you quit smoking.

Get support

Support programs can be a big help, especially for heavy smokers. These groups offer information, ways to change behavior, and peer support. Ask your provider for some resources. Here are some other ways to find support:

• Smokefree.gov at www.smokefree.gov or 800-QUIT-NOW (800-784-8669)

• American Lung Association at www.lung.org/quit-smoking or 800-586-4872

• American Cancer Society at www.cancer.org/quitsmoking or 800-227-2345

Support at home is important too. Family and friends can offer praise and reassurance. Ask your friends who smoke to support your decision. Try to stay away from situations that trigger the desire to smoke. This may include smoking with your morning coffee. Or smoking after a meal. Create new routines to help decrease your cravings.

If the smoker in your life finds it hard to quit, encourage them to keep trying. Remind them of all of the benefits to themselves and people they love.

Try over-the-counter nicotine replacements

Nicotine replacement therapy may make it easier to quit. You can buy some aids without a prescription. These include a nicotine patch, gum, and lozenges. But it's best to use these under the care of your healthcare provider. The skin patch gives a steady supply of nicotine. Nicotine gum and lozenges give short-time doses of low levels of nicotine. Both methods reduce the craving for cigarettes. If you have upset stomach (nausea), vomiting, dizziness, weakness, or a fast heartbeat, stop using these products and see your provider.

Ask about prescription medicine

After reviewing your smoking patterns and past attempts to quit, your provider may offer a prescription medicine. These include bupropion, varenicline, a nicotine inhaler, or nasal spray. Each has advantages and side effects. Your provider can go over these with you.

Keep trying

Most smokers try to quit many times before they succeed. It’s important not to give up.

Eating Heart-Healthy Foods

Eating has a big impact on your heart health. In fact, eating healthier can improve several of your heart risks at once. For instance, it helps you manage weight, cholesterol, and blood pressure. Here are ideas to help you make heart-healthy changes without giving up all the foods and flavors you love.

Getting started

• Talk with your healthcare provider about eating plans, such as the DASH or Mediterranean diet. You may also be referred to a dietitian. Ask a partner, family member, or friend to join you for mutual support.

• Change a few things at a time. Give yourself time to get used to a few eating changes before adding more.

• Work to create a tasty, healthy eating plan that you can stick to for the rest of your life.

Goals for healthy eating

Below are some tips to improve your eating habits:

• Limit saturated fats and trans fats. Saturated fats raise your levels of cholesterol, so keep these fats to a minimum. They are found in foods such as fatty meats, whole milk, cheese, and palm and coconut oils. Avoid trans fats because they lower good cholesterol as well as raise bad cholesterol. Trans fats are most often found in processed foods, such as pastries, cookies, pies, muffins, fried foods, stick margarines, and shortening.

• Reduce how much sodium (salt) you have. Eating too much salt may increase your blood pressure. Limit your sodium intake to 2,300 milligrams (mg) per day (the amount in 1 teaspoon of salt), or less if your healthcare provider recommends it. Dining out less often and eating fewer processed foods are two great ways to decrease the amount of salt you consume. At home, flavor your foods with other spices and herbs instead of salt.

• Managing calories. A calorie is a unit of energy. Your body burns calories for fuel, but if you eat more calories than your body burns, the extras are stored as fat. Your healthcare provider or dietitian can help you create a diet plan to manage your calories. This will likely include eating healthier foods and getting regular exercise. To help you track your progress, keep a food diary to record what you eat and how often you exercise.

Choose the right foods

Aim to make these foods staples of your diet. If you have diabetes, you may have different recommendations than what is listed here:

• Fruits and vegetables provide plenty of nutrients without a lot of calories. At meals, fill half your plate with these foods. Choose between fresh, frozen, canned, or dried fruits and vegetables without added sauces, salt, or sugars. Split the other half of your plate between whole grains and lean protein.

• Whole grains are high in fiber and rich in vitamins and nutrients. Good choices include whole-wheat bread, pasta, oats, and brown rice. Make at least half of your grains whole grains.

• Lean proteins give you nutrition with less fat. Good choices include fish, skinless chicken and turkey, and beans. Draining the fat from cooked ground meat is another way to reduce the amount of fat you eat.

• Low-fat and nonfat dairy provide nutrients without a lot of fat. Try low-fat or nonfat milk, cheese, or yogurt.

• Healthy fats can be good for you in small amounts. These are unsaturated fats, such as olive oil, avocado, nuts, and fish. Try to have at least 2 servings per week of fatty fish, such as salmon, sardines, mackerel, rainbow trout, and albacore tuna. These contain omega-3 fatty acids, which are good for your heart. Flaxseed and walnuts are other sources of heart-healthy fats.

More on heart-healthy eating

Read food labels

Healthy eating starts at the grocery store. Be sure to pay attention to food labels on packaged foods. Look for products that are high in fiber and protein and low in saturated fat, added sugars, and sodium. Avoid products that contain trans fat. And pay close attention to serving size. For instance, if you plan to eat 2 servings, double all the numbers on the label.

Prepare food right

A key part of healthy cooking is cutting down on added fat, sugar, and salt. Look on the Internet for lower-fat, lower-sodium recipes without a lot of added sugars. Also try these tips:

• Remove fat from meat and skin from poultry before cooking.

• Skim fat from the surface of soups and sauces.

• Broil, roast, boil, bake, steam, grill, or microwave food without added fats.

• Choose ingredients that spice up your food without adding calories, fat, sugar, or sodium. Try these items: horseradish, hot sauce, lemon zest and juice, garlic, onion, mustard, nonfat salad dressings, and vinegar. Small amounts of olive oil-based vinaigrettes are OK, too. For salt-free herbs and spices, try basil, cilantro, cinnamon, cumin, paprika, pepper, and rosemary.

© 2000-2023 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.