Teach you how to eat to prevent atherosclerosis!

In recent years, the incidence of atherosclerosis has been increasing, but the age of onset has been getting lower and lower. The blood vessels of many teenagers and even children have begun to become stiff.

Atherosclerosis in different parts of the body can cause a variety of serious consequences. For example, coronary artery atherosclerosis can cause angina pectoris, myocardial infarction, and even sudden death; cerebral artery atherosclerosis can cause cerebral ischemia, brain atrophy, or cerebral hemorrhage; and renal artery atherosclerosis can cause renal insufficiency. Therefore, daily prevention and treatment of atherosclerosis is very important.

Polish scholars have found that for atherosclerosis, relying solely on medication without paying attention to improving lifestyle is not conducive to disease control.

The researchers randomly divided 92 patients with coronary heart disease with an average age of 60 into two groups: one was the control group, which was treated only with optimal medication, and the other was the intervention group, which, in addition to medication, was followed up by a nutritionist and intervened with a dietary plan.

After 66.9±13.7 weeks, coronary CT scans were repeated, and the results showed that atherosclerosis in the drug group increased compared with before, while there was no significant change in the comprehensive intervention group.

That is, controlling diet while receiving optimal medical treatment can help slow the progression of atherosclerosis compared to receiving optimal medical treatment alone.

How can we eat to better prevent and treat atherosclerosis?

There is clear evidence that an unhealthy diet can accelerate the occurrence and progression of atherosclerosis directly or indirectly by increasing blood lipids, blood pressure and blood sugar.

Recently, the Journal of Cardiovascular Research published a review summarizing foods that can prevent atherosclerosis. The article believes that foods can be divided into foods that can be eaten in moderation (green), foods that can be eaten in moderation (yellow), and foods that are recommended to be eaten less (red).

Figure 1 Dietary recommendations based on current evidence on the relationship between food and risk of atherosclerosis

Eat less red meat

Studies have shown that red meat and processed meat products can increase the risk of cardiovascular disease. It is recommended to replace part of the red meat with white meat and plant protein sources.

It is recommended that processed meats such as bacon, sausages and salami should only be eaten occasionally.

It is also recommended to eat less unprocessed red meat, such as beef, pork and lamb, no more than twice a week (100 grams each time).

Poultry is lower in fat and healthier than red meat. White meat can be eaten in moderation (up to three portions of 100g per week).

Eat one egg a day

Existing evidence shows that, except for people with hyperlipidemia and diabetes, 6 eggs per week or 1 egg per day is fine for most people. If the dietary structure is high in saturated fatty acids, the weekly egg intake should not exceed 3.

Eating fish can prevent atherosclerosis

It is recommended to eat 2 to 4 servings (150 grams per serving) of fish per week to prevent atherosclerosis.

Drink 200 grams of yogurt every day

Studies have shown that drinking milk, whether whole milk or low-fat milk, in moderation does not increase the risk of cardiovascular disease.

Existing evidence supports drinking a 200-gram glass of milk every day and eating three servings (50 grams each) of cheese per week. In addition, it is recommended to drink 200 grams of low-sugar yogurt every day, which has a certain preventive effect on cardiovascular disease.

Eating beans, nuts and vegetables is good for you

In addition to being rich in protein, beans are also a good source of viscose fiber, which is beneficial to blood lipids, postprandial blood sugar, insulin response, etc. Beans are also rich in a variety of bioactive ingredients (such as folic acid), which can also improve heart metabolism.

Regular consumption of beans, up to four servings of 180 grams per week, may protect against atherosclerosis.

Regular consumption of nuts can reduce the risk of coronary heart disease and death. Meta-analysis shows that consuming 28 g of nuts per day can reduce the risk of coronary heart disease by 28%. Based on dose-response analysis, it is recommended to consume 30 g of nuts per day.

Meta-analysis shows that eating more fruits and vegetables is associated with a lower risk of coronary heart disease. Existing evidence consistently supports the consumption of large amounts of fruits and vegetables in the daily diet, at least 400 grams per day.

Eat less refined carbohydrates

Evidence consistently shows that refined grains and other starchy foods such as potatoes with a high glycemic index (GI) are associated with an increased risk of atherosclerosis, and it is recommended to eat them in small amounts, preferably no more than two servings per week.

It is recommended to replace refined grains with low-glycemic index cereals and whole grains. The more low-glycemic index foods you eat, the lower your risk of atherosclerotic cardiovascular events.

Eat less saturated fat

When it comes to dietary fat intake, studies have shown that olive oil, soybean oil, sunflower oil, safflower oil and corn oil are healthier than butter and animal oils rich in saturated fat.

The daily intake of oils rich in saturated fatty acids should be reduced. Extra virgin olive oil is particularly recommended for primary prevention of atherosclerosis. According to calorie requirements, an average of 25 to 40 grams per day is appropriate.

Limit salt, sugar and alcohol

High salt intake is a well-recognized risk factor for atherosclerosis. Currently, the average daily salt intake for healthy adults is less than 5 grams, but in most populations, salt intake greatly exceeds this standard.

About 80% of our salt intake is hidden in processed and canned foods, such as processed meats, bread and other baked products, and canned foods.

Therefore, in addition to avoiding the addition of salt, only by widely providing low-salt foods can the salt intake of the population be effectively reduced.

Sugary drinks are associated with an increased incidence of coronary heart disease and can increase coronary heart disease mortality and cardiovascular disease morbidity and mortality.

Sugary drinks have adverse effects on blood pressure, dyslipidemia, insulin sensitivity, C-reactive protein, inflammatory cytokines, and serum uric acid concentration. Based on the existing evidence, the intake of sugary drinks should be strictly limited.

For those who drink, small amounts of alcohol are allowed, with a maximum of two glasses of wine per day for men and one glass per day for women.

Given the various risks of drinking, the overall recommendation is to drink in moderation or not at all.

Up to three cups of coffee or tea per day

Some studies suggest that coffee intake and cardiovascular disease risk have a U-shaped relationship. A recent meta-analysis showed that 3 cups of coffee per day were significantly associated with a reduced incidence and mortality of coronary heart disease. There was no benefit when drinking ≥5 cups of coffee per day.

Tea is also associated with reduced incidence and mortality of coronary heart disease. Drinking 3 cups of tea a day can reduce the risk of coronary heart disease by more than 20%.

Based on the available evidence, up to three cups of coffee or tea per day is acceptable unless contraindicated.

Available evidence suggests that a diet of up to 10 grams of dark chocolate per day may protect against atherosclerosis.

Dietary supplements are ineffective

As for dietary supplements, clinical research results show that supplementation with multivitamin preparations does not improve cardiovascular health in the population. Randomized controlled trials do not support the use of antioxidant vitamins to prevent atherosclerosis.

The role of supplementation with vitamin B complex, calcium, selenium, and other trace elements in the prevention of cardiovascular disease is still unclear.

The new version of the "Dietary Guidelines for Chinese Residents (2022)" proposes eight principles for a balanced diet

The dietary guidelines embody the wisdom of more than a hundred experts, are based on scientific research evidence in recent years, and use easy-to-understand language to provide the most direct guidance to the people on what they should do in terms of eating and drinking, and how to do it more scientifically and healthily.

"Food is the most important thing for people." Eating is not only the most basic behavior to maintain life, but eating scientifically and reasonably can maintain good nutrition, prevent the occurrence of chronic diseases, and make the health state more lasting.

The "Dietary Guidelines for Chinese Residents (2022)" solemnly selected 8 basic principles as the principles that must be followed for a reasonable diet for healthy people over 2 years old.

The red words are the new revisions, which emphasize dietary patterns, food hygiene, regularity of three meals a day, drinking water, food selection, and practical cooking skills.

To implement the eight principles of a balanced diet, you can follow the recommended practices below.

Principle 1: Diverse food and reasonable combination

Core Recommendation:

● Adhere to a balanced diet based on cereals.

● Daily meals should include cereals and potatoes, vegetables and fruits, livestock, poultry, fish, eggs, milk and legumes.

● On average, consume more than 12 types of food every day, and more than 25 types of food per week, with reasonable combinations.

● Daily intake of cereal foods is 200-300 g, including 50-150 g of whole grains and beans; and 50-100 g of potatoes, all in raw weight.

Principle 2: Balance eating and exercise, maintain a healthy weight

Core Recommendation:

● People of all ages should engage in physical activity every day and maintain a healthy weight.

● Don’t eat too much and maintain energy balance.

● Adhere to daily physical activities, perform moderate-intensity physical activities at least 5 days a week, accumulating more than 150 minutes; active physical activities should preferably be 6,000 steps a day.

● Encourage appropriate high-intensity aerobic exercise and increased resistance exercise 2 to 3 days a week.

● Reduce sitting time and get up and move around every hour.

Principle 3: Eat more fruits and vegetables, milk, whole grains, and soy

Core Recommendation:

● Fruits and vegetables, whole grains and dairy products are important components of a balanced diet.

● Include vegetables at every meal and ensure daily intake of no less than 300 g (raw weight) of fresh vegetables, of which dark vegetables should account for 1/2.

● Eat fruit every day and make sure to consume 200-350 g of fresh fruit every day. Juice cannot replace fresh fruit.

● Eat a variety of dairy products, with the intake equivalent to 300-500 grams of liquid milk per day.

● Eat whole grains and soy products regularly, and eat nuts in moderation.

Principle 4 Eat fish, poultry, eggs, and lean meat in moderation

Core Recommendation:

● Fish, poultry, eggs and lean meat should be consumed in moderation, an average of 120 to 200 g per day.

● It is best to eat fish twice a week or 300~500 g, eggs 300~350 g, and livestock and poultry meat 300~500 g.

● Eat less processed meat products.

● Eggs are rich in nutrients, so eat eggs without discarding the yolk.

● Give priority to fish and eat less fatty, smoked and cured meat products.

Principle 5: Less salt, less oil, control sugar and limit alcohol

Core Recommendation:

● Develop a light diet and eat less high-salt and fried foods. Adults should consume no more than 5 g of salt and 25-30 g of cooking oil per day.

● Control the intake of added sugar to no more than 50 g per day, and it is best to control it below 25 g.

● The daily intake of trans fatty acids should not exceed 2 g.

● Do not drink or drink less sugary drinks.

● Children, adolescents, pregnant women, nursing mothers and patients with chronic diseases should not drink alcohol. If adults drink alcohol, the amount of alcohol they drink per day should not exceed 15 g.

Rule 6 Eat regularly and drink plenty of water

Core Recommendation:

● Arrange three meals a day reasonably, eat at regular times and in regular amounts, do not miss meals, and eat breakfast every day.

● Eat regularly and moderately, do not overeat, do not be picky about food, and do not diet excessively.

● Drink plenty of water, in small amounts and frequently. In mild climates, adult men with low physical activity levels should drink 1700 ml of water per day, and adult women should drink 1500 ml of water per day.

● It is recommended to drink plain water or tea, drink less or no sugary drinks, and do not replace plain water with drinks.

Principle 7: Know how to cook, choose and read labels

Core Recommendation:

● Healthy meal planning should be done at every stage of life.

● Learn about food and choose fresh, nutrient-dense foods.

● Learn to read food labels and choose pre-packaged foods wisely.

● Learn to cook, pass on traditional diet, and enjoy the natural taste of food.

● When dining out, remember moderation and balance.

Eight-point rule: Share food with public chopsticks to avoid waste

Core Recommendation:

● Choose fresh and hygienic food and do not eat wild animals.

● Prepare raw and cooked food separately, and make sure cooked food is heated thoroughly when reheated.

● Pay attention to hygiene, starting with using serving chopsticks when eating.

● Cherish food, prepare meals as needed, and encourage sharing of meals to avoid waste.

● Be a practitioner of sustainable food system development.

The guiding ideology for formulating dietary guidelines is to meet human nutritional needs, which is mainly achieved through a reasonable diet.

This is the new version of the dietary pyramid ↓↓↓

This is the old version of the 2016 dietary pyramid ↓↓↓

Balanced Diet Plate for Chinese Residents (2022)

The dietary pyramid uses a "tower shape" to represent food categories and quantities, cleverly describing and quantifying dietary patterns.

The amount of each food type marked next to the pagoda is the average structure of 1600~2400 kcal in three meals a day. This model meets the energy and nutrient requirements to the greatest extent.

Nutrients provided by a balanced diet at a 2000 kcal energy requirement level and their percentage of RNI

In order to provide guidance on special issues for special groups, supplementary instructions have been specially formulated for nine groups, including dietary guidelines for pregnant women, dietary guidelines for nursing mothers, feeding guidelines for infants aged 0-6 months, feeding guidelines for infants aged 7-24 months, dietary guidelines for children aged 3-6 years, dietary guidelines for adolescents aged 7-17 years, dietary guidelines for the elderly, dietary guidelines for the very elderly, and dietary guidelines for vegetarians.

Except for infants under 24 months old and vegetarians, other groups need to apply the eight principles of dietary balance.