Keeping saturated fat to a minimum and focusing on eating fruits, vegetables and whole grains can keep heart attacks at bay, the Israel Heart Society said yesterday, the first time they have released detailed nutritional instructions to prevent heart and cardiovascular disease.

The instructions, formulated by a joint committee of the Heart Society and Dietetic Association over six months and released at a conference yesterday, survey the main updated world studies on food components and their effect on reducing the risk for heart diseases.

The main recommendation was to reduce the amount of saturated fat to a maximum 10 percent of daily calories. Saturated fat exists in dairy products such as butter, whole milk, cream, animal fat and palm and coconut oil.

The committee recommends reducing to a minimum consumption of trans fats, found mostly in processed products such as crackers, snacks, bourekas, store-bought cakes and cookies and microwavable snacks, such as popcorn.

The amount of cholesterol in food should be restricted to 300 milligrams a day.

A low-carbohydrate diet is more conducive to weight loss than a low-fat diet. A low-carbohydrate diet and a Middle Eastern diet ‏(based on a high consumption of vegetables, fruit, whole grains, nuts and olive oil‏) also raise the good cholesterol levels ‏(HDL‏) and reduce fatty acids in the blood ‏(triglycerides‏).

A low carbohydrate diet − in which 30-40 percent of the calories are from carbohydrates, is safe to healthy overweight people and effective in reducing weight. A calorie-restricted Middle-Eastern diet is also recommended as an alternative to Western nutrition. It improves quality of life and life expectancy among healthy people, overweight people and those suffering from diabetes and heart diseases.

The recommendations are based, among other things, on findings from a comparative study at Ben-Gurion University over the past decade among workers in the Negev Nuclear Research Center in Dimona.

It is generally recommended to eat eight portions of vegetables and fruit daily, with a preferance for root vegetables and dark-colored fruits such as spinach, carrots, peaches and berries. The fruit should be eaten whole, not as juice, which strips them of their fiber.

Vegetables should be steamed or sauteed, to preserve their nutritious components.

Low-fat dairy products are recommended to reduce blood pressure.

Eating up to five eggs a week does not raise the risk of heart events among healthy people.

“The myth that eggs raise cholesterol in the blood is inaccurate,” said Dr. Tali Sinai, chairman of the Dietetic Association. “Eggs have considerable nutritional value and contain protein, vitamins and minerals and little saturated fat. Diabetics and heart patients should reduce their consumption to 3-4 eggs a week and calculate, including eggs in other foods such as pies and pastries.”

The committee recommends consuming 2-3 weekly fatty fish portions, such as herring, mackerel, salmon, sardines and trout and leaner parts of chicken, turkey and beef. Fish with high-mercury levels such as shark, king mackerel or swordish should be restricted to 200 grams a day. Fish with low-mercury levels, such as fresh tuna, red snapper and marlin may be eaten up to 400 grams a day.

Children and pregnant women should avoid eating fish and people with heart diseases should take food supplements to complete their nutrition.

“We could not make unequivocal recommendations regarding certain food
components,” said committee member Dr. Ya’akov Henkin of Soroka Medical Center in Be’er Sheva.

For example, the committee did not agree on the recommended consumption of red wine and finally said people should not start consuming alcohol to protect their heart. However, for those with no tendency for alcohol addiction, one alcoholic drink a day ‏(for women‏) and up to two ‏(for men‏) may reduce the risk of heart events.

Coffee should be restricted to up to 400 milliliters ‏(two cups‏) a day. Pregnant women should not have more than 300 milliliters of caffeine a day and children aged 4-6 no more than 45 milliliters.

“There is no significant evidence that caffeine, in moderation, raises the risk for heart diseases,” said Henkin.

The main recommendation is to drink water or tea, preferably green tea, which is associated with reduced risk for heart diseases and stroke, but “the recommended dosage is not known.”

The recommendations do not include eating chocolate to prevent heart diseases, as this has not been proved scientifically. However, it has been found that bitter chocolate, especially with a high cocoa percentage, is high in antioxidants and preferable to milk chocolate.

The committee recommends a daily consumption of 25-40 grams of nutritional fiber, 10-25 grams of them soluble. This requires eating at least five portions of fruit and vegetables daily, combined with whole grains.

Increasing fiber consumption reduces bad cholesterol ‏(LDL‏) and sugar levels in the blood.
Eating two garlic cloves a day reduces blood cholesterol, but only marginally. Eating 20-30 grams or or 150 grams of unsalted nuts a week reduces LDL levels.

Salt consumption must be reduced to 4 grams daily and other seasonings and herbs should replace the use of salt. The consumption of industrial foods should be reduced as much as possible.

There is no recommendation for consuming antioxidants and vitamins A,B,C,D and E, folic acid or calcium, magnesium and coenzyme Q10 supplements to prevent heart disease.