How much food should I eat?
Your aim should be to maintain an ideal body weight. Calorie (energy) restriction is desirable for shedding excess weight. Individual requirements vary according to individual metabolisms, age, sex and activity patterns.
How frequently should I eat?
Three major meals i.e. breakfast, lunch and dinner with 1-2 in-between snacks and/or refreshments are adequate. Dinner should be taken at least 1-2 hours before retiring. Major meals should be light in order to prevent abdominal discomfort and post-meal angina. Skipping meals is not desirable, especially for diabetic and those recovering after heart surgery.
How much and what type of milk should be taken?
Two and a half to four cups (500-800 ml) of skimmed milk or low fat (toned) milk per day is recommended for adults. This includes milk products like yogurt and paneer as well as milk used in preparation of porridge (dalia), tea and coffee. All milk products should be prepared from low-fat milk. Cow's milk without cream may be used.
Which non-vegetarian foods are allowed?
Fish, chicken, lean meat (meat with fat trimmed off) and eggs may be taken. When you choose chicken, breast portion is the best. It may be taken 2-3 times a week. 3-4 whole eggs per week are permissible. About 100 gms fish can also be taken 2-3 times a week. Fatty fish like Hilsa, Black Pomfret, Katla and Surmai are beneficial for the heart. Lean meat may be taken occasionally as its fat content is relatively low. Fatty and organ meats should be avoided.
How should one cook fish?
Fish may be roasted, grilled, baked, lightly curried or pan-fried on a non-stick pan. Once in a while, even batter-fried fish is fine provided you blot the surface oil with brown paper or paper napkin. Unless you live in Goa, avoid fish consumption in summer and rainy season due to risk of easy spoilage.
What about dals?
All dals are desirable. However, emphasize more on whole dals and the ones with their skins (Sabut moong, masur, moth, rajmah, channa, raungi and moong chilka). Sprouted dals make an excellent choice as these contain rich quantities of vitamins, minerals and enzymes along with fibre. They are easily digestible too. Sprouted dals may be lightly steamed or taken raw as salad or used as filling. Soybeans and soy products like tofu, soy chunks, soy nuggets, soy flour and soymilk are beneficial in heart disease.
Can I buy readymade atta off the shelf?
Readymade attas are mostly devoid of dietary fibre. It is better to have atta ground. An excellent blend is a mixture of wheat, barley, soybean and channa. Besides a good source of protein and fibre, blended atta helps to lower your blood cholesterol as well as blood glucose. Recommended proportion of blended atta is 7kg-wheat+ 1.5-kg barley+ 1-kg soybean+ 0.5-kg kala channa. Those with high uric acid should avoid soy bean and kala channa.
Is rice alright for diabetics?
Yes, rice and rice preparations are fine, provided they are a part of a mixed meal. Mixed meals include a dal, a vegetable and some salad. Half a cup of cooked rice is equivalent to one medium size chappati. So do not lose track of how much you are eating. Brown rice, par boiled (sela) rice and hand pounded rice are preferable to polished white rice.
What should I eat in my breakfast?
Choose whole grain cereals and fibre rich preparations. You may have a roti with vegetables, whole wheat bread, brown bread, breakfast cereals or sprouted pulses or low-fat besan (gram flour) preparations.
Which breakfast cereals are good?
High fibre breakfast cereals are the best. These include porridge of whole wheat, oatmeal and barley, or ready to eat ones, like wheat flakes and mueslis. Cornflakes, though low in fibre, may also be taken after adding bran. Traditional sattoos are also excellent.
Which oil should I take?
A blend of oils is preferable to single oil. A blend of sunflower/corn with groundnut oil in equal proportions is a good choice. This should be supplemented by occasional mustard oil. Other suitable alternatives are canola or til (sesame) oil alone or a blend of rice bran and sunflower oils. Olive oil is also a good choice. Non-stick cookware helps minimise oil consumption. Avoid deep frying.* On an average 3-4 teaspoons (15-20 ml) of oil may be used per day. Hydrogenated fat like vanaspati should be strictly avoided. It is used in cheap commercial eateries.
*Oil sprayers may be used to grease cooking surfaces.
Should desi ghee be given up totally?
Desi ghee is rich in saturated fats. It is not advisable to use ghee as the sole cooking medium. However, a limited quantity, say 1 teaspoon (5 gms) per day as part of the total fat allowance or an occasional intake is not detrimental.
Are margarines and low-fat spreads all right?
These are hydrogenated vegetable oils. Although they do not contain cholesterol, they contain saturated fat as well as some unnatural fatty acids known as "transfatty acids," which raise blood cholesterol, hence are not recommended. Almost all commercially available bakery products like cakes, biscuits, patties and pastries are rich in margarines.
What should I spread on my toast instead of butter?
Low-fat spreads like cream-cheese (curd without water), cottage cheese, a low-fat cheese like mozarella, sliced vegetables, homemade chutneys, etc., make good substitutes. You can use your imagination to create a variety of other low-fat spreads. Butter in limited amounts (one teaspoon) out of the fat allowance is also fine.
Which fruits and how much should I take?
Plenty of fresh fruits are highly desirable for healthy heart. For non-diabetics, all fruits are permissible. Upto about 500 gms. of edible portion is recommended. Watery fruits like papaya, melon and watermelon may be taken in larger quantities. However, excessive intake of very sweet fruits like mangoes, cheekoos, bananas, grapes, dates should be avoided. Keep the intake of such fruits between 100-150 gms. per day. About 300 gms should be consumed by diabetics. Eating the whole fruit with the peel increases dietary fibre intake. But the load of chemical pesticides sprayed on them may render this practice counter-productive. Therefore, feel free to remove the peel. You will still be getting 70-80 percent of the fibre present in the fruit pulp.
Are fresh fruit juices permitted?
Juices are not recommended for diabetics, obese and those with kidney dysfunction. For others, fresh fruit juices are all right. Juices are a concentrated source of vitamin C, potassium and energy. However, juices are best as supplements and not a substitute for whole fruits. * Juices should be prepared hygienically. Every time fruit juice is prepared, hands, fruits and juicer should be washed with care. Fresh fruit juice prepared by a vendor may be a source of infection.
*The latter are rich sources of dietary fibre.
How about dry fruits and nuts?
Dry fruits and nuts are rich sources of mono-unsaturated fats and vitamin E, potassium, magnesium which are beneficial for the heart. However, they are rich in energy (calories) too. Therefore, their judicious use is advisable. Restrict their intake to about 25-30 gms a day. Obese people should avoid dry fruits. Dry fruits like dates, raisins (kishmish), figs, apricots are an excellent substitute for fatty desserts, mithais and snacks.
Which vegetables can I take and which ones should I avoid?
All vegetables, especially green leafy vegetables are good. Raw vegetables for salads should be washed thoroughly before eating. Those who are taking the drug acetrom or warfarin should limit the intake of vitamin K rich vegetables like tomatoes, peas, cauliflower, broccoli, cabbage and green leafy vegetables.
Are potatoes, arbi, jimikand, sweet potatoes, etc. all right for diabetics?
All the above mentioned vegetables are starchy with a tendency to raise blood glucose levels due to their high energy content. When taken in limited quantities, as a part of mixed meals, these do not have any adverse effects. Their intake should be limited during a weight reduction program.
How much sugar can I take?
Up to 4-5 teaspoons of sugar per day is all right. Honey, jaggery (shakkar, gur), molasses and brown sugar are the preferred sweeteners. Diabetics and the obese should avoid direct sugar intake. They may use non-saccharine based sweeteners like aspartame.
Are desserts, mithais and sweets banned?
If you are neither a diabetic nor grossly overweight, low-fat and low sugar desserts like puddings, ice-cream, kheer, custard, fruit based preparations and stewed fruits prepared from skimmed milk and egg white and low-fat Indian sweets like rasgoola, petha and sandesh may be taken. Khoya and fried sweets should be avoided.
How spicy should my food be?
Garam masala and black, green and red pepper in small amounts are okay. Other herbs and spices may also be used. In fact, the food should be as tasty as possible. A compromise on salt and fat intake is all that is required. (No more than 6 grams i.e. 1 teaspoon of salt should be taken in a day). Liquorice (mulathi) should be should be avoided in hypertension.
Are pappads, chutneys and pickles banned?
These may be taken in small quantities, unless it is advisable to restrict salt intake drastically. A roasted pappad may be fine. Fresh homemade pickles in vinegar or lemon juice with small quantities of salt are also all right. fresh chutneys of coriander, mint, tomatoes, ginger or garlic, etc. made with a little salt, may be taken to make food more interesting. Occasionally, soy and tomato sauces in small quantities are fine. Ajinomoto (monosodium glutamate) should be avoided due to its high sodium content.
Are fried foods and namkeens to be stopped altogether?
Fried foods are loaded with oil. When these are bought off the shelf, the concern is not only of the amount but also the quality of the oil used for frying. The same is true for "namkins". It is prudent to avoid such foods as far as possible. Blot them with brown paper if you must. If possible, have roasted namkins prepared at home. Some good choices include chirwa (roasted puffed rice), popcorns and cornflakes roasted in a utensil or under the grill. Roasted nuts may also be substituted as a healthy choice.
Are tinned, ready to serve soups and processed foods all right?
Keep them on a very low priority. Nothing is as wholesome as fresh foods. Frozen vegetables are acceptable as the second choice. Processed foods not only have poor nutritive value but they also contain food additives like chemical preservatives and stabilizers. Therefore, these can never be substitutes for fresh foods. Be discreet in their use.
What should I eat if I am hungry in between meals?
It is desirable to have light refreshment in between meals. Go for sprouted preparations, roasted gram (bhuna channa), popcorn, roasted nuts, puffed rice preparations, salads, soups, curds, fruits, light biscuits and light beverages. An occasional sandwich is also fine.
Are supplements desirable?
Protein, vitamin and mineral rich biscuits and powders or capsules may be taken as supplements for some time after major surgery, when it is not possible to take adequate food for some reason. Chronic use of such supplements instead of normal food is not desirable. Those on very low calorie diets i.e. less than 1200 Kcal for long periods do need to supplement their diets. Those living in polluted cities or smokers should include some food supplements.
How much water should I drink?
At least 1.5 to 2 litres of fluid in a day are required for good health. This includes water as well as other beverages. Fluid intake may have to be restricted for sometimes after a major heart surgery or in case of poor heart function.
What about tea, coffee and colas?
2 to 3 cups of tea and 1 cup of coffee is fine. These should be brewed light or medium to prevent excessive caffeine intake. Colas and fizz drinks also contain caffeine. Their intake should be restricted.
What other soft beverages may I take?
Fresh lime juice (nimboo-pani), lassi, fresh fruit juice, fruit soda, mango panna, butter milk (chaach) and coconut water make good choices.
Am I allowed alcohol?
For habitual drinkers 1 or 2 small drinks (30 ml) a day are okay. Wines, particularly French red wines are better than spirits. Teetotalers should not initiate drinking.
Which methods of cooking are best for me?
Methods which employ minimum fat without compromising on palatability should be chosen. These are grilling, roasting, light currying, baking, steaming, boiling, broiling, micro-waving, stir frying using a non-stick pan.
For how long should my food be cooked separately?
Your food need not be cooked separately. Healthy eating habits are good for everybody, not just heart patients and diabetics. Such habits should form right from childhood.
What about eating outside home?
You need to be a bit selective when you eat out. Minimize fatty food prepared outside home. The issue is not only excess of oil, but also its quality. Hence avoid curries and go for the pieces. Take more of dry vegetable preparations and ungreased chappatis. Grilled and steamed foods also make excellent choices. Salads and curd may also be taken under hygienic conditions. Items with an excess of cheese, cream, oil, salt or sugar should be avoided. As a rule, do not over eat.
Can I eat Chinese and Continental food?
Home food cooked in any style is perfect. When cooking Chinese food, excessive salt and ajinomoto should be avoided. In Continental cooking, butter should be replaced by vegetable oil.
Healthy Food Choices
- Eat a variety of foods. Such a diet helps create interesting meals and ensures that you get enough calories, proteins and fibre as well as the vitamins, minerals and other nutrients.
- Control your weight, keep within recommended weight limits for age, sex and build. Balance the food you eat with physical activity to maintain or achieve your desirable weight.
- Eat a low fat, low cholesterol diet.
- Cut back on animal fats. This includes animal food and dairy products with the exception of fish.
- Say no to hydrogenated fats, e.g. Vanaspati and margarine.
- Pay attention to hidden fats in bakery items, sweets, namkeens, milk and meats.
- Choose whole-grain cereals and pulses.
- Eat plenty of fruits and vegetables. Use variety of textures, colours and flavours of fruit and vegetables to enhance the flavour of the nutritional contents of food.
- Use sugar and salt in moderation.
- Limit tea/coffee to 3 cups of tea or one cup of coffee per day.
- Alcohol may be taken in moderation.
- Drink plenty of water (1.5 to 2 litres i.e. 8-10 glasses app.) or as advised by your physician.