In the past, there have been recommendations to
follow high-protein, high-fat diets to control coronary
heart disease. Studies have not shown these types of
diets, such as theAtkins diet, to be successful at con-
trolling weight long term or to reducing coronary
heart disease. Research has shown that diets lower in
carbohydrates and higher in vegetable sources of fat
and protein moderately reduce the risk of coronary
heart disease in women. Certain foods, such as fish
and foods high infiber(whole grains, fruits, and fresh
vegetables) are healthy foods for the diets of people
with coronary heart disease.
The most important aspect of nutrition and diet
for people with coronary heart disease is to eat a bal-
anced diet that helps them to lose and manage weight.
The United States Department of Agriculture (USDA)
and the United States Department of Health and
Human Services revised the Dietary Guidelines for
Americansin 2005. The guidelines are science-based
and outline advice for choosing a nutritious diet and
maintaining a healthy weight. The 2005 guidelines also
address physical activity andfood safetyand make
recommendations for special population groups.
Finally, calorie requirements and servings are based
more on gender, age, and level of physical activity,
whilein2000,theservingsweremoreuniformforall
adults. The USDA also revised the traditional food
pyramid to make it customized for individuals. These
guidelines form the basis for healthy eating. The Amer-
ican Heart Association and the American Dietetic
Association also offer heart healthy diet recommenda-
tions, as do family physicians and cardiologists.Therapy
Some patients with coronary heart disease will be
referred for cardiac rehabilitation, particularly follow-
ing bypass surgery or if they have experienced angina
or a heart attack. The rehabilitation may consist of an
exercise plan to help regain stamina safely based on
individual ability and needs, and education, counsel-
ing, and training. Training may include ways to better
manage stress, as well as how to manage other lifestyle
factors that contribute to coronary heart disease.Prognosis
Coronary heart disease can be successfully man-
aged and treated in many cases. Advances in diagnosis
and techniques such as stenting have helped to
improve the lives of people with the disease, bringing
about a significant decline in death rates from coro-
nary heart disease since the mid-1980s. However, as
the leading cause of death in the United States, coro-nary heart disease is a serious condition that is best
prevented and that requires careful management and
attention once diagnosed. The more risk factors a
person has, the worse the prognosis.Prevention
Preventing coronary heart disease begins with
knowing the risk factors and taking action to act on
those factors. Managing all those contributing factors
that can be avoided goes a long way in preventing the
advancement of atherosclerosis and eventual coronary
heart disease. By quitting smoking, moderating alco-
hol use, controlling blood pressure, preventing diabe-
tes, and maintaining healthy cholesterol levels, people
can prevent many of the causes of coronary heart
disease. Maintaining a healthy body weight by eating
a balanced diet with healthy-sized portions and par-
ticipating in regular physical activity helps to prevent
the disease. Those with known hereditary or other risk
factors for coronary heart disease should have regular
physical examinations with their physicians and
should pay careful attention to the signs and symp-
toms of coronary heart disease and heart attack.Resources
BOOKS
American Heart Association No-Fad Diet: A Personal Plan
for Healthy Weight Loss.Clarkson Potter Publishers,
2005.
American Heart Association: To Your Health. A Guide to
Heart-Smart Living.Clarkson Potter Publishers, 2001.
ORGANIZATIONS
American Dietetic Association. 120 South Riverside Plaza,
Suite 2000. Chicago, IL 60605. (800) 877-1600.<http://
http://www.eatright.org>.
American Heart Association. 7272 Greenville Ave., Dallas,
TX 75231. (800) 242-8721.<http://www.americanheart
.org>.
National Heart, Lung, and Blood Institute. P.O. Box 30105,
Bethesda, MD 20284. (301) 592-8573.<http://www
.nhlbi.nih.gov>.Teresa G. OdleCravings
Definition
Most people, at some time, have a strong desire
for some particular food, such as ice cream or pizza.
Such a desire for a particular food, even when one is
not hungry, is called a craving.Cravings