In the United States, heart disease affects about 9 million adults, killing one every 37 seconds. But the good news—which Dr. Philip Ades, author of the new book Eating for a Healthy Heart has made it his mission to spread—is that heart-disease is mostly preventable. Research shows that up to 90 percent of heart disease can be prevented by changing one’s diet, exercising more, maintaining a healthy weight and not smoking. Reduce your risk by following these 10 simple steps.

Step #1: Know your numbers.

High blood cholesterol is linked with about one-third of heart disease cases worldwide, according to data from the United Nations. Your blood cholesterol (lipid profile) is made up of several readings: high-density cholesterol (HDL), low-density cholesterol (LDL) and triglycerides (TG). LDL cholesterol and triglycerides are often referred to as "bad" cholesterol; high levels (greater than 160 mg/dL and 200 mg/dL, respectively) are considered risk factors for developing heart disease. On the other hand, "good" HDL protects against cardiovascular disease. (A healthy HDL target is 60 mg/dL or higher.) But an undesirable lipid profile doesn’t mean that developing heart disease is inevitable. Research shows that changing your diet for the better can help lower "bad" LDL and TG levels, as well as increase "good" HDL cholesterol, if they’re out of healthy ranges. Talk with your doctor about a screening. Medications are sometimes needed.

Step #2: Calculate your risk.

Having multiple factors for heart disease increases your risk exponentially. For example, if you smoke, have high blood pressure or high cholesterol, any one of these factors doubles your likelihood of developing heart disease in the next six years. But having all three increases your chance eightfold. The good news: treating any one of these risk factors effectively—say, you quit smoking or bring your cholesterol into a healthy range—halves your likelihood of developing heart disease (i.e., you’ll have four times, rather than eight times, the risk of someone who doesn’t have any of these risk factors).

Step #3: Lose weight if you need to.

Losing as little as 5 to 10 percent of your body weight—about 8 to 15 pounds if you start at 150—will result in better blood pressure, lower risk for diabetes and improved cholesterol levels, research suggests. Are you toting around too many pounds? There are two ways to find out. First, calculate your body mass index (BMI). A normal BMI is 18.5 to 24.9. A BMI of 25 to 29.9 is overweight, and 30 and above is considered obese. Some complain that, if you are muscular or "large-boned," you may get a BMI that suggests you’re overweight when you’re really not. To double check, Phil Ades suggests you perform the "Ades-ocular" test: Strip down to your underwear and stand sideways in front of a full-length mirror. If your abdomen droops or sticks out, the high BMI is correct. If it’s flat and firm, your BMI may, indeed, be incorrect.

Step #4: Slash your intake of saturated fat.

Butter. Sour cream. Mayo. These foods—as well as fatty cuts of meats—are high in the saturated fats that elevate "bad" LDL cholesterol, leading to plaque buildup in arteries. Limit saturated fats to 5 percent or less of your total calories (divide your weight by 12 to get the daily total limit in grams). For example, try replacing butter with vegetable-based oils, particularly olive and canola oil, both of which contain good amounts of heart-healthy monounsaturated fats, and by swapping in lean poultry, fish and beans for higher-fat meats.

Step #5: Junk the junk food.

Many packaged snacks, crackers, bakery goods and some margarines contain artificial trans fats (a.k.a. hydrogenated oils), which increase "bad" LDL even more than saturated fats, according to recent research by Walter Willett, M.D., at the Harvard School of Public Health. In a 2003 interview with EatingWell, Willett blamed trans fats for millions of unnecessary premature deaths from heart disease. Read labels carefully: if a package claims "zero trans fat," the amount per serving may be less than 0.5 g and could have been rounded down to zero. The only way to be sure you’re getting a product without trans fats is to avoid products that include "hydrogenated oil." Better yet, stock up on nutrient-rich vegetables, fruit and nuts.

Step #6: Fill up on fiber.

Various studies link a high-fiber diet with a lower risk of heart disease. In a Harvard study of female health professionals, people who ate a high-fiber diet had a 40 percent lower risk of heart disease than those who ate a low-fiber diet.

Aim to include plenty of foods that are rich in soluble fiber, which, studies show, can help lower "bad" LDL. Soluble fiber binds bile acid, a key component in fat digestion that our bodies make from cholesterol. We can’t digest fiber, so when bile acids are bound to it, they get ushered out of the body as waste. This causes the body to convert more cholesterol into bile acids, which ultimately has the effect of lowering circulating cholesterol levels. Foods high in soluble fiber include oatmeal, barley, beans, okra and eggplant, and citrus fruit, such as oranges.

Step #7: Replace refined grains with whole ones.

Eating too many refined carbohydrates (e.g., white bread, pastries, white pasta) fuels the body’s ability to make triglycerides. What’s more, processed grains are quickly converted to glucose, which raises blood glucose levels and may predispose one to developing type 2 diabetes, a risk factor for developing heart disease. Choose whole grains, such as brown rice, wheat berries and quinoa and whole-wheat pastas, which contain more fiber (which slows down the conversion of starches to glucose) and healthful fats than processed grains.

Step #8: Go fish.

Consuming two or more servings of fish per week is associated with a 30 percent lower risk of developing coronary heart disease over the long term, studies show. Fish contain omega-3 fats, which lower levels of triglycerides in the blood that may contribute to blood clotting. Omega-3s also lower blood pressure slightly and can help prevent irregular heart rhythms. (Flaxseed oil, canola oil and walnuts also contain omega-3 fats.)

Step #9: Get nuts.

Research suggests that people who eat nuts—walnuts, pecans, almonds, hazelnuts, pistachios, pine nuts and peanuts (which actually are legumes)—two to four days or more per week have a lower incidence of heart disease than people who eat them less. All nuts contain good amounts of heart-healthy monounsaturated fats and low levels of saturated fats.

Step #10: Enjoy alcohol in moderation.

Scientific literature indicates that people who drink moderately are less likely to have heart disease than those who abstain. Alcohol appears to raise "good" HDL cholesterol. Wine, in particular, "thins" the blood (making it less prone to clotting) and also contains antioxidants that prevent your arteries from taking up LDL cholesterol, a process that can lead to plaque buildup. Remember, 1 drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor.

在美國，心臟病大約影響 900 萬成年人，每 37 秒鐘就致死一人。但是有個好消息——博士菲利普 艾德思，新書“吃出一個健康的心臟”的作者，把傳播這個好消息作為他的使命——說，心臟疾病大多是可以預(yù)防的。研究表明，多達 90％ 的心臟疾病都可以通過改變一個人的飲食習慣、更多的運動鍛煉、保持健康的體重和不吸煙來加以預(yù)防。可以采取下面這 10 個簡單的步驟來降低你的風險。

步驟 1：了解你的指標數(shù)。

根據(jù)來自聯(lián)合國的數(shù)據(jù)，高的血液膽固醇和世界范圍內(nèi)約三分之一的心臟病個案相聯(lián)系。你的血液膽固醇（血脂）是由幾個讀數(shù)所組成：高密度膽固醇（ HDL） 、低密度膽固醇（LDL）和甘油三酯（TG）。低密度脂蛋白（LDL ）和甘油三酯是通常被稱為是“壞的”膽固醇；它們的高值（分別大于 160 mg/dl 和 200 mg/dl）被認為是發(fā)生心臟病的危險因素。另一方面，“好的”高密度脂蛋白（HDL）則可以防止心血管疾病。 （健康的 HDL 的指標是 60 mg/dl 或者更高。）但是，不良的血脂并不意味著發(fā)生心臟病是不可避免的。研究表明，改變你的飲食習慣達到較好一些，可以幫助降低“壞的”LDL 和甘油三酯的水 平，以 及增加“好的” HDL 膽固醇，如果它們健康范圍之外的話。跟你的醫(yī)生交談交談篩檢的情況。有時可能需要藥物治療。

步驟 2：計算你的風險度。

有多種心臟病因素成倍地增加你的風險。例如，如果你吸煙，具有高血壓，或者具有高膽固醇， 這些因素中的任何一個都能加倍你在未來六年中發(fā)生心臟病可能性。而具有所有這三種情況的人會增加八倍得病的機會。好消息是：治療這些危險因素中的任何一個都是有效的——就是說，你 戒了煙，或者將你的膽固醇帶到健康范圍——就把你發(fā)生心臟病的可能性減少一半（即，你將比沒有這些危險因素的人有 4 倍，而不是 8 倍的風險）。

步驟 3：減肥，如果你需要的話。

研究表明，如果你從 150 磅開始稍稍減去你的體重的百分之五到百分之十——大約 8 至 15 磅，就會獲得更好的血壓、較低的糖尿病 風險和改善的膽固醇水平。你量得的磅數(shù)太大了嗎？有兩種方法可以找出答案。首先，算出你的身體體重指數(shù)（BMI） 。正常的體重指數(shù)是 18.5 至 24.9。體重指數(shù) 25 至 29.9 是超重，體重指數(shù) 30 及以上被認為是肥胖。一些人抱怨說，如果你肌肉發(fā)達或者是“大骨架”，你可能得到表明你超重的 BMI ，而實際上你并不是。對此要仔細檢查一下。菲爾 艾德思建議你執(zhí)行“艾德思-視覺”測試：脫下你的內(nèi)衣，側(cè)身站在一面完整長度的鏡子的前面。如果你的腹部下垂或伸出，高 BMI 是正確的。如果腹部是平坦和結(jié)實的，你的 BMI 就可能真的是不正確的。

步驟 4：削減你的飽和脂肪攝取量。

黃油、酸奶、美乃茲這些食物以及從肉類切下的脂肪都是飽和脂肪高的，它們能升高“壞的”LDL 膽固醇，導致斑塊在動脈積累。要將飽和脂肪限制到你的總熱量的 5％ 或更少（將你的體重除以 12  就獲得以克計的每日總限額） 。例如，嘗試用蔬菜油，特別是兩種含有相當數(shù)量有有益于心臟健康的單不飽和脂肪的橄欖油和菜籽油，來替換黃油；并且用瘦的家禽、魚類和豆類來替換高脂肪的肉 類。

步驟 5：清除垃圾食品。

根據(jù)哈佛大學公共衛(wèi)生學院醫(yī)學博士沃爾特 威勒特最近的研究，許多包裝的零食、餅干、面包貨物和一些含有人工轉(zhuǎn)化脂肪（又名氫化油）的人造黃油 ，它們增加的“壞的” LDL 甚至比飽和脂肪增加的還要多。在 2003 年 EatingWell 所進行的訪談中，威勒特指責轉(zhuǎn)脂肪造成數(shù)百萬計不必要的心臟病早亡。要仔細閱讀食物標簽：如果包裝上聲明“零轉(zhuǎn)脂肪”，每份的含量就可能會少于 0.5 g 而四舍五入為零。確保你得到不含轉(zhuǎn)脂肪的產(chǎn)品的唯一方法是避免含有“氫化油”的產(chǎn)品。更棒的是采購營養(yǎng)豐富的蔬菜、水果和干果。

步驟 6：補充纖維。

各種研究都發(fā)現(xiàn)高纖維食品與較低的心臟病風險相關(guān)聯(lián)。按照哈佛大學研究女性健康的專業(yè)人士的說法，吃高纖維食品的人們比吃低纖維食品的人們降低 40％ 患心臟病的危險。

研究顯示，瞄準包括大量富含可溶性纖維的食品，可以幫助降低“壞的” LDL。水溶性纖維能夠約束膽汁酸。這是一種 我們的身體從膽固醇制造出的進行脂肪消化的關(guān)鍵組份。我們不能消化纖維。因此，當膽汁酸被結(jié)合到纖維上時，它們被作為廢物導出體外。這會導致身體轉(zhuǎn)換更多的膽固醇成為膽汁酸，最終達到降低循環(huán)膽固醇水平的效 果。水溶性纖維高的食品包括燕麥、大麥、豆類、秋葵和茄子，以及柑橘類水果，如橘子。

步驟 7：用全麥粉之類取代精制的谷物。

吃太多精制的碳水化合物（例如白面包、糕點、白面食）給身體提供了燃料和產(chǎn)生甘油三酯的能力。何況，加工過的糧食能夠迅速地轉(zhuǎn)化為葡萄糖，提高血糖水平，使人易于罹患 2 型糖尿病，這是發(fā)生心臟病的一個危險因素。選擇全谷類食物，例如糙米、麥胚和奎奴亞藜以及全麥面食，其中包含了更多的纖維（它減緩淀粉向葡萄糖緩的轉(zhuǎn)化）以及比加 工谷物更為健康的脂肪。

步驟 8：吃魚。

研究顯示，每周吃上兩次或兩次以上的魚，可以伴隨著長期降低 30 ％ 發(fā)生冠心病的風險。魚類含有奧米加-3 脂肪酸，它能降低血液中可能有助于血液凝結(jié)的甘油三酯的水平。歐米加- 3 還能稍稍降低血壓，并且可以幫助防止非正常的心臟節(jié)律。 （亞麻籽油、菜籽油和核桃也含有歐米加-3 脂肪酸） 。
步驟 9：吃干果。

研究表明，每周兩到四天或更多地吃干果——胡桃、 山核桃、杏仁、榛子、開心果，松子，花生（其實是豆科植物）——的人 比很少吃這些東西的人具有較低的心臟病發(fā)病率。所有的堅果都含有有益心臟健康的單不飽和脂肪和低水平的飽和脂肪。

步驟 10：適度飲酒。

科學文獻表明，適量飲酒的人比禁酒的人較少可能患心臟疾病。酒精似乎可以提高“好的” HDL 膽固醇。尤其是葡萄酒能夠“稀釋”血液（使其不易凝結(jié)），也包含有抗氧化劑，它能防止你的動脈接納 LDL 膽固醇，這是可能導致斑塊積累的過程。請記住，一次飲酒等于 12 盎司啤酒、5 盎司葡萄酒或者 1.5 盎司白酒。