Heart breaks only look good in books, movies and the teenage years. Once you surpass these three bars, heart breaks are nothing but filled with alcohol, Arijiti’s sad songs and anguish. When talking about people suffering from a real heart break as in the “heart attack” or even known as Myocardial Infarction in medical terms, is something really to be taken care of. There has to be a proper routine, diet and set of things to be followed so that it can be avoided in the future.
In the initial phase the basic clinical objective is cardiac rest. After myocardial infarction, metabolism of the heart switches from utilization of free fatty acids for the primary source of energy to the preferential oxidation of glucose.It is important to monitor a patient’s daily caloric intake and look for ways of increasing energy intake no matter what the consistency of food is served. A typical clear fluid diet provides only 500-600 kcal/day.
Small frequent feeding permits provision of calories and nutrients without taxing the need for intestinal circulation. A brief period of undernutrition during the first few days after the attack is advisable. The caloric level recommended for this period is 800 to 1200 kcal. The caloric value may be gradually increased, depending on the patient’s progress and such factors as nearness to ideal weight, presence of diabetes and hyperlipoproteinemia. Soft food with small and frequent feedings and moderate food restriction per meal, would also prevent distension of the stomach and stimulation of reflexes which may produce arrhythmias that is improper beating of the heart, which can be any too fast or too slow.
During this stage the patient must not even be permitted to feed himself. When the patient’s condition improves, he may be given foods which do not cause strain but are easy to chew and digest.
Liquids are used for 2 to 3 days. All liquids are served at room temperature. Extremes of temperature such as very hot or iced beverages are contraindicated because they may induce arrhythmias. Beverages containing caffeine are omitted because of their stimulating effect on heart rate.
Constipation must also be avoided. This can be relieved through judicious use of fruits and vegetables. The choice of food must be restricted to those which are non-distending. There is variation in individual tolerance in this regard. As the patient improves eggs can be included in the diet restricted amounts. It is also ‘safe’ to include shrimp, crab and other edible crustaceans to a low cholesterol diet. Skim milk can be given as it has a cholesterol lowering effect.
Low sodium diet consisting of 2g is usually prescribed. During recovery of acute phase calories are limited to 1000 to 1200 calories. Cholesterol and saturated fats are restricted. In the rehabilitative stage, calories are adjusted as necessary to bring about weight change if needed. All the other principles maintained earlier should be followed. Three or four smaller meals are suggested instead of two big meals. Evening meals must be two hours before retiring to bed. Smoking and drinking of alcohol should be stopped.
Patients should maintain body weight slightly lower than the standard weight. Accordingly, total calories should be restricted. Calorie intake and physical activity should be balanced to maintain a healthy body weight. For the obese, weight reduction is the key to prevent and treat coronary heart disease. The patient should know the energy requirement to maintain healthy body weight. He should know the energy content of the food he consumes. The patient should consume a variety of foods which are low in fat, saturated fat and cholesterol. Trans fat should be avoided. Intake of bakery products should be limited. Soft margarines have less trans fatty acids than sticky margarines.
Small quantities of almonds and walnuts can be consumed to bring down cholesterol levels. High amounts of nuts and oil seeds increases the calories and fat content in the diet.
This article is written and submitted to The E Today by Shrushti Mehta.
We thank her for her research and analysis and hope to see the awareness about health and nutrition being spread ahead to larger mass of our citizens.