Q: I am 35 and come from a family with poor eating habits and in which every other member has had either a heart-related chest pain or heart attack. What should I eat or avoid to reduce the risk of heart attacks?

SY, Ranchi

• The arteries that supply the heart with blood (coronary arteries) can get progressively thickened, narrowed and clogged with build-up of fatty deposits on their inner walls — a process called atherosclerosis. This deprives and starves the heart muscles of oxygen and nutrients carried in the blood. The deprivation, if shortlived, results in chest pain (angina), and if prolonged, can cause death of part of the heart leading to a heart attack (myocardial infarction).

The reasons for atherosclerosis and blockage of arteries are many and complex. However, making correct and informed food choices can make a tremendous difference in controlling and preventing these pathological processes. Let’s see how:

• High blood cholesterol with high LDL and low HDL as well as the presence of oxidised cholesterol favours atherosclerosis. To lower your blood cholesterol levels, it is foods rich in saturated fats (butter, ghee, full-cream milk and cheese, red meats, coconut) and refined carbohydrates (refined flour, sugar, fruit juices) that you need to stay away from, more than the high-cholesterol containing foods. Also include in your diet almonds, avocados, olive oil or refined rapeseed oil whose monosaturated fat cuts down the bad LDL and raises the good HDL cholesterol. The soluble fibre found in apples, oranges, grapefruits, mangoes, apricots, carrots, turnips, oat bran, oats and legumes also do the same.

• High levels of the hormone insulin in the blood promote damage to the arterial walls and hasten atherosclerosis. In India this is a major cause of heart disease. To keep blood insulin levels down, make sure you:

Have an adequate protein intake

Avoid eating a meal only of carbohydrates — instead have carbohydrates along with proteins

Include lentils (dals), legumes (beans, soyabean) and fruits with your meals as often as possible — these foods prevent sharp rise of blood glucose and insulin

Shun refined flour (maida) and polished rice — replace these with whole-wheat flour (atta) and parboiled or brown or basmati rice.

Take regularly the mineral chromium (50-200 mg) in the form of a supplement

• Our body synthesises hormone-like substances called eicosanoids which can both increase or decrease inflammation. Too much of omega-6 and too little of omega-3 essential fats in our diet (as is the present dietary trend in India) favour production of the pro-inflammatory or bad eicosanoids. These promote atherosclerosis and clogging of arteries causing inflammation of arterial walls, constriction of arteries and clotting of blood. To keep your heart healthy, you must avoid the predominantly omega-6 containing vegetable oils like sunflower, corn, cottonseed, sesame and coconut oils. Eat foods rich in omega-3 like fish, walnuts, soyabean, pumpkin seeds and vegetable oils like rice-bran and soyabean oils.