With heart diseases still the leading cause of death worldwide, dietitians would like to actively participate in promoting healthy food choices which are good for the heart.

There are at least four major nutritional guidelines for a healthy heart: (1) control fat and cholesterol intake; (2) increase fiber intake; (3) frequently consume fish; and (4) enjoy soy and soy products.

Coronary artery plaque is usually made up of fat, cholesterol, and other substances. When plaque builds up in the coronary arteries, the condition is called atherosclerosis.

Plaque narrows the arteries and reduces blood flow to your heart muscle. It also makes it more likely that blood clots will form in your arteries (blood clots can partially or completely block blood flow).

When your coronary arteries are narrowed or blocked, oxygen-rich blood can’t reach your heart muscle. This can cause a heart attack.

But can limitations in dietary cholesterol bring good results to our hearts? Here, I have summarized findings on the manipulation of serum lipids by changes in the diet:

• Despite the fact that most of the serum cholesterol is endogenous (biosynthesized) rather than of dietary origin, alterations in diet can change serum cholesterol. However, the effect of dietary alterations on serum cholesterol varies greatly from person to another.

• The reduction in serum cholesterol is most marked when dietary cholesterol is reduced to a very low level (100 mg/day).

• The fall in serum cholesterol is not directly proportional to the degree of dietary restriction.

• An increased polyunsaturated fat/saturated fat ratio reduces serum cholesterol levels. Reducing dietary cholesterol in addition to increasing the P/S ratio reduces serum cholesterol more than does reducing dietary cholesterol alone.

Protein food highest in polyunsaturated fats are fish; beef, on the other hand, is highest in saturated fats, while the predominant fatty acid in chicken is monounsaturated fats. As for the protein food highest in cholesterol per one exchange, it is pork.

To keep yourself supplied with fiber, simply have an apple or two a day. Apple’s insoluble fiber works like bran, latching on to LDL cholesterol in the digestive tract and removing it from the body, while apple’s soluble fiber pectin reduces the amount of LDL cholesterol produced in the liver.

A study published in the Archives of Internal Medicine confirms that eating foods high in fiber, such as apples, helps prevent heart disease. In the study, people eating the most fiber, 21 grams per day, had a 12% reduced risk of coronary heart disease.

As for the third recommendation of frequently including fish in your diet for a healthy heart, that has been discussed over and over again. Only those who don’t care about their health will not increase fish consumption on a weekly basis.

To enjoy the heart benefits of soy and soy products, eat an average of 50 grams of soy protein per day. In a meta-analysis of 38 controlled trials, there was a 9.3% decrease in total cholesterol and 12.9% decrease in "bad cholesterol" among the study participants.

Soy proteins are available as soy flour, soy milk, soy protein isolates, natto (fermented soy beans), and tofu.