After heart surgery most patients have a very poor appetite for the first three months.
The first month the medical advice is to eat anything. This isn’t a problem as the body needs extra fuel for healing, but in reality many don’t eat much because food doesn’t taste the same or smell the same. This is thought to be an effect from anesthesia. Most of the time is takes 1-3 months for the taste and appetite to come back to normal. After the first month, patients are instructed to eat a heart healthy diet. That can be a little vague, and different health care practitioners have conflicting ideas of what a heart healthy diet is. In my career it was challenging as one physician might promote a Dean Ornish vegetarian diet, and the next might promote a Mediterranean diet, or American Heart Association, Dash diet etc. There are common nutritional principles that all heart patients should try to adhere to.
Tip #1: Know your Caloric needs.
How many calories do you actually need every day? Here are a couple of resources that will help guide you:
Tip #2: Enjoy your food, but eat mindfully
Take the time to fully enjoy your food while you’re eating it (instead of just devouring everything on your plate). Pay attention to hunger and fullness cues before, during and after meals. Be mindful of them and use them to tell you when you’re should be full. Remember it takes about 20 minutes for the food you heave eaten to signal your brain if you are still hungry. For this reason eating slowly, and being aware of the quantity, rather than listening for your body to say it is full. It is ok not to finish everything on your plate.
#3: Avoid oversized portions.
Learn what is the true portion size of the food you are eating. If you are going to overeat eat a larger portion of vegetables. Try using a smaller plate, bowl and glass. When you’re eating out, try splitting a dish or take home part of your meal.
Tip #4: Foods to eat more often.
These are all the foods you know are good for you: fruits, vegetables, whole grains, low-fat dairy, etc. Make them the basis for meals and snacks. Try getting 2 cups of veggies, 1.5 cups of fruit and 3 servings of low-fat dairy or lean protein each day.
Tip #5: Decrease the unhealthy foods in the diet
Foods high in solid fats, added sugars, and salt (e.g. cakes, cookies, ice cream, pizza, fast food, sweetened drinks, etc.) should be cut back in the diet. Try to avoid these as part of your daily meal intake.
Tip #6: Hydrate with healthy fluids
Drink water, sparkling water mixed with a splash of juice, tea, or sparkling water instead of high calorie drinks. High calorie drinks include soda, alcoholic beverages, juices, energy drinks and sports drinks. If you are on a fluid limitation, poor the recommended amount of fluid in a container and use it to help you visualize the amount of liquid you should have each day.
Tip #7: Pay attention to added sodium in foods
Read the labels and choose the lower sodium option for breads, canned goods, and soups. Choose packaged products with labels like “low sodium,” “no salt added,” or “reduced sodium.” Fresh, foods have the least sodium. If it comes from a box, a can, or is ready to eat, it is probably loaded in sodium. Water added usually means sodium added, this is common in poultry. 1500 mgs a day is the recommended amount for heart patients. I had one patient that lost 45 lbs, simply by tracking sodium and adhering to recommendations, it has so far saved him from the disabling CHF symptoms he was experiencing.
Sodium sources are not only food! The medicine cabinet is often an unrecognized source of sodium. Many prescription and non-prescription drugs, such as antacids, ibuprofen, sleep aids, heartburn relievers and cold medicines, have large amounts of sodium. Some antacids have upwards of 250 mg of sodium per tablet. Before taking any medication, it’s always best to consult a doctor, especially if you’re watching your sodium intake for health purposes.
Most people are unaware of the amount of sodium that comes from our tap water. It varies significantly from state to state, but the public health department in any area should be able to provide information on the exact amount of sodium in the water. Even if a home employs a water-softening system, there’s still a certain amount of sodium in the drinking water, since many of these units use sodium as a softening agent. The amount is solely dependent on the type of system installed and the hardness of the water in that area. Bottled waters, especially mineral waters, can also contain significant amounts of sodium.
Tip #8: Keep your dairy low-fat
Drinking whole milk is the equivalent of 3 pats of butter, 2% is 2 pats of butter, 1% is one pat of butter. And low-fat cheese is a good substitute for full-fat cheese, but if you are going to use regular cheese, try using a smaller quantity.
Tip #9: Get healthy fats in your diet every day
When you’re cooking, choose oils high in monounsaturated fats like olive or canola oil. These are better choices, but don’t use large amounts, as oil is high in calories. A pump oil spray is a good way of adding a little oil and avoiding chemicals. Avoid products containing trans fats. Read the labels and avoid hydrogenated oil or shortening or partially hydrogenated oils. This is the same as eating shortening.
Tip #10: Get out of your comfort zone
Many people won’t try new or unusual foods. They are stuck in a rut of eating the same foods, because it is what they know and like. Try new foods regularly. Especially try different vegetables. If you always cook your foods a certain way, challenge yourself, try sauteing, steaming, fresh, juicing, combining with other foods, adding nuts or seeds to foods.
Tip #11: Know your issues
Some heart patients have to be very aware of vitamin Kin diet, if they are on coumadin. Keep your intake of foods rich in vitamin K about the same each day. For example, you may plan to eat only ½ cup of these foods per day. If you like these foods and eat them often, you can eat more, but be consistent. It is a common misconception for patients to think they have to avoid foods rich in Vitamin K, it is more important however to get these in the diet, but as mentioned be consistent and get the same amount each day.
Other’s need to be more aware of the potassium or protein contents of foods. Certain diseases (e.g., kidney disease and gastrointestinal disease with vomiting and diarrhea) and drugs, especially diuretics (‘water pills’), remove potassium from the body. Potassium supplements are taken to replace potassium losses and prevent potassium deficiency. If you can meet with a dietitian to help you understand what the sources of these nutrients are. If you can’t meet with a dietitian do your research, but don’t ignore the recommendations as many can be life threatening if not adhered to.