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.

在美国，心脏病大约影响 900 万成年人，每 37 秒钟就致死一人。但是有个好消息——博士菲利普 艾德思，新书“吃出一个健康的心脏”的作者，把传播这个好消息作为他的使命——说，心脏疾病大多是可以预防的。研究表明，多达 90％ 的心脏疾病都可以通过改变一个人的饮食习惯、更多的运动锻炼、保持健康的体重和不吸烟来加以预防。可以采取下面这 10 个简单的步骤来降低你的风险。

步骤 1：了解你的指标数。

根据来自联合国的数据，高的血液胆固醇和世界范围内约三分之一的心脏病个案相联系。你的血液胆固醇（血脂）是由几个读数所组成：高密度胆固醇（ HDL） 、低密度胆固醇（LDL）和甘油三酯（TG）。低密度脂蛋白（LDL ）和甘油三酯是通常被称为是“坏的”胆固醇；它们的高值（分别大于 160 mg/dl 和 200 mg/dl）被认为是发生心脏病的危险因素。另一方面，“好的”高密度脂蛋白（HDL）则可以防止心血管疾病。 （健康的 HDL 的指标是 60 mg/dl 或者更高。）但是，不良的血脂并不意味着发生心脏病是不可避免的。研究表明，改变你的饮食习惯达到较好一些，可以帮助降低“坏的”LDL 和甘油三酯的水 平，以 及增加“好的” HDL 胆固醇，如果它们健康范围之外的话。跟你的医生交谈交谈筛检的情况。有时可能需要药物治疗。

步骤 2：计算你的风险度。

有多种心脏病因素成倍地增加你的风险。例如，如果你吸烟，具有高血压，或者具有高胆固醇， 这些因素中的任何一个都能加倍你在未来六年中发生心脏病可能性。而具有所有这三种情况的人会增加八倍得病的机会。好消息是：治疗这些危险因素中的任何一个都是有效的——就是说，你 戒了烟，或者将你的胆固醇带到健康范围——就把你发生心脏病的可能性减少一半（即，你将比没有这些危险因素的人有 4 倍，而不是 8 倍的风险）。

步骤 3：减肥，如果你需要的话。

研究表明，如果你从 150 磅开始稍稍减去你的体重的百分之五到百分之十——大约 8 至 15 磅，就会获得更好的血压、较低的糖尿病 风险和改善的胆固醇水平。你量得的磅数太大了吗？有两种方法可以找出答案。首先，算出你的身体体重指数（BMI） 。正常的体重指数是 18.5 至 24.9。体重指数 25 至 29.9 是超重，体重指数 30 及以上被认为是肥胖。一些人抱怨说，如果你肌肉发达或者是“大骨架”，你可能得到表明你超重的 BMI ，而实际上你并不是。对此要仔细检查一下。菲尔 艾德思建议你执行“艾德思-视觉”测试：脱下你的内衣，侧身站在一面完整长度的镜子的前面。如果你的腹部下垂或伸出，高 BMI 是正确的。如果腹部是平坦和结实的，你的 BMI 就可能真的是不正确的。

步骤 4：削减你的饱和脂肪摄取量。

黄油、酸奶、美乃兹这些食物以及从肉类切下的脂肪都是饱和脂肪高的，它们能升高“坏的”LDL 胆固醇，导致斑块在动脉积累。要将饱和脂肪限制到你的总热量的 5％ 或更少（将你的体重除以 12  就获得以克计的每日总限额） 。例如，尝试用蔬菜油，特别是两种含有相当数量有有益于心脏健康的单不饱和脂肪的橄榄油和菜籽油，来替换黄油；并且用瘦的家禽、鱼类和豆类来替换高脂肪的肉 类。

步骤 5：清除垃圾食品。

根据哈佛大学公共卫生学院医学博士沃尔特 威勒特最近的研究，许多包装的零食、饼干、面包货物和一些含有人工转化脂肪（又名氢化油）的人造黄油 ，它们增加的“坏的” LDL 甚至比饱和脂肪增加的还要多。在 2003 年 EatingWell 所进行的访谈中，威勒特指责转脂肪造成数百万计不必要的心脏病早亡。要仔细阅读食物标签：如果包装上声明“零转脂肪”，每份的含量就可能会少于 0.5 g 而四舍五入为零。确保你得到不含转脂肪的产品的唯一方法是避免含有“氢化油”的产品。更棒的是采购营养丰富的蔬菜、水果和干果。

步骤 6：补充纤维。

各种研究都发现高纤维食品与较低的心脏病风险相关联。按照哈佛大学研究女性健康的专业人士的说法，吃高纤维食品的人们比吃低纤维食品的人们降低 40％ 患心脏病的危险。

研究显示，瞄准包括大量富含可溶性纤维的食品，可以帮助降低“坏的” LDL。水溶性纤维能够约束胆汁酸。这是一种 我们的身体从胆固醇制造出的进行脂肪消化的关键组份。我们不能消化纤维。因此，当胆汁酸被结合到纤维上时，它们被作为废物导出体外。这会导致身体转换更多的胆固醇成为胆汁酸，最终达到降低循环胆固醇水平的效 果。水溶性纤维高的食品包括燕麦、大麦、豆类、秋葵和茄子，以及柑橘类水果，如橘子。

步骤 7：用全麦粉之类取代精制的谷物。

吃太多精制的碳水化合物（例如白面包、糕点、白面食）给身体提供了燃料和产生甘油三酯的能力。何况，加工过的粮食能够迅速地转化为葡萄糖，提高血糖水平，使人易于罹患 2 型糖尿病，这是发生心脏病的一个危险因素。选择全谷类食物，例如糙米、麦胚和奎奴亚藜以及全麦面食，其中包含了更多的纤维（它减缓淀粉向葡萄糖缓的转化）以及比加 工谷物更为健康的脂肪。

步骤 8：吃鱼。

研究显示，每周吃上两次或两次以上的鱼，可以伴随着长期降低 30 ％ 发生冠心病的风险。鱼类含有奥米加-3 脂肪酸，它能降低血液中可能有助于血液凝结的甘油三酯的水平。欧米加- 3 还能稍稍降低血压，并且可以帮助防止非正常的心脏节律。 （亚麻籽油、菜籽油和核桃也含有欧米加-3 脂肪酸） 。
步骤 9：吃干果。

研究表明，每周两到四天或更多地吃干果——胡桃、 山核桃、杏仁、榛子、开心果，松子，花生（其实是豆科植物）——的人 比很少吃这些东西的人具有较低的心脏病发病率。所有的坚果都含有有益心脏健康的单不饱和脂肪和低水平的饱和脂肪。

步骤 10：适度饮酒。

科学文献表明，适量饮酒的人比禁酒的人较少可能患心脏疾病。酒精似乎可以提高“好的” HDL 胆固醇。尤其是葡萄酒能够“稀释”血液（使其不易凝结），也包含有抗氧化剂，它能防止你的动脉接纳 LDL 胆固醇，这是可能导致斑块积累的过程。请记住，一次饮酒等于 12 盎司啤酒、5 盎司葡萄酒或者 1.5 盎司白酒。