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. 2020 Feb 25;106(10):724–731. doi: 10.1136/heartjnl-2019-315499

Table 4.

Summary recommendations

Key principles Examples Special considerations
Adequate protein is essential to prevent muscle loss Good quality animal and plant protein such as lean meat, fish, dairy and nuts Older people and those with renal disease
Include higher fibre carbohydrate foods Choose foods high in fibre, for example, wholemeal bread and pasta instead of refined versions. Include non-starchy vegetables Portion control and reducing total carbohydrate required to improve glycaemia
Advise reductions in saturated fat on an individual basis and acknowledge the source Reducing processed baked pastry goods is more advantageous than reducing dairy foods for equivalent amount of saturated fat
Consider dairy intake in the context of the overall diet and health needs As above
Consume eggs as part of a reduced saturated fat healthy eating pattern - May need to consider amount of egg intake/dietary cholesterol intake in individuals with familial hypercholesterolaemia
Eat foods naturally rich in unsaturated fats Nuts, seeds, oily fish extra virgin olive oil is consumed as part of the traditional Mediterranean diet -
Include plenty of fruit and vegetables Root vegetables, green leafy vegetables, for example, kale, lettuce, spinach; cruciferous vegetables. A variety of fruits should be included Ideally fresh or frozen fruit unless canned is the only source available. Be mindful of total carbohydrate and free sugar content particularly for those with dysglycaemia
For those who drink alcohol to consume within local government recommendations of no more than 14 units/week with 1–2 alcohol free days each week. Avoid binge drinking - -
Use a whole diet approach and tailor approaches to individual comorbidities and need A traditional cardioprotective diet rich in vegetables, fruits, nuts, legumes, unrefined cereals, moderate seafood and fermented dairy food; low amounts of red and processed meats; olive oil as main culinary fat Consider reducing the carbohydrate content particularly for those with dysglycaemia, and replacing with plant-based proteins and fats