Q: I am 34 years old. I have rheumatic heart disease. I got a valve changed 5 years ago, and am on anticoagulants. What kind of diet should I take?

A:Even modest changes in diet and lifestyle can improve your health. In general, eat foods low in cholesterol, saturated fat and salt. These are a few foods known to protect the heart - seafood, fruits, vegetables, nuts, grains, legumes, onions, garlic, olive oil, alcohol in moderation, foods high in Vitamin C, E and Beta Carotene. Minimize the following foods - meats and dairy foods high in saturated fat, excessive alcohol.

• Eat little or no meats, dairy and processed foods, which are high in saturated fat.
• If you are overweight, adopt a healthy weight-reduction diet plan and stick to it. Obesity places a strain on the cardiovascular system.
• Make sure that your diet is well balanced and contains plenty of fiber. Fibre from cereal, vegetables, and fruits is the most beneficial. Eat more organically produced grains, legumes, fruits, vegetables and seeds.
• Eat plenty of fresh fruits and vegetables. Emphasize foods that are rich in the antioxidant substances (beta-carotene, vitamins C and E, and selenium) that fight free radicals. Enjoy fruits, tomatoes, carrots, sweet potatoes, dark leafy greens, alfalfa sprouts, and whole-grain products.
• Include grapes, eggplant, and red cabbage in your menu. Pigments called anthocyanins in grapes may help lower the risk of heart attack and stroke. Anthocyanins are found in blue and purple fruits and vegetables.
• Take in no more than 4 to 6 teaspoons oil per day. The type of fat you consume is also very important. Monounsaturated fats, found in olive and canola oil, cause levels of low-density lipoproteins (LDL, often known as the bad cholesterol) to decline without affecting levels of high-density lipoproteins (HDL, often known as the good cholesterol). Saturated fats, (type of fat found in animal products such as meat and dairy foods, and trans - fatty acids found in margarine, shortening, and hydrogenated and partially hydrogenated oils, have the opposite effect. Avoid consumption of saturated fats.
• Include raw nuts (except peanuts), olive oil and mackerel in your diet. These foods contain essential fatty acids that are important for cardiovascular health.
• Include garlic and onions in your diet. They contain compounds that help to reduce serum cholesterol levels.
• Avoid grilled and barbecued foods. Carcinogens that form during the browning process contribute to inflammation of the arteries and the deterioration of the heart muscle.
• Avoid stimulants such as coffee and black tea that contain caffeine. Coffee increases stress hormones in the body. Also avoid tobacco, alcohol, chocolate, sugar, butter, red meat, fats (particularly animal fats and hydrogenated oils), fried foods, processed and refined foods, soft drinks, spicy foods, and white flour products, such as white bread.
• Drink at least eight 8-ounce glasses of water every day.
• Eliminate all sources of sodium from your diet. Salt contains sodium, which increases fluid retention and makes the heart work harder. Limit their sodium intake from all sources to the equivalent of no more than 1 teaspoon of salt daily.
• Since you are taking anticoagulant (blood thinner) limit your intake of foods high in vitamin K. Eating foods containing vitamin K increases the tendency of blood to clot. Foods that are rich in vitamin K include alfalfa, broccoli, cauliflower, egg yolks, liver, spinach, and all dark green vegetables. To enhance the effect of anticoagulants, eat more of the following: wheat germ, vitamin E, and soybeans.
• Eat a variety of foods from the five different food groups to supply your body with the nutrients it needs.