While I appear to be an exception to the rule, most of the grocery shopping is done by the woman rather than the man in the family.

Since most heart attack patients are men, I’d like to urge my male readers to not skip over this section. Men need to get more involved with the food they eat. Moreover, a heart-healthy diet should be a family affair.

The best classroom for learning about food and making healthy choices is the supermarket aisle. All the information you need is typically right there on food labels for you to read. But most people just pick up items and toss them into their shopping carts without giving them much if any thought.

You wouldn’t think of eating some unknown food offered to you by a stranger on the street, but you think nothing of buying and eating foods you know nothing about. The solution is quite painless. For the next three trips to the supermarket, give yourself an extra 20 minutes. That will give you enough time to read and compare labels on the foods on your shopping list. By the fourth shopping trip you’ll find that you’re repeating items, and you’ll know just which ones to pick.

It’s really important that both you and your spouse go shopping together those next three times. That way you can both learn and make decisions together. Some women may complain that the husband will get in the way, that the supermarket is no place for a man. It’s difficult to break habits. But this is the start of a whole new way of looking at foods, and you both should be involved. If you still have children at home, you might want to involve them as well.

The worst thing you can do is prepare two or three meals each evening, so that while the heart patient can have healthy foods the rest of the family can eat “normally”. Those “normal” foods aren’t really that terrific for anyone, and all of us could benefit by cutting back on fat.

While shopping you’ll find that there are two parts to each nutrition label, and that practically all packaged foods are labelled. First look at the breakdown of nutrients. You’ll see protein, carbohydrates and fats listed in terms of grams per serving. Since you now know just how many grams you have as your personal limit, you can decide whether this or that food will fit into your day’s menu. Then look farther down the label and you’ll see a declaration of the ingredients, in decreasing order by weight. Is the fat in the product from a healthy source such as soybean oil, or does it come from lard or tropical oils? With this information, you can make wise decisions. And once you’ve read that label, you needn’t do so again.

Let’s say you’re walking down the aisle and you come to the luncheon meats. Pick up a package of regular ham and another of turkey ham, and you’ll see that the turkey ham actually has more fat than the regular kind, which is actually quite low in fat. That’s because turkey ham is made from the thigh meat rather than the low-fat breasts. Next you walk to the bread section to select some rolls with which to make sandwiches. You pick up two brands, and find that one is made with soybean oil while the other has animal fat. The next time you’re shopping for luncheon meat and rolls you’ll know exactly which ones to select. See how easy it gets?

Remember that cholesterol comes only from animal foods, so don’t be fooled by advertising claims that boast “no cholesterol” for plant foods such as peanut butter or olive oil. What about those “no cholesterol” mayonnaises? Well, regular mayonnaise has only five milligrams of cholesterol per tablespoon, so removing it entirely is no big deal. Rather, read the labels for the fat content of mayonnaise. Look for fat-free mayonnaise.

Some products are very straightforward. You can see clearly that one 250 ml glass of whole milk contains 10 grams of fat while a glass of reduced fat milk has 5 grams and skim milk contains virtually none. But look a bit more closely at how serving sizes and the number of servings are listed on other products.

A can of soup, for example, might have four grams of fat per serving. But the can is said to contain 23/4 servings, or 2V? servings. Needless to say, this complicates things and makes you do a bit of calculation. After a few experiences like that, however, you’ll start rounding things off very quickly and accurately.

An increasing number of companies have begun to list not only the number of grams of fat per serving, but how that fat breaks down as polyunsaturated, monounsaturated and saturated. Of course you’ll want to choose those products that offer the least saturated fat.

A few companies also provide information about cholesterol, listing the number of milligrams per serving. This isn’t mandatory, however, and it’s usually the foods which have nothing to hide that state the facts. Remember, though, that you’ll find cholesterol only in animal foods. The biggest single source of cholesterol in the diet is the egg yolk. Depending on size, the yolk will contain 210 to 250 milligrams. So watch for eggs listed as ingredients.

You have to become familiar with all the foods on your list, even those that seem innocuous at first. Take tortillas, for example. No problem with corn tortillas. But most flour tortillas are made with lard. Look for the ones produced with soybean oil instead; they’ll be marked vegetarian.

There have been a number of conflicting reports on coffee. Fortunately, we now have data that give us the go-ahead for enjoying those steaming cups of Java.

Researchers at the Harvard School of Public Health examined the relation of coffee consumption with the risk of heart attack or stroke, and the need for bypass surgery or angioplasty, in 45,589 men from 1986 through 1990. After a very thorough statistical analysis, adjusting for every possible variable, they concluded that coffee or caffeine consumption does not increase the risk of coronary heart disease or stroke. They published their data in the 11 October 1990 issue of the New England Journal of Medicine.

But what about arrhythmias? Doesn’t caffeine increase the likelihood of irregular heartbeats? A study in the 7 November 1990 issue of the Journal of the American Association provides reassurance along those lines as well.

Cardiologists at the Oregon Health Sciences University worked with 22 patients who were regular coffee drinkers and who had ventricular arrhythmias. First they took them off their anti-arrhythmia medications. Next they asked the patients to abstain from coffee for 24 hours. Then they gave them the caffeine equivalent of two to three cups of coffee. There were no additional arrhythmias, and the researchers concluded that caffeine has little effect on the “arrhythmia threshold”.

Despite such assurances, however, recommendations call for limiting coffee consumption to less than five cups a day, or better yet a more prudent limit of two cups daily.

As for me, I’ll stick with decaf because I drink a lot of coffee while at my typewriter and, combined with all the energising exercise I do, that caffeine would give me jitters (though no arrhythmias). On the other hand, when I need a little pick-me-up at the end of a long day and when I still have a long evening to go, I do enjoy having a cup or two of the regular stuff.

The decision to drink alcohol or to avoid it must be made on an individual basis, and it’s a good idea to discuss this with your physician if you have any doubts about your own situation. On the positive side of the ledger, alcohol tends to raise the levels of the good HDL cholesterol in the blood. Moreover, a number of studies have shown that those who drink alcohol in moderation are likely to live longer than those who totally abstain.

On the other side of the ledger, certain heart patients may well be better off without the booze. Alcohol raises blood pressure in those trying to control their hypertension. Depending on just how severe your hypertension is, your doctor might rule alcohol out altogether. In addition, recent research done in Framingham, Massachusetts has shown that some middle-aged men may increase their heart disease risk by drinking. It appears that any alcohol consumption, but especially three, four or more drinks daily, leads to enlargement of the heart and resultant dysfunction. Women seem to be less affected than men.

Men in the study who already had enlarged hearts were placed in greatest danger by drinking alcohol. Again, those who drank the most had the most problems.

Other research has shown that heavy drinking can damage the heart muscle.

For those who do drink, and whose physicians see no reason that they should not do so, moderation must remain the key. This means no more than one or two drinks daily. That translates to two mixed drinks, two 170 ml glasses of wine, or two 340 ml glasses of beer per day. The kind of liquor you drink doesn’t matter; rather, it’s the total amount of alcohol you consume.

I personally enjoy a cocktail before dinner. For me it’s a way to put the work day behind me, and it gives me a chance to talk about this and that with my wife. On more relaxed occasions, we’ll share some nice wine with dinner.

On the other hand, when I’m under a bit of stress, I cut out the alcohol entirely. Contrary to popular belief, booze is a depressant, and when under stress, that’s the last thing I need. Moreover, alcohol interferes with a good night’s sleep, which is what I sorely need when times are stressful.

As I started out saying in this discussion, the use of alcohol becomes a very personal decision. Talk about it with your doctor and if he or she gives the go-ahead, enjoy a drink or two, but always in moderation.

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Cardio & Blood/ Cholesterol