Introduction

Heart enlargement, also known as cardiomegaly, is a condition in which the heart's width is more than half the width of the chest when seen in an X-ray or CT scan.¹ It can affect the various chambers and walls of the heart, but the most common form is called dilated cardiomyopathy, where the left ventricle becomes bigger and weaker. Cardiomegaly also refers to the thickening of the heart muscle. It usually occurs as a result of another health issue, like heart failure, high blood pressure, irregular heartbeats, anaemia, abnormal thyroid, alcohol or drug abuse.¹

The chances of developing heart failure, and thereby heart enlargement, increase with age, being male or being black and hypertrophic cardiomyopathy, where the heart muscle thickens, is one of the most common genetic heart diseases in the world, affecting 1 in 500 people.¹ Heart enlargement has no direct cure, but one can lead a relatively comfortable life by managing the underlying cause. Treatments usually control symptoms of the causal condition to prevent further damage to the heart. If the causal condition is treated effectively, the heart has been found to return to its normal size.¹

Treatment techniques include medications like ACE inhibitors, beta blockers, diuretics,¹ etc., or devices such as the Ventricle Assist Device or pacemaker.¹ For eligible patients, heart transplants are also an option. However, lifestyle changes like switching to a healthy diet, limiting alcohol and quitting smoking can help manage underlying causes like hypertension, thyroid disorders and diabetes.¹

Here we can explore more about heart health with dietary changes and improve overall cardiovascular function. By focusing on balanced nutrition, reducing sodium, and consuming heart-healthy fats, one can manage heart enlargement and improve the quality of their life.

Components of a heart-healthy diet

A heart-healthy diet focuses on incorporating food that promotes heart function while reducing those foods that contribute to heart disease. The following sections illuminate essential practices of heart-healthy diets:

Reducing sodium intake

One of the most common causes of heart enlargement is high blood pressure, which can be caused by stress, obesity, or excess alcohol or tobacco intake.^1,3 While it can be managed through various medications, one of the key practices that aid in lowering high blood pressure is reducing daily sodium consumption.

Sodium is one of the two elements that make up common salt. When someone consumes too much salt, the body retains more water to dilute this excess of sodium, and this increased fluid volume puts more pressure on the blood vessels.⁴ High sodium levels can also cause the blood vessels to become.⁴ This increased resistance leads to higher blood pressure.

The WHO recommends that adults with or without hypertension should consume less than 2g of salt per day, ideally 1.5g per day, which can be achieved by

• Limiting consumption of salty foods like potato chips, cured meats, instant noodles, soy sauce, jarred salsas, pickles and olives⁶
• Reading food labels on packaged foods and picking products with the least amount of sodium per serving. This applies to canned vegetables, seasoned meat or condiments⁶
• Cooking at home and ensuring that the salt content is within the prescribed limit

Prioritising  fruits and vegetables

Fruits and vegetables are rich in vitamin C and beta-carotene, which is a form of vitamin A. These have antioxidant properties, meaning they protect our body from molecules called free radicals that can cause cellular damage and contribute to health problems like heart disease and.⁷

Citrus fruits like oranges and limes, peppers, strawberries, blackcurrants, broccoli, Brussels sprouts, and potatoes are rich in vitamin C, while carrots, tomatoes, pumpkin, grapefruit, and sweet potatoes are rich in beta-carotene.^8,9 

Fruits and vegetables are low in calories, fats, and sodium and high in fibre and can help maintain a healthy weight. The American Heart Association recommends that an average adult consume 2.5 cups of vegetables and 2 cups of fruits daily.¹¹

Fresh, frozen, and canned produce have around the same nutritional values as long as there is no added salt or sugar.¹⁰ Compare nutritional information on labelling and choose those products that have the lowest amounts of added salts and sugars.

Consuming healthy fats and omega-3 fatty acids

Fats are notoriously frowned upon for being unhealthy for the heart, but the truth is, not all fats are bad for the heart. Unsaturated fats lower LDL cholesterol, which is linked to increased risk of heart disease, raise HDL cholesterol, reduce inflammation, and support brain function.¹²

Saturated fats and trans fats, on the other hand, have negative effects on health as they can increase LDL cholesterol, clog arteries, promote inflammation,  and contribute to weight gain.¹³ Fats also help absorb Vitamins A, D, E and K.¹⁴ Saturated fats and trans fats are found mostly in animal sources of food, like fatty meats, sausages, butter, lard, cheese, cream, chocolate, and in some plant fats like palm oil and nut oil.¹⁴ These must be avoided to keep the heart healthy.

Monounsaturated fats are found in olive oil, rapeseed oil, avocados and avocado oil, almonds, Brazil nuts, and.¹⁴ Omega-3 fatty acids and other polyunsaturated fatty acids are found in rapeseed oil, corn, sunflower seeds and sunflower oil, walnuts and cashews. Animal sources for omega-3 fatty acids include fish like herring, trout, sardines, salmon, and mackerel.¹⁴

However, too much healthy fat is also harmful, as fats are rich in calories, which can lead to weight gain. Therefore, moderation and variety are the  key to a healthy heart

Eating whole grains

Whole grains are good sources of dietary fibre, B complex vitamins, iron, magnesium, and selenium, which are all essential for maintaining normal functioning of the body. Dietary fibre lowers LDL cholesterol and decreases the risk of heart disease. The American Heart Association recommends consuming whole grains and products that contain at least 51% whole versus refined grains.¹⁴ Some whole grains include barley, brown rice, buckwheat, corn, millets, steel-cut or rolled oats, quinoa, and wild rice.¹⁴ Consuming whole grains and avoiding refined grains and products made with refined grains or ultra-processed foods is beneficial for heart health.

Consuming lean protein

Lean protein refers to food sources that are low in fat and calories while being rich in protein content.¹⁶ Lean protein can be chicken, turkey, salmon, cod, tilapia, lentils, chickpeas, black beans, egg whites, Greek yoghurt, cottage cheese, tofu and tempeh.

While red meat has a reputation for being bad for the heart, there is substantial evidence from recent studies showing that red meat trimmed of fat does not increase cardiovascular risk factors.¹⁶

Protein can help us feel full for longer, making it easier to control weight by decreasing the number of times we reach for a snack, because one may feel hungry after eating a low-calorie diet. Increased lean protein also helps lower cholesterol levels and reduces the risk of heart.¹⁷

Limiting added sugars

Added sugars are sugars that are added to foods during processing to increase sweetness as they are not naturally occurring in fruits, vegetables and milk.¹⁸ Examples of such sugars are sucrose, fructose, glucose, high fructose corn syrup, maltose and dextrose.¹⁸ They are generally found in cookies, cakes, sweetened cereals, sugary drinks, condiments like ketchup and salad dressings, pastries and breads. Added sugars lead to weight gain and high blood pressure, which are risk factors for heart disease.¹⁸ They also increase triglycerides and insulin resistance, which may lead to type 2 diabetes, which is a major risk factor for heart disease.¹⁸

Proper hydration

Hydration plays a crucial role in heart health as it helps maintain blood volume, regulate blood pressure, and ease the overall function of cardiovascular health.

Dehydration reduces blood volume and causes blood clots, leading the heart to work harder to pump blood throughout the body. It may also cause blood vessels to narrow, increasing blood pressure. Both instances increase strain on the heart. Proper hydration supports electrolyte balance, which is essential for heart function and helps keep blood vessels.¹⁹ Drinking water regularly throughout the day and eating hydrating fruits and vegetables can help to stay adequately hydrated and support heart health.

Avoiding alcohol consumption

Heavy drinking can damage the heart muscle, increase blood pressure, and raise triglyceride levels and abnormal heartbeats, all of which increase the risk of heart disease.¹⁹ The American Heart Association recommends that patients with heart issues lower their alcohol consumption or avoid it altogether for better management of their heart.²⁰

Controlling food portions in meals

Portion control is essential for overall health by preventing overeating, reducing calorie intake,  and managing weight. Simply eating less of all foods is not always the best approach to a healthy diet, as it could result in a deficiency of micronutrients like vitamins and minerals and an excess of macronutrients like protein and carbohydrates.²⁰ It is important to educate oneself on one’s body’s nutrient and caloric needs and choose healthy foods in the right proportion for the body’s energy expenditure. Being mindful of serving sizes and using measuring tools like cups and weights has been known to help reduce excessive consumption of food.²⁰

Summary

Heart enlargement is a chronic condition that results from various health issues like heart failure, hypertension, anaemia and alcohol or drug abuse. While there is no cure for the condition, it can be effectively managed by treating the underlying diseases through a combination of medications, surgery, and lifestyle changes. To improve heart health and quality of life, a heart-healthy diet is crucial. This diet consists of reducing sodium intake and added sugars, increasing the consumption of fruits, vegetables, and whole grains, consuming healthy fats and lean protein, lowering or completely avoiding alcohol intake, and ensuring proper hydration. Ensuring that these foods are consumed in a good proportion to the body's nutritional and caloric needs can help improve heart health and the quality of one's life.