Many Kentuckians think of gifts for their sweethearts as Valentine's Day approaches. One of the best gifts is to be sweet to your own heart by recognizing risk factors for coronary heart disease, a leading cause of death in Kentucky and nationwide.

Information from university medical sources and national health agencies gives insight into the severity of coronary diseases.

Kentucky, part of the "coronary valley," has the fifth worst rate of coronary disease in the nation, according to information from the University of Kentucky Chandler Medical Center. Heart disease is the leading cause of death for adults in the United States, according to the American Heart Association. Cardiovascular disease accounts for 40 percent of all deaths in the U.S., according to the Centers for Disease Control and Prevention. This disease creates an economic burden of nearly $260 million in the costs of health care and lost work productivity.

"We can't change some risk factors for heart disease, such as family history, but we do have control over lifestyle behaviors -- notably poor nutrition and physical inactivity," said Janet Tietyen, Extension food and nutrition specialist with the UK College of Agriculture.

From a dietary standpoint, it's important to decrease fat intake, especially saturated fat, and consume sufficient amounts of fiber and folic acid, according to Tietyen and Darlene Forester, Extension food and nutrition specialist with the UK College of Agriculture.

"It's important to reduce saturated fat in the diet because excessive amounts of this fat

can raise blood cholesterol levels, which are a high risk factor for heart disease," Tietyen said. "Eating foods high in saturated fat increases the blood cholesterol level more than eating foods high in dietary cholesterol."

Tietyen said confusion about the terms "dietary cholesterol" and "blood cholesterol" might cause some people to avoid certain foods like shellfish and egg yolks that are considered high in dietary cholesterol. Yet these people would eat foods containing high levels of saturated fat like a cheeseburger. The cheeseburger would increase the blood cholesterol level more than eating moderate amounts of shellfish or egg yolks.

"In this example, the risk factor would be the saturated fat content, not the dietary cholesterol, in their food choices," she said.

"Lowering your blood cholesterol level by one percent can give you a two-percent reduction in the risk of coronary heart disease," Forester said.

The composition of a food's total fat might be misleading. Some foods appear to be unhealthy because of their high total fat content. It's important to take a closer look at the percentages of saturated, polyunsaturated and monounsaturated fats. Avocados and some nuts (walnuts, pecans and Brazil) appear to be unhealthy because of their high total fat content. Yet most of the fat content is polyunsaturated and monounsaturated. These fats, when consumed in moderation, are not harmful to heart health.

Differences in the types of fiber in certain foods also can be confusing.

"Some foods contain soluble fiber that helps lower blood cholesterol. These include oranges, bananas, carrots, apples, oats, soy foods, dried beans and peas. Other foods contain insoluble fiber, which helps the body by providing good bowel functions but does not lower blood cholesterol. Insoluble fiber is found in wheat products such as breads and cereals, wheat

bran, vegetables such as beets, carrots, cabbage, cauliflower, and apple skins," Forester said.

Adults need 20 to 30 grams of total fiber a day. At least 30 percent of this total (six to 10 grams) should be from soluble fiber, according to Forester.

"Choosing a diet with plenty of grain products and at least five servings a day of fruits and vegetables will help ensure that you consume enough fiber, as well as certain vitamins that play a role in preventing heart disease. Folic acid is one of these B vitamins. Most people need about 400 micrograms of folic acid a day," Forester added.

Some people might be surprised at the varied sources of folic acid in the diet. These can include foods with fortified wheat flour and grain products made with this flour, fortified cereals and dark green foods such as spinach, various kinds of dark green lettuce and broccoli. Orange juice is another natural source of folic acid.

Physical inactivity is another high risk factor for heart disease. A sedentary lifestyle doubles the risk for this disease. Yet it's easy to reduce this risk. Just 30 minutes of moderate physical activity like walking briskly five or more days a week gives substantial health benefits.