The best diet for heart health

What is a heart-healthy diet? | Heart-healthy diet plans | Heart healthy foods | Other ways to improve heart health

Heart disease is the number one killer of men and women in the United States, according to the Centers for Disease Control and Prevention (CDC). About 697,000 Americans died of heart disease in 2020–that’s 1 in 5 deaths overall, reports the CDC. Why should those statistics—or a heart-healthy diet matter to you?

You may be at greater risk than you think. About 47% of all adults in the U.S., or 116 million people, have high blood pressure. High blood pressure puts you at increased risk for heart disease and stroke. High cholesterol also hurts the heart. Given how prevalent heart disease is, no one can afford to ignore cardiovascular health.

 “Heart health is critically important for all of us to take into account,” says cardiologist Nicole Harkin, MD, founder of Whole Heart Cardiology. One of the best ways to regain control is to plan what you put in your refrigerator, pantry, and body every day. You can decrease your risk of heart disease by making positive changes to your eating patterns. Consider making one heart-healthy change a month, such as only eating dessert on weekends or adopting Meatless Mondays.

What is considered a heart-healthy diet?

In general, a heart-healthy diet is one that is heavy on fruit, vegetables, and whole grains—and light on red meat and unhealthy fats including saturated fats and trans fats. Trans fats, which are often found in foods containing partially hydrogenated oils, raise your low-density lipoprotein (LDL) levels, also known as your bad cholesterol, and decrease your HDL, or good, cholesterol.

 “You’ve heard it before, but it works,” says John P. Cooke, MD, Ph.D., professor of cardiovascular science at Houston Methodist Hospital and science advisory board member for HumanN.

Here’s a bonus: Eating a heart-healthy diet may also help you maintain a healthy weight. That, in turn, may help you further reduce your risk of developing heart disease as obesity is a risk factor for diabetes, hypertension, and heart problems.

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The best heart diets to try

Two of the best diets you can try are the Mediterranean diet and the DASH diet. Here’s what you need to know about both of them.

Mediterranean diet

The Mediterranean eating plan offers numerous health benefits, meeting the AHA’s recommendations for heart-healthy eating and even helping to reverse prediabetes. In fact, a 2013 study in the New England Journal of Medicine noted that the Mediterranean diet helped people at high risk for heart disease “reduce the incidence of major cardiovascular events.”

When you follow this eating plan, you concentrate on eating nutrient-rich, plant-based foods, including fresh fruits, vegetables, whole grains, beans, and nuts and seeds. It also recommends using olive oil instead of butter or margarine. Use  low to moderate amounts of lean meat like fish and skinless chicken, and low-fat or fat-free dairy products (instead of their full-fat counterparts). 

DASH diet

The AHA also gives a thumbs up to the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension. This plan also emphasizes the fruits, veggies, and whole grains, with smaller amounts of low-fat and fat-free dairy, fish, poultry, nuts, and vegetable oils. You also want to cut back on the saturated and trans fats. According to the AHA, this diet allows more meat and low-fat dairy than the Mediterranean diet generally does. Another hallmark of this diet is its approach toward salt: Aim to keep your daily sodium intake below 2300 mg—and ideally less than 1500 mg. 

The DASH diet emphasizes foods that contain dietary nitrates, says Dr. Cooke. Research, such as this 2015 study in the journal Hypertension, suggests that dietary nitrate may help lower blood pressure. How? Your body converts this substance into nitric oxide, which is a vasodilator. In other words, those foods help keep your blood vessels open, which helps the blood vessels of the heart feed the heart muscle itself. 

Foods like beets, leafy green vegetables, citrus foods, and nuts and seeds are high in dietary nitrates that your body can convert to nitric oxide. “Keeping your blood vessels healthy is also going to help you defeat infectious diseases,” Dr. Cooke adds. 

8 foods to include in a heart-healthy diet

First, consider the foods that you want to eat more of. When you’re selecting recipes, look for recipes that prioritize fruit, vegetables, and lean protein. To boost heart health, add these foods to your diet.  

1. Antioxidant-rich foods

“Choose foods that are rich in antioxidants, as they reduce inflammation in the body and can aid in preventing heart issues,” says Bansari Acharya, RDN, a registered dietitian and nutritionist with foodlove.com. “The best foods with antioxidants include any type of berries, especially blueberries, green leafy vegetables, citrus fruits, and avocados.”

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2. Olive oil

Olive oil is an example of monounsaturated fat and has been shown to improve heart health, but experts also note that you’re replacing other, less healthy oils and fats when you use olive oil, which is another benefit. 

3. Low-sodium condiments, soups, and snacks

Opt for low- or reduced-sodium versions of condiments and soup, which often contains more sodium than you might realize. According to the Cleveland Clinic, you can reduce the extra fluid around your heart and lungs by minimizing or reducing sodium in your diet. That means your heart doesn’t have to work as hard to pump blood and it reduces your blood pressure. 

4. Quinoa 

Not only is quinoa filling, but it contains antioxidants and heart-healthy fats that can also help improve your good cholesterol levels. 

5. Whole grain breads, cereals, and pasta 

Whole grains, which are part of a heart-healthy diet, are a great source of dietary fiber, according to the American Heart Association. The AHA recommends reading food labels carefully and choosing 51 percent whole grains versus refined grains. Examples of whole grain foods include whole wheat bread, brown rice, and rolled or steel cut oatmeal.

6. Low-fat yogurt, milk, and other dairy products

When you replace full-fat dairy products in your diet with low-fat versions, you’re making a swap that’s better for your heart according to a study in the American Journal of Clinical Nutrition. That’s because foods that are lower in saturated fat tend to be better for your cardiovascular system. 

7. Walnuts

Walnuts contain high levels of omega-3 fatty acids, which are beneficial for your heart. In fact, according to the Mayo Clinic, one major benefit of omega-3 fatty acids is that they seem to reduce the likelihood of irregular heart rhythms that can lead to heart attacks. Research also suggests that they improve endothelial function, thus helping your arteries stay fully open and functioning correctly. Flaxseeds and soybeans are other examples of foods rich in omega-3s and polyunsaturated fat.

8. Fish rich in omega-3s

Opt for fish that’s high in those healthy omega-3 fatty acids, which can decrease your triglyceride levels, decrease your risk of heart failure and stroke, and even slightly lower your blood pressure. You can choose from a wide variety of fish, including salmon, sardines, mackerel, herring, and cod. 

You can start with a few positive changes or additions to your diet so you don’t get overwhelmed by trying to overhaul your whole diet at once. “Starting small and making those small changes that are easily attainable are key,” Dr. Harkin says.

For example, try introducing one vegetarian meal per week. It could be a new dish or a change to a favorite dish. For example, you could replace the red meat in your Tuesday night tacos with legumes like black beans or lentils, which are good sources of soluble fiber and plant-based protein. Another couple of tips that might help: Try to incorporate as many food groups into your meals as you can, and don’t forget to watch your portion sizes. Aim for having half your plate filled with vegetables. Decrease the amount of food you take in. Fix your plate in the kitchen (as opposed to the dining room table) and then put leftovers in the fridge to make them less accessible.

4 foods to avoid in a heart-healthy diet

After you change to heart-healthy fare, consider the foods that you want to limit or avoid altogether. Foods that are high in saturated fat top the list, as they drive up your blood cholesterol levels, notably your LDL cholesterol. This includes a lot of foods that come from animal products, including many kinds of meat and full-fat dairy. Avoid or eat these foods sparingly.

1. Cured and processed meats

Cured and processed meats—like bacon, sausage, and salami—tend to be high in saturated fat and sodium, which can raise your blood pressure and cause your feet to swell.

2. Red meat 

Research has long suggested that the more red meat you eat, the greater your chances of developing cardiovascular disease. As the Cleveland Clinic suggests, it may be better for your heart to go easy on the red meat, especially the high-saturated fat kinds, and opt for leaner sources of protein as much as possible instead. 

3. Full-fat dairy products

Full-fat cheese, yogurt, and milk make this list of foods to avoid or limit. So does butter. It’s not that you can never eat these foods again, but you want to be judicious about them and only eat small amounts occasionally. 

4. Refined sugars

A diet heavy on foods that are high in refined sugars can result in higher levels of triglycerides and LDL cholesterol, the “bad” cholesterol that can build up in the walls of your arteries. Refined sugars also seem to contribute to inflammation in the body, which can stress your heart and blood vessels, according to the Mayo Clinic. And refined and added sugar appears in lots of foods, including usual suspects like cookies and cakes, but also in salad dressing and pasta sauces. And yes, the list also includes sugary beverages like soft drinks. 

If you’re not already doing so, start reading nutrition facts labels when you’re still at the grocery stores to find out how much saturated fat is in the food before you buy it. The AHA recommends limiting saturated fat consumption to about 5 percent or 6 percent of your total caloric intake. That works out to about 13 grams of saturated fat per day if you’re sticking with a 2,000-calorie daily eating plan. 

But if you occasionally slip up or overindulge in something that’s not quite so good for you, don’t fret. You’ll sometimes have departures from your heart-healthy eating pattern, and that’s okay. As Dr. Cooke notes, everyone gets tempted from time to time. The important thing to do is to acknowledge it and move on. Give yourself some grace and don’t dwell on any so-called mistakes.

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Other ways to improve heart health

If diet alone isn’t improving your heart health, there are other options—from lifestyle changes to medication.

Exercise

In addition to eating a heart-healthy diet, you should commit to regularly working out. “Eat more vegetables, eat more fish, and get exercise every day—30 minutes of exercise every day—and you’ll be healthier,” Dr. Cooke says.

Ideally, you want to incorporate three different kinds of exercise into your life:

• Aerobic exercise
• Strength training
• Balance/flexibility exercise

Most people think of aerobic exercise as the kind that benefits your heart. And true, walking, jogging, cycling, swimming, and other kinds of aerobic exercise improve your circulation and your heart’s ability to pump blood effectively. But you should have a blend of all three kinds because they benefit your overall health, which ultimately is also good for your heart. Plus, you may find it easier to maintain a healthy weight if you’re exercising regularly. And if you already have heart disease, exercise is even more vital. It can improve your health and help you feel better. 

Lifestyle changes

One crucial lifestyle change that you should make, if you haven’t already: stop smoking. As the Centers for Disease Control and Prevention (CDC) warns, smoking is a major cause of cardiovascular disease. And the risk goes up the longer and the more you smoke. Quitting isn’t easy, but you can access many resources to help you, such as the free quitSMART app. 

Other lifestyle changes that the American Heart Association recommends for improving your heart health:

• Limit your alcohol consumption (for women seven drinks or less per week and for men 14 drinks or less per week)
• Reduce your stress levels (try yoga or meditation to help)
• Manage your blood sugar levels if you have diabetes

Medication

Eating a heart-healthy diet is definitely a step in the right direction, but you want to be mindful about your medications, too. Don’t stop taking any medication that your cardiologist may have prescribed without discussing it with your healthcare provider first.

“If you have a heart condition, lifestyle is not a replacement for your medications,” Dr. Harkin says. “There are certain circumstances in which we can certainly decrease the dose or stop some medicine. But that should always be done under the supervision of your doctor.”

If you have heart disease or a condition that raises your risk of heart disease, you may be taking one or more types of medication for your condition. For example, if you have high cholesterol, you might be taking a medication to lower cholesterol levels, perhaps a statin like Lipitor or Crestor.

Other medications that you might be taking include one or more of the following:

• Anticoagulants (blood thinners)
• Antiplatelet agents or dual antiplatelet therapy
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers
• Angiotensin receptor-neprilysin inhibitors
• Beta blockers
• Calcium channel blockers
• Diuretics
• Vasodilators

Of course, there are some foods that are problematic when you’re taking certain meds. Make sure to discuss any potential food-drug interactions with your healthcare provider and pharmacist when you’re planning to start a new diet.

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Supplements

If you aren’t getting all the nutrients you need from heart-healthy food, supplements may help. Some heart-healthy supplements include:

• Omega-3 fatty acids
• Magnesium
• Inositol
• Folate
• Grape seed extract
• Coenzyme CoQ10
• Vitamin D

It’s important to consult your healthcare provider and pharmacist before starting any new supplements because they could interact with other medications you’re taking.