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Eat Smart for a Healthy Heart

The latest Dietary Guidelines for Americans reinforce some important messages for healthy eating. For example, focus on fresh fruits and vegetables; high-fiber foods; whole grains; legumes, including peas, beans, certain nuts; fish and olive oil.

But how do you know where to start? What foods are most beneficial, and which are not? And how can you make sense of reports that say “eat this” one day and “don’t eat that” another?

The good news is there are now several healthy eating plans—two of which were specifically outlined in the Dietary Guidelines—that can help. More and more research shows these diets—really more of a way of eating than “diets”—are heart protective and help to promote healthy eating overall, including how we choose to cook and prepare our foods.

Smart choices and healthy eating can help to lower your risk of high blood pressure, high cholesterol and type 2 diabetes.

Even the healthiest among us can benefit from heart-healthy eating patterns, but adopting a healthy eating plan is especially helpful for people at risk for, or who already have, heart disease. These patterns of eating are designed to help you get the nutrition you need, but also stay within your calorie limits and help manage cardiovascular risk. Heart-healthy dietary patterns have also been shown to lower the risk of many other chronic diseases, including dementia, diabetes and some cancers. Of course, getting regular physical activity is also a key component of any effort to live healthier and prevent heart disease, diabetes and other health issues.

Below is a snapshot of several heart-healthy eating patterns. As always, it’s important to talk with your doctor or heart team about what’s right for you.

What do most of these plans have in common? They stress a diet rich in whole foods that is filled with fruits, vegetables, whole grains and unprocessed foods.


The Mediterranean Diet

What it is: Although there isn’t a single Mediterranean diet, this eating plan commonly emphasizes:

  • Fresh fruits and vegetables
  • High-fiber foods, whole grains
  • Legumes, including peas, beans, certain nuts
  • Some fish
  • Some olive oil

Fats make up a greater proportion of this diet, but they are mostly from unsaturated oils, such as fish oils, olive oil, and certain nut or seed oils (canola, soybean or flaxseed oil), which are thought to have a protective effect on the heart. The Mediterranean diet is also light on dairy and meats.

Benefits: This diet has been linked to weight loss, a lower likelihood of developing diabetes, heart disease, or having a heart attack or second heart attack, improvements in blood pressure and blood cholesterol, and it may even help to slow memory loss.

In fact, a large trial of nearly 7,500 adults showed that following a Mediterranean diet with added olive oil or nuts reduced the number of cardiac events—stroke or heart attack—by nearly one-third among people already at high risk.

Nutrition and healthy eating are an essential part of lowering your risk of heart disease and recovery after a cardiac event.

The DASH (Dietary Approaches to Stop Hypertension) Diet

What it is: The DASH diet is a balanced eating plan that focuses on eating fruits and vegetables, healthy fats, whole grains, protein-rich foods, and low-fat or nonfat dairy. It is often recommended to help treat or prevent high blood pressure (hypertension) and stresses limiting the amount of sodium you consume each day to about a teaspoon of salt (about 2,300 mg). But certain people—those with high blood pressure, diabetes, chronic kidney disease or if you are older than 50—should aim for 1,500 mg or fewer.

Related tip: Many processed foods have unhealthy amounts of fats and sodium. Not eating enough foods with potassium, calcium and magnesium may contribute to high blood pressure, so it’s important to focus on eating a balanced diet.

Benefits: There is a link between eating salt and having high blood pressure. By focusing on foods and preparations that minimize salt, the DASH diet can help you eat healthier so you can prevent or reduce high blood pressure. African-Americans, older adults and people with diabetes who are at greater risk may benefit most from lowering their dietary sodium intake.


Vegetarian Diet

What it is: As it sounds, the vegetarian dietary pattern cuts out meat, sometimes seafood as well, and is rich in plant-based foods. Instead, these diets—and there are several—encourage eating more nuts, seeds and soy products, as well as fruits and vegetables and whole grains. Some people adopt what’s called the “flexitarian” approach to try to limit animal proteins, but still allow for some.

Benefits: There is evidence that a vegetarian diet can reduce blood pressure and may promote health benefits, including lowering the risk of death. This is likely due to the fact that many foods common in the vegetarian diet, including fruit, vegetables and nuts, have been shown to have many health benefits and improve heart health. Also, research has shown that reducing consumption of red meat and increasing consumption of fish and lean meats can help reduce heart disease risk.  Vegetarian dietary patterns have been associated with reductions in atherosclerotic cardiovascular disease and many forms of cancer.

Related tip: Vegetarian diets can range from excluding meats to strictly vegan (no animal products). Following these diets means you may get lower amounts of protein, so it’s important to find alternative sources (e.g., beans, milk).

A number of other eating patterns, including the Therapeutic Lifestyle Changes diet, can help you lower cholesterol or other risk factors and make sense of how many calories, cholesterol, total fat, soluble fiber and other nutrients you need. As with some of the other eating plans, the TLC diet also focuses on other lifestyle changes, including getting exercise most days and weight loss, if needed.

Keep in Mind

  • Try not to be too rigid with your eating pattern, and make sure it fits your lifestyle so you can stick with it.
  • What’s on your plate and proportions of foods matter—aim to include a variety of colorful foods on your plate and remember portion control (for example, a serving of meat should be about the size of a deck of cards).
  • Look for hidden sources of fats, sugar and sodium.  Avoid processed foods because they tend to have these things in them!
  • Ask your doctor or care provider whether you might need certain nutrients or vitamins or whether some are left out of prescribed diets (for example, you may get less protein with a vegetarian diet).
  • Be mindful about ALL food choices—at home, while eating out and while shopping for groceries.
  • Enlist the support of family members and friends to help you adopt and stick to a healthier dietary pattern.
  • Try to cook your own food. This way, you know what is in it.

Talking to Your Care Team

It’s important to talk with your health care provider about your diet; this includes any concerns or obstacles that may make healthy eating difficult.

It’s also a good time to discuss other important lifestyle issues such as stress management and sleep habits. Nutrition and healthy eating are also key parts of any cardiac rehabilitation program.

Here are some questions you might want to ask:

  • How can I change my diet to make it more heart-healthy?
  • Should I consult a dietitian or nutritionist? Who would you recommend?
  • What types of foods should I eat, or avoid, to help prevent or manage cardiovascular disease?
  • What are the best sources of fiber and omega-3 fatty acids?
  • What are the most common sources of added sugars? How can I best avoid excess salt?
  • Is there a specific diet you would recommend (DASH, Mediterranean or vegetarian)?
  • Should I be taking any dietary supplements?
  • Based on my cardiovascular risk factors, what is the most important change I can make to my diet?
  • How can I create a dietary approach that fits my life and culture?

Helpful Resources

CardioSmart provides an array of information and tips for heart-healthy living. Below are some other reputable organizations that you can rely on:

American Academy of Nutrition and Dietetics (This website also help you to find a registered nutritionist or dietitian.)
www.eatright.org

American Heart Association – Nutrition Center
www.heart.org

Choose My Plate/United States Department of Agriculture (This website helps show how to fill your plate to make healthier food choices.)
ChooseMyPlate.gov

National Heart, Lung and Blood Institute
www.nih.nhlbi.gov

National Library of Medicine
www.medlineplus.com — search for heart disease and diet

For more information about the new Dietary Guidelines, or to access the full report, visit: http://health.gov/dietaryguidelines/2015/guidelines/.

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Last Reviewed: March 2019
Medical Reviewer: Andrew Freeman MD, FACC
CardioSmart Editor-in-Chief: Martha Gulati, MD, FACC
Originally Published: May 2016

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