We're going to sound like your parent (or doctor), but we're just going to go for it: A healthy heart starts with a healthy diet. If you think you've just entered an after-school special, well, not quite, but it's true that what you eat can affect your risk for cardiovascular diseases.
"There's actually only one diet that has medical literature, research evidence that shows coronary disease reversal and also happens to be an anti-inflammatory diet, which is good for a variety of medical conditions and also has some efficacy against many types of common cancer—and that is a predominantly plant-based, low-fat, whole-food, unprocessed diet," says Andrew Freeman, MD, director of cardiovascular prevention and wellness at National Jewish Health in Denver and co-chair of the American College of Cardiology's Nutrition & Lifestyle Work Group. "In short, I recommend that people eat a variety of all of nature's bounty, so to speak—eating the rainbow, as I sometimes say to patients. So that includes everything from whole grains to berries to all the different brightly colored vegetables."
Eating whole foods isn't a new concept or tip. In fact, in general, many experts recommend consuming those types of foods rather than processed options for overall health, not just for your heart. But what exactly are the whole foods to add to our grocery lists for hearth health and what are some watch-outs we want to avoid? We asked Freeman and Jennifer Haythe, MD, co-director of the Columbia Women's Heart Center, for their suggestions.
Foods to Eat
The Mayo Clinic says that whole grains are a good source of fiber and other nutrients that can help regulate blood pressure and heart health. When choosing whole grains, make sure to read the labels and not be fooled by the terms "multigrain" or "100% wheat," or "seven-grain," as these products might be made with refined grains.
Berries are part of the "eating the rainbow" pattern that Freeman recommends his patients follow. Studies have shown a link between berries and cardiovascular health, with a recent study released in 2019 that found eating one cup of blueberries a day could reduce risk factors for cardiovascular disease.
When choosing fruits and vegetables, Freeman recommends paying attention to where they're sourced. "I tell people to do their best to be local and to eat organic and non-GMO whenever possible, particularly for fruits that don't have peels and vegetables that don't have peels."
Well, this one is a no-brainer, really. Leafy greens especially will provide you with enough protein if you're cutting back on meat and worried about your intake. "One of the most common misconceptions and myths, particularly in this country, is that we are all protein-deficient," Freeman says. "In all my years of practice, I've never seen protein deficiency at all. To be protein-deficient in this country would require an enormous amount of effort to not get there. What most of us don't realize is that the building blocks of life are all proteins. So the apple that you eat and the orange that you eat, although not necessarily high sources of protein, still contain protein. The most striking fact of all is that pound for pound, spinach, kale, broccoli, and a lot of the green leafy vegetables actually contain more protein than a steak. But remember that a pound of steak is a fistful and a pound of dry weight broccoli or kale or spinach or whatever could be a giant trayful. So there's protein in everything, and it's very easy. I myself follow this [plant-based] diet, and without much effort at all, I'm exceeding 40 or 50 grams a day without even trying."
"Anything in the Mediterranean diet is great for your heart," says Haythe. For those who don't know, the Mediterranean diet is an eating plan inspired by the traditional cuisines of the countries in, you guessed it, the Mediterranean. It includes plenty of vegetables, fruits, whole grains, beans, herbs, and moderate amounts of dairy, poultry, and eggs. Included in the diet is olive oil, a healthy fat that Haythe recommends consuming instead of butter.
Another recommendation from Haythe, fish is also part of the Mediterranean diet. The American Heart Association recommends eating fish at least two times a week because many fish (salmon and tuna included) are high in omega-3 fatty acids, which have been shown to benefit heart health and reduce the risk of cardiovascular disease. In particular, research has shown that omega-3 fatty acids "decrease risk of arrhythmias" and "decrease triglyceride levels, slow growth rate of atherosclerotic plaque, and lower blood pressure (slightly,)" according to the AHA.
Other foods high in omega-3s include flaxseeds, chia seeds, and walnuts.
Nuts are full of healthy fats and protein, and Haythe recommends including them in your diet. According to the Harvard T.H. Chan School of Public Health, studies have found that nut consumption can help lower the risk of cardiovascular disease. The unsaturated fats in nuts can help lower bad cholesterol and raise good cholesterol, and some nuts even contain omega-3s which we already know can benefit heart health.
One note is that while nuts contain healthy fats, a serving does contain a lot of calories, so you might want to stick to recommended serving sizes. But they are still a better snack option compared to salty chips or crackers.
Haythe suggests using herbs and spices instead of salt when cooking and eating. Too much sodium can increase your risk of high blood pressure, the AHA says. Luckily, you don't need large amounts of salt for your food to taste good. There are so many spices out there that are flavor-packed (like oregano, rosemary, red pepper flakes, chili powder, and cayenne, to name a few).
Foods to Avoid
Since the focus is on whole foods, it's not surprising that processed foods are not recommended by both Freeman and Haythe. That's because a lot of processed foods have extra ingredients added like sweeteners and preservatives. Just because you're cutting back on processed foods doesn't mean you have to drastically change your diet, in some cases, it can mean making a few simple swaps. "Instead of eating oatmeal out of a packet with lots of added sugars and chemicals, I recommend just eating plain whole grain oats—add hot water and put blueberries on top. Have a nice big salad for lunch and put some beans and brown rice in there. So, [choose] simple whole foods rather than buying something very overly processed," Freeman says.
If you can't avoid processed foods entirely, the AHA advises reading the food labels carefully.
Haythe says heavily fried foods are tough on the heart, which is another tip that doesn't surprise us. A 2019 study in BMJ found that frequent consumption of fried foods (especially fried chicken, fish, and shellfish) was associated with a higher risk of heart-related death in women in the U.S.
The AHA says that red meat has more saturated fat than other sources of protein, which can raise your blood cholesterol and worsen heart disease. Haythe recommends limiting your intake to leaner cuts once a week if you can't say goodbye to red meat completely. This category includes meats like bacon, sausage, and burgers.
Say it isn't so! While Haythe notes that pizza is hard on the heart, she does say for a lot of these no-nos, there is a silver lining: "You don't have to say goodbye to these favorites forever, but try and limit to the occasional consumption. Moderation is everything!"
It also depends on what goes on your favorite pie. If it's packed with meat, lots of cheese, and of course the carb-y crust, then it's not exactly healthy-eating goals. You might want to choose healthier toppings like veggies, or cut down on the extra cheese.
Sugary drinks are packed with calories and could also contribute to heart disease. A 2019 study in the journal Circulation (published by the AHA) found that drinking four or more artificially sweetened drinks a day was associated with a higher risk of death from heart disease.
So What Else Can You Do for a Healthier Heart?
Even if you've been eating with abandon your whole life, there's still some time to turn it around and prevent cardiovascular disease. And for those who are younger, now's the time to eat better. "It's never too late, and I would argue that, unfortunately, we're all at risk for heart disease. It is the number one killer in this country of men and women. Therefore, making changes now as a younger person could prevent or change your fate in the future. It's never too early to make these changes so that you don't have to worry about things as much later in life. It doesn't mean you're invincible, but it certainly gives you better odds," Freeman says.
Haythe recommends some general lifestyle changes, too: "In general, I tell my patients to see their doctor every year to be screened for cardiac risk factors, exercise four to five times per week, quit smoking, eat a Mediterranean diet, limit alcohol consumption to twice a week, and to do what they love to reduce stress—unless that means eating a cheeseburger and fries!"