Medically reviewed by Angela Ryan Lee, MD
Maintaining a healthy heart is important for overall well-being, especially considering heart disease is the leading cause of death in the U.S. Concerningly, nearly half of Americans have at least one of the three major risk factors of heart disease: high blood pressure, high cholesterol, or a current status of smoking.
Although other heart disease risk factors like family health history and age can't be changed, you can proactively lower heart disease risk through controllable measures like diet. Research shows changing your diet can be a crucial factor in reducing the risk of heart disease and other cardiovascular diseases (CVDs)—after all, a diet that is not well-balanced is the primary cause of CVD.
Heart Disease vs. Cardiovascular Disease
Cardiovascular disease (CVD) is the overarching term for all diseases that affect the heart or blood vessels, including heart disease. Heart disease is the term for conditions that affect the heart’s structure and function. The most common heart disease is coronary heart disease, which is when plaque collects in your arteries. All heart diseases are CVDs, but not all CVDs are heart disease.
Here are the three most effective heart-healthy diets, based on research:
The Mediterranean diet is considered one of the best diets for heart health. The diet describes the eating patterns of people living in the countries along the Mediterranean Sea, including Greece, Italy, Spain, Crete, Southern France, and parts of the Middle East.
Centered on minimally processed, plant-based foods, the Mediterranean diet is made up of the following.
Fruits and vegetables
Legumes (beans, lentils, peas)
Olive oil as the primary fat source
Dairy products, eggs, fish, and poultry in low-to-moderate amounts
Wine (specifically red) in low-to-moderate amounts, usually with meals
The Mediterranean diet's health benefits are attributed to the diet as a whole because the different food groups within the diet target various CVD risk factors like low-density lipoprotein (LDL) cholesterol, blood pressure, and inflammation.
For example, fiber-rich foods like fruits, vegetables, legumes, and whole grains are shown to decrease cholesterol and blood pressure.
Olive oil and fish, due to their unsaturated fat content, can help lower LDL cholesterol. LDL, known as "bad" cholesterol, deposits cholesterol in artery walls, causing inflammation and plaque buildup. This narrowing of arteries can block blood flow, increasing the risk of major cardiovascular events such as heart attack or stroke.
Red wine can be beneficial for reducing inflammation and blood pressure due to its antioxidant properties.
Research has shown the Mediterranean diet is associated with significant improvements in inflammation markers, waist circumference, lipids (fats in the blood), plaque, and other measurements of cardiovascular health. The Mediterranean diet is also linked to a lower risk of death from CVD and a longer life.
One thing to note is the definition of the Mediterranean diet varies across studies and countries, reflecting the region's diverse culinary traditions. It's a dietary pattern without strict rules on portion sizes. This can be beneficial for people who prefer flexibility over rigid diet rules. However, the lack of rules may be a challenge for someone who needs more guidance on watching portions and calories for weight loss.
The DASH diet is another leading heart-healthy diet. It stands for Dietary Approaches to Stop Hypertension. The DASH diet was created in 1997 by the National Heart, Lung, and Blood Institute to prevent and treat high blood pressure (hypertension), a risk factor for CVD.
Research has shown the DASH diet reduces blood pressure in people with or without hypertension. It's also been shown to lower LDL cholesterol, triglycerides (a type of fat in your blood), blood sugar (glucose), and insulin resistance (an inefficient use of insulin, the hormone that controls blood sugar).
The DASH diet is associated with a lower risk of CVD, heart failure, and diabetes. Like the Mediterranean diet, it's linked to a lower risk of death from CVD and as well as greater longevity.
The DASH diet is rich in fruits, vegetables, whole grains, low-fat or fat-free dairy, fish, poultry, beans, nuts, and vegetable oils. It's recommended to consume foods rich in calcium (found in dairy and leafy greens), potassium (found in various fruits and vegetables), and magnesium (found in nuts, seeds, and whole grains). These nutrients help maintain healthy blood vessels.
The DASH diet limits sodium, high-saturated fat foods (fatty meats, full-fat dairy, and tropical oils like coconut and palm oil), and sugary foods and drinks.
The DASH diet offers daily and weekly nutrition targets. These targets vary based on whether you eat 1,200-2,600 calories a day. Here's an example of nutrition targets for a 2,000-calorie DASH diet:
Grains: 6-8 daily servings
Meats, poultry, fish: 6 or less daily servings
Vegetables: 4-5 daily servings
Fruits: 4-5 daily servings
Low-fat or fat-free dairy products: 2-3 daily servings
Fats and oils: 2-3 daily servings
Sodium: No more than 2,300 milligrams daily
Nuts, seeds, beans, and peas: 4-5 weekly servings
Sweets: 5 or fewer weekly servings
The DASH diet is beneficial for people who like a structured eating plan. However, because of the plan's need for substantial food tracking and portion control, the diet can be challenging for some people to follow if they don't have regular support from peers or a healthcare provider knowledgeable about the diet.
A healthful plant-based diet is another proven heart-healthy diet. It's a high-fiber, low-saturated fat diet consisting primarily of fruits, vegetables, whole grains, nuts, and legumes.
There's a variety of plant-based diets, and they differ in terms of how often animal products are consumed. For example, a vegan diet excludes all animal products, a lacto-ovo-vegetarian allows dairy and eggs, and a pescatarian diet includes fish.
This flexibility in diet types is advantageous for people exploring plant-based diets. Regardless of type, a healthful plant-based diet limits or avoids foods associated with CVD risk, such as fried foods and sweets.
Consuming a plant-based diet is linked to a lower incidence of CVD. Plant-based diets typically exclude processed meats, which can increase blood pressure and endothelial (inner lining of blood vessels) dysfunction due to their high sodium and nitrate content.
Additionally, plant-based diets have been shown to reduce LDL cholesterol, blood pressure, blood sugar, inflammation, and excess weight even when compared to an omnivore diet (a diet that includes plant and animal sources) with similar calorie intake.
A further benefit of adopting a plant-based diet is its potential cost-effectiveness, as it's typically more affordable than animal-based foods.
It's important to note that plant-based diets may provide lower levels of specific nutrients, such as vitamin B12, calcium, vitamin D, and protein, compared to omnivorous diets. As such, dietary supplements may be required.
Who Can Benefit From These Diets?
Given that heart disease is the leading cause of death and a third of Americans have a significant risk factor for heart disease, adopting a heart-healthy diet can benefit many people.
You might want to more strongly consider adopting a heart-healthy diet if you have a family history of CVD. Having family members with heart disease makes you more likely to develop the disease yourself.
People from various racial and ethnic groups might also want to consider following a heart-healthy diet. Heart disease is the main cause of death for most groups, including African Americans, American Indians and Alaska Natives, and whites. It's the second-leading cause of death (after cancer) for Asian Americans and Pacific Islanders.
African Americans in particular are at a disproportionately greater risk for heart disease, likely due but not limited to aspects like income, healthcare access, and systemic racism within healthcare that make the population more susceptible to heart disease risk factors like high blood pressure. Making impactful changes to factors you might be more able to change, like diet, can help reduce the risk.
Heart-healthy diets can also provide advantages that extend beyond heart health, encompassing longevity and blood sugar control. So people looking for those benefits might want to consider following a heart-healthy diet, too.
How To Get Started
To implement a heart-healthy diet, start gradually by incorporating more fruits, vegetables, whole grains, and lean proteins. Gradual changes make sustainable habits, so begin with small adjustments.
If cost or time is a barrier for you, know that a heart-healthy diet can be made accessible. Here are some ways you can make a heart-healthy diet more affordable and less time-consuming:
Opt for seasonal produce, which is usually more affordable.
Purchase frozen and canned fruits and vegetables, as they provide cost-effective, shelf-stable alternatives.
Utilize local farmer's markets and community resources for affordable, fresh produce and meal planning tips.
Incorporate legumes, such as beans and lentils, especially in their dried form, for an economical and rich source of protein. Canned beans are especially convenient as they require no soak time.
Diversify your protein sources by including canned fish like tuna or salmon in your rotation. Not only are they nutritionally rich, but they're also a more economical alternative to their fresh counterparts and require less prep time.
Plan meals in advance, and consider buying shelf-stable foods in bulk to save money.
Inquire with your store about available coupons, particularly for items such as produce, canned beans, oats, eggs, and poultry or seafood.
More Tips for Heart-Healthy Eating Habits
Incorporating a Mediterranean, DASH, or plant-based diet isn't the only way you can benefit your heart health through food. There are plenty of other steps you can take when buying or making food to improve and maintain heart health.
Make it a habit to read food labels. Remember, foods with lots of salt, added sugar, and unhealthy fats can increase your risk of heart and metabolic problems.
When comparing products, opt for those labeled as "reduced sodium," "no salt added," or those with lower sodium content for the same serving size. Additionally, choose items with reduced added sugar, and steer clear of unhealthy fats like saturated fats and trans fats.
Eating more often at home gives you more control over the sodium in your meals. Instead of using salt, experiment with different spices and herbs to flavor your meals.
Reduce saturated fat intake by choosing leaner cuts of meats and trimming off the fat and skin. Additionally, opt for healthier cooking oils like olive, avocado, or canola oil rather than using butter, palm oil, coconut oil, or lard.
Familiarize yourself with other terms for sugar like corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, raw sugar, and sucrose. Restrict consumption of products with high added sugar content, including sweetened drinks like soda, sweetened tea, and energy drinks. Similarly, limit the intake of sweet foods such as pastries, ice cream, and candy.
Portion control is also a key aspect of maintaining a heart-healthy diet. Monitoring the size of your servings helps prevent overeating, supporting weight management and overall cardiovascular health. An easy way to regulate portions while ensuring a balanced diet is to incorporate the MyPlate method endorsed by the U.S. Department of Agriculture. By dividing your plate into sections for fruits, vegetables, proteins, and grains, MyPlate offers a visual guide that encourages a balanced diet.
A Quick Review
The best diets for heart health include the Mediterranean diet, DASH diet, and plant-based diet. All three prioritize food groups and specific foods that benefit your heart, including fruits, vegetables, whole grains, and nuts. Following a heart-healthy diet can be beneficial for many people, especially those who may be at even greater risk for heart disease, including those with a family history of heart disease. If you are concerned about accessibility to food, price, or time being a barrier to following a heart-healthy diet, there are ways to make the diet easier and affordable.
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