How To Follow a Heart-Healthy Diet

Many diets are very specific about what you can’t eat. However, the most powerful (and empowering) diets help you focus instead on what you can and should eat. In fact, research shows that adding certain foods to your diet is just as important as cutting back on others.

That especially holds true for a heart-healthy diet.

The connection between nutrition and your heart

Good nutrition and a healthy heart go hand in hand. For example, following a heart-healthy diet can help reduce your total cholesterol and bad (or LDL) cholesterol, lower your blood sugars and triglycerides, and decrease your blood pressure. For instance, potassium — which is found in many fruits and vegetables — can help lower your blood pressure.

Even more importantly, making good diet choices can also address risk factors for heart disease and heart-related conditions. That means eating healthier foods can reduce or even eliminate the chance you’ll develop certain health issues down the line.

What to eat and avoid with a heart-healthy diet

According to the American Heart Association and American College of Cardiology Lifestyle Management Guideline on the Primary Prevention of Cardiovascular Disease (2019), a heart-healthy diet focuses on:

• Vegetables.
• Fruits.
• Nuts.
• Whole grains.
• Lean animal protein.
• Fish.

Heart-healthy diets should avoid:

• Trans fats.
• Saturated fats.
• Red meat (beef, pork, veal and lamb).
• Processed meats (hot dogs, salami, pepperoni, bologna).
• Refined carbohydrates (white breads, crackers, salty snack foods, baked goods).
• Sweetened beverages (such as soda).

However, moderation is key. It can be difficult to eliminate some of these things from your diet completely, so don’t feel bad about occasionally having a small serving of an unhealthy indulgence. The trick is to keep the portion small.

In contrast, you shouldn’t overdo it on some recommended healthy foods either. For example, registered dietitian Julia Zumpano, RD, LD, notes you should limit fish that’s high in mercury, like albacore tuna, swordfish and king mackerel, to 6 ounces a week.

Heart-healthy nutrition tips

It can be overwhelming knowing what to eat (and how much to eat) to be healthy. Zumpano offers some tips on how to put together a balanced, heart-friendly diet.

Increase your fruits and vegetables intake

Your parents were right: Eat your fruits and veggies! These provide a variety of antioxidants, vitamins, minerals and dietary fiber — all things known to help prevent disease. If you have high blood pressure, a diet rich in fruits, vegetables and grains is especially recommended.

Zumpano says to aim for a combined seven to nine servings of fruits and vegetables each day: roughly four or greater for vegetables and two to four for fruit. If you don’t reach recommended serving sizes in a given day, don’t worry. It’s more about what your overall diet looks like in a week, so just load up on veggies or fruits in the following days.

One serving of fruit is equal to:

• 1 medium-sized piece of fresh fruit.
• 1/2 medium banana.
• 1/2 grapefruit.
• 1/4 cup dried fruit.
• 1/2 cup canned fruit (avoid heavy syrup and instead choose fruit in water or fruit in its own juice).
• 4 ounces 100% fruit juice (avoid sweetened juice).

One serving of vegetables is equal to:

• 2 cups raw leafy salad greens.
• 1 cup of cut-up veggies.
• 1 cup 100% vegetable juice.

How to increase fruits and vegetables in your diet

• Buy pre-cut vegetables and fruit (fresh or frozen), and then bag them up for a snack or to add to a dish.
• Have a vegetable-based soup or garden salad with light dressing with your usual sandwich at lunch.
• Instead of a cookie, enjoy frozen banana slices topped with natural peanut butter and semi-sweet chocolate chips or frozen grapes dipped in 1 teaspoon of chocolate syrup.
• Keep fresh fruit on your desk or workspace.
• If you think you’ll be missing a meal, bring a homemade trail mix of your choice of 2 tablespoons dried fruit and 2 tablespoons roasted nuts and/or seeds along with you.
• Make a fruit and veggie smoothie with produce that needs to be eaten quickly.

Eat a variety of fruits and vegetables

Where fruits and veggies are concerned, variety is the spice of a healthy life. Choosing food in a rainbow of colors ensures you’ll ingest a diverse array of nutrients. Eat carrots and oranges; tomatoes, strawberries and raspberries; plums and eggplant; blueberries and blackberries: green grapes, celery, spinach and kiwi; and yellow peppers and bananas.

Decrease saturated fats and trans fats

We all need fat in our diet, but not all fat is created equally. Trans fats and saturated fats are so-called bad fats. These raise your LDL (or bad) cholesterol, the kind that encourages plaque build-up in your arteries (that waxy substance). Red meat is high in saturated fat, as are certain kinds of cheese.

A better choice is consuming good fats, or monounsaturated and polyunsaturated fats. You’ll find these in nuts, seeds, avocados, olives, flaxseed, soy and fatty fish.

Tips

• Prepare your food with cooking oils such as olive oil or avocado oil, both of which contain healthier fats.
• Eat two to three meatless meals weekly — try split pea soup, garbanzo bean salad, bean-based meatless burgers or tofu stir-fry.
• Eat two skinless poultry meals each week.
• Limit red meat to no more than one meal per week. Choose the leanest cuts of meat possible with skin and visible fat removed. Where possible, replace red meat with seafood or skinless poultry.
• Eat omega-3-rich fish at least two to three times per week This includes cold-water fish such as tuna, salmon, trout, sardines and herring.
• Include plant sources of omega-3 fatty acids — like chia seeds, ground flaxseeds, pumpkin seeds and hemp seeds — on a daily basis by adding to meals such as oatmeal, soup, yogurt, smoothies or salads.

Substitute animal protein with plant protein

Animal proteins are the kind of protein found in beef, pork, lamb, poultry and eggs, as well as cheeses and yogurt. Although the American Heart Association recommends you eat 5.5 ounces of protein per day, the kind of protein you eat matters.

For example, animal protein often means you’re ingesting higher amounts of cholesterol and saturated fat— both of which contribute to weight gain and an increased risk of developing heart disease.

Luckily, there’s a solution. In addition to eating more veggies, you should eat more plant-based proteins. These are proteins found in food such as legumes (dried beans, peas and lentils) nuts and seeds. The American Heart Association recommends you eat minimally 5 ounces of plant protein per week.

An easy way to eat more plant-based protein is meatless meals. There are plenty of tasty recipes that provide good sources of protein but that also provide heart-friendly ingredients such as fiber, vitamins, minerals, and antioxidants.

One ounce of protein is equal to:

• 1/2 cup cooked beans, peas or lentils.
• 1/3 cup or 3 ounces tofu.
• 1 ounce nuts or seeds or 2 tablespoons peanut butter.
• 1 ounce cooked seafood, meat or poultry.
• 1 egg or 2 egg whites.

Eat more fiber

Dietary fiber is a type of carbohydrate that your body can’t digest. It’s found primarily in whole grains, fruits, vegetables, nuts/seeds and beans. As fiber passes through your body, it aids in digestion and helps eliminate waste.

When eaten as part of a healthy diet, fiber can reduce cholesterol. But that’s not its only health benefit. A diet rich in fiber helps control blood sugar, keeps your bowels running on a regular schedule, prevents gastrointestinal disease and aids in weight management.

Foods contain a mix of soluble and insoluble fiber. Each type has a unique effect on health:

• Soluble (viscous) fiber: This kind provides the greatest heart benefits because it helps lower your total cholesterol and LDL (bad) cholesterol. Good sources of soluble fiber include oats, oat bran, barley, legumes (such as dried beans, lentils and split peas), flaxseed, root vegetables, apples, pears and citrus fruits.
• Insoluble fiber: This is what people generally refer to as “roughage.” Insoluble fiber promotes regular bowel movements, adds bulk and softness to your poop, helps with weight regulation and helps prevent many gastrointestinal disorders. Good sources of insoluble fiber include wheat bran, whole wheat and other whole grain cereals and breads, nuts and vegetables.

To receive the greatest health benefit, you should eat a wide variety of fiber-rich foods. Overall, aim for a total intake of 25 or more grams of dietary fiber (soluble and insoluble) each day.

Increase whole grains

Zumpano says to stick to three to six servings of whole grains a day. Steer clear of processed or refined carbohydrates. This includes foods like white bread, white pasta and white rice.

Instead, it’s better to load up on what’s called unrefined or whole-grain carbohydrates. These foods provide more vitamins, minerals, antioxidants and dietary fiber than refined carbohydrates.

Examples include:

• Whole grain breads, crackers and cereals.
• Whole wheat pasta.
• Brown rice.
• Oats.
• Barley.
• Bulgur.
• Quinoa.

Examples of one serving of grains:

• One slice of bread.
• One small tortilla.
• 1 cup ready-to-eat cereal flakes.
• 1/2 cup cooked rice, pasta or cereal.
• 3 cups popped popcorn.

Choose lowfat or nonfat dairy products

Dairy is good for your heart, bone and blood pressure health. Zumpano recommends sticking to one to three servings of dairy per day, though. Plus, dairy products can have saturated fat, so it’s best to stick to lower or nonfat versions of your favorites.

These include skim or 1% milk, 1% or nonfat yogurt or cottage cheese, and reduced-fat cheeses. If you cannot tolerate dairy products or choose not to consume them, consider a dairy alternative to meet calcium needs such as unsweetened almond, soy or oat milk.

One serving of dairy includes:

• 1 cup milk.
• 1 cup yogurt.
• 1 ounce cheese.

Limit sweets, desserts and sugary drinks

It’s difficult to resist sugary foods such as a melt-in-your-mouth dessert or a super-sweet beverage. And (good news!) you don’t have to eliminate sugar from your diet completely — just limit your intake. Indulging in sugar a couple times a month is better than a few times a week.

If you drink alcohol, drink in moderation

Drinking alcohol is not encouraged on a heart-healthy diet. But if you do, drink in moderation. Moderate alcohol use is defined as no more than one drink per day for women and no more than two drinks per day for men. Be aware that alcohol should be avoided with some medical conditions or medications. Talk to your doctor about drinking alcohol.

Be mindful of portion control

When you’re trying to follow an eating plan that’s good for you, it may help to know how much of a certain kind of food is considered a “serving.” Here are some examples:

• 1 cup cooked pasta or rice
  Serving size: 2 starch
  Reference size: Tennis ball
• 1 slice bread
  Serving size: 1 starch
  Reference size: An adult hand
• 1/2 cup cooked vegetables or fruit
  Serving size: 1 vegetable or fruit
  Reference size: Baseball
• 1 ounce lowfat cheese
  Serving size: 1 medium-fat protein
  Reference size: Pair of dice
• 1 tablespoon olive oil
  Serving size: 1 fat
  Reference size: Half-dollar
• 3 ounces cooked meat
  Serving size: 3 protein
  Reference size: Deck of cards
• 3 ounces tofu
  Serving size: 1 protein
  Reference size: Deck of cards

Talk to your doctor about a heart-healthy diet

Maintaining an active lifestyle can have considerable heart-health benefits. Following a healthy diet in tandem with getting regular exercise improves blood pressure, cholesterol and your overall heart health. But be sure to engage in exercise that gets your heart rate up, and do so for at least 30 minutes most days of the week.

No matter what physical activity you prefer, it’s best to check with your doctor before starting any exercise regimen or radically changing your eating habits. They can offer advice and support, as well as any referrals (like to a dietitian or nutritionist) for help planning a heart-healthy diet.