Eating “healthy” can be confusing, so it’s pretty common to wonder what a heart- healthy diet really is. But it’s a really important topic to explore. Heart disease kills more Americans than any other cause, according to the Centers for Disease Control and Prevention (CDC). And what you eat can actually play a big part in it: In one 2017 study published in JAMA, researchers estimated that certain eating habits (like consistently having a lot of sodium or not enough veggies) may contribute to about 45% of deaths from cardiometabolic diseases, which include heart disease, strokes, and type 2 diabetes.
To understand why what you eat is so important, it can be helpful to take a closer look at the function of your all-important ticker. Your heart is the epicenter of your body, pumping oxygen-rich blood through your arteries to the rest of you. When arteries narrow or clog, a condition known as coronary heart disease, they cut off blood to your heart, jeopardizing the entire organ.
Your main goal is to keep your blood vessels pliable and unobstructed, so blood can continue to flow freely. And what you eat plays a part in determining the amount of build-up or clarity in those vessels. There’s a lot to unpack with the connection between eating and your heart health, though. Here’s what you need to know.
1. A heart-healthy diet doesn’t have to be a really restrictive diet.
When you picture a heart-healthy diet, you may think of a big bowl of plain oatmeal or a life without butter. The truth is that eating for heart health isn’t about focusing on one (or a few) foods, or avoiding some completely. It’s more about eating foods that are beneficial in multiple ways and establishing patterns you can stick with to protect your heart over time.
“Consistency is really the most important thing rather than doing something that’s very restrictive,” Kurt M. Hong, M.D., Ph.D., a professor of clinical medicine and executive director of the Center for Clinical Nutrition at USC, tells SELF.
Consider your diet part of a preventive approach to avoiding coronary heart disease, as well as to lowering risk factors of it like high blood pressure and high cholesterol—which can contribute to early heart attacks and strokes, Dr. Hong says. For best results, combine your eating plan with exercise, which keeps blood vessels pliable and helps to reduce inflammation. “People who exercise regularly tend to do much, much better in terms of heart health,” says Dr. Hong.
You may have already heard of some eating plans for heart health, including the Mediterranean Diet (rich in whole grains, nuts, seeds, fruits, vegetables, and of course, olive oil) and the Dietary Approaches to Stop Hypertension, or DASH, eating plan (high in whole grains and fruits and vegetables rich in potassium). While these are evidence-backed plans for a heart-healthy diet, the idea of following a “diet” may not be the most appealing for the long term. Instead, you can take some of their tactics—along with some other research-backed components—and use them to create a more general guide for how you can eat to best promote your heart health.
2. You don’t need to avoid all fat.
Keeping your heart healthy doesn’t mean automatically cutting out fat. “Fat is an important macronutrient that should be present in our diet,” Rafaela G. Feresin, Ph.D., an assistant professor of nutrition at Georgia State University, tells SELF. Your body uses fat for energy, nutrient absorption, and organ protection.
Instead, think about emphasizing certain sources of fats over others.
You should consider reducing consumption of saturated fat (mainly found in meat, pork, poultry, and dairy products) and trans fat (which occurs naturally in meat and dairy products and is artificially formed in fried and baked goods), says Dr. Feresin.
When you eat too much of these fats, you can increase the production of cholesterol and activate inflammatory cells that can help that cholesterol nestle into your arteries, potentially leading to blockages. While some recent studies suggest that the link between dietary saturated fat and heart risk is more complicated than once thought, the U.S. Dietary Guidelines still recommend that less than 10% of your daily calories come from saturated fats. And if you already have high cholesterol, the American Heart Association (AHA) recommends keeping saturated fats to just 5-6% of your total daily calories. (The evidence is pretty clear on trans fats, though—minimize them as much as possible. The U.S. Food and Drug Administration has even banned artificially produced trans fats, and they are being phased out of the food supply.)
Monounsaturated fats and polyunsaturated fats, on the other hand, have the opposite effect of saturated fats and trans fats on cholesterol and cardiovascular disease risk, says Dr. Feresin. In fact, according to a presidential advisory from the AHA published in Circulation, replacing saturated fats with unsaturated fats can reduce the risk of cardiovascular disease to an extent similar to statin treatment.
Rich sources of monounsaturated fats include avocado, olives, and avocado and olive oil—again, hello Mediterranean diet. Sources of polyunsaturated fats include omega-3 and omega-6 fatty acids, which you can find in sunflower seeds, flaxseed or flaxseed oil, walnuts, and fish. And those omega-3s may be particularly protective: Not only do they help stabilize the progression of plaques that can clog heart vessels, but they’re also anti-inflammatory, says Dr. Hong—and chronic inflammation itself is an independent risk factor for heart disease. Eat fish at least twice a week, the AHA says. If you’re vegan or vegetarian, you can work on getting those omega-3s through things like flaxseed or chia seeds.
Generally, it’s best to get your omega-3s from natural food sources rather than supplements.
“We never know how the supplements are absorbed,” says Dr. Hong. Plus, supplements can give you a false sense of security and lead you to eat a less balanced diet, he says. They’re also not regulated by the U.S. Food and Drug Administration (FDA) like drugs are, so you can’t be exactly sure what you’re getting.
3. Eat more fiber-rich foods.
Most Americans fall short of the recommended daily intake for fiber, a form of carbohydrate—ideally, you should be taking in 14 grams for every 1,000 calories you eat.
That can be a problem, because fiber, the hard-to-digest components of foods like fruits, vegetables, legumes, and whole grains, can help your heart in multiple ways. For one, fiber can reduce cholesterol, which can keep your arteries clearer, says Dr. Hong. Fiber can also help you regulate your blood sugar, which is important because chronic high blood sugar can put you at risk of diabetes and increase your risk of a heart attack, strokes, and other heart problems, he says. (Diabetes is also a risk factor for issues like heart attacks as well.)
Fiber may also help you cultivate a better, more diverse community of bacteria in your gut, which can ultimately contribute to reduced inflammation throughout your body, including in your cardiovascular system, says Dr. Hong.
Then there’s the fact that naturally fiber-rich foods, like whole grains, are packed with additional helpful nutrients. Most whole grains contain B vitamins and minerals such as selenium and magnesium, says Dr. Feresin, which can help your body regulate blood pressure, ward off damage to the cells, and more.
If you’re looking for ways to add fiber, Dr. Feresin recommends choosing whole wheat pasta or brown rice pasta instead of regular pasta, brown rice rather than white rice, whole wheat bread instead of white bread, whole wheat cereal, and whole oats. Try the pseudo whole grains amaranth, chia seeds, and quinoa. Add quinoa to your salad or chia seeds to your yogurt or overnight oats, she recommends. High-fiber fruits and vegetables include raspberries, pears, apples (with the skin), bananas, green peas, broccoli, and Brussels sprouts.
4. Watch your sodium intake.
Sodium is an essential mineral that helps control your body’s fluid balance. It honestly helps a lot of food taste really great, too. However, most of us consistently take in more sodium than we need—and it’s that chronic overconsumption that can become an issue for your heart. That can mean more fluid in your blood vessels, potentially leading to an increase in blood pressure that can make your heart have to work harder to pump blood throughout your body, says Dr. Feresin.
To reduce blood pressure, the AHA recommends eating no more than 2,300 mg of sodium per day. Canned foods, preserved foods, and restaurant meals can be particularly high in sodium, Dr. Hong says. So can processed meats like hot dogs, salami, sausage, and ham. While delicious, the combo of sodium and saturated fat in these meats, especially if eaten frequently over time, makes them pretty unsavory for heart health, says Dr. Hong. In fact, the top source of sodium and saturated fat in the American diet is sandwiches. Which doesn’t necessarily mean you need to swear off sandwiches forever—but it’s good to know if you’re specifically trying to eat in a way that supports optimum heart health.
Just as important as reducing sodium intake is upping your potassium intake, a mineral that counterbalances sodium in regulating your fluid balance, says Dr. Feresin. The average American consumes far less than the recommended amount of 4,700 mg per day.
Find potassium in apricots, prunes, oranges, squash, spinach, tomato, asparagus, beans, lentils, milk, yogurt, chicken, turkey, beef, salmon, and more, Dr. Feresin says. And to add flavor to dishes without sprinkling on extra salt, try adding seasonings, like herbs, hot spices, garlic, or saffron.
5. Fill your plate with color.
Fruits and vegetables are filled with fiber, and they are delivery vessels for lots of powerful micronutrients, including compounds called polyphenols. “These bioactive compounds not only contribute to taste, color, and flavor of plant foods, but they also have antioxidant, anti-inflammatory, and anti-hypertensive properties,” says Dr. Feresin. They help keep cholesterol from forming plaques, prevent blood cells from sticking together, improve artery dilation, decrease arterial stiffness, decrease blood pressure, and more, she says.
No one polyphenol can be considered the best, and there’s no one particular piece of produce you should pick up every single day. Variety is the key.
“One of the things that we believe is that those polyphenols are acting additively and synergistically, so it’s not just one; it’s actually more than one that is exerting the effect in the body,” says Dr. Feresin. “That’s one of the reasons why we advocate the increased consumption of fruits, vegetables, whole grains, and legumes, because you’re not only going to be getting a single polyphenol. You’re going to be getting hundreds of polyphenols, and getting all the other nutrients as well.”
Aim for at least four to six servings of fruits and vegetables per day, says Dr. Hong. (Servings also depend on factors like your activity level—check out MyPlate.gov for more info.) Mix it up so that you can take in a broad spectrum of nutrients at most meals. “I like to see on your plate at least three or four different colors,” says Dr. Hong.
6. Limit added sugars.
When talking about heart health, it’s a good idea to choose carbs that are rich in nutrients like fiber, rather than those that don’t bring a whole lot else to the nutrient table. That means it may be a good idea to limit your consumption of added sugars, which are often found in items like sodas, baked goods, breads, and salad dressings. “Added sugars” refers to sugars or syrups added during processing, not to the natural sugars in fruits or dairy.
Added sugars contribute to a lot of excess calories, says Dr. Hong. Calories aren’t inherently bad—you need them for energy—but if you’re looking to monitor your calorie intake for health-related reasons, like diabetes management, mainly getting them from other sources may be best. You don’t have to completely avoid all added sugars, but the Dietary Guidelines for Americans recommends limiting your consumption to no more than 10% of your daily caloric intake.
Nearly half of all our added sugars come from beverages, according to the guidelines, which makes what you’re drinking a solid jumping-off point for reevaluation. When you find an area where you can make a change—say, a regular soda habit—take it slowly, says Dr. Hong. Let’s say you drink four sodas a week. You could try reducing it down to two, and then later one, he says.
You may be able to notice some beneficial effects of swapping out your sugary beverages or other kinds of food in some health markers. In a study published in the American Journal of Clinical Nutrition, people who reduced their intake of refined grains, added sugars, and sugar-sweetened beverages (and increased their intake of fruits, vegetables, legumes, fish, and nuts) reduced several markers of cardiovascular risk, such as blood pressure and fasting blood sugar, within six months.
7. Watch your alcohol intake.
“A lot of folks really underestimate how much alcohol they’re drinking,” says Dr. Hong. “They may have a drink when they get home, another drink or two with dinner, and then a nightcap.”
Two drinks a day (for men) and one a day (for women) are considered reasonable amounts—the U.S. Dietary Guidelines consider that “moderate” consumption. More than that, and you’re drinking a lot of excess sugar. “I remind patients: Guess what alcohol gets broken down to? Sugar,” says Dr. Hong. Plus, it’s easy to snack extra when you’re drinking. Like a lot of other behaviors we’ve mentioned, this isn’t an automatically “bad” eating habit that you can never practice if you want a healthy heart. But, depending on what you snack on and how often you’re snacking while drinking, frequent extra snacking on top of your regular eating patterns can lead to weight gain, another risk factor for cardiovascular disease. (The science behind weight and heart health is complex—there are other factors to consider beyond weight that you can read more about here.)
What’s more, research suggests excess drinking can affect your heart in other ways besides weight gain. According to a study review published in the journal Alcohol Research, too much alcohol could contribute to increased blood pressure and inflammation, and may also promote the clumping together of platelets—which can lead to the formation of dangerous blood clots.
A heart-healthy diet doesn’t have to mean never having that glass of wine, that store-bought pack of cupcakes, or that extra sprinkle of salt on your popcorn. It’s more about making small changes—and following them consistently—that can add up to a big difference for your heart.