by Jenny Perez, February 15th 2024
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Helping People Choose the Best Foods for Heart Health

There is so much information out there about what to eat and not to eat. Your patients are confused about carbohydrates, proteins, and fats – the good, the bad, and everything in between.

This excerpt from the American Heart Association’s (AHA) scientific statement on popular dietary patterns, sums up the challenges your patients face on a daily basis:1

“Other sources of confusion can come from the recommendations of popularized dietary patterns for the exclusion of major food groups. For example, the Paleolithic (Paleo) diet excludes dairy; vegan diet excludes animal-sourced foods; and ketogenic diet excludes most food sources of carbohydrates.

Further contributing to consumer misunderstanding is the proliferation of popular diet books, blogs, as well as clinicians with limited understanding of what the dietary patterns entail and the evidence base for promoting cardiometabolic health.” 

As you know there is not one perfect diet, but there are proven and tested eating strategies that support the heart and overall health. In this blog, we cut through the confusion and give you science-backed guidance on how you can advise your patients on eating habits that support heart health.‡ 

The Best Diets for Heart Health

Heart conditions are the leading cause of death in the United States. One person dies every 33 seconds in the U.S. from cardiovascular conditions.2

We stress this because your patients need to be reminded of practical ways they can support their heart health and reduce their chances of developing cardiovascular conditions. Unfortunately, many people simply don’t realize how much control they have over their health, especially when it comes to choosing the foods they eat.3

The AHA reviewed 10 popular eating patterns or diets and scored them based on the association’s guidance for a heart-healthy eating pattern. The top-ranking diets according to the AHA for heart health are:4 

  1. Dietary Approaches to Stop Hypertension (DASH) diet: emphasizes eating fruits, vegetables, whole grains, nuts, legumes, seeds, low-fat dairy, lean meats and poultry, fish, and non-tropical oils.  

The DASH diet is highly flexible, making it easier for your patients to adopt and follow this for the long-term.  

  1. Mediterranean-Style diet: limits dairy and emphasizes fruits, vegetables, whole grains, legumes, seeds, nuts, fatty fish, and extra virgin olive oil. This diet does include moderate consumption of red wine.

This diet is ranked second because it does not explicitly minimize added salt and includes moderate alcohol consumption. 

  1. Pescatarian and Vegetarian diets: both diets emphasize plant-based eating, including eggs and dairy with pescatarian diets including fish. Like the DASH and Mediterranean diets, pescatarian and vegetarian diets are flexible, plant-forward, and minimize animal-based foods.  

Your patients may ask about following a vegan or low-fat diet, and while these do emphasize fruits, vegetables, whole grains, nuts, legumes, and foods and beverages without added sugar, they can be restrictive and may not provide adequate protein. This may make it difficult for your patients to follow these diets in the long-term and when not at home. Additionally, people following a vegan diet may be at risk for a vitamin B-12 deficiency, potentially resulting in anemia.4 

Because low-fat diets do not differentiate between fat sources, there is the possibility for people following a low-fat diet to consume too many not-so-healthy sources of simple carbohydrates.4 The popular ‘very low-fat and low-carbohydrate’ diets scored in the third tier of the AHA’s ranking. These diets are very limited, making them hard to follow, and do restrict recommended AHA food groups. Low-carbohydrate diets restrict fruit, legumes, and grains, resulting in a decrease in fiber and an over-consumption of saturated fat. Very low-fat diets do not permit nuts and healthy non-tropical oils, potentially causing deficiencies in vitamin B-12, essential fatty acids, and protein.4 

At the bottom of the AHA’s ranking are the paleolithic and very low-carb/ketogenic diets. While these diets are popular, they are extremely restrictive, potentially dangerous, and do not align with the AHA’s dietary guidance as they exclude a variety of foods considered healthful and may lead to disordered eating habits. The tight restrictions of these diets make them challenging to follow for the long-term, both at and away from home.4,5 

This sentence from the AHA sums up our perspective on eating for heart and overall health, “A diet that’s effective at helping an individual maintain weight loss goals, from a practical perspective, needs to be sustainable.” 4 

Eating to Support Cardiovascular Health

It helps to give your patients tips and cues when choosing foods, and cooking meals. These evidence-based dietary guidelines from the AHA are an ideal way to help your patients make informed food choices at home and when eating out:1 

  • Eat a wide variety of fruits and vegetables 
  • Choose foods made primarily from whole grains rather than refined grains 
  • Choose healthy sources of protein including fish and seafood, legumes and nuts, low-fat or fat-free dairy products, lean meat or poultry, and avoid processed meats and poultry 
  • Cook with liquid plant oils including olive, safflower, and avocado 
  • Choose minimally processed foods instead of ultra-processed foods 
  • Minimize drinking naturally sweetened or carbonated beverages and foods with added sugar 
  • Choose and prepare foods with little or no added salt 
  • Limit your alcohol intake and if you do not drink alcohol, do not start 

Best Foods for Heart Health

Remind your patients that the foods they eat do impact their heart health status. The phrase, you are what you eat rings true always.6,7,8,9,10 

  1. Fruits and Vegetables 

Numerous studies reinforce the importance of eating fruits and vegetables. Rich in vitamins, antioxidants, minerals, and fiber, fruits and vegetables are the foundation of a heart-healthy diet.

Some of your patients may not be big fans of fruits and vegetables. To help them get started, vegetables and fruits such as spinach, collard greens, cabbage, kale, carrots, peppers, tomatoes, beets, edamame, broccoli, apples, oranges, berries, pears, grapes, bananas, and grapes are easy to prepare, nutrient-packed, and widely available.   

  1. Whole Grains 

Rich in heart-healthy fiber, whole grains may help lower the chances of developing cardiovascular conditions. Along with fruits and vegetables, whole grains are important sources of fiber, vitamins, and minerals.

Encourage your patients to choose whole-grain and whole-wheat pastas, breads, tortillas, bagels, English muffins, hot and cold cereals, oats, and brown or wild rice.   

  1. Healthy Proteins

Proteins including nuts, fish, and legumes contribute to reduced risk of developing cardiovascular conditions. 

Legumes are overlooked nutritional powerhouses packed with fiber, antioxidants, and protein, helping to support lower cholesterol levels and blood pressure levels. Encourage your patients to add lentils, chickpeas, split peas, edamame, and beans to their diet.  

High in polyunsaturated fats, protein, and fiber, nuts and seeds are shown to help lower risks of cardiovascular conditions including stroke and coronary heart disease. 

Fatty fish like tuna, mackerel, sardines, and salmon are delicious sources of omega-3 fatty acids. These omega-3 fatty acids are widely studied for their heart-health support and may help encourage lower levels of fasting blood sugar, total cholesterol, systolic blood pressure, and blood triglycerides.

Encourage your patients to choose 95% lean ground beef, skinless turkey and chicken, pork tenderloin, and to avoid processed meats.  

  1. Low-Fat Dairy, Full-Fat in Moderation

Low-fat dairy products such as 1% milk, or low-fat plain yogurt, cheese, and cottage cheese, and fortified soy yogurt and beverages are ideal sources of unsaturated fats. Everything in moderation, including moderation. Keep in mind, that recent research indicates full fat milk may not increase risk of heart disease due to a lack of sufficient evidence.11

  1. Unsaturated Oils and Fats

Knowing the differences between saturated and unsaturated fats is not easy for most of your patients.

Examples of unsaturated oils include corn, canola, sesame, safflower, olive, and soybean. Trout, salmon, pine nuts, almonds, walnuts, tofu, avocado, flax, sesame, pumpkin, and sunflower seeds are all good sources of unsaturated fats.  

As equally important as eating foods shown to support heart health, is limiting consumption of sodium, added sugar, and alcohol:9 

  • Talk to your patients about reading nutrition labels and choosing low-sodium, no-salt-added, and reduced-sodium foods. 
  • Sweetened drinks, snacks, candy, and sweets are leading sources of added sugars. Added sugars are sugars that do not naturally occur in foods. Examples of added sugars include corn syrup, dextrose, glucose, fructose, sucrose, high-fructose corn syrup, brown sugar, and raw sugar.  
  • Encourage your patients to limit or stop their alcohol consumption. Alcohol is associated with raising blood pressure and triglyceride levels, weight gain, and contributing to higher risks of other health conditions and illnesses. 

February is American Heart Health Month, and we encourage you to share this article with all your patients – regardless of their heart health status.
The more people know and understand about eating for heart health, the easier it is for them to make informed and healthy food choices.

 

‡ The products and claims made about specific products on or through this Site have not been evaluated by the United States Food and Drug Administration and are not approved to diagnose, treat, cure or prevent disease. 

‡ This Site is not intended to provide diagnosis, treatment, or medical advice. Products, services, information and other content provided on this Site, including information that may be provided on this Site directly or by linking to third-party websites are provided for informational purposes only. Please consult accredited healthcare professional organizations, evidence-based herbal monographs, and published clinical research regarding any medical or health related diagnosis or treatment options. 

References 

  1. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. Christopher D. Gardner, PhD, FAHA, Chair, Maya K. Vadiveloo, PhD, RD, FAHA, Vice Chair, Kristina S. Petersen, PhD, APD, FAHA, Cheryl A.M. Anderson, PhD, MPH, FAHA, Sparkle Springfield, PhD, Linda Van Horn, PhD, RDN, FAHA, Amit Khera, MD, MSc, FAHA, Cindy Lamendola, MSN, ANP-BC, FAHA, Shawyntee M. Mayo, MD, Joshua J. Joseph, MD, MPH, FAHA, on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health. (Accessed February 7, 2024) https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001146  
  2. Heart Disease Facts: CDC.gov (Accessed February 7, 2024)
    https://www.cdc.gov/heartdisease/facts.htm   
  3. Prevent Heart Disease: CDC.gov (Accessed February 7, 2024) https://www.cdc.gov/heartdisease/prevention.htm  
  4. 10 Popular Diets Scored For Heart-Healthy Elements; Some Need Improvement: American Heart Association (Accessed February 7, 2024) https://newsroom.heart.org/news/10-popular-diets-scored-for-heart-healthy-elements-some-need-improvement  
  5. Keto and paleo diets: What are the differences? (Accessed February 13, 2024) https://www.medicalnewstoday.com/articles/326287   
  6. Heart-Healthy Foods: What To Eat and What To Avoid: Harvard Health (Accessed February 7, 2024) https://www.health.harvard.edu/heart-health/heart-healthy-foods-what-to-eat-and-what-to-avoid  
  7. 17 Incredibly Heart-Healthy Foods: Healthline.com (Accessed February 7, 2024) https://www.healthline.com/nutrition/heart-healthy-foods  
  8. Saturated Fat: Heart.org (Accessed February 7, 2024) https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/saturated-fats  
  9. Choose Heart-Healthy Foods: National Heart, Lung, and Blood Institute (Accessed February 7, 2024) https://www.nhlbi.nih.gov/health/heart-healthy-living/healthy-foods  
  10. Dietary Fat: Know Which to Choose: Mayoclinic.org (Accessed February 7, 2024) https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fat/art-20045550 
  11. Which type of cow’s milk is the healthiest? (Accessed February 13, 2024) https://www.medicalnewstoday.com/articles/whole-vs-skim-milk  

Jenny Perez is an herbal educator, researcher, and writer who has been immersed in the field of nutrition and botanical medicine for more than 20 years. Jenny has created curriculum, content, and educational materials for Quantum Nutrition Labs, Premier Research Labs, the American Botanical Council, and Bastyr University’s Botanical Medicine Department where she was Adjunct Faculty, Herb Garden Manager, and Director of the Holistic Landscape Design certificate program.