Your heart is a complex organ that works continuously to provide your body with a constant supply of oxygenated blood (1).
It’s part of the cardiovascular system, which also includes arteries, veins, and capillaries (2).
One of the most important ways to keep your cardiovascular system healthy is by following a nutritious diet low in foods and beverages linked to poor heart health and increased cardiovascular disease risk.
In fact, research suggests that diet may be the most preventative factor in heart disease-related death, which accounts for one-third of global mortality (3, 4).
Fortunately, following a heart-healthy diet can significantly reduce your risk of heart disease-related death and may even reverse heart disease risk factors, including high blood pressure, high blood sugar, and high blood fat levels (3, 5, 6, 7).
In this article, I will explain how diet impacts heart health and share evidence-based ways to reduce heart disease risk and promote optimal cardiovascular health using simple, realistic dietary changes.
Your diet affects the health of every part of your body, including your heart.
After all, food provides the nutrients your body needs to function optimally, including protein, carbohydrates, fats, vitamins, and minerals (8).
The foods and beverages you consume on a daily basis may affect heart health, either positively or negatively, which is why diet is considered a modifiable risk factor for heart disease.
Heart disease risk factors are categorized as modifiable or non-modifiable.
Diet falls into the modifiable category because it’s something that you can change. Other modifiable heart disease risk factors include:
People can modify their diet in order to improve and protect the health of their heart. Your dietary choices can either increase or decrease your risk of some of these risk factors like obesity, high blood pressure, and high blood fat levels.
On the other hand, family health history and age fit into the non-modifiable risk factor category because they can’t be changed (9).
Blood pressure
Hypertension, or high blood pressure, occurs when there’s a persistent elevation in the pressure measured within the large arteries (10).
Hypertension is currently defined as systolic blood pressure (the top number) of 130mmHg or higher and/or diastolic blood pressure (the bottom number) of more than 80 mmHg (10).
Keeping your blood pressure within a healthy range is critical for heart health.
High blood pressure can damage blood vessels and narrows arteries, which increases the workload on your heart. This can lead to an enlarged heart and increase the risk of heart failure (11).
Diet is an important part of keeping your blood pressure at a healthy level, since some nutrients — including sodium, potassium, and magnesium — affect blood pressure regulation (12, 13, 14).
While diets high in calories, sugar, and salt can lead to high blood pressure, diets rich in nutritious foods like vegetables, nuts, olive oil, and fish can help promote healthy blood pressure regulation and may even help reduce high blood pressure (15).
One review of 28 studies found that avoiding foods linked with high blood pressure, like sugar-sweetened beverages and processed meat, was associated with 44{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} lower risk of hypertension (16).
Blood fat levels
Elevated levels of blood lipids (fats), including high levels of low density lipoprotein (LDL, or “bad”) cholesterol, can negatively affect heart health and increase your risk of heart disease (17).
Managing blood lipid levels is essential for keeping your heart healthy. Elevated levels of cholesterol and triglycerides can contribute to atherosclerosis — the accumulation of plaque along the artery walls.
Elevated LDL cholesterol is a major risk factor for atherosclerosis.
When LDL levels get too high, it can lead to a buildup of plaque in the arteries, which contributes to inflammation and increases the risk of heart disease (18, 19).
Having elevated triglyceride levels can also contribute to atherosclerosis and raise your risk of heart disease (20, 21).
Maintaining a healthy diet is one of the most important ways to manage blood fat levels.
Dietary patterns high in fiber-rich plant foods and low in added sugar and highly processed foods have been consistently associated with healthy blood fat levels and lower heart disease risk (22, 23, 24).
Blood sugar and insulin levels
Having elevated blood sugar and insulin resistance can take a serious toll on the heart.
High blood sugar can cause an accumulation of compounds called advanced glycation end-products (AGEs) and create oxidative stress, which damages the cardiovascular system and causes blood vessel dysfunction (25, 26).
Insulin resistance — when cells don’t respond appropriately to insulin and therefore can’t take up sugar from the bloodstream — also leads to cellular dysfunction, inflammation, and oxidative stress, which harm the heart (27).
That’s why diabetes is considered an independent risk factor for heart disease. In fact, people with diabetes are at two to four times the risk of developing coronary artery disease (CAD) and heart attack (28).
Diet plays a critical role in both the prevention and management of type 2 diabetes. Dietary patterns high in ultra-processed foods and added sugar are significantly linked to an increased risk of type 2 diabetes and insulin resistance (29, 30, 31).
Remember that the term “processed foods” includes a wide variety of products, many of which are more convenient and less expensive than other foods. Not all foods that undergo processing are considered unhealthy or harmful. Learn more here.
Body weight
Obesity is considered a major risk factor for heart disease (31).
Having too much body fat may contribute, both directly and indirectly, to heart disease.
The accumulation of body fat puts strain on the muscles of the heart, known as the myocardium, and can trigger the development of fibrosis, or a scarring of the heart tissue. This can lead to cardiac dysfunction and increase the risk of heart failure (32, 33).
Additionally, obesity may increase the risk of high blood pressure, high blood lipid levels, and diabetes, which are considered major risk factors for heart disease (33).
Importantly, even in people who aren’t considered obese, having abdominal adiposity (or too much fat in the abdomen) can increase heart disease risk. Abdominal adiposity is usually measured by waist circumference (WC) (31).
A higher WC indicates visceral adiposity, or a high level of body fat surrounding the organs in the abdominal cavity, which can promote systemic inflammation and contribute to atherosclerosis — the buildup of fatty deposits along artery walls (31).
Overconsumption of calories causes you to gain body fat, which can lead to obesity over time.
The standard Western diet, which is rich in calorie-dense foods like fried foods, sugary foods and beverages, and highly processed snack foods is significantly linked with obesity and heart disease risk (34).
Summary
Your diet can either increase or decrease your risk of heart disease risk factors, including obesity, high blood lipid levels, high blood pressure, and type 2 diabetes.
Diets rich in ultra-processed foods and added sugar can damage heart health and increase the risk of health conditions that contribute to heart disease development like high blood pressure and type 2 diabetes.
However, other dietary patterns can help promote heart health and protect against heart disease.
Through decades of research, scientists have narrowed down which diets are most associated with a healthy heart and low risk of cardiovascular disease.
The Mediterranean diet
The Mediterranean diet is perhaps the most studied diet when it comes to heart health. It’s based on the diets of people living in countries along the coast of the Mediterranean Sea, including Italy, southern France, Greece, and Spain (35, 36).
Mediterranean dietary patterns are generally high in plant-based foods like beans, vegetables, fruits, whole grains, seafood, and healthy fats like olive oil and nuts. These diets are generally low in ultra-processed foods, red and processed meats, and added sugar (36).
Research shows that people who follow Mediterranean-style diets have much lower rates of heart disease and heart disease-related death than people who follow Western dietary patterns (37, 38, 39).
Some studies have found that adherence to a Mediterranean-style diet could decrease the risk of heart disease by as much as 40{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} (38, 40).
The Mediterranean diet has also been shown to improve heart health and survival in those with existing heart disease (38, 41).
For example, a study including 939 people with heart disease found that those who were randomized to follow a Mediterranean diet high in extra virgin olive oil for 7 years had decreased atherosclerosis progression (42).
Those who followed a low fat diet had no changes to atherosclerosis progression (42).
These benefits may be attributed to the Mediterranean-style diets’ emphasis on nutrient-dense foods like vegetables, fruits, beans, nuts, and seafood.
These foods help reduce the risk of heart disease risk factors like obesity, high blood pressure, high blood sugar, and high blood fat levels.
Plant-based diets
In addition to the Mediterranean diet, some plant-based diets of different types, including vegetarian and vegan diets, are strongly associated with improved heart health and decreased heart disease risk.
For example, a 2021 review that included data on 410,085 people found that greater adherence to a plant-based diet was associated with a 8.1{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} reduction in heart disease-related death and a 10.2{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} reduction in heart disease development (43).
Another 2021 review that included 10 studies involving 698,707 people found that, compared with people with the lowest adherence, people with the highest adherence to plant-based diets had a 16{35112b74ca1a6bc4decb6697edde3f9edcc1b44915f2ccb9995df8df6b4364bc} lower risk of heart disease (44).
However, not all plant-based diets offer the same benefits. Plant-based diets high in refined grains, sugar-sweetened beverages, and highly processed snacks are still associated with higher risks of cardiovascular disease (44).
Other diets, such as the high fiber Dietary Approaches to Stop Hypertension (DASH) diet, have been linked with reduced heart disease risk as well (45).
In general, diets that are most associated with improved heart health outcomes are high in plant foods like vegetables, fruits, beans, nuts, and seeds, and low in ultra-processed foods, processed and red meats, and added sugar.
Summary
Certain dietary patterns rich in plant foods like the Mediterranean diet and vegetarian diets are considered cardioprotective and may help reduce your risk of developing heart disease.
Research suggests that diets high in specific foods, including vegetables, fruits, whole grains, legumes, and fish, could benefit heart health and reduce the risk of heart disease.
For example, diets rich in vegetables and fruits have been consistently linked with improved heart health outcomes and reductions in heart disease risk factors like high blood pressure and diabetes (46, 47, 48).
Of course, it’s your diet as a whole that matters most when it comes to disease prevention, but regularly consuming the following foods can benefit the health of your heart and promote overall wellness.
Fruits
All fruit is beneficial for heart health, but citrus fruits, apples, pears, and berries may be especially cardioprotective. Fruits are high in fiber, vitamins, minerals, and antioxidant and anti-inflammatory compounds like anthocyanins (48, 49).
Vegetables
Following a vegetable-rich diet can help protect your heart.
Some studies suggest that onions, garlic, cruciferous vegetables, leafy green vegetables, and carrots may have greater heart health benefits compared with other vegetables, though all vegetables are heart-healthy (48, 50).
Seafood
Seafood is high in nutrients like omega-3 fats, which benefit cardiovascular health.
A 2020 review found that each 100-gram increase in fish consumption was associated with a lower risk of coronary heart disease, heart attack, and heart failure (51).
Legumes
Beans and lentils are loaded with fiber and minerals like magnesium and potassium, which are essential to cardiovascular health. Studies show that legume-rich diets are associated with lower rates of heart disease (52).
However, more research is needed.
Whole grains
Whole grains like quinoa, brown rice, and oats are high in fiber and other nutrients associated with improved heart health. Replacing refined grains with whole grains may help reduce heart disease risk (53, 54).
Healthy fats
Adding sources of healthy fats like olive oil, olives, nuts and seeds, fatty fish, and avocado to your diet may help improve heart health. Olive oil, an important part of Mediterranean-style diets, seems to be especially cardioprotective (55).
Spices
Using certain spices regularly may benefit heart health. Studies show that spices like turmeric, garlic, saffron, and ginger have powerful anti-inflammatory effects and may help reduce heart disease risk factors (56, 57, 58, 59).
Following a diet rich in the foods listed above while limiting your intake of foods that can harm heart health is one way to take care of your cardiovascular system and reduce your risk of heart disease.
Summary
A diet rich in fruits, vegetables, legumes, fish, whole grains, and healthy fats like olive oil can protect the health of your cardiovascular system.
If you’re concerned about your heart health and want to follow a healthier diet in order to reduce your risk of cardiovascular disease, there are simple ways to make your diet more heart-healthy.
For example, adding more fiber into your diet by increasing your intake of fiber-rich foods like fruits, vegetables, and beans is an easy and delicious way to improve heart health (60).
Here’s a 3-day heart-healthy meal plan to help get you started.
Day 1
- Breakfast: an egg omelet made with sautéed peppers, kale, and onions served with sliced avocado and berries
- Lunch: lentil soup served with a green salad with pumpkin seeds, feta cheese, cherry tomatoes, and olive oil and balsamic vinaigrette
- Dinner: salmon with pesto served with broccoli and roasted sweet potatoes
- Snacks: trail mix made with almonds, cashews, sunflower seeds, and dried cherries
Day 2
- Breakfast: overnight oats made with almond butter, chia seeds, cashew milk, golden raisins, and mixed berries
- Lunch: Mediterranean quinoa salad, with arugula, chickpeas, sun-dried tomatoes, roasted red peppers, olives, and feta cheese with an olive oil and balsamic vinaigrette
- Dinner: baked chicken breast with butternut squash and asparagus
- Snacks: unsweetened Greek yogurt with diced apples, sliced almonds, and cinnamon
Day 3
- Breakfast: shakshuka — a Mediterranean-style breakfast made with eggs and tomatoes — served with a slice of sprouted grain bread topped with mashed avocado and chili flakes
- Lunch: grilled shrimp and pineapple kabobs over a large green salad with an olive oil and herb vinaigrette
- Dinner: black bean burgers served with cucumber and red onion salad and roasted herbed potato wedges
- Snacks: garlic hummus with fresh vegetable sticks
Following a diet rich in nutrient-dense foods like the ones above while limiting foods and beverages associated with negative heart health outcomes can help keep your cardiovascular system healthy and reduce your risk of heart disease.
Summary
A heart-healthy diet should consist of whole, nutrient-dense foods, particularly fruits and vegetables.
Whether you want to support treatment for an existing heart disease or reduce your risk of developing heart disease, there are many simple ways to protect your cardiovascular system through diet and lifestyle modification.
Here are some evidence-based diet and lifestyle tips for heart health.
Quit smoking
Smoking significantly increases your risk of developing heart disease and can worsen heart disease symptoms. If you currently smoke, consider quitting (61).
If you need help and resources to do so, visit smokefree.gov.
Eat more fiber-rich plant foods
Diets high in fiber have been linked to improved heart health and decreased heart disease risk. Try eating more high-fiber foods like fruits, vegetables, nuts, seeds, and whole grains (60).
Sit less and move more
Leading a sedentary lifestyle could increase your risk of developing heart disease. Make an effort to sit less and move more, if you can, by going for regular walks or engaging in other exercise you enjoy (62).
Switch to healthier fats
Fats are satisfying and make meals taste delicious. Focus on eating more sources of healthy fat like olive oil, avocados, nuts, seeds, nut butter, and fatty fish.
Consider supplements
Studies show that certain dietary supplements — specifically fish oil and magnesium — may help lower heart disease risk, especially for those with heart disease risk factors like type 2 diabetes and high blood pressure (63, 64).
Limit certain foods and beverages
Some foods and drinks like fast food, sugary beverages (such as soda), processed meats, and refined grains appear to negatively affect heart health (65, 66, 67).
Do your best to consume these only in small amounts, especially if you’re at risk of developing heart disease.
Manage stress
Chronic stress negatively affects the body in many ways and may even increase the risk of heart disease. Learning ways to manage or relieve stress whenever possible is a smart way to care for your heart (68, 69).
In addition to the tips listed above, there are many other ways to protect your heart health, including getting enough sleep and limiting your alcohol intake.
Summary
Quitting smoking, eating more fiber-rich foods, managing stress, and sitting less (if you can) are just some of the ways to promote heart health through diet and lifestyle modification.
Studies show that your diet can either increase or decrease your risk of developing heart disease.
While diets high in ultra-processed foods and added sugar have been associated with increased risk, dietary patterns high in fiber-rich plant foods like fruits and vegetables, fish, and healthy fats like olive oil can support heart health.
Whether you’re living with heart disease or simply trying to reduce your risk of developing cardiovascular disease in the future, making a few simple dietary changes can have a profound effect on your heart health.
