Heart-healthy diet: what is it and 9 tips to following one

The campaign to raise heart-health awareness is going about as well as the War on Drugs—that is to say, not so much. About 800,000 Americans will have a heart attack each year—that's around one every 40 seconds. Over 200 million American adults have coronary heart disease (Virani, 2021). One way to combat this frightening trend is to adopt a heart-healthy diet. Read on to learn more about how to incorporate a heart-healthy diet into your life.

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Heart disease is the leading cause of death in the U.S. But you can do something to improve your health—change your diet. Healthy eating is essential in preventing and treating heart disease. 

Eating a heart-healthy diet means incorporating more fruits and vegetables, fiber, and whole grains into your meals while cutting back on processed foods, red meat, and foods high in saturated fats. It is not a specific “diet” in and of itself; rather, it’s more a change in the kinds of foods you eat (Arnett, 2019)

Examples of foods that you should eat while following a heart-healthy diet include (Fischer, 2020): 

• High fiber fruits and vegetables, like leafy greens and legumes (lentils, chickpeas, peas, green beans, etc.)

• Lean meats, like poultry and fish 

• Whole grains, like whole-wheat bread, brown rice, oats, quinoa

• Limited intake of healthy fats, like nuts, seeds, extra virgin olive oil, avocados

• Limited intake of low-fat dairy products, like low-fat milk, greek yogurt, cheese 

As part of a heart-healthy diet plan, you should avoid fatty foods and those with high amounts of sugar. Here are some examples of foods to avoid (or eat in small quantities) (Arnett, 2019; Fischer, 2020):

• Sugar-sweetened beverages, like soft drinks, juices, etc. 

• Foods high in saturated fats, like red meats, eggs, butter, full-fat dairy products

• Processed meats, like bacon, salami, ham, hot dogs, and sausage

• Sugary foods, like sweets, candy, etc.

• Refined carbohydrates, like white bread, white flour, etc.

• Processed foods that contain trans-fats like partially hydrogenated oils 

Eating a heart-healthy diet has been shown to decrease your risk of heart disease, along with the risk of heart attacks and strokes. It can also lower your blood pressure, cholesterol levels, and the likelihood of developing diabetes (Virani, 2021). 

It has other health benefits, too. A heart-healthy diet may help you lose weight, lower your body mass index (BMI), and further improve your overall health.  

So, how do you put this into action? Here are nine tips to get you on the right foot. 

1. Limit serving sizes

Portion sizes have grown exponentially over the years, affecting how much you eat. Studies show that if you are served a double-sized portion, you’ll eat up to 35% more than if the portion was smaller (Embling, 2021). Data from the CDC shows that people are eating more than the recommended caloric intake (for the average male, the recommendation is 2,000 calories, and for the average female, it’s 1,600 calories) (CDC, 2003).

According to dietary guidelines, one standard serving of a high-protein food like meat or chicken is 3 ounces, about the size of a deck of cards or the palm of your hand. A serving of pasta is 1 cup. One serving of cheese is the size of three to four dice. When's the last time your dinner looked like that? Portion size is not the same as the recommended serving size. 

Being mindful of portion sizes overall, but particularly in foods high in calories or saturated fat (like red meat), is key to maintaining a healthy weight and heart.

2. Reduce sodium intake

A diet high in salt raises your risk of high blood pressure and heart disease. And if you're like most Americans, you're consuming too much sodium. The average American eats almost 3,400 mg of sodium per day, while the recommended amount is closer to 2,300 mg daily. And it's not just about the salt shaker. Most people get their sodium from fast food and restaurant dining, not home cooking. Check the nutrition labels for the sodium levels of products you buy, and eat fast food sparingly (HHS, 2020).  

3. Eat fresh fruits and vegetables

Fruits and vegetables contain vitamins, minerals, fiber, and natural phytochemicals that can protect your heart. Experts recommend that you fill half your plate with vegetables and fruit at every meal and aim to eat four to five servings a day (HHS, 2020). 

But you might want to think about eating more than that. One analysis of 95 studies found that eating ten servings of fruits and vegetables daily could lower your risk of heart disease by up to 28% (Aune, 2017). 

The fruits and veggies that seemed to offer the most benefits include (Aune, 2017): 

• Apples

• Pears

• Oranges and other citrus fruits

• Green leafy vegetables

• Cruciferous vegetables (such as broccoli, cabbage, and cauliflower)

• Tomatoes

• Green and yellow vegetables (such as green beans, carrots, and peppers) 

4. Eat whole grains

Whole grains can be good for cardiovascular health because they're high in dietary fiber, which seems to help lower cholesterol and blood pressure and improve blood vessel function  (Harvard Health Publishing, 2017). 

At least half of the grains you eat daily should be whole grains. Good sources include quinoa, oats, brown rice, buckwheat, and barley. When buying bread, make sure it's actually whole grain. Some breads labeled "whole wheat" are just white bread in disguise—they can contain high levels of sugar and high fructose corn syrup.  

5. Switch to healthy fats

Avoid saturated and trans fats. These types of fats raise blood cholesterol, which increases your risk of cardiovascular disease. Saturated fats are found in red meat, chicken with skin, cheese, butter, and whole-milk or 2% dairy products. Trans fats should be easier to avoid, as they have been banned in processed foods in the U.S. and many other countries. 

Focus on monounsaturated and polyunsaturated fats and omega-3 fatty acids. These healthy fats can benefit your heart: Monounsaturated and polyunsaturated fats lower blood cholesterol, and omega-3s seem to decrease the risk of coronary artery disease. These good fats are found in fish, avocados, olive oil or canola oil, flaxseed, nuts, and seeds (Arnett, 2019).

6. Choose lean protein options

To be heart-healthy, limit your consumption of red meat. Choose low-fat protein such as skinless chicken and fish like salmon, mackerel, sardines, and orange roughy. Fish are rich in omega-3 fatty acids, reducing triglycerides and lowering your heart disease risk. It's so good for your heart that experts recommend eating two servings of seafood a week in place of meat (HHS, 2020). 

Opt for low-fat milk and yogurt, too. Low-fat dairy products can be a good source of lean protein, particularly Greek yogurt and cottage cheese.

7. Limit foods and beverages with added sugar

The calories can add up fast, whether you drink juice, soda, or other sugar-sweetened beverages. Data estimates that Americans take in 260 calories a day from added sugar—mainly from sugary drinks and sweet snacks (HHS, 2020).

That can be dangerous. One study found that drinking sugary drinks was correlated with an increased risk of death, particularly from heart disease (Malik, 2019).

Be alert to added sugar in foods, too. Manufacturers sneak sugar into all kinds of unlikely products, like low-fat fruit yogurt, instant oatmeal, cereals, and whole-wheat bread. Check Nutrition Facts labels for added sugar. Every 4 grams of sugar equals one teaspoon.

8. Drink alcohol in moderation

You know that alcohol can wreak havoc on your liver, but it weakens the heart too. Excessive drinking can increase blood pressure and raise blood triglycerides, increasing your risk of heart disease.

The best course is moderate drinking—no more than two drinks daily for men and one drink a day for women.

Some studies suggest that moderate drinking can be good for heart health because it raises HDL ("good") cholesterol. However, the evidence isn't strong enough to recommend that people start drinking to improve their health (Piano, 2017)

9. Don't eat processed food

Heart-healthy eating means avoiding processed food. Several studies suggest that people who eat "highly processed" food have a higher risk of heart disease. Examples of ultra-processed foods include sausages, mayonnaise, potato chips, pizza, cookies, chocolates and candies, and artificially sweetened beverages (Srour, 2019)

You're better off limiting your consumption of all processed foods. Food manufacturers love to pack them with fat, added sugar, sodium, and tons of chemicals that create flavor and texture and keep them shelf-stable. Opt for whole foods whenever possible.

Suppose you are the type of person who likes to have a specific diet to follow. In that case, the AHA recommends three healthy eating patterns: the DASH diet, the Mediterranean diet, and a healthy vegetarian eating pattern (Fischer, 2020).

DASH diet

The DASH diet (which stands for Dietary Approaches to Stop Hypertension) is an eating plan designed to lower blood pressure or keep it in a healthy range. It's a low-sodium eating plan that's a variation on the Mediterranean diet—it includes plenty of fruits and vegetables, whole grains, fish, poultry, and heart-healthy fats. However, some find that sticking to a strict low sodium diet is very difficult.

Mediterranean diet

The Mediterranean diet is based on the traditional foods of the regions near the Mediterranean Sea. 

It focuses on plant-based foods like vegetables, fruits, whole grains, beans, and nuts. Heart-healthy fats like olive oil are emphasized, poultry and fatty fish like salmon are the typical main courses, and the consumption of red meat is discouraged. Moderate amounts of red wine are included too. 

Healthy vegetarian eating pattern

A healthy vegetarian eating pattern emphasizes vegetables, fruits, whole grains, legumes, soy products, nuts, low-fat dairy products, and seeds. There is more emphasis on plant-based proteins like soy products, legumes, and dairy products since there is no consumption of meats, poultry, or seafood.

The short answer—yes. 

A heart-healthy diet is a relatively flexible eating plan that can accommodate most dietary restrictions, including vegan or vegetarian preferences. 

Think of a heart-healthy eating plan as more of a lifestyle change than a diet. Whether you follow the general guidelines or a specific eating plan like the Mediterranean diet or DASH,  improving your diet can reduce your risk of heart disease, heart attacks, and strokes.

Before starting any diet plan, talk to your healthcare provider about your medical history and nutritional needs.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

December 22, 2021

Written by

Michael Martin

Fact checked by

Chimene Richa, MD

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About the medical reviewer

Chimene Richa, MD

Dr. Richa is a board-certified Ophthalmologist and medical writer for Ro.