Heart disease: Eating a heart-healthy diet

Heart disease is the number one killer of both men and women in the United States. If you are worried about heart disease, one of the most important things you can do is to start eating a heart-healthy diet. Changing your diet can help stop or even reverse heart disease.

At first, it may seem like there is a lot to learn. But you don't have to make these changes all at once. Start with small steps. Over time, making a number of small changes can add up to a big difference in your heart health.

To have a heart-healthy diet:

• Eat more fruits, vegetables, whole grains, and other high-fiber foods.
• Choose foods that are low in saturated fat, trans fat, and cholesterol.
• Limit salt (sodium).
• Stay at a healthy weight by balancing the calories you eat with your physical activity.
• Eat more foods high in omega-3 fatty acids, such as fish.

 What foods are part of a heart-healthy diet?
 Why is it important to choose a heart-healthy diet?
 How to eat a heart-healthy diet
 Where to go from here

For related information, see:

Heart disease: Exercising for a healthy heart.

Walking for a healthy heart.

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A heart-healthy diet focuses on adding more healthy foods to your diet and cutting back on foods that are not so good for you.

Healthy foods are ones that are high in vitamins, minerals, fiber, and other nutrients, such as:

• Fruits and vegetables.
• Beans (including chickpeas and lentils) and whole grains (such as whole wheat, brown rice, oats, rye, bulgur, barley, quinoa, and corn).
• Oily fish like salmon, trout, albacore tuna, herring, mackerel, and sardines, which contain heart-healthy omega-3 fatty acids. You can also get omega-3 fats from omega-3 eggs, walnuts, flax seeds, and canola oil.

Foods to limit are ones that are high in:

• Unhealthy fats, such as saturated fats, trans fats, and cholesterol.
  • Saturated fats are mostly found in animal products, such as meats and dairy products.
  • Trans fats include shortening, partially hydrogenated vegetable oils, and hydrogenated vegetable oils. Trans fats are made when a liquid fat is turned into a solid fat (for example, when corn oil is made into stick margarine). They are found in many processed foods, such as cookies, crackers, and snack foods. Restaurants often use hydrogenated oils for frying foods, so try to limit fried foods when eating out.
  • Cholesterol is found in animal products, such as eggs, dairy products, and meats.
• Salt (sodium). You need some sodium in your diet, but most people get far more than they need. Too much sodium tends to raise blood pressure. Processed foods and fast foods often contain a lot of sodium. Try to limit these foods and eat more fresh foods.

Eating foods that contain unhealthy fats can raise the LDL ("bad") cholesterol in your blood. Having a high level of LDL cholesterol increases your chance of having clogged arteries (atherosclerosis), which can lead to coronary artery disease and heart attack.

Trans fat is especially bad. It both raises the level of "bad” cholesterol and lowers the "good" cholesterol in the blood. Try to avoid trans fat as much as possible.

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Making good food choices can have a big impact on your health. Eating a heart-healthy diet can help you to:

• Lower your blood pressure.
• Lower your cholesterol.
• Reach and stay at a healthy weight.
• Control or prevent diabetes.
• Improve your overall health.

A heart-healthy diet is not just for people with existing health problems. It is good for anyone. (But children younger than 2 should drink 2% or whole milk, not 1% or skim milk. At age 2, they can switch to low-fat or nonfat dairy products.) Learning heart-healthy eating habits now can help prevent heart disease in years to come.

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To have a heart-healthy diet:

• Eat fruits and vegetables. Eat a variety of fruit and vegetable servings every day. Dark green, deep orange, or yellow fruits and vegetables are especially nutritious. Examples include spinach, carrots, peaches, and berries.
• Eat a variety of grain products every day. Include whole-grain foods that have lots of fiber and nutrients. Examples of whole grains include oats, whole wheat bread, and brown rice.
• Eat fish at least 2 times each week. Oily fish, which contain omega-3 fatty acids, are best for your heart. These fish include tuna, salmon, mackerel, lake trout, herring, and sardines.
• Limit saturated fat and cholesterol. To limit saturated fat and cholesterol, try to choose the following foods:
  • Lean meats and meat alternatives like beans or tofu
  • Fish, vegetables, beans, and nuts
  • Nonfat and low-fat dairy products
  • Polyunsaturated or monounsaturated fats, like canola and olive oils, to replace saturated fats, such as butter
• Read food labels and limit the amount of trans fat you eat. Trans fat raises the levels of LDL ("bad”) cholesterol and also lowers high-density lipoprotein (HDL, or "good") cholesterol in the blood. Trans fat is found in many processed foods made with shortening or with partially hydrogenated or hydrogenated vegetable oils. These foods include cookies, crackers, chips, and many snack foods.
• Choose healthy fats. Unsaturated fats, such as olive, canola, corn, and sunflower oils, are part of a healthy diet. But all fats are high in calories, so watch your serving sizes.
• Limit salt (sodium). Limit sodium intake to less than 2,300 mg of sodium per day (about one teaspoon). Choose and prepare foods with little or no salt. Watch for hidden sodium in foods.
• Eat only as many calories as you need to stay at a healthy weight. Learn how much is a serving, and then check your portion sizes. Limit drinks with added sugar and high-fructose corn syrup. If you want to lose weight, increase your activity level to burn more calories than you eat.
• If you drink alcohol, drink in moderation. Limit alcohol intake to 2 drinks a day for men and 1 drink a day for women. See a picture of a standard drink.
• Limit added sugar. Limit drinks and foods with added sugar.
• When you are eating away from home, try to follow these heart-healthy diet tips.

You can get even more benefit from making diet changes if you also get some exercise on most, preferably all, days of the week and don't smoke.

But you don't have to be perfect, and you don't have to do it all at once. Make one or two changes at a time. As soon as you are used to those, make another one or two changes. Over time, making a number of small changes can add up and make a big difference in your health.

Here are some ideas about how to get started:

• Choose whole-grain bread instead of white bread.
• Have a piece of fruit instead of a candy bar.
• Try to eat at least 5 servings of fruits and vegetables every day. Add one or two servings of fruits and vegetables to your day. Slowly add more servings until you are eating at least 5 servings a day.
• Switch from 2% or whole milk to 1% or nonfat milk.
• Instead of meat, have fish for dinner. Brush it with olive oil, and broil or grill it.
• Switch from butter to a cholesterol-lowering soft spread. Use olive or canola oil for cooking.
• Use herbs and spices, instead of salt, to add flavor to foods.

It may take some time to get used to new tastes and habits, but don't give up. Keep in mind the good things you are doing for your heart and your overall health.

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Now that you have read this information, you are ready to eat a more heart-healthy diet.

Talk with your doctor

If you have questions about this information, take it with you when you visit your doctor or dietitian. You may want to mark areas or make notes in the margins where you have questions.

If you would like more information on eating a heart-healthy diet, the following resources are available:

Online Resource

Organizations

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Other Works Consulted

• American Heart Association (2006). Diet and lifestyle recommendations revision 2006. Circulation, 114(1): 82–96.

• Gidding SS, et al. (2005). Dietary recommendations for children and adolescents: A guide for practitioners. Consensus statement from the American Heart Association. Circulation, 112: 2061–2075.