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What Should You Eat for a Healthy Heart?

When you choose what to eat for a healthy heart, pick vegetables, fruits and whole grains, and avoid highly processed fried foods and sugar.

How important is diet in the prevention of heart disease? And what exactly should you eat for a healthy heart? Cardiologists have long emphasized the importance of avoiding cholesterol and saturated fat in the diet. Within the last decade or so, they have also started to endorse a Mediterranean-style diet to maintain cardiovascular health. A new study shows how that works.

A Mediterranean Diet Can Improve Blood Lipids:

Spanish researchers have been testing the effects of a Mediterranean diet on cardiovascular disease for decades. The PREDIMED trial began recruiting a large number of high-risk volunteers in 2003. Since then, the study has evolved to examine the impact of diet on a variety of health outcomes.

This latest chapter asseses adherence to a Mediterranean-type diet for blood lipids and glycemic markers (American Journal of Clinical Nutrition, Jan. 2024). This trial is different from previous studies because the investigators used nuclear magnetic resonance spectroscopy to study the lipid fractions carefully.

People who stuck more closely to a Mediterranean diet rich in vegetables and legumes, with extra-virgin olive oil as the primary fat and nuts as part of the mix, had better lipid profiles. Their HDL levels were higher and they had lower concentrations of nasty particles known as VLDL and very large VLDL. They also lowered their Diabetes Risk Index Scores.

According to the authors,

“The results suggest that lipoprotein subclass distribution and glycemic control are potential mechanisms behind the well-known salutary effects of MedDiet on CVD and diabetes risk.”

Even though the Mediterranean diet uses olive oil liberally as salad dressing and in cooking, a previous study underscored the hazards of deep-fried foods specifically.

Fried Foods Are Linked to Cardiovascular Problems:

People all over the world love fried foods like French fries, falafel, fried chicken, fish and chips and churros, to name just a few. However, evidence suggests that fried foods are bad for our health (Heart, Jan. 19, 2021).

Researchers conducted a meta-analysis of 23 observational studies. According to the results, people who eat the most fried food have a 28% higher risk of major cardiovascular events. Those who consumed a diet laden with fried foods were more likely to experience strokes or heart failure. Additional servings of fried foods increased the risk in a linear fashion.

Choose Anti-Inflammatory Foods to Eat for a Healthy Heart:

An earlier study in the Journal of the American College of Cardiology found that inflammatory foods high in refined carbohydrates, sugary drinks and processed meats also boost the risk of strokes and heart disease (Journal of the American College of Cardiology, Nov. 10, 2020). The investigators analyzed data from three long-running cohort studies of health care providers. These are the Nurses’ Health Study, the Nurses’ Health Study II and the Health Professionals Follow-up Study, with more than 200,000 well-educated volunteers. Over the years, these women and men completed questionnaires on their activities and diets at regular intervals.

As a result, the researchers had more than 5 million person-years of information. During that time, 15,837 of the participants suffered a heart problem or a stroke. The scientists had found that certain eating patterns increase circulating markers of inflammation, such as interleukin-6 and C-reactive protein. People who consumed lots of highly processed foods and sugary beverages had higher levels of these compounds in their bloodstreams. In addition, those who ate such foods most frequently were about 38 percent more likely to experience a cardiovascular complication compared to those whose diets rarely included them.

The authors conclude:

“Findings from 3 large U.S. prospective cohort studies indicate that dietary patterns with higher inflammatory potential were significantly associated with a higher incidence of CVD, CHD, and stroke. Our study suggests that modulation of chronic inflammation may be a potential mechanism linking dietary patterns with CVD.”

Which Foods Should You Eat?

In an editorial in the same issue, three scientists noted for their role in the influential PREDIMED study underscored the importance of diet for controlling inflammation (Journal of the American College of Cardiology, Nov. 10, 2020).

They offer readers this advice on what to eat for a healthy heart:

“Based on their food-based dietary inflammatory score, Li et al. recommended the consumption of green leafy vegetables (kale, spinaches, cabbage, watercress, romaine lettuce, Swiss chard, arugula, endive), yellow vegetables (pumpkin, yellow peppers, beans, and carrots), whole grains (wheat, oat, rye, buck wheat, millet), and coffee, tea and wine, which are all foods rich in antioxidants.”

The editorialists continue:

“According to the results of the RCT by Cofan et al. (Journal of the American College of Cardiology, Nov. 10, 2020), walnuts should be added to this list. Other relevant foods with established anti-inflammatory activity also deserve to be included, such as extra-virgin olive oil, fatty fish, and tomatoes, as well as fruits like blueberries, pomegranate, orange, cherries, strawberry, apples, and pears (Critical Reviews in Food Science and Nutrition, May 24, 2018). In contrast, refined sugars, fried foods, sodas, lard, and processed meat strongly contribute to the pro-inflammatory effect of the diet (Journal of the American College of Cardiology, Nov. 10, 2020).”

In summary, anti-inflammatory foods such as whole grains, colorful vegetables, fruits and beverages such as coffee, tea and wine can be beneficial. Chronic inflammation caused by diet could be an important contributor to cardiovascular disease. As a result, it makes sense to pay attention to what you eat for a healthy heart.

Learn More:

You may want to listen to our recent interviews with cardiologist Michael Blaha and lipidologist Robert DuBroff. To do so, go to Show 1232: What Should People Do to Protect Their Hearts?    We also offer information on healthful recipes in our book, Recipes & Remedies From The People’s Pharmacy. In it, you’ll find plenty of ideas for tasty ways to prepare anti-inflammatory foods and make them part of your regular diet.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Paz-Graniel I et al, "Adherence to the Mediterranean diet and nuclear magnetic resonance spectroscopy biomarkers in older individuals at high cardiovascular disease risk: cross-sectional and longitudinal analyses." American Journal of Clinical Nutrition, Jan. 2024. DOI: 10.1016/j.ajcnut.2023.11.003
  • Qin P et al, "Fried-food consumption and risk of cardiovascular disease and all-cause mortality: a meta-analysis of observational studies." Heart, Jan. 19, 2021. http://dx.doi.org/10.1136/heartjnl-2020-317883
  • DuBroff R & de Lorgeril M, "Fat or fiction: the diet-heart hypothesis." BMJ Evidence-Based Medicine, online May 29, 2019. doi: 10.1136/bmjebm-2019-111180
  • Li J et al, "Dietary inflammatory potential and risk of cardiovascular disease among men and women in the U.S.." Journal of the American College of Cardiology, Nov. 10, 2020.
  • Estruch R et al, "Ideal dietary patterns and foods to prevent cardiovascular disease: Beware of their anti-inflammatory potential*." Journal of the American College of Cardiology, Nov. 10, 2020.
  • Cofan M et al, "Effects of 2-year walnut-supplemented diet on inflammatory biomarkers." Journal of the American College of Cardiology, Nov. 10, 2020.
  • Zhu F et al, "Anti-inflammatory effects of phytochemicals from fruits, vegetables, and food legumes: A review." Critical Reviews in Food Science and Nutrition, May 24, 2018. DOI: 10.1080/10408398.2016.1251390
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