As the saying goes, you are what you eat, and that's especially true when it comes to heart health. Dietary choices can influence your weight, blood pressure, cholesterol levels, and blood sugar levels — all factors that can determine your risk for heart disease, heart attack, and stroke.
So when it comes to diet and heart health, what foods should you eat more of, less of, or not at all? Here's what a Harvard nutritionist and cardiologist suggest.
Eat less: Saturated fat
Saturated fat is found primarily in meats, such as beef, pork, and deli meat; dairy foods like milk, butter, cream, and cheese; and tropical oils like coconut oil and palm oil. High amounts of saturated fat also are found in many fast, processed, and baked foods like frozen pizza, desserts, hamburgers, and packaged sweets.
The main health issue with saturated fat is its impact on cholesterol levels. "Consuming high amounts of saturated fat produces more 'bad' LDL cholesterol, which can form plaque in the arteries that blocks blood flow and increases your risk for heart attack and stroke," says registered dietitian Marc O'Meara, an outpatient senior nutrition counselor at Harvard-affiliated Brigham and Women's Hospital.
Eat more: Healthy fats
"Besides avoiding saturated fat, you should increase your intake of healthy monounsaturated and polyunsaturated fat," says O'Meara. These "good" fats help lower LDL cholesterol and triglycerides.
Sources of monounsaturated fats are olive oil, peanut oil, canola oil, avocados, and most nuts. There are two main types of polyunsaturated fats: omega-3 fatty acids and omega-6 fatty acids. Sources of omega-3s include fatty fish, such as salmon, mackerel, and sardines; flaxseeds; walnuts; and soybean oil. Many vegetable oils — such as soybean, sunflower, walnut, and corn oils — are rich in omega-6s.
"For heart health, it's important to focus on eating omega-3 fats several times a week, since they are in limited foods," says O'Meara. "Omega-6 fats are easier to get as they are in a wider array of foods."
Follow the 80/20 rule
It's not realistic to refrain from all problem foods. It's fine to occasionally eat chips while watching the game, treat yourself to dessert, and dine out with friends. To ensure you consistently follow an overall heart-healthy diet, while allowing yourself to live a little, adopt the 80/20 rule: eat healthy 80% of the time, and save 20% of your meals and snack for fun foods. "This eliminates the stress of having to eat perfectly every day," says registered dietitian Marc O'Meara with Brigham and Women's Hospital. "Weekends count, so don't pile all your fun foods into a couple days. Instead, sprinkle them throughout the week for the best chance at weight control."
Eat less: Refined sugar
Refined sugar is what's added to food products to improve taste (which is why it's also known as "added" sugar). Refined sugar comes from cane, sugar beets, and corn, which are processed to isolate the sugar.
Refined sugar has several indirect connections with heart health. Consuming too much refined sugar contributes to weight gain, the leading cause of fatty liver disease and type 2 diabetes, both of which are closely linked to a higher risk of cardiovascular disease. Excess added sugar may also play a role in elevating blood pressure and stimulating chronic inflammation, two other factors related to heart disease.
The top food sources of refined sugar include soft drinks, energy drinks, fruit-flavored drinks, flavored yogurts, cereals, cookies, and cakes. But refined sugar is also found in many other processed foods, such as canned soups, cured meats, and ketchup.
Guidelines recommend men consume no more than 36 grams (about 9 teaspoons' worth) of refined sugar per day, about equal to what's in a 12-ounce can of soda. "The best way to control your intake of added sugar is to read food labels," says O'Meara. "To get an accurate amount, multiple the grams of sugar on the label by the total number of servings."
Eat more: Plant-based foods
Science has provided strong evidence of the heart-healthy benefits of plant-based diets like the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets.
"These diets have consistently shown they help manage the main markers of heart disease: cholesterol, blood pressure, and blood sugar," says Dr. Ron Blankstein, a cardiologist with Brigham and Women's Hospital's Heart and Vascular Center.
Both diets emphasize high amounts of fruits and vegetables, whole grains, fatty fish, legumes, and nuts; olive oil as the principal source of fat; and minimal amounts of red meat, dairy, and alcohol. (While whole fruits and vegetables are ideal, low-sodium canned vegetables and frozen fruits and vegetables without added sauces and cream are just as nutritious.)
"These diets offer nutrients your heart requires, like healthy mono-unsaturated and polyunsaturated fats and antioxidants that help fight inflammation," says Dr. Blankstein.
Perhaps best of all, following a plant-based diet also can steer you away from unhealthy eating habits.
"If you're eating more of these plant-based foods, that means you're eating less of processed and high-sugar foods," says Dr. Blankstein. "And always remember that it's never too late to begin paying more attention to your diet. Don't wait for some heart-related event to change how you eat."
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