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10 Steps to a Heart-Healthy Diet Plan

The term "Heart Healthy" gets thrown around a lot like it's common knowledge, but do you really know what that means?

The basics of a heart-healthy diet plan are actually pretty simple and looks very similar to basic healthy eating which includes a nutritious, balanced diet. Eating for heart health doesn't have to feel complicated, time-consuming, or restrictive. 

It's important to keep in mind that you don't have to overhaul your diet all at once, and taking small steps towards healthy eating will make a big difference in the long run.  

What is a Heart-Healthy Diet?

A heart-healthy diet can be recognized by many different names. Some refer to it as the cardiac diet, the dash diet, low sodium diet, or low cholesterol diet. For the most part, these diets prioritize similar eating behaviors with small differences in their focus relating to different cardiac conditions such as congestive heart failure, hypertension, or hyperlipidemia.

The American Heart Association (AHA) explains heart-healthy eating as a meal plan focused around nutrient-dense foods like whole grains, fruits, and vegetables, and following a calorie-controlled diet that supports weight management (2). 

For the most part, a heart-healthy diet looks similar to a generally healthy diet: high in nutrient-dense whole foods from whole grains, fruits, vegetables, and quality proteins. 

However, certain nutrients can supply potential heart health benefits, and foods that provide high amounts of these critical nutrients, as well as generally good nutrition overall, tend to rank highest on the list for the best heart-healthy foods to eat. 

Who Should Adopt A Heart-Healthy Meal Plan 

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Heart-healthy meal plans are often recommended by health practitioners following a diagnosis like hypertension (high blood pressure) or a cardiac event such as a heart attack or congestive heart failure exacerbation.

Heart-healthy diets may also be recommended for individuals with chronic conditions or comorbidities such as dyslipidemia meaning either too high of LDL cholesterol or too low of HDL cholesterol, diabetes, or kidney disease that puts you at higher risk for developing heart disease. 

While these are the conditions we often associate with needing to adopt a heart-healthy diet, the truth is everyone could benefit from eating foods and a diet to support heart health. 

Here are the steps to take to support cardiac health with your diet, focusing on adding nutrients linked to improved heart health and limiting those linked to impairing it. 

10 Steps to a Heart-Healthy Diet

1. Eat More Fiber

Research has linked dietary fiber, especially from whole grains, to improved heart health for nearly 50 years (3,4,5,6,7). It is thought that high fiber intake may help reduce blood cholesterol and blood pressure.

Additionally, fiber intake is associated with improved digestion and better weight management. 

The IOM suggests that most adults should be getting anywhere from 19 to 38 grams of fiber a day, depending on their age (1). However, survey data suggests that only 5% of people are getting enough fiber. 

Before you start reaching for processed foods marketed as high fiber, it is important to note that not all sources of fiber are created equal. Fiber supplements and foods fortified with added fiber may not provide the same health benefits as foods that are naturally high in fiber - mainly because whole foods that provide fiber also tend to be packaged with other important nutrients (8). 

Keep it simple by looking for more natural sources like fruits, vegetables, whole grains, beans, or legumes. Or try adding some of the following high-fiber food options to your meal plan:

  • Green Peas
  • Kale
  • Lentils
  • Pears
  • Quinoa
  • Oats
  • Raspberries
  • Whole Wheat Pasta

Aim to get more of your fiber intake from nutrient-dense whole foods over fiber supplements. 

2. Add in Healthy Fats

"Healthy fats" is another term that gets thrown around pretty often, referring most often to unsaturated fats.  

It is fairly well established that omega-3 fats can help lower blood triglyceride levels (9,10). Additionally, replacing saturated fat intake with plant-based sources of unsaturated fat may reduce your risk for heart disease (11,12,13). 

However, most foods are a source of many different types of fat, not just one in particular. This can make studying the role of fat in the diet as it relates to heart health challenging and making specific food recommendations even more difficult. 

Regardless, diets high in healthy fats are associated with a wide range of health benefits, including potential heart health impacts. To ensure you are getting the most out of your fat intake, focus on overall balance.

Aim to get 20 to 35% of your calories from healthy fats by including more of the following high-fat foods in your diet: 

  • Avocados
  • Almonds
  • Chia Seeds
  • Flax Seeds
  • Olives
  • Peanuts
  • Pistachios
  • Salmon
  • Tahini
  • Walnuts

Diets high in unsaturated fats, especially monounsaturated fat and omega-3 fats, have long been associated with positive heart health outcomes.

3. Meet Your Magnesium Needs

High magnesium intake is associated with lower risk for some heart disease risk factors including metabolic syndrome and high blood pressure (14). Moreover, a low intake of magnesium is linked to an increased risk of heart disease (15). 

How exactly magnesium plays a role in heart health is not completely understood, but it is becoming more clear that getting enough of it through healthy eating has some serious heart health benefits. 

To get more magnesium through diet, try including more of the following foods: 
 

  • Almonds
  • Beans
  • Black Eyed Peas
  • Bran Cereal
  • Brazil Nuts
  • Cashews
  • Edamame
  • Flax Seeds
  • Lentils

4. Get Enough Potassium

Potassium itself does not directly improve heart health, however, getting enough of it in your diet can provide some potential benefits. Mainly because potassium plays a key role in mitigating some of the negative effects of high sodium intake, helping to reduce blood pressure (16). 

The more potassium you eat, the more your body excretes excess sodium. Moreover, potassium is thought to help eases tension in your blood vessel walls, further improving blood pressure (18). 

Potassium can be found primarily in fruits and vegetables, as well as some dairy and seafood. The best sources for potassium in the diet include: 

  • Apricots
  • Avocados
  • Cantaloupe
  • Dates
  • Grapefruit
  • Halibut
  • Leafy Greens
  • Lima beans
  • Milk (Low Fat)
  • Mushrooms
  • Oranges
  • Peas
  • Potatoes
  • Prunes
  • Raisins 
  • Spinach
  • Tomatoes
  • Tuna
  • Yogurt (Low Fat)
Higher potassium intake is associated with a 24% lower risk of stroke (17).

5. Increase Your Folic Acid Intake

Folic acid, and B vitamins in general, may play a role in reducing levels of Homocysteine—an amino acid that is linked to arterial hardening and thickening (19). In fact, a meta‐analysis study published in the Journal of the American Heart Association suggests folic acid supplementation might lower the risk of stroke by up to 10% (20). 

Some of the best food sources of folic acid are: 

  • Avocado
  • Artichokes
  • Asparagus
  • Beans
  • Beets
  • Broccoli
  • Brussels Sprouts
  • Edamame
  • Lentils
  • Orange
  • Peas
  • Potatoes
  • Spinach
  • Turnip Greens
Folic acid is also commonly found in fortified foods like cereal and breads.

6. Ensure Adequacy of Vitamin D 

It is unclear whether or not increasing intakes of vitamin D beyond your basic nutrient needs has benefits for heart health, but research does suggest that vitamin D deficiency is associated with heart health risks. In other words, not getting enough vitamin D may play a role in heart disease (21,22). 

Vitamin D is not naturally found in high amounts in many foods, especially plant-based foods, and this can make getting enough through diet alone difficult. Thus, your best source of vitamin D is sunlight!

However, if you are looking for more ways to boost your intake, try adding some of the following foods with Vitamin D to your diet: 

  • Canned Tuna
  • Egg Yolks
  • Fortified Foods: orange juice, milk, yogurt, etc. 
  • Herring
  • Mushrooms
  • Oysters
  • Salmon
  • Shrimp
  • Sardines

If you are concerned about vitamin D deficiency, talk with your doctor about getting your blood levels tested. 

7. Reduce Your Sodium Intake 

High sodium diets are associated with increased blood pressure, which can increase the risk of heart disease and stroke (23). However, this doesn't mean sodium should be avoided entirely, it is more about keeping your intake below the recommended amount of 2,400mg a day by following a low sodium diet plan

Small amounts of sodium are essential for good health, but it can be easy to overdo it. Sodium can be found naturally occurring in vegetables but is also added to processed foods and cooked meals through table salt. 

Here are some simple tips to help you keep your sodium intake in check:

  • Eat more fresh, whole foods
  • Cook more meals at home where you control the ingredients
  • Check the nutrition label on packaged foods including condiments and sauces
  • Ask for restaurant food to be cooked without salt and keep sauces and dressings on the side

A DASH diet is also commonly recommended as a way to reduce sodium intake and improve blood pressure. 

8. Eat Less Saturated Fat

While diets high in unsaturated fat are linked to positive heart health, saturated fat is thought to play a slightly different role. 

Saturated fat is not thought to directly impact your risk of heart disease, but diets high in saturated fat have shown some concerning associations. Some studies have linked saturated fat intake to increased blood cholesterol (24). Additionally, research suggests that replacing saturated fat intake with unsaturated fats can help lower cholesterol (25).

The bottom line is eating high amounts of saturated fat over other types of fat can cause you to miss out on nutrition important for heart health. But it is also impossible to avoid completely since saturated fat is found in a number of nutritious foods, including olive oil and salmon.

Thus, your main focus should be on eating more sources of healthy fats (unsaturated) overall. 

Here are some simple tips to help you get a better balance of fat intake:

  • Eat more fat from plant-based sources
  • Opt for lean proteins like grass-fed beef and poultry
  • Include some fatty fish and seafood
  • Limit your intake of full-fat dairy

9. Avoid Trans Fat

Trans fats occur naturally in some foods and during the cooking process, but they can also be added to processed foods through the use of partially hydrogenated oils. 

A good amount of research suggests that high intakes of trans fat may increase your LDL (bad) cholesterol and decrease your HDL (good) cholesterol levels, leading to an increased risk of heart disease (26). In fact, the evidence is so compelling that it led the FDA to take steps to eliminate added trans fats in foods. 

While a majority of food manufacturers have removed partially hydrogenated oils from their ingredients, it is still possible to find small amounts of trans fats in packaged foods and it is difficult to avoid them entirely.

Even if the nutrition facts label says 0 grams of trans fats, legally items can contain up to 1/2 a gram and label it as zero grams. 

In order to help you avoid trans fats even further, here are some foods that you'll want to double-check the ingredients label for:

  • Biscuits
  • Buttery Crackers
  • Coffee Creamer
  • Fast-Food
  • Frozen Pies
  • Frozen Pizza
  • Frosting (ready-to-use)
  • Microwave Popcorn
  • Packaged Cookies 
  • Refrigerated Dough Products
  • Shelf Stable Cakes 
  • Vegetable Shortenings

10. Limit Your Added Sugar

More research is starting to point to higher intakes of refined carbohydrates, specifically sugar, along with low fiber intakes, as a factor for increased risk of heart disease (27,28). 

While small amounts of added sugar are likely not harmful to your health, it can be easy to overdo it. Sugar is added to just about every packaged food and beverage. In fact, there are over 50 different names for added sugar on the ingredients label.

To make matters worse, food manufacturers are still not required to label how much-added sugar is in the food.

Some brands have already stepped up to provide this information, but for other brands, it can feel like a guessing game.

Here are some easy ways to cut back on added sugar in your diet:

  • Limit your intake of sweetened beverages
  • Skip dessert more often
  • Cook more of your meals and snacks from scratch so you can control the ingredients
  • Check the ingredients label for packaged food items

How to Plan a Heart-Healthy Diet

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In short, heart-healthy eating is all about balance - opting for more nutrient-dense, heart-healthy options while cutting back on everything else. Additionally, heart-healthy eating is most effective when included as part of an overall healthy lifestyle that emphasizes weight management, exercise, and overall wellbeing. 

Taking steps to improve your diet and health doesn't have to feel stressful either. Start with small goals and find habits that work for you personally and then keep at it. 

Here are some key tips and habits to work on to help you to get started on a heart-healthy eating plan:

  1. Figure out how many calories you need a day
  2. Estimate a macro balance that works for your health and fitness needs
  3. Eat nutritious foods you enjoy that help you reach your daily goals. Try focusing on one to two key nutrients and gradually adding more. Try some of these heart-healthy recipes
  4. Track your daily intake using a food tracking app to ensure you are staying on track
  5. Incorporate exercise and healthy behaviors in all areas of your life.

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