For years, scientists were convinced that banning most dietary fats was the key to curbing cholesterol and keeping the heart healthy. But recently, experts recognize that certain fats (including monounsaturated fats like olive oil and polyunsaturated fats like omega-3 fatty acids) are actually beneficial to keeping your circulation and heart strong. “A low-fat diet is not considered part of the heart-healthy diet today,” notes Susan Ryskamp, MS, RDN, a dietitian at Michigan Medicine’s Frankel Cardiovascular Center in Ann Arbor. “We encourage plant-based fats, like monounsaturated fats and polyunsaturated fats, and that people reduce their intake of saturated fats and eliminate trans fats.”
Although numerous diets claim to be good for your heart (and any weight loss can help reduce some of the more significant risk factors for heart disease, including diabetes and elevated cholesterol), scientific evidence is pickier about what really helps. “There are only two diets that are supported by the literature as having an impact with respect to decreasing the risk of having cardiovascular issues,” says Michael Goyfman, MD, director of clinical cardiology at Northwell Health’s Long Island Jewish Medical Center in Queens, New York.
“Those are the DASH Diet [Dietary Approaches to Stop Hypertension] and the Mediterranean. They’re the ones to show sustained impact on health after more than a year.” The Mediterranean diet, in particular, is popular among nutrition experts and cardiologists alike. This is because of its ability to improve cardiovascular health and reduce the risk of heart disease. Consider a randomized trial published in The New England Journal of Medicine in 2018 that followed over 7,000 participants who were at high cardiovascular risk. After following up with them nearly five years later, participants who followed a Mediterranean diet supplemented with extra-virgin olive oil or nuts had fewer strokes and heart attacks than those assigned to a reduced-fat diet. And because this diet has a wide range of appetizing fare, including fresh fruits and vegetables, whole grains, fish, and nuts, it’s easy to follow, Goyfman adds.
The Vegetarian Approach
Other experts also recommend emphasizing a largely vegetarian diet, one that is made up of at least 50 percent plant foods, when it comes to reducing heart disease risk. “A plant-based diet can be either vegan, vegetarian, or Mediterranean,” explains Lisa Stollman, MA, RDN, a nutritionist based out of Greenlawn, New York. “Plant foods are heart-healthy because they are low in saturated fats and contain many phytonutrients, such as lycopene and resveratrol, which are important for heart health.”
Another benefit of plant foods: They can help decrease inflammation in the body, reducing the risk for diabetes, heart disease, and many types of cancer, says Stollman.
Facts About Fat
Gone are the days when fat was the enemy of heart health. But not all fats are equal, and more isn’t necessarily better, even among healthy fats. The American Heart Association (AHA) recommends 30 percent of your diet come from fats. For a 2,000-calorie diet, that would be 70 grams of fat per day, or roughly 4 tablespoons.
The AHA does not recommend large amounts of saturated fats (like those from animal products), maintaining that a diet high in saturated fats can boost total cholesterol and increase levels of LDL (“bad”) cholesterol. Saturated fats are also pro-inflammatory. “It’s becoming increasingly clear that chronic inflammation is a root cause of heart disease, as well as many cancers and possibly Alzheimer’s disease,” says Ryskamp.
And while some research has concluded there isn’t enough evidence that saturated fat directly increases the risk of heart disease, it can help to replace saturated fat with polyunsaturated fats, like those from vegetables and other plant or monounsaturated fats.
On the “good” fats list are ones like monounsaturated plant-based fats like olive oil, canola, avocados, nuts, and seeds. Fatty fish, like salmon, are good sources of omega-3 fatty acids, which can decrease triglyceride levels, slow plaque growth, and help lower blood pressure. Just remember that more isn’t always better, even with healthy fats. “If you eat too many nuts or go crazy with the olive oil, it’s still fattening,” notes Goyfman. “Too much of a good thing can become a bad thing.”
A high-protein diet may be all the rage as a way to lose weight. However, it’s not always the best plan to follow, especially if you worry about your heart health. Research has shown that those who consume a high-protein diet may increase their risk of heart disease.
One Finnish study found that men who followed a high-protein eating plan increased their risk of developing heart failure by 33 percent. Those who ate the most protein from animal sources had a 43 percent increased risk of heart failure compared to those who had the least amount of protein. Those who consumed high protein from dairy sources had a 49 percent increased risk.
That’s not to say you can never enjoy red meat — just limit your servings to one or two a week. “If you’re limiting your red meat to a serving or two a week and eating very healthy the rest
of the time, it’s okay to enjoy a burger or steak once in a while,” says Goyfman. Whenever
possible, choose lean cuts of red meat labeled “round,” “loin,” or “sirloin” on the package or a menu. And keep an eye on serving size. A portion of red meat is about 3 ounces, the size of a computer mouse.
Just like fat and protein, some carbs are a lot better for your heart health than others. Getting the green light: Carbs that are high in dietary fiber, such as whole grains, can help improve cholesterol levels and lower risk of stroke. The Nurses’ Health Study found that women who ate two to three servings of whole grains a day were 30 percent less likely to have a heart attack or die from heart disease over a 10-year period compared to women who ate less than one serving of whole grains per week. And a meta-analysis of seven major studies found that cardiovascular disease was 21 percent less likely to occur in subjects who ate two-and-a-half-or-more servings of whole grains a week compared to those who ate less than two servings a week.
Vegetables and fruits can also play an important role in helping your heart. “The more colors you have, the more nutrient-rich your diet is,” says Ryskamp. “With different fruits, vegetables, and legumes, you’ll get a variety of important nutrients that will ultimately benefit your health.”
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
A version of this article appeared in our partner magazine, The Complete Guide to Heart Health, in 2019.