Heart-Healthy Foods And Drinks

What is heart-healthy living? 

Heart-healthy living is the act of protecting your heart through healthy lifestyle choices, such as being more active and implementing a flexible and balanced diet. Prioritising a heart-healthy lifestyle is vital as heart disease is one of the deadliest diseases, being one of the leading causes of death worldwide. Cardiovascular health and nutrition go hand-in-hand, so understanding heart-healthy foods and drinks can help empower you to take control of and improve your heart health.

Nutrient-rich foods for heart health

Heart-healthy foods are those that have been associated with a lower risk of cardiovascular disease. These foods promote good heart health by helping you reduce inflammation, blood pressure, cholesterol and triglyceride levels. A heart-healthy diet is often referred to as a “cardiac diet” and consists of fruits and vegetables, whole grains, and lean proteins. 

Fruits and vegetables

Serving and vitamin information 

Fruits and vegetable intake has been shown to lower mortality rates, specifically those caused by cardiovascular disease.¹ Research shows that getting 5 servings of fruit and vegetables is an optimum number to see these positive effects. One reason these foods boost your heart health is because of the valuable nutrients found in fruits and vegetables, such as potassium, magnesium, and fibre.² 

Antioxidant benefits 

Fruits and vegetables also contain antioxidant properties. Antioxidants, such as vitamins A, C, and E, are found in fruits and vegetables. These antioxidants help to delay and prevent cell damage. One study of over 5000 men and women found a significantly decreased risk of cardiovascular disease after long-term vitamin E intake through diet.³ This research suggests that antioxidants found in fruits and vegetables, such as vitamin E, can play a protective role in heart health. 

Ensure variety and eat whole fruits and vegetables

Research indicates that eating a variety of fruits and vegetables is crucial to reaping all the heart-healthy benefits.² Additionally, there is evidence that starchy vegetables (e.g., peas, corn, and potatoes) do not lower mortality rates as effectively as other fruits and vegetables.¹

While canned, frozen, or dried options are good alternatives to fresh fruits and vegetables, researchers advise against relying solely on juicing or artificial supplements for nutrients.² It's essential to remember that the entire fruit or vegetable is perfectly balanced to provide your body with the heart-healthy nutrients it needs for protection – something that juicing or supplements alone cannot supply.

Whole grains

What are whole grains?

Whole grains are grains such as wheat, oats, and rice, that have all parts of the grain intact. Whole grains should not be confused with refined grains, enriched grains, or fortified grains. Refined grains are grains that have had nutrients removed (e.g., white bread or pastries). Enriched grains have nutrients added back to them after removal (e.g., enriched rice). Fortified grains have nutrients added to them that are not naturally present in the grains (e.g., breakfast cereals with added iron).

Benefits of whole grains

Whole grains are beneficial because of the carbohydrates they provide the body.⁴ In fact, a research review found that consuming whole-grain carbohydrates was associated with an overall reduced risk of mortality.⁵ 

Whole grains are a heart-healthy choice as they are also rich in fibre. High-fibre options help with weight patterns, digestion, and cholesterol levels. These have been associated with lower cardiovascular disease risk, making them an important part of a heart-healthy diet.⁶ 

Lean proteins

Importance of lean protein sources

Lean protein sources are generally lower in fat and calories. The best heart-healthy lean protein sources include:

• Legumes
• Nuts
• Fish
• Seafood

Legumes and nuts are not only rich in protein but also high in fibre, while fish have shown benefits attributed to omega-3 fatty acid content.² Meats with higher fat content are associated with higher cardiovascular disease and mortality. 

Meat and plant-based protein options

If you are interested in incorporating meat or meat alternatives into your heart-healthy diet, the following are recommendations: 

• Unprocessed poultry, such as skinless chicken or turkey 
• 95% lean ground beef or pork tenderloin
• Plant-based options such as eggs, tofu, nuts, and legumes
• Low-fat dairy options

Avoiding red meat and processed meats 

Processed meats and red meat (e.g., beef, pork, and lamb) are associated with higher mortality and cardiovascular disease rates.^2,7 Processed meats are those that have been smoked, cured, or salted – such as bacon, sausage, and deli meat.

In fact, sandwiches containing high amounts of deli meat are considered to be a large contributor to unhealthy diets. In American diets, sandwiches are the primary source of sodium and saturated fats. That said, don’t let this stop you from eating sandwiches! You can still eat them but consider using healthier, more nutritious breads and fillings. 

Essential fats and heart health

While saturated fats are not ideal for heart health, some unsaturated fats are beneficial, including omega-3 fatty acids, or polyunsaturated fats.⁸ The main source of omega-3s are fatty fish, including:

• Salmon
• Tuna
• Mackerel
• Trout
• Herring
• Halibut
• Cod

Prioritising these foods is a must for heart health, as several studies have shown that individuals who consumed fatty fish had almost one-third the risk of fatal heart attacks, and almost one-half the risk of dying from coronary heart disease compared to those who do not consume fish.⁸ In plant-based foods, heart-healthy omega-3 compounds can be found in oils such as:

• Olive
• Soybean
• Canola
• Walnut and flaxseed, as well as whole walnuts and flaxseeds

Similarly, monounsaturated fats promote heart health and can be found in avocados, nuts, and olives. 

Foods to limit or avoid

Trans fats

Trans fats are commonly found in fried and processed foods. They are made during an industrial process where hydrogen is added to liquid oils to convert them into solids. These are referred to as partially hydrogenated oils (PHOs). These oils can improve the shelf life of foods, but they have been linked to an increased risk of heart attack, type 2 diabetes, and stroke. Trans fats have also been shown to increase bad cholesterol and decrease good cholesterol.⁹

To avoid trans fats in your diet, common foods to limit include:

• Deep fried food
• Baked goods, such as cakes or pastries
• Butter, margarine, or shortening
• Foods listing hydrogenated or PHOs in ingredients 

Saturated fats

Saturated fats are generally those that turn solid at room temperature. These include:

• Meat fat
• Butter
• Cheese
• Tropical oils (such as coconut and palm oil)
• Some baked and fried foods 

Research suggests the best method of removing these from your diet is swapping items with saturated fat with unsaturated fats - like those mentioned above. Research reviews show that diets low in saturated fats and high in unsaturated fat were associated with lower risk of cardiovascular disease, diabetes, and other causes of death.¹⁰ 

Sodium

Sodium is the amount of salt in your diet. High sodium is related to high blood pressure, a known risk factor for heart disease. In a heart-healthy diet, limiting sodium with low-salt alternatives can be beneficial. Sodium-rich foods are often found in canned, processed, frozen or pre-seasoned foods.

To limit sodium, great options include:

• Cooking at home to control the amount of salt used
• Look for low-salt food products, especially condiments
• Flavour food with herbs and spices rather than salt
• Limit pre-made options while you are cooking (e.g., mixes, sauces, or instant products)

Added sugar 

Added sugars are those that are not naturally occurring in food and are added to sweeten the product. Over-consuming added sugar is shown to triple the risk of cardiovascular disease.¹¹ Added sugar is often found in:

• Sweetened drinks (e.g., soft drinks, fruit juices, and energy drinks)
• Processed snacks and sweets (e.g., pastries, frozen dairy desserts, and candies)

Heart-healthy drinks

Of course, maintaining a heart-healthy diet involves more than just food. Paying attention to our beverage choices is also a crucial aspect. Here are some heart-healthy drinks you can choose, and some to limit or avoid completely. 

Water 

Water is the healthiest, most accessible and affordable option for heart-healthy drinks.¹² Hydration is key to a healthy lifestyle, and water helps to prevent dehydration while also:

• Keeping a healthy body temperature
• Lubricating and cushioning joints
• Removing waste from the body
• Protecting sensitive tissues and the spinal cord 

Other heart-healthy drinks

• Unflavoured and plant-based milk
• Unsweetened teas and coffees (green tea has evidence in support of heart health)¹³ 
• 100% fruit or vegetable juices in moderation 

Drinks to avoid

• Sweetened drinks
• Energy drinks 
• Alcohol 

What about red wine?

Alcohol has been shown to increase your risk of developing cardiovascular disease.² However, research on red wine has shown some benefits due to its antioxidant benefits. While more research is needed for clear recommendations, research studies suggest a moderate intake of red wine may have protective effects on heart health.¹⁴ 

Incorporating heart-healthy choices into your Diet

• Use meal planning, menu selection, or shopping list tools to guide your eating habits throughout the week. This also ensures incorporating variety into your meals for essential nutrients²
• Portion control is important to implement, as even eating large amounts of healthy foods can increase body weight and cardiovascular disease risk
• Cooking methods such as grilling, steaming, and baking limit unhealthy fats and provide an easy way to lessen the negative effects caused by added oils or fats
• Limiting treats, processed and fried foods, and incorporating smart snacking can contribute towards a heart-healthy diet. Occasional treats are ok, and should be offered to ensure your diet is doable and enjoyable!

Evidence-based heart-healthy diets

Diets with evidence for their benefits on heart health are the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and plant-based diets. Other newer diets such as the ketogenic diet or intermittent fasting have not been systematically studied so it is unclear whether they have significant benefits for heart health. 

Mediterranean diet

The Mediterranean diet consists of fruits and vegetables, whole grains, and lean protein sources, such as seafood.⁴ Specifically, the Mediterranean diet incorporates: 

• Emphasis on green leafy vegetables, fruits, nuts, legumes, whole grains, and extra-virgin olive oil
• Moderate levels of lean meats, fish, and low-fat dairy products
• Limited red meats and sweets 

This diet is heart-healthy based on high fibre, complex carbohydrates, vitamins, minerals, polyunsaturated fat, and phytochemicals.¹⁵

DASH diet

As the name suggests, this diet was developed to specifically control hypertension. It differs from the Mediterranean diet by having more allowance for dairy and expanding from fruits and vegetables, whole grains, and seafood. 

DASH diet consists of the following:¹⁵

• Fruits and vegetables, lean protein, and low-fat dairy
• A limited intake of sodium and saturated fats 

Plant-based diet 

A vegetarian diet is shown to lower the risk of cardiovascular disease by lowering bad cholesterol and blood pressure. While this diet can have benefits, what you replace your protein sources with can drastically change the health benefits. Research shows that those who replaced protein with unhealthy options (such as refined grains, potatoes, and sweets) were 32% more likely to develop heart disease compared to those who replaced protein with healthy options.¹⁵ 

Which diet is right for you? 

Do you have trouble sticking with one diet, or limiting your food to one set of rules? Luckily, researchers have shown that individuals have several options for improving their overall cardiovascular health. In one study, participants were randomly assigned to one of three groups: one similar to the DASH diet, one similar to the low unsaturated fats in the Mediterranean diet, and one with increased protein. After 19 weeks, all groups in the study showed reduced blood pressure, cholesterol levels, and estimated heart disease risk.¹⁶

Personalised diet

Precision nutrition, or personalised diet, is considered the gold standard for customising dietary needs to the individual.² It is important to consider your own specific dietary restrictions and consult healthcare professionals or nutritionists. They will help you devise a personalised nutrition plan to improve your heart health. 

Summary

A healthy heart starts with a heart-healthy lifestyle. Your diet is one important aspect that you can focus on to add heart-healthy nutrients. These include consuming more fruits and vegetables, whole grains, and lean protein or plant-based options. Essential fats such as unsaturated fats and omega-3s should be added in place of unhealthy saturated and trans fats. Avoiding these excess fats, sodium, and added sugars often found in red meat, processed meats and foods, and sweets can help maintain a heart-healthy diet. 

The drinks we consume also play a part in a heart-healthy diet. Prioritise water and supplement with unsweetened drinks. Sweetened juices, energy drinks, and alcohol should be avoided. If you do drink alcohol, moderate red wine may be an option for its antioxidant benefits. 

To incorporate heart-healthy foods, there are three diets that you can follow to lower your risk of cardiovascular disease: the Mediterranean Diet, the DASH diet, and a vegetarian/plant-based diet. By meal planning, adding variety in foods and cooking methods, implementing portion control, and limiting treats, you can incorporate a heart-healthy diet into your daily life. 

Remember that everybody is different. Working alongside a healthcare provider and nutritionist will offer the best options for your health. 

Jessica Maier

Master of Science - MS, Florida State University, USA

Jessica is a medical writer with robust research experience in cognitive neuroscience and clinical neurodegeneration. Her published work spans topics from functional brain network interactions to disease diagnosis tools. She is a life-long learner, driven to gather information and synthesize complex subjects into understandable insights.

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