Following a heart-healthy diet is one of the key ways to reduce your risk of heart disease. In recent years, there has been growing consensus as to what a heart-healthy diet looks like.
While some people may tell you that you must eat the Mediterranean diet or the DASH diet or the Ornish diet, there are broader principles that determine whether a diet is heart-healthy or not.
According to the American Heart Association, a heart-healthy diet should consist of:
- A wide variety of fruits and vegetables
- Whole grains and whole-grain products
- Healthy sources of protein, including nuts, legumes, fish, lean poultry, and low-fat or nonfat dairy
- Liquid non-tropical vegetable oils, like olive oil or canola oil
Here is a list of 12 foods you should consider adding to any heart-healthy diet. Studies suggest that they may help reduce the risk of heart disease either directly (by improving heart function) or indirectly (by reducing cholesterol and other factors that contribute to heart disease).
Tomato
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Photo: Alexandra Shytsman
Tomatoes may help fend off heart disease, according to a 2017 review of studies. Tomatoes and tomato products reduce "bad" LDL cholesterol levels in the blood that might otherwise lead to fatty deposits, called plaque, on the walls of arteries.
The buildup of plaque can lead to a condition called atherosclerosis, which not only raises blood pressure but also increases the risk of heart attacks and stroke.
The researchers also found that a compound in tomatoes called lycopene can help lower blood pressure and increase levels of "good" HDL cholesterol.
Flaxseed
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Photo: Alexandra Shytsman
Eating flaxseed may help reduce blood pressure, according to a study published in the Journal of Nutrition.
According to the researchers, adding 30 grams of ground flaxseed to a diet can lower LDL cholesterol by 15%, in some cases within one month. The effect was greater when a flaxseed-rich diet was combined with cholesterol-lowering medications like statins.
Studies suggest that certain plant-based compounds in flaxseed, called secoisolariciresinol and enterodiol, are responsible for this effect.
Oats
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Photo: Alexandra Shytsman
Oats have long been considered an important part of a heart-healthy diet. According to a review of studies published in the British Journal of Nutrition, oats contain a compound called beta-glucan that can help lower LDL cholesterol and raise HDL cholesterol.
An earlier study in Nutrition Review concluded that the daily consumption of oat is associated with a 7% reduction in LDL cholesterol and a 5% reduction in total cholesterol.
Studies suggest that oats may also help reduce levels of apolipoprotein B (apoB), a type of protein commonly linked to the formation of plaque.
Dark Chocolate
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Studies have shown that cacao (made from unroasted cacao beans) can help keep cholesterol levels in check and lower the risk of heart disease. These benefits are linked to a group of plant-based compounds called flavonoids.
Dark chocolate contains higher concentrations of cacao and, in turn, higher concentrations of flavonoids. Dark chocolates that contain at least 60% cacao are thought to be the most beneficial in the prevention of heart disease.
A 2019 review of studies concluded that eating 45 grams of dark chocolate every week significantly reduced the risk of heart disease. Eating more than 100 grams per week negated the benefits due to the substantially higher sugar intake.
Chia Seeds
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Chia seeds are a rich source of fiber and a type of fatty acid called alpha-linolenic acid. Both help keep cholesterol levels in check and lower inflammation that promotes the development of plaque and atherosclerosis.
The fiber content in chia seeds is especially high. Chia seeds contain between 34 and 40 grams of dietary fiber per 100 grams of seed. This level of daily intake can reduce the risk of heart disease but also type 2 diabetes.
Alpha-linoleic acid can also improve the movement of calcium and sodium through cells. This can lower blood pressure and help stabilize heart rhythms.
Pomegranate
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A 2017 review in Pharmacological Research reported that pomegranate juice reduced systolic blood pressure (the top number in blood pressure reading) by an average of 5 mm Hg. Having high systolic blood pressure can increase your risk of heart disease and stroke as well as chronic kidney disease.
According to the researchers, a reduction in blood pressure was seen when drinking at least one cup (8 fluid ounces) of pomegranate juice. Drinking less than this had little effect.
With that said, drinking this much pomegranate juice may not be possible for people with diabetes or prediabetes as even the unsweetened juice is high in sugar.
Walnuts
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Antioxidants are compounds that prevent damage to the genetic material of cells. They can help prevent changes in the heart and blood vessels that can contribute to heart disease,
Walnuts are especially rich in antioxidants and are frequently touted as a heart-healthy food. The antioxidants found in walnuts include plant-based compounds known as polyphenols.
A 2018 study found that consuming walnuts regularly lowered both total cholesterol and apoB levels. Although walnuts contain 65% fat by weight, a walnut-rich diet is not seen to increase body weight or contribute to obesity.
Kefir
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Verywell / Alexandra Shytsman
Kefir made from fermented milk is rich in probiotics. Probiotics are foods or supplements that contain live microorganisms that help maintain the "good" bacteria in the body. In addition to aiding with digestion, probiotics also create acids that counter the production of cholesterol.
A 2017 study published in the Journal of Clinical Lipidology reported that females with overweight or obesity had significant drops in their LDL and total cholesterol after drinking a daily low-fat kefir drink for eight weeks.
Kefir drinks are often sweetened, so opt for unsweetened brands to avoid increasing your blood sugar levels.
White Mulberry
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Since antioxidants may help thwart the formation of plaque, some people consume antioxidant-rich foods like white mulberry to boost their heart health.
One of the most important antioxidants in mulberry fruits is called anthocyanin. Anthocyanins are also found in tart fruits such as cranberries, elderberries, and tart cherries.
A small study published in 2016 reported that 58 adults with high cholesterol experienced a significant drop in LDL and total cholesterol after taking a daily dose of freeze-dried white mulberry (equivalent to 325 milligrams of anthocyanin) for six weeks.
Açai
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Açai is another fruit that is rich in anthocyanin. A 2016 study published in the American Journal of Clinical Nutrition reported that an açai-based smoothie improved the cardiovascular health of 28 males with overweight or obesity. The effect was largely attributed to anthocyanin.
Study participants all had signs of endothelial dysfunction (in which cells that regulate the relaxation of blood vessels do not work properly). After consuming the açai smoothies, the function of these cells improved.
This suggests that compounds in açai may benefit people with atherosclerosis, a condition often referred to as the "hardening of arteries."
Apples
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Apples are rich in a flavonoid called quercetin. Some studies suggest that quercetin in apples may lower the risk of heart disease in some people.
In a 2016 study, researchers analyzed data from 1,052 females over the age of 70 and found that higher apple consumption was associated with a lower risk of aortic calcification.
Aortic calcification is the build-up of calcium deposits in one of the major blood vessels to the heart, called the aorta. It is commonly seen when atherosclerosis is widespread and generally indicates a high risk of heart attack and stroke.
Cranberries
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Research suggests that anthocyanins in cranberries may boost heart health by improving vascular function and lowering cholesterol.
In a study published in 2015, scientists reported that cranberry juice consumed daily for eight weeks significantly reduced diastolic blood pressure (the bottom number in a blood pressure reading).
High diastolic pressure generally occurs when there is a condition affecting the aorta. This includes problems like aortic stenosis, a type of heart valve disease.
It was also reported that cranberry juice reduced a substance known as C-reactive protein produced by the body in response to inflammation. This suggests that cranberry juice has anti-inflammatory effects.
Summary
A heart-healthy diet should consist of a variety of fruits and vegetables, whole grains, healthy fats, and healthy sources of protein. Studies suggest that some foods are especially beneficial, either by improving the function of the heart or preventing conditions that contribute to heart disease,
Tomatoes, flaxseed, oats, walnuts, dark chocolate, and white mulberry are all linked to improvements in cholesterol levels. Similarly, chia seeds, pomegranate, kefir, açai, apples, and cranberries are all thought to either reduce blood pressure, improve blood flow, or reduce inflammation that contributes to the build-up of plaque in arteries.
A Word From Verywell
There is not one heart-healthy diet. While certain eating patterns, like the Mediterranean diet, offer significant benefits if you are at risk of heart disease, they are not a one-size-fits-all solution.
What is arguably more important than following a diet plan is learning the principles of heart-healthy eating. This is where a certified dietitian can help. By understanding not only which foods you can eat but also which foods and habits you should avoid (like eating processed foods and smoking), you can build heart-healthy habits that last a lifetime.