Cardiovascular disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention — and what we eat has a real influence on its development. Yet our understanding of what makes for a heart-healthy diet has changed over time.
For years, cholesterol and saturated fats were considered the culprits behind the heart health epidemic. It turns out, though, that our bodies need cholesterol to function and operate — and that saturated fats aren’t as bad as we once believed.
Thankfully, thinking around heart health has begun to shift, and now research casts a different light on the causes of heart disease. “Dietary cholesterol alone really doesn’t influence the incidence of heart disease,” says Trent Orfanos, MD, director of integrative and functional cardiology at Case Integrative Health in Chicago. (For more on how integrative practitioners are looking beyond cholesterol, see “Rethinking Heart Health.”)
So if cholesterol and saturated fats aren’t to blame, what is?
“Cardiovascular disease is a disease of inflammation and oxidative stress,” explains Mimi Guarneri, MD, FACC, a functional-medicine cardiologist in La Jolla, Calif., and president of the Academy of Integrative Health and Medicine. Inflammation is a vital function in your body, helping it to heal from injury and illness, but regular bouts of inflammation can be harmful.
Research shows that foods containing simple sugars, such as cookies, cakes, fruit juice, and soda, as well as foods made with white flour (which is converted to sugar in the body), increase blood sugar and cause inflammation
Chronic inflammation leads to oxidative stress, which can cause plaque production in your arteries, according to Elizabeth W. Boham, MD, MS, RD, medical director for The UltraWellness Center in Lenox, Mass. And though there are multiple factors that can contribute to chronic inflammation, diet is a vital piece of the puzzle. (For more on managing chronic inflammation, read “How Chronic Inflammation Affects Your Health.”)
Ultraprocessed foods, refined grains, sugar, trans fats, and alcohol all tend to fuel the fire. Research shows that foods containing simple sugars, such as cookies, cakes, fruit juice, and soda, as well as foods made with white flour (which is converted to sugar in the body), increase blood sugar and cause inflammation, Guarneri notes.
If reducing inflammatory foods in your diet is the first step in lowering your risk for cardiovascular disease, the second step is replacing them with more beneficial foods. “Nutrition is the bedrock to good health, so not just your heart, but your brain, your kidneys, your whole physiology requires proper nutrition,” explains Orfanos. “Eating a healthy diet is what will protect us against these chronic diseases.”
Your Heart-Health Pantry
To feed your heart well, most experts recommend plant-forward diets for their emphasis on whole foods, healthy fats, and plenty of vegetables. “The Mediterranean diet focuses on a large volume of fruits and vegetables, nuts and seeds, olive oil, and fatty fish. All those things have a lot of benefits in terms of heart health,” says Boham. “The Mediterranean diet is also high in antioxidants, which are associated with less oxidative stress.”
Whether or not the Mediterranean diet is right for you, eating a balanced diet with a variety of macronutrients, vitamins, minerals, and antioxidants is key to keeping inflammation at bay. At every meal, Boham says, “I have a good source of protein, a good source of fat, and a lot of fiber.” The fiber helps to slow digestion and keep her insulin from spiking, she explains, “and that is really important for preventing that inflammatory response after a meal.”
If you want to add more heart-healthy foods to your diet, doctors recommend starting with these eight staples.
1) Berries
“Blueberries, pomegranate seeds, raspberries — they’ve got a lot of anti-inflammatory, antioxidant benefits to them,” says Boham. “Antioxidants can help decrease plaque production in the arteries and decrease oxidative stress.”
She likes to add berries to a bowl of nondairy yogurt along with ground flaxseeds and walnuts. (Or try our Salad of Mixed Greens With Blueberries or this Berry Protein Shake.)
2) Fatty Fish
Fish like salmon, tuna, black cod, anchovies, herring, mackerel, and sardines are high in omega-3 fatty acids, which research has shown can help soothe inflammation, reduce arterial-plaque buildup, and lower blood pressure.
Boham recommends smaller fish, like sardines, because they typically contain lower levels of mercury than do larger fish. “They’re a great source of protein and fat that helps balance your blood sugar,” she adds.
One of Boham’s favorite heart-healthy lunches is a leafy green salad topped with walnuts and a can of sardines. She recommends trying different brands of canned fish, as there can be variations in flavor and preparation. You can also use tuna to make a classic Salade Niçoise, or use anchovies to make your own Spanish Salsa Verde.
3) Garlic
Garlic is the flavorful backbone of many sauces, stews, soups, and more — and it also comes with a host of health benefits, including reducing both blood pressure and oxidative stress. It’s good for arterial health because it makes platelets in your blood less likely to stick to the arterial wall. It’s that buildup, Orfanos explains, that often leads to heart attack or stroke.
He leans on garlic for a variety of dishes, including one he recalls from a recent trip to Greece: a rich garlic sauce served over roasted fish. “It was olive oil, potatoes, and dozens of cloves of garlic all mashed up together.”
(Try roasting whole garlic heads for this creamy gnocchi, or ferment your own garlic for an added dose of healthy bacteria for your gut.)
4) Green Tea
Though green tea is often associated with reducing cancer risk, research has found that it’s also good for the heart. “It’s been shown to help with lowering blood pressure and increasing glutathione, which is a great detoxifier in the body and a great antioxidant,” explains Boham.
She buys organic tea leaves instead of bags, for both quality and flavor. Though you can drink green tea anytime, it can be particularly beneficial after a heavy, rich meal, she adds, because “it can help reduce the inflammatory response.” (Try our tips for brewing a perfect cup of green tea, or use green tea to make this elegant martini-like mocktail.)
5) Leafy Greens
Arugula, collards, kale, lettuce, spinach, and Swiss chard contain vital minerals that keep your heart in rhythm. For example, collard greens are packed with calcium, while Swiss chard is a good source of magnesium and potassium. “Dark green leafy vegetables have a ton of phytonutrients, and I think they’re the best source of calcium, even above dairy,” says Shilpa Saxena, MD, IFMCP, medical director at Forum Health in Tampa.
“One of my favorite ways to get a dose of leafy greens is to massage kale with olive oil and let it sit for a while before eating,” Saxena says. The kale will soften so it’s easier to digest — but because it’s still raw, it retains all its nutritional value. (Try collards in our Collard Salad With Broccoli and Butternut Squash, or combine arugula with heart-healthy raspberries in this Raspberry Arugula Salad.)
6) Nuts and Seeds
A review published in Nutrients in February 2023 showed nuts and seeds are helpful for reducing cardiovascular disease. They’re also a favorite of both Saxena and Boham because of their nutrient profiles and how easy it is to incorporate them into meals.
“I love walnuts. They’re rich in omega-3s and monounsaturated fats, and they’re really a great protein and fiber source,” says Boham. “They’ve also been shown to lower LDL cholesterol, support artery elasticity, lower oxidative stress, and improve cholesterol balance as a whole.”
Boham and Saxena both like to sprinkle nuts or seeds on a salad. You can also use a mix of your favorite nuts and seeds to make your own energy bars or homemade nut or seed butter.
7) Olive Oil
Olive oil is a staple of the Mediterranean diet for good reason. It’s rich in healthy fats and antioxidants as well as in polyphenols — “the active ingredients, so to speak, [that] help soothe inflammation,” says Orfanos. A 2022 meta-analysis published in Frontiers in Nutrition found a correlation between people who consume higher amounts of extra-virgin olive oil and a decreased risk of cardiovascular disease.
Orfanos’s favorite recipe starring olive oil comes from his Greek grandmother. “It’s a big vegetable casserole with potatoes, zucchini, tomatoes, onions, and garlic,” he explains. “And it’s just swimming in olive oil.”
He also loves olive oil for dipping bread, frying eggs, and making homemade salad dressings. (Try infusing olive oil with fresh herbs or use it in our recipe for Pasta Trapanese.)
8) Spices
Cooking with spices that contain anti-inflammatory properties can be a wonderful way to add plenty of flavor to a dish while also supporting your heart health. “Anti-inflammatory spices, such as turmeric, have been shown to lower blood sugar,” Guarneri says. One review of studies, published in 2021, found that turmeric can reduce fasting blood sugar. Saxena likes to cook vegetables with plenty of Indian spices, such as turmeric, ginger, and chili. (Try this recipe to make a turmeric latte at home, or use a mix of heart-healthy spices to make this Tandoori Chicken One-Pan Dinner.)
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