Keeping it Ticking – Heart Healthy Diet Basics

Heart Healthy Diet Basics – The number one killer!

Heart disease the number one killer in the US, according to the Centers for Disease Control and its causes are intimately tied to diet and lifestyle.  The good news is that heart disease prevention is grounded similarly in diet and lifestyle solutions.

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Improved lifestyle and diet, namely more fruit and veg , less saturated and trans fats, no smoking and more regular exercise is associated with lower rates of heart disease among certain groups over the last four decades.  A heart healthy diet has been the cornerstone of this decrease.

heart healthy diet - Heart disease the number one killer in the US, according to the Centers for Disease Control and its causes are intimately tied to diet and lifestyle.
Heart Healthy Diet Basics - Not just a man’s disease - Statistically men are more vulnerable to heart attack than women - thought to be a result of the protective effect of female hormones prior to menopause. After menopause the heart disease rates between the sexes gradually become identical.

Despite overall fewer deaths from heart disease in the US, certain groups remain vulnerable to cardiovascular disease, including blacks, Hispanics, women and the increasing obese population.  These groups are ones that could benefit from a heart healthy diet.

Heart Healthy Diet: Risk factors for Cardiovascular Disease

Any heart healthy diet has got to deal with the risk factors for heart and cardiovascular disease.

These heart healthy diet risk factors are as follows:

  • Being overweight (BMI above 25)

  • Smoking
  • High LDL Cholesterol
  • High Triglycerides
  • High Blood Pressure
  • High Homocysteine
  • Chronic Inflammation
  • Low Fruit and Veg intake

Heart Healthy Diet Risk Factor # 1: Being overweight – Having a BMI above 25 increases your risk of heart attack by 65%. Being over your ideal weight obviously puts a strain on your body including the heart that has to pump more blood through a greater area.

Heart Healthy Diet Basics – How much abdominal fat is too much? Waist to Hip Ratio can tell you. Expert bodies including the World Health Organization use the waist to hip circumference ratio to help determine, if you have too much abdominal fat and increased risk for various diseases. To calculate your ratio, divide your hip circumference by your waist circumference. A waist-to-hip circumference greater than.90 for a man ; and .85 for a woman indicate abdominal obesity and increased health risk.

Studies have found that those whose fat accumulates around the abdomen (apples), as opposed to the hips (pears),have a higher rate of cardiovascular disease as well as other conditions like diabetes, kidney disease, dementia and overall mortality. It appears that abdominal fat is more biologically active than fat elsewhere.

Keeping abdominal fat at bay is part of a heart healthy diet.


Heart Healthy Diet Risk Factor # 2: Smoking - Studies show smoking doubles your risk of cardiovascular disease, through its effect on blood pressure, cholesterol levels and artery integrity. Smoking - a free radicle generator- directly damages the blood vessels, increasing the risk for cardiovascular disease including both heart attack and stroke. So butt out for a heart healthy diet or, better yet, don’t light up!


Heart Healthy Diet Risk Factor # 3: High LDL cholesterol – especially when you are diabetic or insulin resistant - Not all cholesterol is bad when it comes to a heart healthy diet. Cholesterol is needed for many functions including hormone production and liver function.  

Soluble Fiber and LDL Cholesterol Studies show that a diet high in soluble fiber found in fruit and veg reduces LDL cholesterol levels along with blood triglyceride levels.

In fact, HDL cholesterol can protect against CAD because this type of cholesterol transport fats from the blood to the liver where they can be discarded instead of contributing to clogged arteries. Indeed, low HDL cholesterol is another heart disease risk factor, especially for females with high triglycerides.

 Studies suggest that high LDL cholesterol (the bad kind) is a more accurate risk factor for male heart attack than for female. A more accurate risk factor for women than high HDL alone is thought to be high triglycerides combined with low HDL levels.

Ways to lower HDL – the Bad Cholesterol – Reduce saturated and trans fat intake and increase regular exercise. Vegans who eat no animal products have lower HDL cholesterol levels thought to be because they avoid animal products and include a surfeit of anti-oxidant and fiber rich fruit and veg.

While much of the conventional medical establishment says that 190 to 210 mg/dL of total cholesterol is a healthy heart diet goal, other more nutritionally focused doctors disagree. Some advise 150 mg/dL , if you want to eliminate the risk of cardiovascular disease or try to stop or reverse your existing arthrosclerosis.

Dr.  Caldwell Esselstyn, Jr   promotes these lower  levels on the basis that

  1. they prevail in populations in which heart disease is extremely rare; and
  2. a significant number of people eating a Western diet whose levels are within the conventional range for healthy suffer heart attack or stroke.

Esselstyn explains that to achieve these lower 150 mg/dL cholesterol levels, people must limit overall fat intake to 10% of total calories (as opposed to 30% as the US government suggests and the 35% that Americans average). This can be achieved by eliminating all animal products from the diet and relying exclusively on plants for food.

For more on Dr. Esselstyn’s work, read Prevent and Reverse Heart Disease.

Heart healthy diet Secrets - Low Density Lipoprotein (LDL) cholesterol – prevents CAD because it transports triglycerides (a type of blood fat) from the blood to the liver where they can be metabolized and not clog arteries. Omega 6 and Omega 3 oils along with soluble fiber found abundantly in most fruit and veg can increase LDL cholesterol levels.

Heart Healthy Diet Risk Factor # 4: High Blood Triglycerides – arise from an excess of saturated fats or too many high glycemic refined foods on the menu. High levels of triglycerides in the blood can attach to artery walls and contribute to arthrosclerosis. While conventional medicine says fasting triglyceride levels of up to 149 mg/dL are okay; other experts say fewer are ideal. In fact, those with fasting blood triglycerides levels of less than 104 mg/dL have a 48% lesser risk of CAD than those with levels between 105 and 170 mg/dL; and a 94% lesser risk than those with a fasting blood triglyceride level over 170 mg/dL.

High Triglycerides and other Health Risks Elevated levels are associated with higher risk of not only heart attack, stroke, and metabolic syndrome, but pancreatitis, dementia and chronic inflammation among other conditions. Triglycerides are clearly something to keep in check for reasons in addition to a heart healthy diet.

While certain triglyceride lowering drugs are available, diet can effectively lower triglycerides as well:

  1. Reduce Saturated Fat predominately found in animal products including  all meat and dairy by eating low fat versions of the above or substituting plant foods.
  2. Avoid refined grains and sugars – these convert readily into triglycerides in the blood. Instead aim for less processed or refined foods without added sugars.
  3. Fish oil supplements containing EPA and DHA.  Studies have found these Omega 3s have a powerful cardio-protective effect.
  4. Green tea; grapes including those in red wine and grape seed; dark chocolate – contain procyanidins that include catechins and other flavonoids. These contribute to lower triglyceride levels among other heart benefits.
  5. NiacinVitamin B3. Some people experience a harmless flushing. If this is the case, take a non-flush version.
  6. A low glycemic diet - Substitute complex carbohydrates from whole grains like oats and whole wheat for refined carbs and sugar and most processed foods.

The French Paradox is the high consumption of saturated fat in France compared to its relatively low level of cardiovascular disease. One explanation is the French’s greater consumption of wine, especially red wine, and fruits and vegetables compared to other Western countries’ citizens. These foods contain a surfeit of flavonoids including procyanidins and resveratrol that are cardio-protective and arguably decrease risk of CAD.


Heart Healthy Diet Risk Factor # 5: High Blood Pressure – High blood pressure strains the heart because it must pump harder to get the blood where needed due to increased resistance. High blood  pressure also strains blood vessels, increasing the risk for arterial wall damage that can trigger arthrosclerosis and blood clots (thrombosis). These are the results of the body’s attempts to heal damaged tissue, which, in turn, increase stroke and heart attack risk. High blood pressure also raises the risk for kidney disease, diabetes side effects and other health conditions.

Four heart healthy diet strategies to lower blood pressure:–


  1. Maintain a normal weight – Aim for a BMI between 18 and 25.
  2. Exercise regularly – Aerobic exercise which raises the heart beat is a sure fire way to lower blood pressure. Aim for 20 minutes 3 times a week as a minimum.
  3. Ensure moderate sodium intake – the American Heart Association recommends limiting sodium to 1,500 mg per day, if at risk for high blood pressure; others can consume 2,300 mg per day safely.
  4. Eat enough potassium rich foods including lentils, seafood, sunflower seeds, and bananas. Potassium is a key electrolyte that acts as an  antagonist to excess sodium and chloride to  lower blood pressure.


For more on ways to help maintain a healthy blood pressure, press on high blood pressure supplements.

Press here to read more about the benefits of grapes for high blood pressure.

High Levels of Homocysteine – a blood metabolite?–are associated with higher risk of cardiovascular disease. Supplementing Vitamin B6, Vitamin B12 and folate can decrease homocysteine levels and risk for CAD.

Heart Healthy Diet Risk Factor # 6: High Homocysteine Levels – Homocysteine is an amino acid that forms as a result of deficiency in several B vitamins. Elevated homocysteine can harm arteries and increase the risk for heart attack, stroke and other health conditions.

Many heart researchers consider raised homocysteine blood levels (above 11 mmol/l) a more accurate risk factor for heart disease than elevated cholesterol levels. Many experts suggest 7 mmol/l  or below is a better goal for avoiding heart disease and improving health.


Benefits of Lowering Homocysteine include more than just for a heart healthy diet Raised homocysteine levels have been linked to increased incidence of cardiovascular disease including heart attack and stroke, as well as increased risk for type 2 diabetes, cancer, Alzheimer’s, and mortality from all causes.

For most people, other than a small group who have high levels for genetic reasons, you can lower your homocysteine by supplementing B vitamins including  

  1. folic acid,
  2. Vitamin B6,
  3. Vitamin B12.

Some consider betaine or trimethyl glycine (TMG) a good addition to a homocysteine lowering program, especially if you are one of the 10% of people who can’t metabolize effectively B vitamins to lower homocysteine. 

Consuming enough B vitamins can lower your heart attack risk by 50%.

Heart Healthy Diet Risk Factor # 7: Chronic Inflammation – Chronic inflammation can make you  more susceptible to heart attack and stroke, aside from other risk factors for CAD. It appears that inflammation is involved both the formation of atherosclerosis plaques as well as their rupturing and blocking arteries.

Peridontal disease is one such example of an inflammatory condition that raises CAD risk.  Being overweight,  smoking and not excercise also increase your inflammatory markers.

Your doctor can determine your levels of inflammation by testing blood levels of C-reactive protein (CRP). Myriad studies show that this test can predict future risk for heart attack, stroke, sudden cardiac death as well as peripheral artery disease. It's also a good marker as to which heart attack patients may suffer another.

A high CRP can increase your risk of CAD 2 to 3 times over those with low levels.


Heart Healthy Diet - Diet and Lifestyle Tips

A diet low in cholesterol - Minimizing or eliminating animal products like red meat and dairy products is the best way of reducing dietary cholesterol.  While targets for total cholesterol have changed over the years, many conventional doctors consider a total cholesterol of 200 ml/dL  a healthy goal to avoid CAD. However, populations where coronary artery disease is relatively rare routinely have total cholesterol levels that average 150 ml/dL suggesting conventional Western medical targets may be too high.


A diet low in saturated and Trans fats: Saturated and Trans fats have been linked to a higher incidence of coronary artery disease.  

Saturated fat predominately is found in animal products so eliminate these from your heart healthy diet or source low fat cuts of meat and no-fat dairy or opt for Omega-rich fish to reduce your intake of saturated fats.  While we need fat for proper brain and metabolic function among other reasons, those following a Western diet generally consume too much of the wrong kinds of fat.


Focus on healthy fats, namely, the essential fatty acids Omega 3s and Omega 6s in a balanced ratio and not eat excessive amounts of any kind of fat. Along with too much saturated fat and overall dietary fat, beware of trans fats (hydrogenated or partially hydrogenated vegetable oils) found in margarine and many processed foods and commercial baked goods.  The fat has been denatured and contributes towards heart disease and other health conditions.

Trans fats also prevent you from metabolizing the healthy Omega 3 and Omega 6 fats that can have anti-inflammatory and anti-clotting benefits.

Trans Fats – Bad for the Heart High trans-fat intake is associated with a higher risk of cardiovascular disease including arthrosclerosis, heart attack and stroke. Trans fats are hydrogenated or partially hydrogenated vegetable oils and are a common constituent of margarine as well as many commercial baked goods and processed foods. You can read labels to avoid trans fats in your groceries but restaurant food is another matter. Many cities and regions in North America, including New York City, now ban trans fats in restaurants because of the health risks.

Press here for more on healthy fats and Omega 3s.

A diet high in fruits and vegetables  - They are chockablock with anti-oxidants, bioflavonoids and soluble fiber that prevent free radicals that can damage arteries and HDL cholesterol; help maintain blood vessel integrity; and ensure a healthy ratio of HDL to LDL cholesterol.

Fruits and veg are good sources of heart protective magnesium, calcium, potassium, vitamin C, folate and soluble fiber, as well as cardio protective flavonoids including procyanidins like catechins.

  • Magnesium found in green leafies lower blood pressure and help with muscle contraction and relaxation including the heart as well as healthy blood vessel tone. Press here for more on the benefits of magnesium  and a magnesium recipe.
  • Calcium relaxes muscles, important for heart and artery health. It is rich in green leafy veg like kale and spinach as well as legumes and seeds and citrus.
The Benefits of Getting Calcium from Fruit and Veg While calcium is also rich in dairy products, some experts consider getting a good proportion of your calcium from vegetables including legumes and whole grains is wise because too much dairy or other animal products for that matter can lead to an acidic blood PH which can encourage calcium excretion.

Studies suggest that, when it comes to heart health, dietary calcium is preferable to calcium from supplements. For more on the latest research, press here.  Press here for more about the benefits of calcium including dietary sources.


  • Potassium, as found in seafood and fruits and veg both lowers blood pressure and protects the heart. Aim for 4,700 mg per day from fruits and veg.
  • Vitamin C both thins the blood preventing thrombosis, protects HDL cholesterol from oxidizing and becoming sludge like, as well as maintaining and repairing blood vessels. Press here for more on the benefits of vitamin C.
  • Procyanidins including catechins in green tea, grapes including red wine and dark chocolate are associated with reduced risk for cardiovascular disease.
  • B vitamins – Niacin (vitamin B3), folate, and vitamin B12 are important for lowering homocysteine – high levels are closely associated with increased cardiovascular disease risk. Make sure you get enough of the B vitamins through food or supplements. Some people who are genetically susceptible, need betaine to keep homocysteine levels in check as well as the above B vitamins.
  • Soluble Fiber from fruits and vegetables including oats, beans and lentils can lower bad LDL cholesterol and raise good HDL cholesterol.
Olive Oil–Olive oil is the staple fat of the Mediterranean Diet and is associated with decreased cardiovascular risk and decreased mortality. The benefit on cardiovascular health is not thought to be the oil itself, which is a monounsaturated fat. Instead it is a group of polyphenols that make up less than 2% of the oil that researchers theorize have an antioxidant and heart protective effect. These include hydroxytyrosol, secoiridoid aglycones and squalene . Opt for high quality extra virgin oil from a reputable source. Research shows that many of the cheaper extra virgin olive oil sold in grocery stores are adulterated with other less healthy oils where most, if not all of the polyphenols and health benefits associated with extra virgin olive oil, would be absent.

A diet containing enough healthy fats including all-important Omega 3s. Fish oil and vegetable oils contain Omega 3’s and Omega 6s that are essential for good health. Omega 3s are found in concentrated levels in oily cold water fish and some nuts and seeds like flax, chia and  pumpkin seeds and their oils. These fats are particularly important for a heart healthy diet because they reduce clotting, help maintain supple blood vessels and are anti-inflammatory. Get enough Omega 3 fats!

Press here for more on the benefits of Omega 3s and other heart healthy diet fats.

Press here for more on fish oils, mental stress and heart health.

Regular aerobic exercise – get walking, running, dancing, bicycling or take the stairs. The heart is a muscle, like any other, and needs to be exercised to stay toned and strong.  20 minutes of strenuous exercise during which your heart beat increases substantially 3 times a week has been found to lower the risk of CAD by 50%.


Moderate sodium intake - Moderating sodium is key to keeping  blood pressure levels in check.   Many processed foods are chockablock with salt especially those claiming to be low fat, so avoid these foods and opt for less processed unsalted foods when you can.  Read labels to determine sodium intake. It takes about three weeks to train your taste buds to less salt in your food. When salting for cooking or at table, opt for a salt substitute like Pansalt or Cardia Salt that contains potassium and magnesium.

Press here for information about Cardia  Salt – potassium/magnesium salt substitute.

Press here for more about reading food labels so you can figure out how much sodium is in a serving.

Take measures to reduce inflammation - Many of the above measures will help reduce or avoid chronic inflammation.

For more dietary tips on how to eliminate inflammation, press on anti-inflammatory diet.

For  more on foods to avoid, press on inflammatory foods.

For additional anit-inflammatory support press on anti-inflammatory supplements.


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For more on Heart Healthy Diet and related topics…

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As mentioned, check out anti-inflammatory diet, inflammatory foods and anti-inflammatory supplements  to get a handle on preventing and resolving inflammation.

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