The 3 Best Heart Health Diets

Key Takeaways

• Your diet influences all the major modifiable cardiovascular risk factors — blood pressure, LDL cholesterol, blood glucose, and inflammation.
• Plant diets, the DASH diet and the Mediterranean diet have the strongest and most consistent evidence for reducing cardiovascular disease risk.
• All three diets share the same core principles: more plants, whole grains, and healthy fats; less saturated fat, sodium, added sugar, and red meat.

Cardiovascular disease is the leading cause of death worldwide, and has been for some time. It accounts for more deaths than cancer, diabetes and lung diseases combined. However, the good news is that it is “modifiable”, meaning it can be delayed, prevented, or its effects minimised. 

Smoking, being inactive, having too much body fat, and a poor diet are the main drivers that you can modify. In this article, we will examine the role that your diet plays.

Why Diet Matters for Heart Health

Whatever you eat, its constituent parts will eventually find their way inside your cardiovascular system (in your bloodstream), where your heart and blood vessels are exposed to them — there is no getting around this. So, the foods you eat every day affect your blood, the elasticity of your arteries, your immune system and your metabolism.

When the doctors look at how “healthy” your cardiovascular system is, they’ll look at a few risk factors: high LDL or ApoB, high blood pressure, glucose and insulin, triglycerides, inflammation, and body fat.

No medication can act on all of the risk factors at the same time. But the right diet can. For people who are at risk of cardiovascular disease, changing to a heart-healthy diet can meaningfully reduce all these risk factors with minimal side effects^1,2.

The Basic Dietary Practices That Protect Your Heart

We’ll go through specific diets in a minute, but if you don’t want to overhaul your diet entirely, and prefer to adapt your current diet, there are a few basic principles that appear consistently that you should consider^3,4.

Eat more plants

This means eating more vegetables (most important), legumes (also important), whole grains and fruit. They are rich in fibre, potassium, antioxidants and anti-inflammatory “phytonutrients”. 

Fibre reduces LDL and helps stabilise your blood sugar levels⁵. Potassium helps control your blood pressure. The antioxidant and anti-inflammatory molecules in plants protect your blood vessels.

Choose healthy fats

Unsaturated fats — found in olive oil, nuts, seeds, avocados, and oily fish — lower cholesterol and reduce inflammation. Saturated fats from processed meats, butter, and full-fat dairy do the opposite. Replacing saturated fats with unsaturated fats is one of the easiest and most effective ways to improve heart health⁶.

Eat whole grains, not refined ones

Whole grains provide soluble fibre, which directly lowers your cholesterol. “Refined” carbohydrates spike your blood glucose and triglycerides. The swap from the white processed carbohydrates to whole-grain, whole-food carbohydrates is a quick, easy and effective substitution.

Reduce sodium intake

Eating too much sodium (mainly from salt) is the main thing in your diet that increases your blood pressure. That said, in most modern diets, the added salt comes from processed and packaged foods, not the salt shaker. Reducing your salt intake is probably not enough if you’re eating a lot of processed foods.

Limit red and processed meat

It’s controversial, but high consumption of red meat is associated with increased cardiovascular risk. This includes unprocessed red meat, but processed meat like sausages, bacon, and deli meats is generally worse. 

Replacing red meat and all processed meats with fish, legumes, or poultry is consistently beneficial. If you’re going to eat red meat, keep servings to under 3.5 oz and two servings a week max.

Cut out ultra-processed foods

They’re high in salt, sugar, refined carbohydrates, and unhealthy fats, everything you don’t want for maintaining good heart health. Ultra-processed foods hit nearly every cardiovascular disease risk factor, but in the wrong direction. Avoid at all costs.

The Top 3 Diets for Heart Health

1. Mediterranean Diet

The Mediterranean diet is the most studied diet for cardiovascular health and consistently tops most lists for preventing heart disease. It is based on vegetables, fruits, legumes, whole grains, olive oil, and oily fish, with moderate poultry and dairy, and limits red meat and sweet treats.

Several high-quality independent studies have shown that people who follow the Mediterranean diet can substantially reduce their chances of having a heart attack, stroke or dying from cardiovascular disease⁶ — that’s the headline. It also leads to healthier body weights, weight loss, lower blood pressure, blood sugar levels, insulin, triglycerides, cholesterol, and inflammation markers in people who have elevated levels at baseline⁷.

Its benefits are explained by the diet’s large amounts of anti-inflammatory foods and healthy fats, and low intake of processed food and red meat. It is also flexible enough that it can be adapted to a diverse array of people, budgets, and is more sustainable than more restrictive diets.

Read: The Mediterranean Diet: A Review

2. DASH Diet

The “DASH” diet (short for Dietary Approaches to Stop Hypertension) was specifically designed (and proven) to target high blood pressure. The DASH diet is similar to the Mediterranean diet, emphasising plants, whole grains, low-fat dairy, nuts, lean proteins, while restricting sodium, saturated fat, red meat and added sugars.

The blood pressure-lowering effects of the DASH diet are among the largest seen for any diet (or other non-drug treatments) — it's actually comparable to some anti-hypertensive medications². In addition to lowering blood pressure, the DASH diet also lowers cholesterol, insulin and your chances of getting diagnosed with cardiovascular disease, stroke, coronary heart disease and type 2 diabetes.

Its main distinction from the Mediterranean diet is the strict sodium limits (under 2.3 g or approximately 1 teaspoon of salt) and the inclusion of low-fat dairy, which provides calcium, magnesium, and potassium. It’s the rebalancing of these minerals that helps keep your blood pressure low and under control. There is probably no other diet that has been as rigorously tested for treating high blood pressure as the DASH diet.

Read: The DASH Diet: A Review

3. Plant-Based and Flexitarian Diets

Plant-based diets cover a spectrum of diets, from fully vegan to “flexitarian” diets (ones that are predominantly but not exclusively plant-based). They are sometimes referred to as “plant-slant” or “plant-forward” diets. But what unites all plant diets is that they replace animal food (especially meats) with vegetables, legumes, whole-grains, nuts and seeds. You don’t have to go fully vegan to benefit.

In people who are at risk of cardiovascular disease, a plant-based diet reduces cholesterol, blood sugar, and body weight⁹. People who eat more plants also tend to have lower chances of getting heart disease and dying from it. 

However, the prefix “healthy” needs to be put before plant-based diets to work. There are “unhealthy” plant-based diets that rely on refined carbohydrates (sugar and refined grains) and processed and packaged products, which do not have the same health benefits.

If you don’t want to go fully plant-based, adopt a flexitarian approach by substituting animal fats with “non-tropical” plant oils (e.g., olive, canola, sunflower or soybean oil, but not coconut or palm oil), red meat for legumes and refined carbohydrates for vegetables is a great start to capture the health benefits.

Browse: Plant-Based Diet Resources

Bottom Line

The most effective diets for heart health are not complicated or exotic. They are based on whole foods, mostly plants, healthy fats, whole grains and some lean proteins, and keeping away from saturated fats, too much sodium, sugar and ultra-processed foods. The Mediterranean, DASH, and general plant-based diets represent three different diets that adhere to these basic principles.

For heart health, especially if you’re already at risk (e.g., older, male, have had, or have a family history of cardiovascular disease, or any of the risk factors mentioned above), the best diet is one that fits your life well enough to be maintained long-term. Any one of the three diets in this article is a good place to start.

For a broader look at heart-healthy diets, exercise and lifestyle recommendations, have a look at our heart health page.