Heart health is influenced by far more than genetics or exercise. What we eat every day plays a significant role in blood pressure, cholesterol, blood sugar, body weight and overall cardiovascular risk. In fact, poor diet quality remains one of the major contributors to cardiovascular disease (CVD) worldwide.
The good news is that eating for a healthy heart does not require an extremely restrictive diet or eliminating your favourite foods. A heart-healthy dietary pattern is flexible and can be adapted to different cultures, cuisines, budgets, religious practices, and stages of life. The focus is on what you eat most often and the overall pattern of your diet, rather than perfection at every meal.
What does a heart-healthy diet look like?
A heart-healthy diet prioritises vegetables, fruits, whole grains, healthy sources of protein, unsaturated fats and minimally processed foods while limiting excess sodium, added sugars, saturated fats and alcohol. Here are ten key principles to build your diet around:
Balance food intake with your energy needs
Maintaining a healthy body weight is an important part of cardiovascular health. Excess body weight can increase the risk of high blood pressure, abnormal cholesterol, diabetes and other conditions that affect the heart.
Rather than following extreme diets, aim to match your food intake with your activity level. Regular movement, adequate portions and a balanced diet can help achieve and maintain a healthy weight over the long term.
Consume plenty of vegetables and fruits
Vegetables and fruits provide fibre, vitamins, minerals, antioxidants and other beneficial plant compounds.
Aim for variety rather than focusing on a single “superfood.” Include different colours, textures and types throughout the week. Leafy greens, tomatoes, carrots, berries, citrus fruits, cruciferous vegetables and seasonal produce can all contribute to a heart-healthy pattern. Fresh isn’t the only option.
Frozen and canned vegetables and fruits can also count, particularly when they are affordable and convenient. When choosing canned products, look for options with little or no added sodium or sugar.
Make whole grains your usual grain choice
Whole grains retain more of the naturally occurring fibre and nutrients found in the grain compared with refined grains. Choose foods such as whole-wheat bread, oats, brown rice, quinoa, barley and other intact or minimally processed whole grains more often than refined options such as white bread, pastries and highly refined cereals.
The fibre in whole grains can support healthier cholesterol levels, blood sugar regulation, satiety and overall metabolic health.
Choose healthy sources of protein to add in diet
Protein is essential, but the source of protein matters. Shift more of your protein intake toward beans, lentils, peas, chickpeas, nuts and seeds. Fish and seafood can also be regular choices, alongside low-fat or fat-free dairy products where appropriate. Animal proteins do not have to be eliminated. If you eat red meat, choose lean cuts, keep portions moderate and minimise processed meats such as sausages, bacon and other cured meats.
A useful approach is to gradually increase the proportion of plant-based protein in your diet rather than thinking in terms of an all-or-nothing plant-versus-animal approach.
Replace saturated with unsaturated fats
Not all dietary fats affect cardiovascular health in the same way. Instead of relying heavily on saturated-fat sources such as butter and fatty meats, incorporate more unsaturated fats from nuts, seeds, avocados, and non-tropical plant oils.
The goal is not to eliminate fat. Rather, replace less favourable sources of fat with healthier ones while keeping overall portions appropriate for all your energy needs.
Choose minimally processed foods often
A heart-healthy diet should prioritise foods that are closer to their natural or minimally processed form. Vegetables, fruits, whole grains, legumes, nuts, seeds, fish and other minimally processed foods can form the foundation of meals. Highly processed foods often contribute excess sodium, added sugars, saturated fat and calories.
A heart-healthy dietary pattern is flexible and can be adapted to different cultures, cuisines, and budgets. The focus is on the overall pattern of your diet, rather than perfection at every meal
Minimise added sugars
Excess intake of added sugars, particularly from sugar-sweetened beverages, can contribute to excess calorie intake and poor cardiometabolic health. Water should be the default beverage for most people. Sparkling water, unsweetened tea and other low- or no-sugar options can provide variety.
When buying packaged foods, check the nutrition label for added sugars and ingredients such as cane sugar, syrups and other sources of added sugar.
Be mindful of sodium
Too much sodium can raise blood pressure, which is one of the most important modifiable risk factors for cardiovascular disease. For many adults, keeping sodium below 2,300 mg per day is a useful upper limit, while some people at higher cardiovascular risk may benefit from a lower target under medical guidance.
Much of the sodium in modern diets comes from packaged, restaurant and commercially prepared foods rather than the salt shaker alone. Read food labels, choose lower-sodium products when possible and flavour meals with herbs, spices, garlic, ginger, lemon, vinegar and other seasonings instead of relying heavily on salt. Potassium-rich foods such as vegetables, fruits, and legumes can also support healthy blood pressure.
If you don’t drink alcohol, don’t start
Alcohol should not be considered a strategy for improving heart health. Even low-to-moderate alcohol intake can raise blood pressure. Alcohol is also associated with other health risks, including certain cancers. If you drink, limiting your intake can reduce overall health risks.
Don’t forget fibre
Fibre deserves special attention because many people do not consume enough of it. Vegetables, fruits, whole grains, legumes, nuts and seeds are excellent sources. Adequate fibre can support healthier cholesterol levels, blood pressure, blood sugar regulation, digestion and satiety.
Instead of relying on supplements, build fibre into your meals naturally: add vegetables to lunch and dinner, choose whole grains, include legumes regularly and have fruit as a snack or alongside meals.
Healthy eating habits are not only for adults with cardiovascular risk factors. Heart-healthy dietary patterns can begin from childhood, with dietary needs adapted to each stage of growth and development.
As nutritional requirements change with age, pregnancy, medical conditions and other individual circumstances, dietary choices should be personalised with appropriate healthcare guidance when needed.
You can enjoy cultural foods, festive meals, restaurant meals and occasional treats while still following a cardiovascular-friendly eating pattern. The objective is to make nutritious choices the foundation of your everyday diet.
Eat more plants. Choose whole grains. Prioritise quality protein. Replace saturated fats with unsaturated fats. Reduce excess sodium and added sugar. Limit alcohol. And most importantly, build a pattern of eating that you can sustain for life.
Understanding lifestyle diseases
What are the causes
Smoking, alcohol abuse, drugs
Exposure to pollutants at work/home
Lack of physical activity, restricted movement for prolonged hours
Damaging habits such as excess use of smartphones and poor posture
Poor/unhealthy eating habits involving processed food and lack of hydration
High stress levels and poor quality of sleep
Tips to reduce risk of lifestyle disorders
Focus on whole, unprocessed foods like fresh fruits, vegetables, whole grains, lean proteins and healthy fats. Avoid ultra-processed foods high in sugar and trans fat
Engage in regular physical activity - Counteract sedentary habits by incorporating at least half an hour of moderate exercise such as walking and yoga
Manage stress effectively — Practise stress-relieving activities like meditation, deep-breathing exercises, journaling, or spending time in nature
Prioritise quality sleep - Poor sleep disrupts hormone regulation, leading to insulin resistance. Sleep for at least seven to nine hours every day by maintaining a consistent sleep schedule and limiting screen time before bed
Stay hydrated to support kidney health - Drink plenty of water throughout the day while limiting sugary and caffeinated beverages that can contribute to kidney strain and dehydration
Maintain a healthy weight - Focus on mindful eating, portion control and a well-balanced lifestyle rather than restrictive diets for sustainable weight management
Avoid smoking and limit alcohol intake - Smoking and excessive alcohol consumption contribute to liver damage, cardiovascular diseases, and metabolic imbalances. Reducing or eliminating these habits can significantly lower the risk of developing lifestyle-related disorders
Conduct regular health screenings - Early diagnosis and interventions lead to better management. Regular screenings for sugar and cholesterol levels, blood pressure and kidney and liver functions will help detect issues early
(The writer is the director and chief nutritionist, LivStack Health and Performance Centre, Adyar, Chennai)