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Experts say moderate changes in your diet can produce improvements in heart health. LukaTDB/Getty Images
  • Researchers say 2 out of 3 deaths from heart disease could be prevented if people adopted healthier diets.
  • Experts say diet is one of the risk factors for heart disease that can be easily modified.
  • They recommend making minor changes, such as eating fruit instead of chips for lunch and more vegetables and less meat at dinner.

Diet is the single most important factor in preventing heart disease, which kills more people worldwide than any other illness.

In fact, 2 out of every 3 deaths from heart disease could be prevented by adopting a healthier diet, researchers say in a new study.

“More than 6 million deaths could be avoided by reducing intake of processed foods, sugary beverages, trans and saturated fats, and added salt and sugar, while increasing intake of fish, fruits, vegetables, nuts, and whole grains. Ideally, we should eat 200 to 300 mg of omega-3 fatty acids from seafood each day,” according to Dr. Xinyao Liu, a researcher at Central South University in Changsha, China, and a study lead author.

“On top of that, every day we should aim for 200 to 300 grams of fruit, 290 to 430 grams of vegetables, 16 to 25 grams of nuts, and 100 to 150 grams of whole grains,” Liu added.

The study, published in European Heart Journal — Quality of Care and Clinical Outcomes, estimated that 69 percent of ischemic heart disease deaths worldwide could be prevented if healthier diets were adopted.

That’s greater than the deaths that could be prevented by keeping systolic blood pressure at 110–115 mmHg (54 percent), maintaining a healthy serum LDL cholesterol level of 0.7–1.3 mmol/L (42 percent), keeping fasting plasma glucose levels at 4.8–5.4 mmol/L (25 percent), or eradicating smoking and secondhand smoke (20 percent), the study concluded.

“Ischemic heart disease is largely preventable with healthy behaviors, and individuals should take the initiative to improve their habits,” said Liu.

“There are nine major risk factors for heart disease, only two of which you can do nothing about — age and family history,” Dr. Elizabeth Klodas, a cardiologist and founder of Step One Foods, told Healthline. “The rest you can modify, and five of those seven are driven in whole or in part by food.”

Researchers based their findings on data from the Global Burden of Disease Study 2017, which was conducted in 195 countries between 1990 and 2017. The findings were consistent across developed and undeveloped countries, according to Liu.

Ischemic heart disease caused nearly 9 million deaths worldwide in 2017, accounting for 16 percent of all deaths, compared with 12 percent of all deaths in 1990.

Lui noted that age-standardized prevalence, incidence, and death rates for ischemic heart disease all declined between 1990 and 2017, but the overall numbers of deaths almost doubled during the same time period.

“While progress has been made in preventing heart disease and improving survival, particularly in developed countries, the numbers of people affected continues to rise because of population growth and aging,” said Liu.

The investigators calculated the impact of 11 risk factors on death from ischemic heart disease:

  • diet
  • high blood pressure
  • high serum low-density lipoprotein (LDL) cholesterol
  • high plasma glucose
  • tobacco use
  • high body mass index (BMI)
  • air pollution
  • low physical activity
  • impaired kidney function
  • lead exposure
  • alcohol use

The authors estimated the proportion of deaths that could be stopped by eliminating each risk factor.

Felicia Stoler, MS, a registered dietitian nutritionist, told Healthline that the study demonstrated how little progress has been made over the past 2 decades in changing dietary habits that are well-known to impact cardiac health and morbidity.

“There’s so much confusing information on what constitutes a healthy diet, and not just in the U.S.,” said Stoler.

She noted that nutrient-dense carbohydrates — “which have sustained people for thousands of years” — are demonized while nutritionally unbalanced keto and paleo diets are lionized.

Klodas emphasized that most people don’t need to make radical changes in their diet in order to improve their cardiac health.

“It’s not all about eliminating the bad stuff. It’s about adding good stuff in,” she said. “If you eat an apple a day, in a year that’s three bushels of apples and a substantial amount of fiber and antioxidants. Substitute an apple for a cookie, and, whoa.”

Klodas endorsed the mantra, “Eat real food, not too much, and mostly plants” as promulgated by food author Michael Pollan.

“Before lunch, have a piece of fruit before you eat what you would normally eat — you might eat a little less,” she advised. “At dinner, change the proportions on your plate. Have vegetables with meat instead of meat and vegetables. Liquids are a tremendous source of unnecessary calories, so transfer as much as you can from sweetened drinks to water.”

“Whenever you can, make a better choice, even if it’s just a little choice,” Klodas said. “All of those little choices add up over time.”