- Eating more whole fruits, vegetables, legumes, nuts, fish, and whole-fat dairy products may help lower your heart disease risk.
- Experts found that following a heart-healthy diet can be achieved in various ways, such as consuming moderate amounts of whole grains or unprocessed meats.
- Focusing on starting small when making diet changes can help you stick with new eating habits.
A new report finds that you may be at a higher risk of cardiovascular disease if you don’t eat enough of six key heart-healthy foods.
That’s according to a study from McMaster University and Hamilton Health Sciences researchers at the Population Research Health Institute (PHRI).
The researchers derived a diet score from the PHRI’s large-scale global Prospective Urban and Rural Epidemiological (PURE) study. They replicated their findings in five independent studies designed to measure health outcomes in different regions around the world and in people with and without prior cardiovascular disease.
They found that consuming whole fruits, vegetables, legumes, nuts, fish, and whole-fat dairy products was the key to lowering the risk of cardiovascular disease, including heart attacks and strokes.
They also found that a healthy diet can be achieved in various ways, like consuming moderate amounts of whole grains or unprocessed meats, for instance.
“Previous diet scores — including the EAT-Lancet Planetary Diet and the Mediterranean Diet tested the relationship of diet to [cardiovascular disease] and death mainly in Western countries, but the PURE Healthy Diet Score included a good representation of high, middle, and low-income countries,” said Salim Yusuf, senior author and principal investigator of PURE in a press release.
This study is also unique in that the other diet scores combined foods considered to be harmful — such as processed and ultra-processed foods — with foods and nutrients believed to be protective of one’s health, explained first author Andrew Mente, PhD, a scientist and assistant professor at McMaster’s Department of Health Research Methods, Evidence, and Impact in the same press release.
The PURE Healthy Diet Score recommends an average of:
- Fruit: 2–3 servings daily
- Vegetables: 2–3 servings daily
- Nuts: 1 serving daily
- Dairy: 2 servings daily
- Legumes: 3–4 weekly servings weekly
- Fish: 2–3 weekly servings weekly
Possible substitutes include whole grains at one serving daily, and unprocessed red meat or poultry at one serving daily.
Yu-Ming Ni, MD, a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, said these six food groups are the same foods that he has advocated for years, in the form of the Mediterranean diet.
“We have plenty of evidence for the benefits of the Mediterranean diet in preventing heart disease, and there are many resources for meal preparation and recipes for following the Mediterranean diet,” says Dr. Ni.
Ni adds that he allows space in the diet for full-fat dairy products, if consumed in an appropriate portion.
Appropriate portions of full-fat dairy products, according to Ni, look like:
- 2 slices of cheese, or
- 1 cup of milk or yogurt, or
- a palm-sized amount of cubed cheese
“Portion control is especially important for calorie-dense foods such as proteins, nuts, and dairy. If unsure, check the nutrition label and look for serving size,” Ni told Healthline.
Andy De Santis, a registered dietitian in Toronto, Canada, said that “diversity in protein intake is fundamental for eating for optimal heart health.”
“Most of our protein intake skews heavily toward chicken, pork, eggs, beef, and dairy, and while there is nothing wrong with these options, they are inevitably higher in saturated fat and generally lack truly unique beneficial compounds.”
By comparison, De Santis said other protein sources like nuts, legumes, fish, and soy are significantly under-consumed.
“Each of these food families has unique and relevant properties that play a role in heart health,” he said.
“So it’s not to say one must eat these protein foods and not the others, but it is absolutely the case that a correction must be made to pursue better balance across protein sources to tap into the unique benefits they offer individually and, of course, collectively, to cardiovascular health,” De Santis added.
“We are all emotional beings and there is a lot of confusion about what’s what with food,” she told Healthline.
“If we remove the emotions and focus on the body there isn’t really much confusion,” she adds. “Our body is a self-healing, self-regulating system that requires a variety of nutrients that come from a balanced diet,” she explains.
Shapira explains we can start making changes and immediately start to benefit. “And the other good news is we don’t have to be perfect, we just need to start,” she said.
Focus on what you like
De Santis said while getting started on shifting eating patterns, it’s crucial to work with heart-healthy foods you enjoy.
He recommended identifying your favorite foods from each food group and ensuring that you have those things around.
“You can also think of foods in these groups that you enjoy but haven’t had recently,” he said.
Start with small changes
If eating a balanced diet with more whole, heart-healthy foods feels overwhelming, experts recommend starting small.
Shapira, for example, suggested finding some new foods at the grocery store each week.
“And if that feels challenging, bring a friend to shop with that can introduce new foods,” she said. “Buy enough to try 3-4 new fruits, vegetables, or whole grains.”
Add rather than subtract
“Don’t worry so much about what you can’t eat, focus more on what you can add,” Shapiro said. “This will shift your diet in the right direction.”
As an example, she says organic seeds and nuts are also great add-ons to many dishes.
“Get adventurous with seeds and nuts by sprinkling them on your toast, in your salad, or in your smoothie,” she suggests. “Or, you may want to try a new nut or nut butter this week,” she added.
“These simple taste tests will be fun for the whole family,” Shapira said. “Get everyone involved and see who loves what.”
Prepare snacks and meals ahead of time
Shapira recommended preparing your heart-healthy foods when you get home so they’re easier to grab later.
“Fruits and vegetables make great snacks, try finding ones you love and making them available for when you are hungry,” she said.
Preparing ahead of time is something that Dr. Ni also suggested.
“It is harder to consume a whole-food diet while having a busy schedule, since most whole food recipes require some amount of preparation,” Ni noted.
Ni says being prepared may look like cutting up fruit, throwing together a salad, purchasing premade cooked proteins to add to vegetables, or making entire meals to freeze for later.
“Preparing foods for later will make it easier to have a ready-made whole-food based meal than to pick up unhealthy fast food,” Ni said.
Pay attention to portion sizes
“Next, you can find portion-controlled whole-food snacks to have between meals, such as nuts, whole fruits, and cheeses, that can satisfy hunger cravings with minimal effort,” Ni suggested.
“Along with water, these snacks can help control calorie intake and thus help to maintain a healthy weight,” Ni added.
Get creative with convenience foods
Finally, Ni says that one last tip is taking advantage of an ever-growing number of casual eateries serving healthy meals that emphasize these 6 food groups, in place of eateries that serve highly processed fast food.