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Heart Health: Managing Heart
Disease through Diet
Fact Sheet No. 9.384 Food and Nutrition Series|Health
by L. Bellows and R. Moore*
What is Heart Disease? and cholesterol affect blood cholesterol Quick Facts
Heart disease, also known as and triglyceride levels, see fact sheet
cardiovascular disease or coronary heart Cholesterol and Fats. For more information • Heart disease is the number
disease, is a broad term for conditions that on how dietary patterns affect one’s risk one killer in the United States.
result in narrowed or blocked blood vessels for hypertension, see fact sheet Diet and However, healthy lifestyle
that may lead to chest pain, heart attack, or Hypertension. modifications may reduce
stroke. Common cardiovascular diseases many risk factors.
include atherosclerosis (hardening of the Reducing the Risk for Heart • Healthy weight maintenance
arteries), hypertension (high blood pressure), Disease through a nutritious diet and
and heart failure, all of which are related physical activity are important
and often coexist. Other conditions such as Heart Disease Management and the steps to decrease one’s risk
arrhythmia (irregular heart beat), heart valve Diet:
problems, or congenital heart defects, also fall for heart disease.
under the definition of heart disease. Despite The following tips are general dietary • Fruits and vegetables
being a mostly preventable disease, death as a recommendations for the prevention
result of cardiovascular disease is the number and management of heart disease. Most contain cholesterol
one killer in the United States. importantly, one should attempt to maintain lowering compounds
a healthy body weight by balancing such as antioxidants and
caloric intake and physical activity, as phytonutrients that may help
What Causes Heart these guidelines are aimed at meeting this prevent heart disease.
Disease? overarching goal. These tips should be used • Limiting dietary saturated
Most often, heart disease occurs due alongside the American Heart Association
to poor lifestyle choices including lack of (AHA) general lifestyle recommendations for fat, trans fat, and cholesterol
physical activity, tobacco use, or an unhealthy managing heart disease and the United States intake is an important strategy
diet. Risk factors such as age, gender, Department of Agriculture (USDA) Dietary to reduce one’s risk for heart
and family history also play a major role. Guidelines for Americans. disease, and can be achieved
Heart disease may also occur as a result of through label reading,
infections or genetic abnormalities affecting Important Dietary Tips for the shopping carefully for non-fat
the heart, not related to lifestyle choices. Prevention and Management of Heart or low-fat dairy products, and
An unhealthy diet and lack of physical Disease choosing lean meats.
activity can lead to conditions that are 1. Consume a diet rich in vegetables, • Dietary approaches such as
often precursors to heart disease such fruits, and whole-grains.
as: high blood cholesterol, high blood 2. Limit the amount of saturated fat, trans the Dietary Approaches to
pressure, diabetes, and obesity. High blood fat, and cholesterol in the diet. Stop Hypertension (DASH)
cholesterol, often from a high fat diet, can a. Read the ‘Nutrition Facts’ on food and the Therapeutic Lifestyle
lead to plaque formation in vessel walls. labels. Change (TLC) may help one
Plaque buildup occurs with no symptoms b. Choose lean meats and plant-based follow a heart healthy diet.
and causes narrowing of the arteries, high protein sources.
blood pressure, and may lead to a heart c. Cook meals that are low in saturated
attack without warning. An unhealthy fat, trans fat, and cholesterol.
diet may also lead to obesity and diabetes. 3. Limit foods and beverages with added ©Colorado State University
For more information on how dietary fat sugar. Extension. 3/13.
4. Choose foods with low salt content. www.ext.colostate.edu
*L. Bellows, Colorado State University Extension food
and nutrition specialist and assistant professor; R. Moore,
graduate student. 3/2013
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1. Consume a diet rich 2. Limit the amount of Health Claims on
in vegetables, fruits,and saturated fats, trans fat, Food Labels
whole-grains: and cholesterol in the diet:
Fruits and vegetables help to regulate Healthy individuals without heart • ‘Percent’ Fat Free: This term must
appetite and are naturally low in fat. Fiber disease should limit saturated fat to less accurately reflect the amount of fat
and various plant compounds found in than 10% of total daily calories, while present in 100 grams of the food.
fruits, vegetables, and whole-grains may those with heart disease, diabetes, or high ‘Percent fat free’ products must
have cholesterol-lowering properties. For LDL cholesterol should limit intake of meet the low fat or fat free product
in-between meal snacks, it is important to saturated fat to less than 7% of total daily definitions. For example, if a product
choose fresh, frozen, or canned fruits and calories. All individuals should limit trans contains 2.5 grams of fat per 50
vegetables without added salt and sugar, fat to less than 1% of total daily calories. grams, the claim must be ‘95 percent
instead of high calorie snack foods. Cholesterol should be limited to less than fat free.’
• Antioxidants: Research indicates 300 milligrams daily for healthy individuals
that consuming a diet rich in fruits and and less than 200 milligrams daily for • Fat Free: Less than 0.5 grams of fat
vegetables may help to lower blood those with heart disease, diabetes, or high per serving.
cholesterol levels and aid in healthy weight LDL cholesterol. Following a diet low in • Low Fat: 3 grams of fat or less per
maintenance. Certain properties in fruits saturated fat, trans fat, and cholesterol may
and vegetables known as antioxidants may lower one’s risk for cardiovascular disease serving.
be responsible for this effect. In particular, by reducing LDL cholesterol levels. • Saturated Fat Free: Less than 0.5
beta-carotene and vitamin C are both Recent research indicates that following grams of saturated fat and less than
important antioxidants that play a role in the Mediterranean Diet (which includes 0.5 grams of trans fat per serving.
heart disease prevention. plant-based fat sources such as nuts and
• Phytonutrients: Various olive oil that contain healthy unsaturated • Low Saturated Fat: 1 gram of
phytonutrients that promote heart health fats, as opposed to harmful saturated fats) saturated fat or less, and less than 0.5
can be found in fruits and vegetables. can reduce cardiovascular disease events by grams of trans fat per serving.
Soybeans and products made from soy such up to 30%. • Cholesterol Free: Less than 2
as tofu and tempeh contain phytonutrients a. Read the 'Nutrition Facts' on milligrams of cholesterol and 2 grams
that may reduce the risk for heart disease. food labels—This panel on a food label or less of saturated fat per serving.
This is especially true when plants that provides the necessary information to help
contain phytonutrients are consumed consumers meet dietary guidelines from • Low Cholesterol: Less than 20
instead of products high in saturated fat. the AHA and USDA Dietary Guidelines milligrams of cholesterol and 2 grams
• Plant Stanols and Sterols: These for Americans. The ‘Nutrition Facts’ panel or less of both saturated fat and trans
compounds are naturally found in fruits lists the Daily Reference Values (DRV) for fat per serving.
and vegetables, and can help lower low- specific nutrients including fat, saturated
density lipoprotein (LDL) ‘bad’ cholesterol. fat, cholesterol, and sodium. • Lean: Less than 10 grams of fat, less
They work by inhibiting the body’s Health Claims on Food Labels—Specific than 4 grams of saturated fat, and less
absorption of cholesterol in the intestine. health claims can be made for food than 95 milligrams of cholesterol per
• Fiber: Research has shown eating products that meet certain requirements serving and per 100 grams.
foods rich in soluble fiber may decrease such as "lean," "low fat," or "low in • Reduced: At least 25 percent fewer
LDL cholesterol levels. Fiber acts by cholesterol." Though these products may calories, fat, saturated fat, cholesterol,
binding to cholesterol in the intestine and have reduced fat, one should still pay or sodium per serving than the original
passing it out of the body. Foods high in attention to portion size and calories
soluble fiber include beans, peas, legumes, per serving size. For more information product.
fruits, vegetables, grain products, oatmeal, on food labels in general, see fact sheet • Extra lean: Less than 5 grams of fat,
rice, oat and wheat bran, and barley. Fiber Understanding the Food Label, and for more less than 2 grams of saturated fat and
supplements have no known benefits information on health claims and food trans fat, and less than 95 milligrams
for heart disease prevention. For more labels for sodium, see fact sheet Sodium in of cholesterol per serving and per 100
information on fiber, see fact sheet Dietary the Diet. grams.
Fiber.
• Light: 1/3 fewer calories, 1/2 the fat,
or 1/2 the sodium of reference food.
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b. Choose lean meats and plant-based • Be aware of fat content in sauces. Plan of Action
protein sources—Selecting lean cuts of • Try cutting oil or fat in half when cooking
beef and pork, along with preparing all on the stove top, as this usually does not for Heart Disease
meats in a heart-healthy way are important affect the taste of the food. Be aware that Management
tips to meet this recommendation. reducing oil or fat when baking may affect
Adding two servings of fish per week and the taste and properties of the finished • Healthy weight maintenance, by
incorporating protein from vegetable product. following these four dietary tips, is
sources may decrease one’s risk for heart • Use low-fat alternatives such as nonfat an important step in preventing and
disease and high blood lipid levels (Table 1). yogurt or whipped topping made from managing heart disease.
c. Cook meals that are low in saturated skim milk, instead of high fat condiments • A healthy diet that aides in healthy
fat, trans fat and cholesterol—Preparing like sour cream, mayonnaise and whipping weight maintenance can help achieve
meals in a heart-healthy way involves cream. recommended levels of LDL ‘bad’
recognizing hidden fat and cholesterol • Use two egg whites instead of one yolk.
sources in food items. Simply substituting cholesterol, high-density lipoprotein
olive oil and vinegar in place of creamy 3. Limit foods and (HDL) ‘good’ cholesterol, triglycerides,
salad dressings, or using other easy tips beverages with added normal blood pressure, and normal
to reduce saturated fat and cholesterol in blood glucose levels. For a list of
recipes can be effective ways to lower the sugar: normal levels, see fact sheet Dietary
risk for heart disease. The following are Consumption of added sugars and Fat and Cholesterol, and fact sheet
recommendations for reducing saturated sweeteners such as sucrose, corn syrup, Diet and Hypertension.
fat, trans fat, and cholesterol in meats, dairy, and high-fructose corn syrup has increased • Several dietary patterns meet
and recipes: dramatically in the past few decades,
To reduce fat and cholesterol in meat and leading to an increase in total calories dietary recommendations, such as the
poultry: and weight gain in many individuals. DASH dietary pattern (see fact sheet
• Cut off all visible fat. Added sweeteners are present in most DASHing to Lower Blood Pressure),
• Thoroughly drain fat off of all cooked pre-packaged food items and processed and the Therapeutic Lifestyle Change
meats. beverages (such as soda). In order to Dietary Pattern (TLC) (http://www.
• Make stews, broths, and stocks a day maintain a healthy weight, one should nhlbi.nih.gov/health/public/heart/chol/
ahead of time and refrigerate. Remove reduce intake of foods and beverages with chol_tlc.pdf). These diets are low in
the hardened fat from the top before it is added sugar. For more information on dietary fat, cholesterol, and sodium
reheated or used in soups and other recipes. sugar and the diet, see fact sheet Sugar and and rich in dietary fiber, fruits, and
• Baste with wine or tomato juice instead of Sweeteners. vegetables (Table 2).
drippings. • In addition to dietary
• Broil rather than pan-fry meats such as 4. Choose foods with low recommendations, regular physical
hamburgers, chops, and steak. salt content:
• Remove skin from chicken. activity is necessary to maintain a
• Purchase lean or extra lean meats. Sodium, a major component of salt, healthy weight. Regular physical
• Purchase white meat as opposed to dark plays a crucial role in blood pressure activity also improves blood pressure
meat. regulation. Dietary guidelines suggest that levels, cholesterol and triglyceride
• Flavor meat with herbs and spices instead reducing sodium intake may prevent and profiles, and blood sugar levels.
of high-fat marinades. control high blood pressure (hypertension) Moderate exercise for at least thirty
To reduce fat and cholesterol from dairy by helping to lower blood pressure. A minutes every day is recommended.
foods: decreased sodium intake is also associated
• Choose 1% or nonfat milk instead of with reduced risk for congestive heart • Limit tobacco use and exposure,
whole milk. failure. General guidelines for sodium and moderate alcohol consumption.
• Choose fat free yogurt. intake for adults recommend no more
• Use lower fat chesses or limit portion than 2,300 milligrams daily. Those who
sizes. are African American, over the age of fifty,
To reduce fat and cholesterol in recipes: or have hypertension, diabetes, or chronic
• Broil, bake, boil, steam, stir-fry, or kidney disease should consume no more
microwave foods instead of deep frying or than 1,500 milligrams of sodium per day.
pan frying. For more information on sodium and
• Use lean meats in recipes. the diet, see fact sheet Sodium in the Diet,
• Limit use of butter, margarine, and lard, and for more information on how the diet
and replace with vegetable oil. affects one’s risk for hypertension, see fact
• In casseroles, use more vegetables and less sheet Diet and Hypertension.
meat.
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Table 1. Heart-Healthy Lean Protein Choices.
Protein Source Healthy Lean Choices Why are they Heart Healthy?
Beef Round steak, rump roast, top ground steak Lean cuts of beef still contain saturated fat
and roast, tip steak and roast, lean cubed and cholesterol, but in reduced amounts.
steak, top loin steak, tenderloin steak, flank, A healthy portion of meat is 3 ounces,
sirloin, and ground beef (lean or extra lean). roughly the size of a deck of cards.
Pork Leg roast (fresh ham), leg steak, lean pork Lean cuts of pork still contain saturated fat
cutlets, center rib chop and roast, butterfly and cholesterol, but in reduced amounts.
chop, sirloin roast, tenderloin, tenderloin A healthy portion of meat is 3 ounces,
roast, ground pork (lean or extra lean), lean roughly the size of a deck of cards.
shoulder cubes, lamb-leg, and loin chops.
Fish Cold-water fish: salmon, herring, mackerel, Diets high in fish have been linked to
and whitefish. reduced risk of heart disease. Those
who include fish in their diet tend to have
lower blood cholesterol and triglyceride
levels, most likely due to high amounts of
omega-3 fatty acids found in fish.
Poultry Skinless, white meat. Eliminating the skin and dark meat from
poultry will reduce its overall fat content.
Vegetable Protein Legumes, beans and bean products such These proteins have cholesterol lowering
as chick-peas, black beans, soybeans, qualities. They are also low in fat, low in
tempeh, and tofu. saturated fat, and high in starches and fiber.
These sources are also rich in unsaturated
fatty acids, which can replace saturated fat
found in red meats.
Table 2: Examples of Heart Healthy Dietary Patterns: DASH and TLC.
Food Group DASH (servings/day) TLC (servings/day) Examples of 1 serving
Grains 6-8 7 1 slice of bread
1 ounce of cereal
½ cup cooked rice or pasta
Vegetables 4-5 5 1 cup raw vegetable
½ cup cooked vegetable
½ cup vegetable juice
Fruits 4-5 4 1 medium fruit, ¼ cup dried
fruit, ½ cup fresh/ frozen/
canned fruit, ½ cup fruit juice
Fat-free or low-fat dairy 2-3 2-3 1 cup of milk, yogurt, or 1- ½
products ounces cheese
Lean meats, poultry, fish Less than 6 oz. Less than 5 oz. 3 ounces is the size of a deck
of cards
Nuts, seeds, legumes (beans) 4-5 Counted as vegetable servings 2 tablespoons of peanut butter,
seeds, or ½ cup dry beans
Fats and Oils 2-3 Dependent on daily calorie level 1 teaspoon of margarine,
1 tablespoon of mayonnaise,
2 tablespoons of salad
dressing, 1 teaspoon of
vegetable oil
Sweeteners and sugars Less than 5 servings per week No recommendation 1 tablespoon of sugar or jelly, ½
cup sorbet, 1 cup of lemonade
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