Six Foods to Combat Cardiovascular Disease
A 2023 study1 revealed six food groups that protect against heart disease. Cardiovascular disease, also known as heart disease, refers to several types of heart conditions, many of which are related to atherosclerosis. This is the medical term to describe a buildup of plaque along the walls of an artery, which makes it difficult for blood to flow and for oxygen to reach muscles, including the heart.
This can be one of the underlying problems that causes heart attacks, stroke and heart failure. Other types of cardiovascular disease occur when heart valves are affected or there’s an abnormal heart rhythm. Scientists have identified some of the key contributing factors, including high blood pressure, physical inactivity, excessive alcohol use, smoking and diabetes.2
Data from 2018 to 2019 show heart disease costs the U.S. roughly $239.9 billion each year, including the cost of medicine, health care services and lost productivity due to death.
Each year roughly 805,000 people have a heart attack and 1 in 5 of those are silent. In other words, the heart is damaged, but the person is not aware that the heart attack happened. The researchers in the featured study concluded their recommendations “contrasts with the usual recommendations from the Western guidelines.”3
Key Foods Associated With Cardiovascular Risk
The study4 was led by McMaster University and Hamilton Health Sciences researchers at the Population Research Health Institute (PRHI) headquartered in Hamilton, Ontario.5 The researchers sought to develop a method of scoring dietary intake they could associate with healthy outcomes.
To do this, they used data from the Prospective Urban Rural Epidemiology (PURE) study6 using 147,642 participants from the general population in 21 countries. The scoring system was then applied to five independent studies from 70 countries. The system was based on six foods that past research had associated with a lower risk of mortality.
The main outcome measures were all-cause mortality and major cardiovascular events. The six food groups on which the scoring system was based were fruits, vegetables, nuts, legumes, fish and dairy. The data showed that participants with a higher diet score had a lower risk of mortality, myocardial infarction and stroke.
Importantly, the researchers also found that participants with a higher diet score had a lower risk of death or cardiovascular disease in areas of the world with lower gross national income. Past research that was similar had focused on diets that also included ultraprocessed foods and nutrient-dense foods.
This study was unique in that it focused only on foods that are known to be healthy and have a preventive effect on cardiovascular disease. Another unique aspect was that the study was truly global in scale.
“Previous diet scores — including the EAT-Lancet Planetary Diet and the Mediterranean Diet tested the relationship of diet to CVD and death mainly in Western countries. 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.7
Andrew Mente, PRHI scientist and assistant professor at McMaster’s Department of Health Research Methods, Evidence, and Impact, also commented on the results, saying:8
“There is a recent increased focus on higher consumption of protective foods for disease prevention. Outside of larger amounts of fruits, vegetables, nuts, and legumes, the researchers showed that moderation is key in the consumption of natural foods.
Moderate amounts of fish and whole-fat dairy are associated with a lower risk of CVD and mortality. The same health outcomes can be achieved with moderate consumption of grains and meats — as long as they are unrefined whole grains and unprocessed meats.”
Choose Your Food Carefully
SciTechDaily9 reported the data suggest your daily diet should include two to three servings of fruit and vegetables, one serving of nuts and two servings of dairy each day. The suggested menu also includes up to four servings of legumes and three servings of fish each week.
Possible substitutes on your menu could include one daily serving of whole grains and one daily serving of unprocessed red meat or poultry. “We were unique in that focus. The other diet scores combined foods considered to be harmful — such as processed and ultraprocessed foods — with foods and nutrients believed to be protective of one’s health,” Mente said.10
It is crucial to note that most nuts and nearly all poultry are high in linoleic acid (LA), which is a highly destructive fatty acid. There is a wide range found in nuts. For example, pecans are 50% LA while macadamia nuts are 2% LA. Most chicken meat is 25% LA, which the animals absorb from the corn and soy they are fed.
More Dangers Linked to Ultraprocessed Foods
In addition to the link between ultraprocessed food — also high in LA — and heart disease, research has found a correlation between a person’s “high consumption” of ultraprocessed food and a decline in cognitive function, specifically memory and executive function. The research was presented at the Alzheimer’s Association International Conference in San Diego.11
The researchers engaged 10,775 people living in Brazil and followed them over an eight-year period. In this study, “high consumption” was defined as eating more than 20% of their daily caloric intake, which could equate to 400 daily calories for women or 500 calories for men.
The loss of cognitive function was not insignificant. The men and women who ate the most ultraprocessed food had a “28% faster decline in global cognitive scores, including memory, verbal fluency and executive function.”12 Another 2023 study13 by the Imperial College London demonstrated that ultraprocessed foods are also linked to an increased risk of certain cancers.
The researchers collected dietary information on middle-aged adult participants over a 10-year period to look for the risk of developing any type of cancer as well as the specific risk of 34 types of cancer. The data showed that ultraprocessed food was linked with a greater risk of developing cancer overall and more specifically ovarian and brain cancer.
For every 10% increase in the amount of ultraprocessed food, there was a 2% increase in overall cancer and a 19% increase in ovarian cancer.14 A second Brazilian study15 used a risk assessment model to estimate the number of premature deaths that are linked to ultraprocessed food intake in adults aged 30 to 69.
In Brazil, ultraprocessed foods make up 13% to 21% of total energy intake, which is significantly less than in America, where they make up about 57% of daily calories.16 The Brazilian study showed roughly 57,000 premature deaths were related to the consumption of ultraprocessed foods, which was 10.5% of all-cause premature deaths.
The researchers suggest that the percentage of premature deaths linked to food in the U.S. is likely greater based on the higher percentage of ultraprocessed foods eaten by Americans.
Include 3 Fundamental Micronutrients to Support Heart Health
The data from the featured study supports what many, including myself, have been advising for years to protect your heart and overall health — steer clear of ultraprocessed foods and eat a whole food diet in moderation. Also as I’ve written in the past, when you’re focused on heart health, there are three important micronutrients your heart needs to function optimally — omega-3 fatty acids, folate, and CoQ10.
Multiple studies have demonstrated that omega-3 fatty acids have a beneficial effect on heart health. For instance, omega-3 fats derived from krill oil have been found to reduce triglyceride levels and help reduce cardiovascular risk.17
An omega-3 index test is one of the most important annual health screens and is a better predictor of heart disease risk than cholesterol levels. Even research18 supported by the National Institutes of Health suggests an omega-3 test is a good predictor of overall health and all-cause mortality.
The study measured the omega-3 index in 2,500 participants, finding those with the highest percentage had the lowest risk of heart problems and total mortality. The omega-3 index has been validated as a stable, long-term marker of your omega-3 status and it reflects your tissue levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
An index over 8%19 is associated with the lowest risk of death from heart disease and an index below 4% places you at the highest risk. The ideal sources include cold-water fatty fish, like wild-caught Alaskan salmon, sardines, herring and anchovies. If you do not eat these fish on a regular basis, consider taking a krill oil supplement.
One 2022 study20 revealed folic acid reduces stroke risk. Folic acid is the synthetic version of folate, or vitamin B9, and it’s the most important dietary determinant of homocysteine. Elevated levels of homocysteine are a risk factor for coronary artery disease and are found in most patients with vascular disease.
CoQ10 was also shown to decrease all-cause mortality in the same paper. Ubiquinol — the reduced electron-rich form of CoQ10 your body produces naturally — plays an important role in the electron transport chain of your mitochondria.
CoQ10 is used by every cell in your body, but especially your heart cells where the supplement helps protect your mitochondrial membrane from oxidative damage. Your body naturally makes CoQ10, but several factors can interfere with this production and lead to deficiency.
Take a Personalized Approach to Protecting Heart Health
There is no one-size-fits-all approach to supporting heart health. Researchers wrote in the Journal of the American College of Cardiology that “an optimal nutritional strategy to promote cardiometabolic health will likely involve personalized combinations of these nutrients.”21
However, a healthy diet, exercise, stress reduction and heart-based connections — i.e., strong and positive relationships — are key to heart health and overall health. As mentioned, I also believe an omega-3 index test is one of the most important annual health screenings you can receive.
In your personalized approach to heart health, it’s also wise to remember that while cholesterol has been promoted as the sole and primary cause of plaque formation leading to heart disease, research has revealed that the truth is far different. The 2015-2020 Dietary Guidelines for Americans addressed this shortcoming when they announced that “cholesterol is not considered a nutrient of concern for overconsumption.”22
Yet, by the 2020-2025 guidelines that statement was not included and instead the guidelines recommend that “trans-fat and dietary cholesterol consumption be as low as possible.”23 While trans fats should be limited or eliminated, to this day evidence keeps mounting that there is no link between cholesterol and heart disease.
Similarly, the evidence supporting the use of cholesterol-lowering statin drugs to lower your risk of heart disease is slim to none and is likely little more than the manufactured work of statin makers — at least that’s the implied conclusion of a scientific review.24 For more information about cholesterol see “Cholesterol Does Not Cause Heart Disease.”