Does a good diet reduce your heart disease risk?

You can reduce your risk of heart disease by changing your diet. This can involve eating more healthy fats, vegetables, and whole grains, and less saturated fat, sugar, and salt.

But your diet is just one part of the puzzle. Avoiding smoking, getting enough exercise and sleep, and keeping up a moderate body weight can all make a big difference.

Heart disease is responsible for around 1 in 5 deaths in the United States. And it’s the main cause of death for males and females across most racial and ethnic backgrounds.

We can’t change some risk factors for heart disease. But even in your 50s, there are some steps you can take to lower your risk.

What is a heart-healthy diet?

A heart-healthy diet means eating: 

  • a wide range of fruits and vegetables

  • plenty of legumes, like pulses and beans

  • whole grains instead of refined grains

  • sources of healthy fats, like oily fish, extra virgin olive oil, and nuts

  • moderate or no alcohol

  • limited amounts of red meat and processed meat

  • limited foods and drinks with added sugar, like soda

An eating pattern like this is often called the Mediterranean diet

Large, long-term studies have shown that having a diet with many or all of the points above can reduce the risk of developing heart disease by as much as 31%

And it’s never too late to make a difference.

A study in Spain looked at participants aged 55–80. It found that people who switched to a Mediterranean diet — supplemented with either extra virgin olive oil or nuts — were significantly less likely to have a heart attack in the next 5 years, compared with people on a low-fat diet.

Added sugars

Added sugars in foods and drinks can cause your blood sugar levels to shoot up quickly.

And having these blood sugar spikes regularly may contribute to the hardening of your arteries. This can lead to heart disease.

These spikes can cause unwanted inflammation, too. And this is linked to chronic health conditions, like heart disease.

Examples of foods for heart health

Heart-healthy foods to add to your diet include:

  • oily fish, like salmon and mackerel

  • tofu

  • avocados

  • legumes, like chickpeas, lentils, and beans

  • leafy green vegetables, like spinach, cabbage, and broccoli

  • extra virgin olive oil

  • whole grains, like oats, barley, brown rice, and whole wheat pasta

  • nuts, like almonds, hazelnuts, and walnuts

  • seeds, like pumpkin, sesame, and flaxseeds

  • garlic

Learn more about oily fish and the effects of different fats in this episode of the ZOE Science & Nutrition podcast.

Dietary fats, cholesterol, and heart health

Doctors once thought all fat was bad for your heart, so a low-fat diet would improve your heart health. This is a long way from the truth. 

There is evidence that saturated fats, like those in butter and lard, can increase your levels of “bad” LDL cholesterol. This is a risk factor for heart disease. 

But different foods with saturated fats have different structures. This changes how the fats affect your body. 

More recent studies suggest that whole-fat dairy, dark chocolate, unprocessed meat, and some other sources of saturated fat don’t increase your risk of heart disease.

Meanwhile, unsaturated fats can help reduce levels of LDL cholesterol.

You can find unsaturated fats in:

  • avocados

  • nuts and seeds

  • plant oils, like extra virgin olive oil and sunflower oil

  • oily fish, like salmon

These fish are rich in unsaturated fats called omega-3s, which you can only get from your diet. Nuts contain certain types of omega-3s too.

Researchers have investigated whether omega-3 fish oil supplements can improve your heart health, and the evidence is conflicting. But eating oily fish and eating nuts can have this benefit.

Editor’s summary

Scientists used to think all fats were bad for your heart, but now we know this isn’t the case.

Sources of healthy fat, such as certain plants and oily fish, are actually good for your heart and could help reduce levels of “bad” LDL cholesterol.

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Blood pressure and salt

Too much salt in your diet can significantly increase your blood pressure. This can lead to hypertension — blood pressure that’s too high. 

Hypertension is a major risk factor for heart disease.

Eating larger amounts of salt may also be directly linked to an increased risk of heart disease, even without taking blood pressure into account. 

The good news? Eating less salt can reduce your blood pressure and your heart disease risk.

Most of the excess salt in our diets comes from ultra-processed foods, like snack foods and breakfast cereals. Cutting back on these can help you have healthier amounts of salt.

Sodium makes up about 40% of salt, and it’s sodium that’s linked to blood pressure changes. 

The World Health Organization (WHO) recommends having less than 2 grams of sodium per day, which is 5 g of salt.

Other diet tips

What’s the best way to fill your diet with more fruits, veggies, healthy fats, and proteins — while getting less salt and heavily processed food? Here are some strategies:

  • Swap refined grains for whole grains: Try whole wheat instead of white pasta, and brown rice, quinoa, or pulses (like lentils) instead of white rice.

  • Use herbs and spices for flavor: Reduce the amount of salt you add by boosting flavor with herbs and spices instead.

  • Opt for legumes or fish: Instead of meat, try chickpeas in your curry, lentils in your bolognese, and salmon or tofu in your stir-fry.

  • Switch to whole snack foods: Snack on nuts, fruit, or veggie sticks instead of chips or cookies.

  • Use extra virgin olive oil: Try it instead of butter for frying, and drizzle it on salads and veggies.

  • Stock up on canned and frozen veggies: These don’t go bad, and they’re easy to toss into dishes as you cook.

  • Add nuts and seeds: Get more flavor, texture, and heart-healthy fats and proteins by sprinkling a variety of nuts and seeds onto salads, stir-fries, and yogurt.

At ZOE, we run the largest nutrition science study in the world. We know our bodies respond to different foods in different ways, so a one-size-fits-all approach to nutrition doesn’t work.

Our at-home test assesses your gut health along with how your blood sugar and fat levels respond to food. With this information, our personalized nutrition program can advise you about the best foods to eat for you and your health goals.

Learn more by taking our free quiz. 

Other ways to reduce your risk

Having a heart-healthy diet is just one way to reduce your risk of heart disease. Here are some other tips:

  • Stop smoking: If you smoke, quitting will have the biggest impact on your risk of developing heart disease. It will improve your heart health, no matter how much you smoke or how long you’ve smoked for.

  • Maintain a moderate weight: People with overweight or obesity have an increased risk of heart disease because weight adds stress to the heart and blood vessels.

  • Exercise: Regular exercise is essential for your heart. It can help you manage your weight and lower your blood pressure and cholesterol levels.

  • Get quality sleep: Trouble falling or staying asleep is linked to the risk of high blood pressure and heart disease. Being tired may make you less able to exercise and more likely to eat unhealthily.

What is heart disease?

Heart disease is the collective name for a range of different heart conditions. It most often refers to coronary artery disease (CAD), which is the most common form of heart disease in the U.S. 

CAD occurs when cholesterol builds up in the linings of the large arteries that connect to your heart. This restricts the flow of blood to the heart and can lead to a heart attack.

Symptoms of heart disease can vary, but often there aren’t obvious signs until you have a heart attack. This is why reducing your risk is so important.

Risk factors for heart disease

You can take steps to control many risk factors for heart disease, such as:

  • smoking

  • having an unhealthy diet

  • not getting enough exercise

  • drinking too much alcohol

  • having high blood pressure

  • having unhealthy cholesterol levels

  • developing diabetes

  • having obesity or overweight

We can’t control other risk factors, like: 

  • Age: People over 65 are more likely to develop heart disease than younger people. 

  • Sex: Males are at greater risk of heart disease than females and develop cardiovascular diseases earlier in life.

  • Family history: You may be more likely to develop heart disease if a close blood relative (like a parent, sibling, or grandparent) has it. 

  • Race and ethnicity: There tend to be higher rates of hypertension and obesity among Black non-Hispanic people, compared with white non-Hispanic people. And American Indians and Alaska Natives are 1.5 times as likely to get coronary heart disease, compared with their white counterparts.

However, it can be difficult to unpick the effects of genetics from those of environmental and social factors.


You can reduce your risk of heart disease with an eating pattern like the Mediterranean diet. This means:

  • eating a wide range of fruits, vegetables, and legumes

  • swapping out refined grains for whole grains

  • eating plenty of healthy fats and protein

You should also limit saturated fat, salt, and foods and drinks with added sugar.

Quitting smoking, getting enough exercise and sleep, and maintaining a moderate weight are important, too.

It isn’t easy to switch up a routine, and it can take time. But these changes are worth pursuing.


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