Published 02 May 2024
Good nutrition is vital for our overall health and wellbeing, and crucial to ensuring our body gets what it needs to function at its best. As the adage goes, we really are what we eat. Here nutritionist Mel Bald takes us through the foods to favour – and ones to avoid – to support our cardiovascular system and help maintain a healthy heart.
Listen to the 20 minute podcast here.
What are some of the things we can do to support our heart health through our diet?
A diet that consists of largely unprocessed foods and includes lots of fruit and vegetables, wholegrains, lean proteins and healthy fats will provide the essential vitamins, minerals, anti-oxidants and fibre that will help to promote our heart health.
Nutrient-dense foods help to:
- support healthy blood pressure levels
- regulate the body’s cholesterol levels
- reduce inflammation in the body, including in the cardiovascular system
Another benefit of an unprocessed, nutrient-rich diet is that it helps us to maintain a healthy weight. We know that excess weight puts an additional strain on our heart and increases the risk of other conditions like hypertension (high blood pressure) and diabetes which are also linked to heart disease.
What is cholesterol and what role does it play in our heart health?
It is important to know that cholesterol is essential to many processes in our body. A lot of people think of it as being ‘bad’, but we need it to build the structure of things like cell membranes, hormones such as estrogen and testosterone and adrenal hormones. It also helps our body to produce Vitamin D. Our liver and intestines make about 80% of our cholesterol that we need to stay healthy and only about 20% comes from the food we eat.
There are two types of cholesterol:
- low-density lipoprotein (LDL) which is known as the ‘bad’ cholesterol
- high-density lipoprotein (HDL) which is the ‘good’
Over time, raised LDL levels can cause fatty plaques to build up on the blood vessel walls (a condition known as atherosclerosis). This can narrow the arteries and restrict the flow of blood to the heart muscle. This reduced blood flow can lead to:
- coronary artery disease
- heart attack
- stroke
Low HDL is also a known risk factor in the development of heart disease as its role is to help remove excess cholesterol out of the cells, including the cells of the arteries.
We will ideally have a balance of low LDLs and high HDLs.
Triglycerides are also an important part of a blood reading for cholesterol. These are a little different and are a type of fat that contribute to the development of atherosclerosis alongside having high LDL and low HDL.
High cholesterol is not something that you can ‘feel’, making regular testing important for detection and management.
Can we influence our cholesterol levels through diet?
There is a lot we can do to prevent our cholesterol getting too high.
A diet high in trans-fats and saturated fats can raise the LDL cholesterol levels. Saturated fats are mostly found in animal products such as processed meats, beef, lamb, chicken with skin as well as baked or fried goods, palm oils and coconut products.
On the other hand, consuming foods rich in ‘healthy fats’ (monounsaturated or polyunsaturated fats) can help to raise the HDL levels and lower LDLs. Good sources include avocados, nuts, seeds, extra virgin olive oil, fatty fish like tuna and salmon and also flax seeds.
Ideally, we’ll try to increase healthy fats in our diets and reduce trans or saturated fats.
There are also certain fibres that can help to reduce LDLs in our body. These soluble fibres can be found in oats, legumes, sweet potato, apples and citrus, and they’ve been shown to have cholesterol-lowering effects. They’re not absorbed in the intestine – they bind to the cholesterol in the intestine and remove it from the body which helps to lower our levels.
Are there recommendations around the amount or type of meat that we eat?
The latest healthy eating guidelines encourage Australians to limit their meat intake, and this is something that is not widely known but is gaining more traction with increased research around the benefits of a plant-based diet.
The current recommendation is to restrict unprocessed meat such as beef, veal, pork and lamb to around 350g per week, per person, and this is due to the high saturated fats it contains. Red meat also contains higher amounts of trimethylamine N-oxide (TMAO), a substance that is formed by the gut bacteria during digestion. The good news is that there is research showing that it is possible to reverse TMAO levels in the body by switching to eating white meat or reducing consumption of red meat.
Deli and processed meats such as ham, salami and cured sausages should be avoided in a heart-healthy diet. This recommendation is because there is now strong evidence that eating this type of processed meat increases the risk of bowel cancer. Deli meats also contain a high salt content which is linked to high blood pressure. We want to keep blood pressure in balance for our heart health.
Moderation is the key here – you don’t have to completely cut out meat but reduce and be conscious of deli-meat consumption and cutting this back.
What about dairy? Should I choose low-fat or high-fat milk products?
The latest research shows that there is little evidence that restricting full-fat dairy has an impact on heart disease risk, and it has a neutral effect on a healthy person’s risk of heart attack or stroke. If you have high cholesterol, a history of heart disease or type 2 diabetes then it is advised to stick with reduced-fat dairy. Full-fat products have higher calories, so if you’re trying to manage your weight, this is something to keep in mind.
Are we able to eat eggs if we’re thinking about our heart health?
Eggs are another food that we were previously told to avoid. Egg yolks do contain cholesterol so there was this link to thinking that you should avoid if you have high cholesterol. Evidence now suggest that eggs also have a neutral relationship with heart health, and don’t need to be avoided for the general population (those who have not had any heart-related issues in the past).
Eggs are a great source of protein, they’re readily available and not too expensive. For those with type 2 diabetes, or who are required to lower their LDLs, the recommendation is for a maximum of seven eggs a week. For everyone else, there is no recommended limit with eggs.
How does salt affect our heart health?
We know that salt or sodium has an influence on our blood pressure, and this increases our heart health and the risk of kidney disease. The average Australian consumes double the amount of sodium that they need for good health. 80% of the salt in our diet comes from packaged foods. Bread and cheese contain a lot of salt, so it’s not always snack foods and takeaway. The aim is for no more than 1tsp (5g) of salt per day, which equates to 2000mg of sodium per day, in order to prevent chronic disease.
Some tips for reducing the amount of salt in our diet include:
- cutting down on packaged snack foods and takeaway
- checking the nutritional panel on packaged foods and aim for less than 120mg of sodium per 100g
- limiting foods typically high in sodium – soy sauce, crackers, biscuits, chips, deli meats, cheese, olives etc.
- choosing products that have no added salt or that are salt-reduced
- not adding salt to home-cooked food and replacing salt in cooking with herbs and spices to increase flavour
It can take a while – up to six weeks – for our taste buds to get used to reduced salt in our food, so hang in there.
What effect does alcohol have on our heart?
There is strong evidence that drinking alcohol doesn’t have any heart-health benefits and it isn’t recommended as part of a heart healthy diet.
Unfortunately for some people, it is a myth that a glass of red wine a night is good for your heart.
Current Australian guidelines state that the less we drink, the lower the risk of harm and no more than 10 standard drinks per week and 4 standard drinks on any one day is recommended.
If you have a higher risk of heart disease it is best to reduce the consumption of alcohol.
Are there foods that can have a positive impact on our heart health?
Eating a wide variety of food, focusing on fresh, unprocessed foods is best not only for your heart health but your health overall. Fruits and vegetables provide a range of minerals, vitamins as well as fibre and anti-oxidants which are great for your heart. Some other tips include:
- having two pieces of fruit per day, including anti-oxidant-rich berries (fresh or frozen)
- aiming for five serves of vegetables – this will boost your fibre levels
- eating oily fish rich in omega-3 fatty acids (fresh or tinned tuna, salmon, sardines or mackerel) for three meals per week
- incorporating plant-based sources of omega-3 fats, including avocado oil, extra virgin olive oil, nuts and seeds
- increasing soluble fibres in the diet – these can be found in bran, rolled oats, legumes (chickpeas and kidney beans), psyllium husks, ground flax seeds, fruit and veggies.
How can we up our serves of veggies throughout the day?
I recommend the following to boost your veggie intake:
- Start with breakfast and add some spinach, tomatoes or mushrooms with your eggs
- Make sure you always have veggies – cooked or raw – at both lunch and dinner to get five serves
- Aim for four different types of veg to get that variety of nutrients. This will also help your gut health
- Trying different cooking methods can help – some veggies that are not crash hot when steamed, can be delicious when roasted
- Add spice mixes without additives to bump up the flavour
- Keep some chopped veggies in the fridge to have on hand for snacking
- Add veggies to soups and stews, and include chickpeas to increase fibre
- Have frozen vegetables on hand, these are quick, easy and nutritious.
Where can I go for inspiration?
- The Heart Foundation has plenty of recipe ideas and there is a Heart Age Calculator where you can do a quick quiz to estimate your heart-health age.
- Better Health is always a great place to go for any health information, and they have a range of articles on heart health.
- Healthier Together recipes have a great range of ideas and inspiration for meals
I’d also encourage those who are aged over 45, people with diabetes over 35 years or First Nations people from 30 years, to get a 20-minute heart health check at your local GP. This is covered by Medicare for these recommended age groups.
Listen to this podcast in full and explore others in the Healthier Together series.
