A heart-healthy diet is built on vegetables, fruit, whole grains, beans, nuts, seeds and oily fish, with olive or rapeseed oil as the main fat, while cutting back on saturated fat, salt and added sugar. The NHS advises eating more oily fish, olive and rapeseed oils, whole grains, nuts, seeds, fruit and vegetables, and less fatty meat, butter, cream, cheese, cakes and biscuits. The strongest single piece of evidence comes from the PREDIMED trial, in which a Mediterranean diet cut major cardiovascular events by about 30%.
Why diet matters for your heart
Cardiovascular disease, which includes heart attacks and strokes, has many risk factors. The NHS lists smoking, drinking too much alcohol, being overweight, not being active, high blood pressure, high cholesterol and diabetes, along with age, sex, ethnicity and family history. Diet affects several of these at once: cholesterol, blood pressure, weight and blood sugar.
Foods to eat more of
| Food | Why it helps |
|---|---|
| Oily fish (salmon, mackerel, sardines, trout) | Omega-3 fats; the NHS suggests at least 1 portion a week |
| Olive and rapeseed (canola) oil | Mostly unsaturated fat |
| Whole grains (oats, brown rice, whole wheat bread and pasta) | Fiber |
| Beans, lentils and chickpeas | Fiber and plant protein |
| Nuts and seeds | Unsaturated fats and fiber |
| Fruit and vegetables | Fiber, potassium and vitamins; the WHO recommends at least 400 g a day |
Sources: the NHS guide to lowering cholesterol, the NHS on fish and the WHO healthy diet fact sheet.
Foods to cut down on
The NHS lists these as foods to reduce if you want to lower your cholesterol:
- Meat pies, sausages and fatty meat
- Butter, lard and ghee
- Cream and cheese
- Cakes and biscuits
- Foods containing coconut oil or palm oil
To this list, add salty and sugary foods. The World Health Organization recommends less than 5 g of salt a day and keeping saturated fat to no more than 10% of your energy intake. A diet high in salt is a major cause of high blood pressure, and the WHO’s salt fact sheet notes that most adults eat about 11 g of salt a day, more than double the recommended limit.
What the research shows
In the PREDIMED trial, 7,447 adults in Spain at high risk of heart disease were assigned to a Mediterranean diet with extra olive oil, a Mediterranean diet with nuts, or a lower-fat control diet. Over a median of 4.8 years, major cardiovascular events (heart attack, stroke or cardiovascular death) were about 30% lower in the two Mediterranean groups. Our beginner’s guide to the Mediterranean diet explains how to follow it.
The NHS also explains that there’s good evidence replacing saturated fats with some unsaturated fats helps lower cholesterol.
8 simple heart-healthy swaps
- Butter to olive or rapeseed oil for cooking.
- White bread and pasta to whole grain versions.
- Processed meat to fish or beans a few times a week.
- Salty snacks to unsalted nuts or fruit.
- Sugary drinks to water or unsweetened tea and coffee.
- Creamy sauces to tomato-based ones.
- Adding salt at the table to herbs, lemon, garlic and spices.
- Biscuits and cakes to fruit and yogurt as everyday snacks.
A heart-healthy day: an example
- Breakfast: porridge with berries and a few walnuts.
- Lunch: lentil and vegetable soup with whole grain bread.
- Snack: an apple and a small handful of unsalted almonds.
- Dinner: baked salmon with tomatoes and mushrooms, and a side of green beans. Our baked salmon recipe takes 30 minutes.
Beyond food
The NHS advice for preventing cardiovascular disease also includes regular exercise, keeping to a healthy weight, cutting down on alcohol and stopping smoking. For cholesterol, the NHS recommends at least 150 minutes of moderate-intensity exercise a week, or 75 minutes of vigorous activity.
Reading labels for heart health
The NHS uses these per 100 g thresholds:
| High | Low | |
|---|---|---|
| Saturated fat | More than 5 g | 1.5 g or less |
| Salt | More than 1.5 g | 0.3 g or less |
| Sugars | More than 22.5 g | 5 g or less |
Choose foods with more green (low) values, and keep red (high) ones for occasional treats.
If you already have a heart condition
If you have heart disease, high blood pressure, high cholesterol or diabetes, or take medicines such as statins, blood thinners or blood pressure tablets, ask your doctor or a registered dietitian for advice tailored to you. Some foods interact with medicines: grapefruit, for example, can affect some statins and blood pressure drugs, according to the FDA, and leafy greens matter if you take warfarin.
Common questions
Are eggs bad for your heart?
For most people, eggs can be part of a heart-healthy diet. The NHS guidance on lowering cholesterol focuses on cutting saturated fat from foods such as fatty meat, butter, cream and cakes, rather than on eggs. If you have high cholesterol, heart disease or diabetes, ask your doctor or dietitian how many suit you.
Is coffee bad for your heart?
For most healthy adults, moderate coffee is fine. The FDA says up to 400 mg of caffeine a day is not generally associated with negative effects. If you have a heart rhythm problem or high blood pressure, ask your doctor.
Does a heart-healthy diet mean low fat?
No. The emphasis is on the type of fat. In the PREDIMED trial, the groups that did best ate a Mediterranean diet with extra olive oil or nuts, not a low-fat diet.
How quickly can diet changes help?
Some changes, such as cutting salt, can help blood pressure fairly quickly, while others build up over months and years. The best diet is one you can stick with long term.
Is salt the same as sodium?
Not quite. Salt is sodium chloride, and about 40% of it is sodium. The WHO’s limit of 5 g of salt a day equals about 2 g of sodium. Check which one a food label shows before comparing.
This article is general information, not medical advice. Talk to your doctor or a registered dietitian before making big changes to how you eat, especially if you have a health condition, take regular medication, or are pregnant or breastfeeding.
