How To Lower Cholesterol, Prevent Heart Disease and Improve Cardiovascular Health

While you may be tempted to eat unhealthy foods when you feel stressed, anxious, or depressed, it’s important to think about your heart health even when you’re feeling down.

If you are concerned about your cardiovascular health or have already been diagnosed with high cholesterol or heart disease, the food you eat can be just as critical for your heart as controlling your weight and exercising. In fact, a heart-healthy diet can reduce your risk of heart disease or stroke by 80%.

By understanding which foods are healthiest for your heart, you may be able to lower cholesterol, prevent or manage heart disease and high blood pressure, and take greater control over the quality and length of your life.



You can take steps to prevent heart disease

Heart disease is the leading killer of men and women—and claims more lives than all forms of cancer combined. Being diagnosed with cardiovascular disease can take an emotional toll as well, affecting your mood, outlook, and quality of life. But that doesn’t mean you can’t protect yourself. In addition to exercise, being careful about what you eat can help you lower cholesterol, control blood pressure and blood sugar levels, and maintain a healthy weight—while simultaneously improving your mood. If you’ve already been diagnosed with heart disease or have high cholesterol or blood pressure, a heart-smart diet can help you better manage these conditions, improve your outlook, and lower your risk for heart attack.

Improving your diet is an important step toward preventing heart disease, but you may feel unsure where to begin. Take a look at the big picture: your overall eating patterns are more important than obsessing over individual foods. No single food can make you magically healthy, so your goal can be to incorporate a variety of healthy foods prepared in healthy ways into your diet, and make these habits your new lifestyle.

Eat More:

• Healthy fats: raw nuts, olive oil, fish oils, flax seeds, or avocados
• Nutrients: colorful fruits and vegetables—fresh or frozen, prepared without butter
• Fiber: cereals, breads, and pasta made from whole grains or legumes
• Omega 3 and protein: fish and shellfish, poultry
• Calcium and protein: Egg whites, skim or 1% milk, low-fat or nonfat cheeses or unsweetened yogurt

Eat Less:

• Trans fats from partially hydrogenated or deep-fried foods; saturated fats from whole-fat dairy or red meat
• Packaged foods, especially those high in sodium and sugar
• White or egg breads, sugary cereals, refined pastas or rice
• Red meat, bacon, sausage, fried chicken
• Whole or 2 percent milk, whole milk products like cheese or yogurt, or yogurt with added sugar

Heart healthy diet tip 1: Reduce saturated and trans fats

One of the most important improvements you can make to your diet is to limit saturated fats and entirely cut out trans fats. Both types of fat raise your LDL, or “bad” cholesterol level, which can increase your risk for heart attack and stroke. Trans fat also lowers your levels of HDL or “good cholesterol, which can put you at increased cardiovascular risk. Luckily, there are many ways to control how much saturated and trans fats you take in and replace them with foods that lower your cholesterol.

• Avoid foods containing high levels of saturated fats or trans fats—such as potato chips and packaged cookies. These foods can increase your cholesterol levels much more significantly than cholesterol-containing foods such as eggs.
• Limit solid fat. Reduce the amount of solid fats like butter, margarine, or shortening you add to food when cooking or serving. Instead of cooking with butter, for example, use olive oil or flavor your dishes with herbs or lemon juice. You can also limit solid fat by trimming fat off your meat or choosing leaner, healthier proteins.
• Substitute. Swap out high-fat foods for their lower-fat counterparts. Choose 1% or skimmed milk instead of whole milk, soft margarine for butter, and lean meats like chicken and fish in place of ribs or ground meat. When cooking, use liquid oils like canola, olive, safflower, or sunflower, and substitute two egg whites for one whole egg in a recipe. These substitutions can save you an entire day’s worth of saturated fat.
• Be label-savvy. Check food labels on any prepared foods. Many meals and snacks—even those labeled "reduced fat" or "low cholesterol" —may be made with oils containing trans fats. One clue that a food has some trans fat is the phrase "partially hydrogenated." And look for hidden fat; refried beans may contain lard, or breakfast cereals may have significant amounts of fat (as well as lots of heart-risky sugar).
• Change your habits. The best way to avoid saturated or trans fats is to change your lifestyle practices. Instead of chips, snack on fruit, vegetables, or unsalted nuts. At restaurants, ask that sauces or dressings be put on the side—or left off altogether.
• Make smart choices. Choose foods rich in unsaturated fats, fiber, and protein. Fruits, vegetables, fish, beans, nuts, and seeds are all great cholesterol regulators. The best foods for lowering cholesterol are oatmeal, fish, walnuts (and other nuts), olive oil, and foods fortified with sterols or stanols—substances found in plants that help block the absorption of cholesterol—such as corn, beans, peanut butter, almonds, oranges, apples, and avocados.

Not all fats are bad for your heart
While saturated and trans fats are roadblocks to a healthy heart, unsaturated fats are essential for good health. You just have to know the difference. “Good” fats include:

• Omega 3 Fatty Acids. Fatty fish like salmon, trout, or herring and flaxseed, canola oil, and walnuts all contain polyunsaturated fats that are vital for the body.
• Omega 6 Fatty Acids. Vegetable oils, soy nuts, and many types of seeds all contain healthy fats.
• Monounsaturated fats. Almonds, cashews, peanuts, pecans, and butters made from these nuts, as well as avocadoes, are all great sources of “good” fat.

Heart healthy diet tip 2: Don't replace bad fats with sugar

Despite all the low-fat meal options on offer in every grocery aisle, obesity and heart disease are still on the rise. That may be because many of these low-fat foods have removed the saturated fat but replaced it with added sugar to improve the taste. But the truth is your body doesn’t need any added sugar—it gets all it needs from the sugar that naturally occurs in food. So when sugar is hidden in foods such as bread, cereals, canned soups and vegetables, pasta sauce, margarine, instant mashed potatoes, frozen dinners, soy sauce, ketchup, and many “low-fat” or “no-fat” food options, it adds up to a lot of empty calories that are as bad for your heart as they are for your waistline.

The latest research suggests that added sugars may contribute to high blood pressure and cardiovascular disease as much as, or even more than, added salt. To reduce your risk of heart disease, the American Heart Association recommends that the daily intake of sugar should be no more than:

• 6 teaspoons or 100 calories for women.
• 9 teaspoons or 150 calories a day for men.

Currently, most adults consume about 22 teaspoons of added sugars a day.

Tips for cutting down on sugar

• Make the right changes. When cutting back on heart-risky foods, such unhealthy fats, it’s important to replace them with healthy alternatives. Replacing animal fats with vegetable fats—such as ditching butter for olive oil—can make a positive difference to your health. But switching animal fats for refined carbohydrates, though—such as replacing your breakfast bacon with a donut—won’t do anything to lower your risk for cardiovascular disease.
• Slowly reduce the sugar in your diet a little at a time to give your taste buds time to adjust and wean yourself off the craving for sweetness.
• Check labels and choose low-sugar products. Remember low-fat doesn’t mean low-sugar.
• Avoid processed or packaged foods like canned soups, frozen dinners, or low-fat meals that often contain hidden sugar. Prepare more meals at home and using fresh ingredients.
• Be careful when eating out. Most gravy, dressings and sauces are packed with salt and sugar, so ask for them to be served on the side.
• Cut down on sweet snacks such as candy, chocolate, and cakes. Instead, eat naturally sweet food such as fruit, peppers, or natural peanut butter to satisfy your sweet tooth.
• Avoid sugary drinks. Even drinking diet sodas containing artificial sweeteners can make it harder to kick your craving for sugary foods. Try drinking sparkling water with a splash of fruit juice instead.

Heart healthy diet tip 3: Steer clear of salt and processed foods

Reducing the salt in your food is a big part of any heart-healthy diet. Eating a lot of salt can contribute to high blood pressure, which is a major risk factor for cardiovascular disease. The American Heart Association recommends no more than a teaspoon of salt a day for an adult. That may sound alarmingly small, but there are actually many painless—even delicious—ways to reduce your sodium intake.

• Reduce canned or processed foods. Much of the salt you eat comes from canned or processed foods like soups or frozen dinners—even poultry or other meats often have salt added during processing. Eating fresh foods, looking for unsalted meats, and making your own soups or stews can dramatically reduce your sodium intake.
• Cook at home, using spices for flavor. Cooking for yourself enables you to have more control over your salt intake. Make use of the many delicious alternatives to salt. Try fresh herbs like basil, thyme, or chives. In the dried spices aisle, you can find alternatives such as allspice, bay leaves, or cumin to flavor your meal without sodium.
• Substitute reduced sodium versions, or salt substitutes. Choose your condiments and packaged foods carefully, looking for foods labeled sodium free, low sodium, or unsalted. Better yet, use fresh ingredients and cook without salt.

Heart healthy diet tip 4: Steer clear of salt and processed foods

A diet high in fiber can lower “bad” cholesterol and provide nutrients that can help protect against heart disease.

Go for whole grains
Refined or processed foods are lower in fiber content, so make whole grains an integral part of your diet. There are many simple ways to add whole grains to your meals.

• Breakfast better. For breakfast choose a high-fiber breakfast cereal—one with five or more grams of fiber per serving. Or add a few tablespoons of unprocessed wheat bran to your favorite cereal.
• Try a new grain. Experiment with brown rice, wild rice, barley, whole-wheat pasta, and bulgur. These alternatives are higher in fiber than their more mainstream counterparts—and you may find you love their tastes.
• Bulk up your baking. Substitute whole-grain flour for half or all of the white flour, since whole-grain flour is heavier than white flour. In yeast breads, use a bit more yeast or let the dough rise longer. Try adding crushed bran cereal or unprocessed wheat bran to muffins, cakes, and cookies.
• Add flaxseed that is high in fiber and omega-3 fatty acids, which can lower your total blood cholesterol. Add ground flaxseed to yogurt, applesauce, or cereal.

Eat a variety of fruits and vegetables
Most fruits and vegetables are low in calories and high in fiber, making them heart healthy.

• Keep fruit and vegetables at your fingertips. Wash and cut fruit and veggies and put them in your refrigerator for quick and healthy snacks. Choose recipes that feature these high-fiber ingredients, like veggie stir-fries or fruit salad.
• Incorporate veggies into your cooking. Add pre-cut fresh or frozen vegetables to soups and sauces. For example, mix chopped frozen broccoli into prepared spaghetti sauce or toss fresh baby carrots into stews.
• Don’t leave out the legumes. Add kidney beans, peas, or lentils to soups or black beans to a green salad.
• Make snacks count. Fresh and dried fruit, raw vegetables, and whole-grain crackers are all good ways to add fiber at snack time. An occasional handful of nuts is also a healthy, high-fiber snack.

Heart healthy diet tip 5: Rekindle home cooking

It’s very difficult to eat right when you’re eating out a lot, ordering in, or eating microwave dinners and other processed foods because the portions are usually too large and the meals contain too much salt, sugar, and fat. Cooking at home will give you better control over the nutritional content of your meals and can also help you to save money and lose weight. Making quick, heart healthy meals is easier and less time-consuming than you may think—and you don’t have to be an experienced cook to master some quick and wholesome meals.

• Get the whole family involved. Trade off shopping and cleanup duties with your spouse or get the kids to help shop for groceries and prepare dinner. Kids find it fun to eat what they've helped to make and cooking together is a great way to expand the pallets of picky eaters.
• Make cooking fun. If you hate the idea of spending time in the kitchen, you need to embrace your fun side. Try singing along to your favorite music as you cook, sip a glass of wine, or listen to the radio or a book on tape.
• Make foods ready-to-eat. You’re more likely to stay heart-healthy during your busy week if you make healthy foods easily accessible. When you come home from grocery shopping, cut up vegetables and fruit and store them in the fridge, ready for the next meal or when you are looking for a ready-to-eat snack.
• Create a library of heart-healthy recipes. Stock up on healthy cookbooks, bookmark recipes online, use healthy eating apps on your smartphone, or find cookbooks and cooking magazines at your local library.
• Use heart healthy cooking methods. Just as important as choosing healthy ingredients is preparing them in healthy ways. Use low-fat methods: you can bake, broil, microwave, roast, steam, poach, lightly stir fry, or sauté—using a small amount of vegetable or olive oil, reduced sodium broth, and spices instead of salt.
• Cook just once or twice a week and make meals for the whole week. Cook a large batch of heart healthy food and store leftovers in reusable containers—or directly on plates—for easy reheating during the rest of the week. Or you can freeze meals in individual portions to eat on those days when you don’t have time to cook.

Heart healthy diet tip 6: Control portion size—and your weight

Carrying excess weight means that your heart must work harder, and this often leads to high blood pressure—a major cause of heart disease. Achieving a healthy body weight is key to reducing your risk of heart disease. As well as eating less sugar, salt, and unhealthy fats, reducing portion sizes is a crucial step toward losing or maintaining a healthy weight. Try the following tactics to control your portion sizes:

• Understand serving sizes. A serving size is a specific amount of food, defined by common measurements such as cups, ounces, or pieces—and a healthy serving size may be a lot smaller than you’re used to. The recommended serving size for pasta is ½ cup, while a serving of meat, fish, or chicken is 2 to 3 ounces (57-85 grams). Judging serving size is a learned skill, so you may need to use measuring cups, spoons, and a food scale to help.
• Eyeball it. Once you have a better idea of what a serving should be, you can estimate your portion. You can use common objects for reference; for example, a serving of pasta should be about the size of a baseball (slightly smaller than a cricket ball), while a serving of meat, fish, or chicken is about the size and thickness of a deck of cards.
• If you’re still hungry at the end of a meal fill up on extra servings of vegetables or fruit.
• Beware of restaurant portions. Portions served in many restaurants are often more than anyone needs. Order an appetizer instead of an entrée, split an entrée with your dining companion, or take half your meal home for tomorrow’s lunch.

Good Sources of Fiber
Food	Serving size	Fiber grams
CEREALS
Fiber One	1/2 cup	14
All-Bran	1/2 cup	10
Bran Flakes	1 cup	7
Shredded Wheat	1 cup	6
Oatmeal (cooked)	1 cup	4
VEGETABLES
Spinach (cooked)	1 cup	4
Broccoli	1/2 cup	3
Carrots	1 medium	2
Brussels sprouts	1/2 cup	2
Green beans	1/2 cup	2
BAKED GOODS
Whole-wheat bread	1 slice	3
Bran muffin	1	2
Rye bread	1 slice	2
Rice cakes	2	1
LEGUMES (cooked)
Lentils	1/2 cup	8
Kidney beans	1/2 cup	6
Lima beans	1/2 cup	6
Baked beans (canned)*	1/2 cup	5
Green peas	1/2 cup	4
GRAINS (cooked)
Barley	1 cup	9
Wheat bran, dry	1/4 cup	6
Spaghetti, whole wheat	1 cup	4
Brown rice	1 cup	4
Bulger	1/2 cup	4
FRUIT
Pear (with skin)	1 medium	6
Apple (with skin)	1 medium	4
Strawberries (fresh)	1 cup	4
Banana	1 medium	3
Orange	1 medium	3
DRIED FRUIT
Prunes	6	12
Apricots	5 halves	2
Raisins	1/4 cup	2
Dates	3	2
Plums	3	2
NUTS AND SEEDS
Peanuts, dry roasted*	1/4 cup	3
Walnuts	1/4 cup	2
Popcorn*	1 cup	1
Peanuts*	10	1
Filberts, raw	10	1
* Choose no-salt or low-salt version of these foods