Heart disease diet

Simple changes to your diet can combat weight gain, high blood pressure, and high blood cholesterol, thereby helping to prevent cardiovascular disease (heart attack and stroke).

The beneficial effects of a better diet will be further enhanced by regular exercise (see Heart disease exercise), not smoking, and drinking alcohol in moderation.

General information

An important way of maintaining a healthy weight is to balance the calories you consume with the calories you use up in your daily activity. But that is just part of the story – preventing heart disease is as much about what you eat, as how much you eat.

In particular, foods high in saturated fat are a major driver of high blood cholesterol; and too much salt in your diet can contribute to high blood pressure. Both of these conditions increase your risk of developing cardiovascular disease (heart attack and stroke).

So, what kind of diet is good for your heart? Generally, we should aim to:

• Reduce "bad" fats (saturated fat and trans fats)
• Reduce salt (sodium)
• "Right-size" your calorie intake (adjust what, how much, and how often you eat) to better manage your weight.

Reducing "bad" fats

There are four main kinds of dietary fat. All are high in calories, so will contribute to weight gain. However, not all are "bad" in terms of heart health.

Saturated fat and trans fats (or trans-fatty acids) are bad. These fats stimulate your liver to produce "bad" cholesterol (low-density lipoprotein cholesterol or LDL-C), which enters the blood stream and attaches to artery walls, leading to a narrowing and hardening of the arteries (a process known as atherosclerosis).

Monounsaturated and polyunsaturated fats are healthier types of fat that increase levels of "good" cholesterol (high-density lipoprotein cholesterol or HDL-C), which helps to remove bad cholesterol from the blood and prevent atherosclerosis. Replacing bad fats with good fats has been consistently shown to lower levels of "bad" cholesterol and increase levels of "good" cholesterol in the bloodstream.

For this reason it is very important to be able to distinguish between "good" fats and "bad" fats:

Saturated fats ("Bad")

Meat fat, whole milk, butter, cream, fatty cheeses, coconut and palm oils, cocoa butter.

Trans-fatty acids or Trans fats ("Bad")

Mainly found in hydrogenated vegetable fats typically used in snack foods like crackers, cookies, chips, and pastries to create a longer shelf life; a small amount is found in processed vegetable oils used to make some spreads, but very little is found in New Zealand margarines.

Monounsaturated fats ("Good")

Olive oil, canola oil, avocados; most nuts and nut butters.

Polyunsaturated fats ("Good")

Soybean, sunflower, and safflower oils; oily fish such as sardines

Simple ways to reduce "bad" fats

Reducing bad fats and increasing good fats can be as simple as substituting one food for another. For example, butter and margarine contain the same amount of fat (5g in every teaspoon) but butter consists mainly of saturated fat, while margarine is mostly polyunsaturated or monounsaturated fat.

Here are some simple steps you can take to remove saturated fat from your diet:

• Reduce your butter intake and/or replace butter with margarine or olive oil-based spreads
• Replace full fat milk with reduced or low-fat milk, or milk alternatives like soy milk or almond milk
• Replace full-fat ice cream with low-fat varieties, or alternatives like frozen yoghurt or sorbets
• Trim the fat off your meat and remove the skin from chicken
• Replace butter, dripping, or lard with non-saturated fat alternatives when roasting or pan frying food. Alternatively, grill your meat instead.

Fat is often contained in manufactured foods, so reading nutritional information relating to the foods we buy and eat is also important (see the Nutrition Information Panel section below).

Reducing salt

A high salt (sodium) intake is associated with raised blood pressure. Many of us are accustomed to adding salt to our meals for taste but salt also makes its way into our bodies via many processed foods, some of which you would not necessarily suspect have salt in them. Two simple ways to reduce dietary salt are:

• Compare the information on the nutrition information panels on manufactured/packaged food to identify options that contain less sodium
• Rather than adding salt to your own cooking, use herbs and spices to add flavour.

Nutrition information panels

The nutrition information panel on most packaged foods we eat can be particularly useful in managing the fat and salt in our diets. That is because they are required to state the quantity of the very things we are trying to reduce for heart-health. Nutrition information panels also state the calorie (energy/kilojoule) content of food, which is very important if weight management is one of your goals.

The nutrition information panels always appear in the same format. The right-hand column features how much of these nutrients are included per 100g or 100mL, so you can easily compare different sized products.

The calories of the food item appear in the Energy column (kilojoules and calories are a measure of energy). The sodium row represents the salt content. Comparing these numbers on two alternative food options (for example, butter and low salt margarine) will help you select the lower saturated fat, lower calorie, and/or lower salt option.

The nutrition information panel makes it easy to understand the proportion of fat in the food. For example, a snack bar that has 30g of fat per 100g is made up of almost one third fat. If a product claims to be "98% fat free" you would expect to see 2g of fat per 100g in its nutrition information panel.

Unfortunately, trans fatty acids are not always listed separately in the panel but may appear in the ingredients section instead.

Another useful tool to use when shopping for food is the Heart Foundation Tick logo. Products with the Tick are a healthier variety of that food.

Eating for general health and wellbeing

The Heart Foundation recommends five simple steps to help you choose food for a healthy heart:

• Eat plenty of fruit and vegetables
• If choosing meat, trim off the fat to make it lean; consider fish as an alternative.
• Choose low-fat milk
• Replace butter with margarines and healthy oils for cooking and spreads
• Reduce salt: check sodium quantities on food labels.

Nutritionists will often suggest additional general tips that will complement heart-healthy food choices, and help your overall physical health and wellbeing:

• Enjoy three meals a day but control your portion sizes to avoid consuming more calories than you should (e.g. the size of your hand can be used as a rough guide to how much to cook or serve). How much you eat is as important as the types of food you eat.
• Eat fruit or vegetables at every meal and for snacks. They are high in fibre, and contain no cholesterol and little fat
• Eat fish, chicken, and lean meat instead of processed meat products like sausages and salami
• Eat whole grains, whole grain breads, or high fibre breakfast cereals instead of white bread
• Use lemon juice or vinegar rather than oily dressings or mayonnaise
• Drink plenty of fluids each day, particularly water, instead of sugar-sweetened drinks and alcohol
• Avoid prepared food, snacks, and meals unless you have checked the energy, fat, and salt content
• Leave pies, pastries, biscuits, cakes, and puddings for special occasions only – not every day
• For dairy products, choose low or reduced fat options where available, e.g. milk, yoghurt, ice cream, cream cheese, and sour cream
• Avoid fatty and salty takeaways because they tend to be high in all the wrong things (calories, fat, and salt)
• Use mozzarella cheese instead of hard cheeses on pizza, pasta, and salads
• Use filo pastry rather than puff pastry as it is lower in fat
• Keep a food diary to become more aware of your food habits and note areas where changes are required.

Tips when cooking:

• Steam, microwave, poach, grill, or bake food rather than fry or roast
• Use non-stick sprays on cookware rather than oil.

Further information and recipes

For assessment and treatment of high cholesterol and/or high blood pressure levels see a doctor. For ideas about how to implement a healthy diet, a dietitian or doctor can assist. For more information on the internet, check out National Heart Foundation recipes.

Last reviewed: January 2023