Heart disease was the No. 1 cause of death in the US in 2020, according to the Centers for Disease Control and Prevention (CDC). But researchers continue to learn more about how to prevent cardiovascular disease, which includes both strokes and heart attacks—and it’s clear that healthy eating and living (like exercising more) can make a huge difference.
Here, nutritionists highlighted what you can include in your diet to keep your heart happy for decades to come.
Salmon and other fatty fish such as sardines and mackerel are the superstars of heart-healthy foods. That’s because they contain copious amounts of omega-3 fatty acids, shown in studies to lower the risk of arrhythmia (irregular heart beat) and atherosclerosis (plaque build-up in the arteries) and decrease triglycerides (fat found in blood).
The American Heart Association recommends eating fish and preferably fatty fish at least twice a week. You can also get omega-3-rich fish oils as dietary supplements, though they may not have the DHA and EPA omega-3s specifically found in fatty fish.
Oatmeal is high in soluble fiber, which can lower cholesterol. “It acts as a sponge in the digestive tract and soaks up the cholesterol so it is eliminated from the body and not absorbed into the bloodstream,” Lauren Graf, a registered dietician and co-director of the Cardiac Wellness Program at Montefiore Medical Center in New York City, told Health.
Graf recommends avoiding instant oatmeal, which often contains sugar, and heading instead for old-fashioned or even quick-cooking oats.
Not just blueberries, but strawberries and other berries may lower the risk for heart disease. According to a 2013 study published in the journal Circulation, women aged 25–42 who ate more than three servings of blueberries and strawberries a week had a 32% lower risk of heart attack compared with those who ate less.
The authors of the study attributed the benefit to compounds known as anthocyanins, flavonoids (which are antioxidants) that may decrease blood pressure and dilate blood vessels. Anthocyanins give plants their red and blue colors.
A 2021 review of studies about berries and heart health published in the journal Frontiers in Nutrition suggested that anthocyanin-rich berries can prevent heart diseases by lowering lipids and reducing inflammation in the body.
Some studies have shown that dark chocolate—chocolate made up of at least 60-70% cocoa—may benefit your heart. A review published in 2015 in the journal Vascular Pharmacology acknowledged evidence for several ways dark chocolate could help with heart disease, but cautioned that more studies were needed to confirm and explain the mechanism.
One theory is that dark chocolate contains flavonoids called polyphenols, which may help blood pressure, clotting, and inflammation. Unfortunately, milk chocolate and most candy bars don’t make the grade when it comes to protecting your heart.
People who consume high amounts of the flavonoids found in citrus fruits have a lower risk of stroke and heart disease, according to a 2017 review published in the International Journal of Epidemiology.
Stick with whole citrus fruits, which also provide filling fiber, or small portions of fresh squeezed or 100% citrus juice. But be aware that grapefruit products may interfere with the action of the cholesterol-lowering drugs known as statins, as well as other medications, according to the US Food and Drug Administration (FDA).
There’s no reason to shun potatoes because they are often considered a “bad” starch. As long as they’re not deep-fried, potatoes can be good for your heart. They’re rich in potassium, which can help lower blood pressure. And they’re high in fiber, which can lower the risk for heart disease.
“They are definitely not a junk food or refined carbohydrate,” said Graf. “They have a lot of health benefits.”
Like potatoes, tomatoes are high in heart-healthy potassium. Plus, they’re a good source of the antioxidant, lycopene, which have been linked to lower incidence of stroke, according to Harvard Medical School.
Lycopene is a carotenoid that may help lower levels of “bad” LDL cholesterol, keep blood vessels open, and lower heart attack risk. And because they’re low in calories and low in sugar, they don’t detract from an already-healthy diet. “They’re excellent for the body in a number of ways,” said Graf.
Nuts, including almonds, walnuts, pistachios, peanuts, and macadamia nuts, contain good-for-your-heart fiber. They also contain vitamin E, which helps lower bad cholesterol. And some, like walnuts, are high in a type of plant based omega-3 fatty acid called alpha-linolenic acid, or ALA, tied to anti-inflammation and improved circulation.
“Some people in the past have avoided nuts because they’re higher in fat, but most of the studies show that people who consume nuts daily are leaner than people who don’t,” Graf said. And leaner people are at a lower risk for heart problems. Look for varieties that don’t have a lot of added salt.
Because they come from plants, legumes such as beans, lentils, and peas are an excellent source of protein without a lot of unhealthy fat. A 2017 review published in Critical Reviews in Food Science and Nutritionfound “moderate evidence” for the benefit of legumes on coronary heart disease (also known as coronary artery disease).
And legumes may help control blood sugar in people with diabetes, according to a 2020 study published in in the journal Nutrients. Lowering blood sugar levels is key in helping people avoid diabetes complications, one of which is heart disease.
10-Extra-virgin olive oil
There are many studies that have suggested mechanisms by which extra-virgin olive oil (EVOO) helps with the prevention of heart diseases, according to a 2019 review published in the journal Nutrients. This is especially true when EVOO is a supplement to the Mediterranean diet, which is high in grains, fruits, and vegetables.
Olive oil is a good source of monounsaturated fat, which can help reduce both cholesterol and blood sugar levels. Olives themselves—both green and black—are another source of “good” fat, said Graf.
Green tea may bring significant health benefits. A 2013 study published in the journal Stroke found that people who drank four or more cups of green tea daily had a 20% reduced risk of cardiovascular disease and stroke compared with people who “seldom” consumed the beverage.
A 2018 letter published in the European Journal of Preventive Cardiology reaffirmed these results, suggesting that the heart protection came from polyphenols, antioxidants capable of dissolving a compound that could be one of the major causes of heart disease.
12-Broccoli, spinach, and kale
When it comes to your health, you really can’t go wrong with vegetables. But dark green vegetables may give an extra boost to your heart. These are high in carotenoids, which act as antioxidants which counter potentially harmful compounds in your body. They’re also high in fiber and contain tons of vitamins and minerals.
Another widely consumed beverage—coffee—may also promote heart health. A 2018 review published in Progress in Cardiovascular Diseases found that coffee led to reductions in heart disease mortality. “Daily consumption of 2 to 5 cups of coffee (16 to 40 oz) with caffeine intakes up to 400 mg/day appears to be safe and is linked with the strongest beneficial effects for the majority of the studied health outcomes,” the authors wrote.
But the news isn’t necessarily a reason to pick up the habit. “If you’re already drinking coffee and enjoying it, continue,” said Graf. “If not, there’s no reason to start.”
One thing to note about caffeine, however: Due to a genetic variant, some people break down caffeine more slowly. When this is the case, it can have a negative impact on heart health. You can get tested, through sites like https://www.nutrigenomix.com, though the test isn’t covered by insurance.
14-Flax and chia seeds
Flax and chia seeds are high in plant-based omega-3 fatty acids. That’s one reason they’re good for your heart. Another reason is their high fiber content.
Plus, there are a million ways to enjoy the seeds. Try them ground up with other heart-healthy foods, such as dried blueberries, cranberries, or oatmeal, or even blended with plant milk and fruit to create a smoothie.
These soft, tasty fruits have a well-established reputation for providing the body and heart with healthy fats. Like olive oil, they’re rich in monounsaturated fat, which may lower heart disease risk factors, such as cholesterol.
Avocados are also high in antioxidants and in potassium. They can be eaten on their own or blended into guacamole, perhaps with some heart-healthy tomatoes. But don’t overeat avocados—they are high in calories, as well.
Pomegranates contain numerous antioxidants, including heart-promoting polyphenols and anthocyanins, which may help stave off hardening of the arteries.
A 2021 review published in the Journal of Nutrition and Metabolism found that pomegranates were preventive for coronary heart disease because they had “potent antioxidant properties.”
But note that it’s important to have variety in your diet. If you don’t like pomegranates or can’t afford them, reach for apples, which also contain plenty of health-promoting compounds, said Graf.
In addition to their proven ability to reduce total cholesterol, apples help protect the heart due to their prebiotic content. Prebiotics serve as “food” for beneficial bacteria housed in the gut, which are tied to cardiovascular protection.
Additionally, a 2012 study of healthy, middle-aged adults published in the Journal of Functional Foods found that an apple a day habit reduced blood levels of a substance linked to hardening of the arteries by 40% over four weeks. A 2019 literature review in Current Developments in Nutrition supported this evidence.
Chop and add apples to oatmeal or overnight oats at breakfast, slice and add to a garden salad at lunch, dip into almond butter as a snack, or dice and add to a stir-fry at dinner.
This plant butter, made from ground sesame seeds, contains five grams of plant protein and three grams of healthful fiber per two-tablespoon portion. It also provides a variety of key nutrients, including calcium, magnesium, iron, and zinc, in addition to antioxidants. The phytosterols in tahini have also been shown to improve artery health, and lower blood cholesterol.
Tahini is a great alternative for those with nut allergies or sensitivities, and it makes a terrific base for creamy, dairy-free dressings and sauces.
19-Garlic and onions
Allium vegetables, which include garlic and onions, have been shown to reduce inflammation in the body, which in turn lowers the risk of artery hardening. The sulphur compounds in these veggies have also been shown to open up blood flow and improve circulation.
This may be why a 2017 study published in the Journal of Hypertension found that adult men and women with a higher habitual intake of allium vegetables had a 64% reduced risk of cardiovascular disease over a six-year period.
20 – Beets
Beetroot is one of the few vegetables that contain important bioactive pigments known as betalains, which provide the beets’ red-violet color. Betalains offer high antioxidant and anti-inflammatory capabilities known to protect a variety of systems in the body, including cardiovascular health. The natural nitrates found in beetroot help dilate blood vessels to decrease blood pressure, and may reduce the overstimulation of the nervous system that occurs with heart disease.
Fresh, peeled beets can be thinly sliced or shredded to add to salads, or blended into smoothies. Note: beeturia (red or pinkish urine and stools) may occur after upping your beet intake. It’s harmless, so don’t be startled if you notice this sudden change.
21 – Chili peppers
Chili peppers have been shown to help lower heart disease risk by improving cholesterol, lowering blood pressure, and enhancing circulation, as well as combating obesity. These spicy peppers also contain potent anti-inflammatory compounds and are even linked to extending longevity.
Bonus: fresh or dried hot peppers are a smart way to flavor meals without the need to add salt or sugar. Sprinkle a chopped fresh or some dried chili pepper onto anything from black bean soup to hummus, potatoes, and sautéed veggies.