Heart-Healthy Lifestyle Changes

Heart-healthy eating involves consuming vegetables, fruits, whole grains, fat-free or low-fat dairy products, fish, lean meats, poultry, eggs, nuts, seeds, soy products, legumes, and vegetable oils (except coconut and palm oils). Also, it limits sodium, saturated and trans fats, added sugars, and alcohol.

Your doctor may recommend the heart-healthy Dietary Approaches to Stop Hypertension (DASH) eating plan because it has been proven to lower blood pressure and bad LDL cholesterol in the blood.

Foods to eat

The following foods are the foundation of a heart-healthy diet.

• Vegetables such as greens (spinach, collard greens, kale), broccoli, cabbage, and carrots
• Fruits such as apples, bananas, oranges, pears, grapes, and prunes
• Whole grains such as plain oatmeal, brown rice, and whole-grain bread or tortillas
• Fat-free or low-fat dairy foods such as milk, cheese, or yogurt
• Protein-rich foods:
  • Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about 8 ounces a week
  • Lean meats such as 95 percent lean ground beef or pork tenderloin
  • Poultry such as skinless chicken or turkey
  • Eggs
  • Nuts, seeds, and soy products
  • Legumes such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
• Oils and foods containing high levels of monounsaturated and polyunsaturated fats that can help lower blood cholesterol levels and the risk of cardiovascular disease. Some sources of these oils are:
  • Canola, corn, olive, safflower, sesame, sunflower, and soybean oils
  • Nuts such as walnuts, almonds, and pine nuts
  • Nut and seed butters
  • Salmon and trout
  • Seeds such as sesame, sunflower, pumpkin, or flax
  • Avocados
  • Tofu

How much should you eat?

You should eat the right amount of calories for your body, which will vary based on your sex, age, and physical activity level. Find out your daily calorie needs or goals with the Body Weight Planner. You may also visit the U.S. Department of Health and Human Services’ and U.S. Department of Agriculture’s 2015-2020 Dietary Guidelines for Americans for more information about healthy eating and to read about their recommendations for the following healthy eating patterns.

• Healthy U.S.-style eating pattern
• Healthy Mediterranean-style eating pattern
• Healthy vegetarian eating pattern

Nutrients to limit

A heart-healthy diet limits sodium, saturated and trans fats, added sugars, and alcohol.

Sodium

Adults and children over the age of 14 should eat less than 2,300 mg of sodium a day. Children younger than 14 may need to eat even less sodium each day based on their sex and age. If you have high blood pressure, you may need to restrict your sodium intake even more. Talk to your doctor or health care provider about what amount of sodium is right for you or your child.

Try these shopping and cooking tips to help you choose and prepare foods that are lower in sodium.  

• Read food labels and choose products that have less sodium for the same serving size.
• Choose low-sodium, reduced sodium, or no-salt added products.
• Choose fresh, frozen, or no-salt-added foods instead of pre-seasoned, sauce-marinated, brined, or processed meats, poultry, and vegetables.
• Eat at home more often so you can cook food from scratch, which will allow you to control the amount of sodium in your meals.
• When cooking, limit your use of premade sauces, mixes, and “instant” products such as rice, noodles, and ready-made pasta.
• Flavor foods with herbs and spices instead of salt.

For more ways to control sodium intake, visit Living With the DASH Eating Plan.

Saturated and trans fats

When you follow a heart-healthy eating plan, you should:

• Eat less than 10 percent of your daily calories from saturated fats found naturally in foods that come from animals and some plants.
• Limit intake of trans fats to as low as possible by limiting foods that contain high amounts of trans fats.

The following are examples of foods that are high in saturated or trans fats.  

• Saturated fats are found in high amounts in fatty cuts of meat, poultry with skin, whole-milk dairy foods, butter, lard, and coconut and palm oils.
• trans fats are found in high amounts in foods made with partially hydrogenated oils, such as some desserts, microwave popcorn, frozen pizza, stick margarines, and coffee creamers.

To help you limit your intake of saturated fats and trans fats:

• Read the nutrition labels and replace foods high in saturated fats with leaner, lower-fat animal products or vegetable oils, such as olive or canola oil instead of butter. Foods that are higher in saturated fats, such as fatty meats and high-fat dairy products, tend to be higher in dietary cholesterol that should also be limited.
• Read the nutrition labels and choose foods that do not contain trans fats. Some trans fats naturally occur in very small amounts in dairy products and meats. Foods containing these very low levels of natural trans fats do not need to be eliminated from your diet because they have other important nutrients.

Added sugars

When you follow a heart-healthy eating plan, you should limit the amount of calories you consume each day from added sugars. Because added sugars do not provide essential nutrients and are extra calories, limiting them can help you choose nutrient-rich foods and stay within your daily calorie limit.

Some foods, such as fruit, contain natural sugars. Added sugars do not occur naturally in foods, but instead are used to sweeten foods and drinks. Some examples of added sugars include brown sugar, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, raw sugar, and sucrose.

In the United States, sweetened drinks, snacks, and sweets are the major sources of added sugars. Sweetened drinks account for about half of all added sugars consumed. The following are examples of foods and drinks with added sugars.

• Sweetened drinks include soft drinks or sodas, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic drinks, and favored waters.
• Snacks and sweets include grain-based desserts such as cakes, pies, cookies, brownies, doughnuts; dairy desserts such as ice cream, frozen desserts, and pudding; candies; sugars; jams; syrups; and sweet toppings.

To help you reduce the amount of added sugars in your diet:

• Choose unsweetened or whole fruits for snacks or dessert.
• Choose drinks without added sugar such as water, low-fat or fat-free milk, or 100 percent fruit or vegetable juice.
• Limit intake of sweetened drinks, snacks and desserts by eating them less often and in smaller amounts.

Alcohol

If you drink alcohol, you should limit your intake. Men should have no more than two alcoholic drinks per day. Women should have no more than one alcoholic drink per day. One drink is:

• 12 ounces of regular beer (5 percent alcohol)
• 5 ounces of wine (12 percent alcohol)
• 1½ ounces of 80-proof liquor (40 percent alcohol)

Talk to your doctor about how much alcohol you drink. Your doctor may recommend that you reduce the amount of alcohol you drink or that you stop drinking alcohol. Too much alcohol can:

• Raise your blood pressure and levels of triglyceride fats in your blood.
• Add calories to your daily diet and possibly cause you to gain weight.
• Worsen heart failure in some patients.
• Contribute to heart failure in some people with cardiomyopathy.

If you do not drink, you should not start drinking. You should not drink if you are pregnant, under the age of 21, taking certain medicines, or have certain medical conditions including heart failure. It is important for people with heart failure to take in the correct amounts and types of liquids because too much liquid can worsen heart failure.

Remember that alcoholic drinks do contain calories and contribute to your daily calorie limits. The amount of calories will vary by the type of alcoholic drink. Read more of the 2015-2020 Dietary Guidelines for Americans to learn about what is considered one alcoholic drink and how calories vary by drink.

A healthy weight for adults is usually when your body mass index (BMI) is between 18.5 and 24.9. To figure out your BMI, use the National Heart, Lung, and Blood Institute’s online BMI calculator and compare your BMI with the following table. You can also download the BMI calculator app for iPhone and Android.

Always talk to your doctor or healthcare provider about what BMI is right for you. Talk to your child’s doctor to determine if your growing child is a healthy weight, because his or her BMI should be compared to growth charts specific for your child’s age and sex. Following a heart-healthy eating plan and being physically active are some ways to help you achieve and maintain a healthy weight. For more information, visit Aim for a Healthy Weight.

Learn about the health risks of being overweight or obese, and the health benefits of maintaining a healthy weight.

Health risks of being overweight or obese

The more body fat that you have and the more you weigh, the more likely you are to develop coronary heart disease, high blood pressure, type 2 diabetes, breathing problems, and certain cancers. Visit our Overweight and Obesity Health Topic for more information.

Measuring waist circumference

If you are overweight or obese, your doctor may measure your waist circumference to help determine your risk of developing other health conditions. To correctly measure your waist circumference, stand and place a tape measure around your middle, just above your hipbones. Measure your waist just after you breathe out.

If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be high with a waist circumference that is more than 35 inches for women or more than 40 inches for men.

Benefits of maintaining a healthy weight

If you are overweight or obese, try to lose weight. Health professionals recommend losing 5 to 10 percent of your initial weight over the course of about 6 months. Even before you reach this goal, a loss of just 3 to 5 percent of your current weight can lower triglycerides and glucose levels in your blood, as well as your risk of developing type 2 diabetes. Losing more than 3 to 5 percent of your weight can improve blood pressure readings, lower bad LDL cholesterol, and increase good HDL cholesterol.

Research suggests that an emotionally upsetting event—particularly one involving anger—can serve as a trigger for a heart attack or angina in some people. Stress can contribute to high blood pressure and other cardiovascular risks. Some of the ways people cope with stress—drinking alcohol, abusing other substances, smoking, or overeating—are not healthy ways to manage stress.

Learning how to manage stress and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities such as:

• Visiting a qualified mental healthcare provider
• Participating in a stress management program
• Practicing meditation
• Being physically active
• Trying relaxation therapy
• Talking with friends, family, and community or religious support systems

Ask your doctor what kinds of stress management, if any, are safe for you.

Routine physical activity and reduction in sedentary lifestyle can improve physical fitness, lower many heart disease risk factors such as bad LDL cholesterol levels and increasing good HDL cholesterol levels in the blood, controlling high blood pressure, and helping you lose excess weight. Physical activity also can lower your risk for type 2 diabetes.

Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week, or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.

Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.

Another way you can begin to increase your activity level is by reducing how long you sit at a given time. People who sit for long periods of time have been found to have higher rates of heart disease, diabetes, and death. Reducing sedentary behavior by breaking up how long you sit will benefit your overall health.

Learn more about physical activity in:

• Physical Activity and Your Heart Health Topic
• U.S. Department of Health and Human Services’ 2008 Physical Activity Guidelines for Americans

If you smoke, quit. Smoking can raise your risk for coronary heart disease and heart attack and worsen other coronary heart disease risk factors. Talk with your doctor about programs and products that can help you quit smoking. Also, try to avoid secondhand smoke.

If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.

Learn more about quitting smoking in our Smoking and Your Heart Health Topic.