Over the years, the definition of a heart-healthy diet has changed. "Cutting saturated fat to lower cholesterol used to be the focus, but now we know if that's all you're doing, you're missing other dietary chances to further protect your heart," says Melissa Ohlson, R.D., nutrition coordinator of preventive cardiology at the Cleveland Clinic. Additional risk factors, like hypertension and inflammation, can also be tamed by diet, but the foods that help aren't necessarily the same as the ones that slash cholesterol. The following 15 foods will help you tackle heart disease from every angle. We show you how to fit them all into your daily diet.
Head off high blood pressure
Hypertension (blood pressure that's 140/90 or higher) is the most common risk factor for heart disease. When blood pressure is elevated, your heart has to work harder to pump blood through your body. "That damages the lining of your arteries, leading to plaque buildup, which can ultimately cause a heart attack or stroke," says New York City cardiologist Richard Stein, M.D., a spokesman for the American Heart Association. To maintain a healthy blood pressure (120/80 or lower), eat these foods regularly.
SWISS CHARD A potassium powerhouse, this vegetable supplies nearly 1,000 milligrams (mg) of the mineral per cup, cooked. Studies show you need about 4,000 mg of potassium (found in fruits, vegetables, legumes, and yogurt) a day to keep blood low. "When you don't get enough potassium, sodium levels in your body rise, which causes a buildup of fluid in the cells, increasing blood pressure," says Stein. On top of that, the greens are rich in calcium and magnesium, which also help prevent hypertension. Not a Swiss chard lover? The rainbow variety, with stalks that are yellow, red, or hot pink, tastes less bitter than other types and is worth a try.
FRESH HERBS They're a healthy substitute for salt, which has almost 2,400 mg of sodium per teaspoon— more than what you should get in an entire day if you want to control your blood pressure. Instead, try sprinkling dishes you'd usually salt with chopped fresh herbs, which are typically more flavorful than dried ones. Chives and rosemary complement potatoes, parsley perks up eggs, sage goes well with poultry, and thyme can add zip to air-popped popcorn. As an added bonus, herbs are rich in antioxidants that protect your cells against the kind of damage that can lead to heart disease. If you simply can't cut out salt completely, try this trick: Use a mortar and pestle to crush the kosher variety (which has about half the sodium of table salt) with herbs like oregano, thyme, and lavender, suggests Connie Gutterson, Ph.D., a registered dietitian and nutrition instructor at the Culinary Institute of America in Napa, California.
LOWFAT OR NONFAT YOGURT Have yogurt for breakfast and as a snack. It has about 50 percent more blood pressure–lowering calcium and potassium than lowfat milk. In studies, people who ate enough of these two minerals and kept their sodium intake low experienced drops in both systolic and diastolic blood pressure. The reduction is larger in people with hyper- tension, but yogurt also lowers blood pressure a little in people with normal levels. This is important, because the closer you can get your blood pressure to a healthy level of 120/80, the better off your heart will be. If you're not a yogurt fan, drink lowfat or nonfat milk instead, or use it as an ingredient in everyday cooking, suggests Susan Moores, R.D., a nutritionist in St. Paul, Minnesota, who specializes in heart disease. "Substitute an equal amount of milk for water in packaged foods that need to be reconstituted, like instant oatmeal, condensed soup, and hot chocolate."
Curb unhealthy cholesterol levels
LDL, or "bad," cholesterol, accumulates on artery walls, hardening into plaque that can block blood flow. "Without enough blood reaching the heart, you can suffer chest pain or heart damage," says Stein. To keep plaque at bay, you want to lower LDL and raise HDL ("good") cholesterol. These foods will help.
GARLIC This tasty bulb has a mild cholesterol-lowering effect and also keeps LDL from building up in the arteries and contributing to plaque. You need to consume several loves a day to get the protective benefits. To fit it into your meals, use garlic as often as you can in cooking. It pairs well with everything from roast meats and poultry to vegetables, soups, and pasta dishes. An even easier way: Stir a teaspoon of chopped garlic into 2 tablespoons of lowfat mayo and use it as a spread on your sandwich or wrap.
EXTRA-VIRGIN OLIVE OIL Olive oil is rich in mono- unsaturated fats, which can lower LDL when they replace saturated fat in your diet. "In fact, every 1 percent decrease in your intake of saturated fat— found in cheese, butter, and fatty meats—can reduce your LDL level by 2 percent," says Ohlson. But be careful what you replace it with, she says. Many people substitute carbohydrates like white bread and lowfat cookies for saturated fat. While that strategy may lower your LDL level, it causes your HDL to drop—and that's also not good for your heart. Try replacing saturated fat–rich foods with olive oil, as well as with avocado, nuts, and other sources of monos. Extra- virgin olive oil has an advantage over other types: It packs extra polyphenols, compounds that keep LDL cholesterol from sticking to artery walls. "Since extra- virgin olive oil costs several dollars more than the regular kind, don't use it for cooking," says Moores. "Instead, incorporate it where you can really savor the flavor—in a salad dressing, as a topping for bread, or drizzled over steamed veggies."
ALMONDS When adults ate about an ounce of these nuts a day as part of a healthy diet, their LDL levels dropped 13 to 20 percent—the amount comparable to the reduction that occurs with some medications— according to researchers at the University of Toronto.
"All nuts are nutritious, but almonds are particularly heart-healthy because they have the most vitamin E. This antioxidant protects cells against the kind of damage that can lead to atherosclerosis," says Moores. They're also a good source of calcium. If almonds are a little too blah for you, toast them in a shallow baking pan at 350°F for 10 to 15 minutes to bring out their flavor.
Beat high blood sugar
About 24 million women have fasting blood sugar (glucose) levels high enough to qualify them as prediabetic, and another 10 million have type 2 diabetes—and many of them don't know it. "Type 2 diabetes is a powerful risk factor for heart disease, particularly in women," says Stein. "It can damage the nerves and blood vessels that lead to the heart and quadruple your chances of having a heart attack." To keep your blood sugar levels in check, add these foods to your diet.
BARLEY It's the grain least likely to produce spikes in your blood sugar; in fact, a study from the Creighton University School of Medicine found barley was better than much-touted oats at keeping glucose levels under control. The reason may be that the grain has high levels of a soluble fiber called beta-glucan, which is digested very slowly and helps lower cholesterol levels. (Hulled barley has more fiber than pearl barley, but it takes longer to cook. Either one makes a smart addition to your diet.) Substitute barley flour for about half the all-purpose type called for in your muffin and quick-bread recipes. You can also add barley to soups or serve it as a side dish with fish, meat, or poultry in place of rice or potatoes.
CAYENNE CHILI PEPPER Sprinkling this spice on your food helps prevent a big spike in blood sugar after a meal, according to a new study from the University of Tasmania. When adults polished off a chili-seasoned burger on a bun with a sugary beverage, their blood sugar was much lower than when they finished the drink and the burger sans spices. The researchers credit capsaicin—the fiery substance in chili peppers—for at least part of the benefit.
CARROTS A Harvard University study found that crunching on half a cup of dark yellow vegetables, like carrots, each day cuts the risk of diabetes in women by 27 percent. The researchers aren't sure why, but they think it may be due to the high level of antioxidants in these vegetables. To enhance your absorption of antioxidants from carrots (or any colorful veggie), serve them with a little fat, such as olive oil.
Scale back your weight
Simply carrying a few extra pounds on your frame raises your chances of developing chest pain or having a heart attack by 17 percent, according to a review of 21 studies published in the Archives of Internal Medicine. Being obese—having a body mass index of 30 or greater—increases your risk by 49 percent. Excess pounds also raise your odds of developing high blood pressure, high cholesterol, inflammation, diabetes, and other conditions that increase heart disease risk. To maintain a healthy weight, incorporate these foods into your meals.
BROCCOLI While it's true that all veggies are low- cal, broccoli is one of the biggest diet bargains: A half cup of cooked florets has a mere 27 calories, about the amount in just a tiny bite of lasagna. You'll also get 3 grams of fiber, which helps fill you up. "Before you cook broccoli, chop it into small pieces. That way, it will absorb the seasonings better," says Gutterson.
ORANGES One of the few fruits in season this time of year, oranges deliver that sweet taste you crave for just 65 calories apiece. In addition, oranges contain a type of fiber called pectin that not only keeps you full, but also controls cholesterol. "Plus, it takes a while to peel and eat one, so it helps increase satisfaction and control appetite," says Moores. A good choice: California navel oranges, which are at their peak in January and February.
LEAN PORK Adults who have a high-protein meal burn twice as many calories afterward as those who eat a high-carb one, according to a study at Arizona State University in Mesa. With just 122 calories per 3 ounces, pork tenderloin is one of the leanest sources of protein, supplying as much as prime rib for one- third to one-eighth of the fat. The same size serving of pork top loin has 147 calories and 5 grams of fat.
"Most heart attacks happen when plaque that has built up in the artery bursts, forming a blood clot that blocks blood flow. Researchers now believe inflammatory compounds trigger plaque eruption," says Stein. In fact, a recent study at Brigham and Women's Hospital in Boston found that high levels of C-reactive protein (or CRP, a measure of inflammation) is a more reliable predictor of heart trouble than high cholesterol. To fight inflammation, rely on the following foods.
SALMON This fish is one of the best sources of omega-3 fatty acids, which ease inflammation, boasting three to six times the amount found in other popular seafood, like shrimp, flounder, and mahimahi. If salmon's flavor is a little too fishy for you, Gutterson suggests mellowing it by poaching fillets in white wine, chicken or vegetable stock, lemon zest, and dill or fennel.
BLACK BEANS Few foods supply as much magnesium as black beans, and adults who don't get enough of the mineral in their diets are about twice as likely to have high levels of CRP, according to a study by the Medical University of South Carolina. A cup of canned beans delivers 120 of the 320 milligrams of magnesium you need daily.
DRIED CHERRIES Tart or sweet, they're loaded with anthocyanins, antioxidants that help neutralize the enzymes that cause plaque to break apart. "Fresh cherries do the same thing, but dried ones are more versatile and are available year-round," says Gutterson. Mix a tablespoon or two into cereal, wild rice, salads, muffin batter, or yogurt.