Jill Weisenberger, M.S., R.D., C.D.E.

Help protect your heart with a whole plant foods diet -- choose plenty of vegetables, healthy fats, fish, whole grains and legumes.

Scores of books on the shelves and articles on the Internet promise the perfect diet plan to stave off heart disease. The problem is that a lot of these plans just add noise to the discussion and offer no clear solution. Some advise eating plenty of fish rich in omega-3 fatty acids, while others tout the benefits of a strict vegan diet. Some plans have you munching nuts and drizzling olive oil, while others require you to shun all fats. What's a heart-wise dieter to do?

A common factor in all these diets is that meals are based on whole foods. There's no arguing the benefits of such a diet, especially when plant foods such as fruits, vegetables, whole grains and beans take center stage. Such eating patterns are linked to lower risks of heart and other chronic disease, including several forms of cancer. We reviewed the evidence to cut through the confusion and bring you the best diet for your heart health.

Based on the current body of science, these are the foods you should power up on to protect your heart from disease:

1. Vegetables

Dig into Mother Nature's medicine chest, urges Janet Brill, Ph.D., R.D., author of "Prevent a Second Heart Attack" (Three Rivers Press, 2011). Vegetables, especially dark leafy greens, are loaded with potassium that helps control blood pressure, and antioxidants and phytochemicals to fight heart disease and other illnesses. They may bring us more birthday candles, too: According to a 2009 report in the British Journal of Medicine, researchers who examined which components of the Greek Mediterranean diet had the greatest impact on longevity found a high consumption of vegetables was No. 3, just after moderate consumption of alcohol and low intake of meat. Go for variety -- eat all colors and all varieties often. They'll fill you up for few calories and increase your blood's total antioxidant capacity, helping to prevent dangerous plaque formation in your arteries, explains Brill.

2. Fruit

Research published in the Public Library of Science Medicine (October 2011) suggests that fruit, berries and raw vegetables may cut the risk of heart disease in people with genetic risks. Many components likely exert some influence. Quercetin, a flavonoid in apples, onions, grapes, cherries and berries, appears to have antioxidant and anti-inflammatory properties. And many fruits are potassium superstars, with blood pressure-lowering effects. Vitamin C, an antioxidant vitamin common in fruits, may protect against heart disease by shielding the body from the damaging effects of oxidative stress by relaxing arteries and stabilizing arterial plaque -- preventing it from breaking off and causing a heart attack.

3. Extra Virgin Olive Oil

"Its beauty is that it comes packed with monounsaturated fats, polyphenols and vitamin E," says Brill. These compounds reduce inflammation of the arteries and decrease the formation of arterial plaque. "Make this your main fat source," she adds. A Greek study published in Clinical Cardiology in 2007 reported that the exclusive use of olive oil in food preparation was associated with a 47 percent lower risk of acute coronary syndrome (sudden reduced blood flow to the heart) compared to not using olive oil. However, consuming olive oil in combination with other fats and oils did not significantly improve outcomes. Nevertheless, don't go overboard with olive oil or any other fat, urges Blake. Use it for cooking and to add flavor, so you enjoy your vegetables more.

4. Nuts and Seeds

Nuts and seeds add a heart-healthy crunch, as well as nutrients to your meals and snacks. Brill favors walnuts for their omega-3 fatty acids, heart-healthy monounsaturated fats and high antioxidant content relative to other nuts. Almonds also have been linked to heart health. Chia seeds and flax seeds provide vegetarian omega-3 fats. Flax seeds contain lignans, strong antioxidants, and cholesterol-lowering fiber. Chia seeds are the new star on the scene. Unlike flax seeds, chia seeds do not need to be ground to release their omega-3 fats, and because chia seeds are less likely to go rancid, they don't require refrigeration as flax seeds do.

However, Neal Barnard, M.D., president of the Physician's Committee for Responsible Medicine, a nonprofit organization that promotes a vegan diet, encourages a low-fat diet. Eating nuts, seeds and oils increases the calorie content of a diet, making it harder to control your weight, he explains. So consider limiting nuts and seeds to two ounces per day.

5. Fish

The omega-3 fats in fish are good for your heart and are different from omega-3 fats in walnuts, ground flaxseed and other vegetarian sources. EPA and DHA, the omega-3 fatty acids in fish, prevent electrical disturbances to the heart, reduce inflammation, make the blood less sticky and lower blood triglycerides. Brill suggests eating oily fish such as salmon, mackerel, sardines and herring at least three times per week. The American Heart Association recommends consuming fish, particularly oily fish, at least twice weekly. Barnard takes an opposing view and touts the benefits of a diet without fish or animal products. "Fish are more like beef than they are like broccoli," he says. "Only about 15 to 30 percent of the fat in fish is omega-3. The rest is a mixture of saturated and unsaturated fats, none of which are necessary -- and all of which are calorically dense." Furthermore, vegans tend to be thinner and have less type 2 diabetes than non-vegetarians, including pesco-vegetarians (who eat fish), Barnard adds.

"There is no question that in the U.S., vegans and vegetarians are thinner and tend to be healthier than people eating the standard American diet," says Brill. However, research supports fish as a heart-healthy, low saturated fat choice, she adds. Scientists compared the health of the arteries of middle-aged Japanese men with middle-aged white American and Japanese-American men living in the U.S. The Japanese, who have a very high fish intake, had low levels of atherosclerosis and twice the amount of omega-3 fats in their blood. "The fact that the Japanese had almost no evidence of disease, yet the Japanese-Americans had high rates indicates that genetics is not a protective factor in disease risk. The researchers concluded that eating fish year in and year out protects against atherosclerosis," Brill says.

6. Grains

Various studies spotlight whole grains in disease prevention, says Cynthia Harriman, director of food and nutrition strategies for the Whole Grains Council, a nonprofit organization that promotes the health benefits of whole grains. In the Iowa Women's Health Study, those with the highest intakes of whole grains had 30 percent less risk of cardiovascular disease. Additionally, in a 2003 meta-analysis of 12 studies, researchers concluded that higher intake of whole grains reduced heart disease by 27 percent. Many components of whole grains are likely responsible for shielding the heart: Whole grains have more antioxidants than refined grains, and both oats and barley are good sources of beta-glucan, a fiber known to lower blood cholesterol and improve the action of insulin.

7. Legumes

Beans may be the Fountain of Youth. When researchers studied the diets of older adults in Japan, Greece, Sweden and Australia, they found that consumption of legumes was the most important dietary predictor of survival. According to a study of nearly 10,000 men and women in the U.S, eating at least four servings of beans weekly lowers the risk of coronary heart disease by 22 percent. Beans provide several heart-protecting nutrients, including potassium, magnesium, folate, cholesterol-lowering fibers and glucose-lowering resistant starches. Don't fear the gas that comes with eating beans. Start with small servings, and your body will adjust over time.

 

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