Diet changes for a healthy Heart
When it comes to protecting your heart, the foods you eat play a powerful role. Research shows that plant-based diets can support a healthy heart (1). By focusing on nutrient-dense plant foods, and minimising saturated fat a person eating a plant based diet will tend to have lower cholesterol levels, reduced blood pressure, and a decreased risk of heart disease.
A diet rich in fruits, vegetables, whole grains, legumes, nuts, and seeds, provides an abundance of fibre, antioxidants, and healthy fats, all of which support a healthy cardiovascular system. But how does changing your diet impact your heart? In this blog post, I’ll explore the science behind how a whole foods plant predominant diet can lower cholesterol, reduce inflammation, and improve overall heart function.
This is one why I often suggest a plant predominant diet for my clients, despite a large focus on animal based protein intake on social media, there is a strong relationship between animal protein intake and mortality risk, (2) the study showed that as animal protein intake increase, so did cardiovascular disease. And while some people might experience weight loss on this type of diet, in my opinion, the point of weight loss is not to fit into a smaller casket.
Whether you’re already vegan and want to make sure your diet is heart protective or if you’re considering making the shift to a more plant focused diet, understanding how a whole foods plant based diet supports heart health could help get you on your way to lifestyle change!
What do we need for a healthy heart?
To answer this instead I’ll flip it to what constitutes an unhealthy heart. And this is closely tied to the condition of your arteries. These transport blood around your body and factors like blood pressure & cholesterol levels can impact their condition. When your arteries are functioning your heart can efficiently pump blood throughout your body, but when they are not, this is when we begin to develop cardiovascular disease.
We’re going to start with some things you might test for: Blood pressure, LDL cholesterol & APOB and blood sugar.
Blood Pressure:
Blood pressure is a commonly measured sign of heart health, and maintaining it within a normal range reduces the risk of heart disease. Normal blood pressure is typically defined as between 90/60mmHg and 120/80mmHg (3). When blood pressure consistently stays high (a condition known as hypertension), the heart is forced to work harder to pump blood through the body. Over time, this strain can damage the walls of blood vessels, leading to tiny tears. Cholesterol and fats (which we’ll go on to talk about later) can latch onto these tears, slowly forming plaque. This process is known as atherosclerosis and over time this build up gradually restricts the blood vessels ability to transport blood to vital areas like the heart and brain.
LDL cholesterol
One of the biggest contributors to atherosclerosis and heart disease is LDL cholesterol (low-density lipoprotein). When LDL levels are too high, the cholesterol enters the artery walls, triggering an immune response. This leads to a buildup and plaques in the artery wall, restricting blood flow. These plaques can rupture, causing blood clots that further obstruct blood flow and increase the risk of heart disease.
LDL cholesterol has been consistently shown in clinical studies to be a major cause of cardiovascular disease (4). Keeping LDL levels in check is crucial for preventing the development of heart conditions.
What about Apolipoprotein B?
Another important marker is Apolipoprotein B (ApoB). ApoB is a protein found in LDL particles. ApoB gives a direct measurement of the number of LDL particles circulating in the blood. As mentioned above, these particles can penetrate the arterial walls, contributing to plaque buildup and the development of atherosclerosis (5).
High levels of ApoB are associated with a higher risk of cardiovascular disease, even if overall cholesterol levels seem normal. In fact, some researchers argue that ApoB is a more accurate predictor of heart disease risk than traditional LDL cholesterol measurements. This is because even when LDL cholesterol levels are normal, the number of LDL particles (reflected in ApoB levels) might still be high, increasing the risk of heart disease (6).
Research has shown that for every 10 mg/dL reduction in ApoB, there is a 5% reduction in all-cause mortality and a 7% reduction in cardiovascular deaths (7). This underscores the strong link between lowering ApoB levels and reducing the risk of both death and cardiovascular disease.
Blood sugar regulation:
Blood sugar regulation and insulin sensitivity are closely tied to heart health, particularly in how they influence cholesterol and ApoB levels. Insulin resistance, where your body can not regulate your blood sugar well, can lead to higher levels of triglycerides and very low-density lipoprotein (VLDL) particles (8).
Dietary risk factors for heart disease
Research has also shown that a high-fat diet (HFD), particularly one rich in saturated fats, leads to a decrease in insulin sensitivity (9). Which, as described above, can also lead to higher LDL (10).
Saturated and trans fats not only worsen insulin resistance and increase LDL, but they also create a pro-inflammatory environment in the body (11). Chronic inflammation is a key driver of many health problems, including heart disease. Inflammation triggered by poor dietary choices can further impair the body’s ability to use insulin properly, compounding the effects on blood sugar and lipid levels.
What are saturated fats?
They are a type of fat that can be found in food products like:
- Butter
- Cheese
- Fatty meats
- Baked goods like cakes and biscuits
- Certain plant-based oils like coconut and palm oil
Trans fats are made when a liquid fat is turned into a solid (or an unsaturated fat is turned into saturated) this can happen industrially when making a vegan butter for example. They can also be naturally occurring in meat and dairy.
There is very strong evidence that lowering your intake of Saturated and trans fats is key to reducing LDL cholesterol and ApoB (12).
By improving insulin sensitivity through a diet low in saturated fats and rich in anti-inflammatory, plant-based foods, individuals can lower LDL levels and reduce their overall cardiovascular risk.
What should you eat instead?
Studies have shown that diets rich in fruits, vegetables, and whole grains, support a healthy heart by reducing LDL cholesterol and inflammation (13). Fruit and vegetable consumption has been associated with a reduced risk of cardiovascular disease, cancer, and all-cause mortality (14). This is why the “5-a-day” recommendation is so crucial—not just for overall health but for reducing cardiovascular disease risk.
More specifically a whole foods plant based diet has been consistently associated with a lower risk of heart disease (15), with significant reductions in LDL cholesterol, oxidised LDL, and overall cholesterol levels (16). These improvements are not only attributed to the exclusion of animal products but also the abundance of plant-based foods rich in fibre and antioxidants.
Additionally, a plant predominant Mediterranean-style diet, has been shown to prevent cardiovascular disease and improve artery function (17,18).
The Role of Fibre
A high-fibre diet, rich in soluble fiber from foods like oats, beans, fruits, and vegetables, can have a profound impact on lowering LDL cholesterol (19,20). Fibre works by binding to bile acids in the digestive tract, forcing the liver to use cholesterol from the blood to produce more bile, effectively lowering cholesterol levels. The fermentation of fibre in the gut produces short-chain fatty acids (SCFAs), which have been shown to reduce cholesterol synthesis in the liver (21).
By adopting a diet rich in plant-based foods, reducing unhealthy fats, and boosting fibre intake, you could significantly lower your risk of heart disease while promoting overall health and longevity.
There are more lifestyle and dietary changes you could make to help support your heart health as you age but these points are a really good start in understanding your risks, what markers you should test and track to observe your risk and some ways to get going with dietary changes! But if you’d like more in depth, personalised advice for you, your health history, family history and current diet, click here for more information on working with me 1:1 and here to book a free health planning call.
Does vegan = heart healthy?
For those following a vegan or plant-based diet, it’s important to remember that while these diets are generally heart-healthy, certain factors, including genetics, can still lead to high ApoB levels. If you’re concerned about your cardiovascular risk, monitoring ApoB and LDL cholesterol levels can help you make informed adjustments to your diet and lifestyle. Reducing processed foods, limiting oils high in saturated fat, and emphasising whole plant foods are practical steps that can improve heart health.
References
- PMID: 37226630
- PMID: 32076944
- https://www.nhs.uk/conditions/blood-pressure-test/
- PMID: 28444290
- PMID: 38169767
- PMID: 31882375
- PMID: 31475865
- PMID: 20356594
- PMID: 26615402
- PMID: 20356594
- PMID: 23509418
- PMID: 18541549
- PMID: 30571591
- PMID: 28338764
- PMID: 36030329
- PMID: 32893710
- PMID: 37571293
- PMID: 32903262
- PMID: 30239559
- PMID: 28356275
- PMID: 34956218