Keeping track of every one of the specific components of a heart-healthy diet can be complicated and difficult. To make things easier, experts recommend that you simply revise your entire diet so that your diet, in effect, keeps track of the right things for you. Their recommendation is that if you have heart disease you should:

• Consume foods that are high in unsaturated fats, especially polyunsaturated fats, instead of foods that are high in saturated fats.
• Increase your consumption of omega-3 fatty acids found in certain types of fish and plant foods.
• Eat more fruits, vegetables, nuts, and whole grains and fewer refined grains.

What would a diet based on these principles look like? Well, it certainly wouldn’t look like the conventional “Western” diet, which is heavy on red and processed meats, saturated fats, sweets, potatoes, and refined grains. What it would look like is the diet eaten by millions of people in the countries ringing the Mediterranean Sea.

Some years ago, when scientists looked around the world for places where heart disease was uncommon they made a surprising discovery. Heart disease was exceptionally rare among the people of Crete, the largest of the Greek islands. What was surprising about this discovery coming, as it did, when experts were promoting low-fat diets was the fact that almost half of all the calories consumed by the people of Crete came from fat!

The difference, it soon became clear, was that they were consuming olive oil, which is a primary source of monounsaturated fat the kind of fat that lowers bad cholesterol and raises good cholesterol. But that’s not all. A closer look at what the people on Crete were eating revealed that it was an almost perfect model of what researchers now know is a heart-healthy diet.

In fact, it is a model that forms the basis of the cuisines of many Mediterranean countries Italy, Greece, France, Spain, Portugal, Morocco, Tunisia, Turkey, and Syria, among others. Though it varies slightly from country to country, this “Mediterranean diet” has a number of common characteristics: It emphasizes:

• An abundance of plant food (fruit, vegetables, breads and cereals, beans, nuts, seeds).
• Minimally processed, seasonally fresh, and locally grown foods.
• Fresh fruit as the typical daily dessert while sweets containing concentrated sugars or honey are consumed only a few times per week.
• Olive oil as the main source of fat.
• Dairy products mainly cheese and yogurt eaten in low to moderate amounts.
• Up to 4 eggs per week.
• Low amounts of red meat.
• Low to moderate amounts of wine, normally with meals.

Studies suggest that switching to a Mediterranean diet even after already having had a heart attack may lower your risk of having more heart problems, including another heart attack, by as much as 70 percent. So instead of trying to keep track of everything you eat in order to keep your heart healthy, there’s an easy and attractive alternative: eat like a Mediterranean!

Frequently Asked Questions

Will eating soy-baes foods help my hear?

Probably. A number of studies have found that eating soy-based foods can lower LDL (bad) cholesterol and triglycerides while raising HDL (good) cholesterol, and that this effect is strongest in people with the highest cholesterol levels. According to this research, eating approximately 50 grams of soy per day may lower your LDL cholesterol alone by up to 20 mg/dL, or 13 percent.

Therefore, the American Heart Association encourages people with very high cholesterol to eat more soy foods in addition to using other cholesterol-lowering therapies. Since it is thought that the effective amount of soy needed to achieve any significant cholesterol benefit is 20 to 50 grams of soy per day.

The FDA has allowed food packaging to advertise “heart-healthy” contents if they contain at least 6.25 grams of soy per serving based on the idea that four servings of that food would be within the effective range. You can also find 6.25 grams of soy protein in many soy-based foods, including: 1 glass of soy milk, 2 to 4 ounces of tofu, or a half an ounce of soy flour.

What about drinking black tea?

A number of studies suggest that people who drink one or two cups of black tea per day may be at lower risk for developing heart disease and having a heart attack than those who don’t. Some experts theorize that the flavonoids in black tea prevent plaque buildup and keep blood vessel walls relaxed and healthy.

More studies are needed to determine whether black tea on its own truly has a protective effect on the heart. Since drinking this much black tea per day is safe for most people, it is certainly something you can try if it suits your taste. The studies to date suggest that coffee, caffeinated or decaffeinated, probably does not protect the heart.

Although green tea contains many of the same substances found in black tea, little is known at this point about the potential heart-protective effects of green tea or other types of teas, including various herbal teas.

Can garlic help my heart?

It’s not clear. A comprehensive analysis of all the trials studying the effects of garlic on cholesterol showed that while it may have some modest ability to lower total cholesterol levels, there are not yet enough data to make a strong recommendation.

A review of randomized trials found that garlic reduced total cholesterol levels by 4 to 6 percent. For now, if you have heart disease, you should use more proven approaches for lowering your cholesterol levels. On the other hand, garlic certainly won’t hurt you and it may help.

Is eating smaller, more frequent meals better for my heart?

Possibly. A few studies have suggested that eating smaller, more frequent meals may lower your cholesterol. One study surveying over 14,000 people found that those who ate more than six times a day had cholesterol levels that were 5 to 6 mg/dL lower when compared with people who ate only once or twice a day.

However, more research is still needed to determine whether increasing the number of mealtimes per day can truly be used as a way to lower cholesterol levels. One danger of eating more frequent meals, of course, is that you may well consume more calories than before, which would be counterproductive. For this reason, and because more needs to be known, it’s wise to stick with more conventional methods for lowering your cholesterol for now.

Are fat substitutes healthier than fats?

Probably not. When consumers began to be concerned about the amount of fat in their foods, some food companies created fat substitutes, such as olestra, to replace the saturated fats typically used, notably in snack foods such as potato chips. But the real issue here is lowering your overall calorie consumption, not necessarily just lowering fats; “fat free” snacks have calories, too.

What’s more, fat substitutes such as olestra can decrease the absorption of important dietary nutrients and can have unpleasant side effects for many people. The fact is that the long-term safety of fat substitutes is unknown. Therefore, dietary experts at the American Heart Association recommend that people who choose to consume fat substitutes do so while paying very close attention to their diet overall.

What about calorie restriction?

Many people believe that the way to longer life is a very restrictive low-calorie diet. Advocates of this approach believe that they can postpone normal aging and avoid the onset of cancer, heart disease, kidney failure, and Alzheimer’s disease.

There is some scattered evidence that calorie restriction can extend life, but we are far from a scientific consensus on this issue. This evidence comes from animal studies and some observations of the experience of populations that have experienced food deprivation.

Thus, the relevance to an average person is not clear. Reducing your food intake to take off extra weight is a good idea. Restricting yourself to a very low-calorie diet is not yet a widely recommended practice. Even if it were, it is doubtful that many people would be able to adhere to it. Several studies are being conducted to determine if this strategy really works.