In New Zealand, 1 in 20 adults (or 172,000 people) have heart disease. It's the leading cause of death and accounts for 33% of all death each year.
According to the World Health Organisation, 80% of lifestyle diseases can be prevented if positive health changes are made, like eating a healthy diet, increasing physical activity, reducing alcohol consumption, and abstaining from smoking.
In a healthy diet, fats should account for about 20-35% of the energy you eat. Healthy fats supply valuable fatty acids that help nurture your body and brain, and help you absorb important fat-soluble vitamins and nutrients like vitamins A, D, E, K.
There are different types of dietary fats in food, including unsaturated fats, saturated fats, and trans fats.
Healthy fats, including unsaturated fats and omega 3s - from avocados and nuts for example - will reduce your risk of developing heart disease whereas unhealthy fats, including saturated and trans fats - fatty meats, processed pastries, cakes and pies - will increase your risk.
When it comes to heart disease and healthy eating in general, it’s best to reduce your intake of saturated and trans fats as much as possible. By reducing your saturated fat and adding in healthy fats, you can lower your LDL (low density lipoprotein) ‘bad’ cholesterol by about 6-8%!
Here are some tips:
avoid processed meats like salami and sausages
trim the fat off meat and choose leaner cuts
remove the skin from chicken
try eating more plant proteins like legumes instead of meat 2-3 times per week
choose low-fat dairy products or use calcium fortified dairy alternatives on your cereal or in your coffee instead
replace butter, ghee, and coconut oil with extra virgin cold pressed olive oil for cooking
reduce your intake of processed and refined foods
Also try to include some heart protective unsaturated fats in your diet each day:
add 1tbs of chia seeds or freshly ground linseeds (flaxseeds) to your cereal every morning
enjoy lightly roasted sunflower and pumpkin seeds sprinkled over your cereal, yoghurt, salads, or meals
have a handful (30g) of unsalted nuts as a snack
use avocado or nut butters like peanut butter as spreads
cook with extra virgin cold pressed olive oil and use it as a dressing for salads, soups and meals.
Add legumes like chickpeas, butter beans and cannelini beans to soups and sauces or delicious dips
2. Choose wholegrains
The research on the benefits of wholegrains for heart health is strong. Wholegrain foods, with fibre and rich in nutrients, can help your heart health.
Try to replace refined grains in your diet with wholegrains, including wholegrain cereals, brown grainy breads, rolled oats, brown rice and pasta, pearled barley, quinoa, buckwheat and sorghum.
Did you know? A recent Danish study of 55,000 adults followed over 13 years showed that those who consumed the most amount of wholegrains had a 25% lower risk of having a heart attack than those that consumed the least.
3. Boost fruits and vegetables
Eating a variety of fruits and vegetables daily is important for heart disease prevention. Along with valuable fibre, fruits and vegetables have important antioxidants and phytochemicals which help to protect your heart.
An 8-year European study of 313,000 adults showed that those who had 8 portions of fruits and vegetables daily had a 22% lower risk of heart disease than those who had three portions or less.
Bump up your fruits and vegetables:
add fresh fruits to your cereal or smoothies
pack in a piece of fruit as a snack
have fresh veggie sticks with hummus or a tzatziki dip
fill your wraps and sandwiches with a variety of salads, sprouts, beans and legumes, tomato, cucumber, grated carrot, and olives
fill half your plate with fresh, lightly steamed, sauteed, or stir-fried vegetables at lunch and dinner.
4. Increase plant sterols
Plant sterols help to lower your cholesterol by blocking its absorption from food in your gut, meaning less cholesterol ends up in your bloodstream. Plant sterols are naturally found in very small amounts in plant foods, including plant based oils, nuts, seeds, wholegrains, breads, legumes, fruits and vegetables.
A plant-based diet can supply around 1/2g per day. But, if you need to manage your cholesterol, increasing the amount of plant sterols in your diet may help. Studies show that when 2g of plant sterols are added to the diet each day through a plant sterol enriched food (like cereal, milk or spread) or a plant sterol supplement, it can help reduce your LDL ‘bad’ cholesterol by about 9%!
Plant sterol enriched foods are specifically developed for those with high cholesterol levels. If your cholesterol levels are high, aim for 2-3g of plant sterols per day. Studies confirm that having more than 3g of plant sterols per day is unnecessary, as these higher intakes do not reduce cholesterol levels any further.
Although plant sterols are safe for children and pregnant women, plant sterol enriched foods are not necessary in their diet (unless advised by their health practitioner) as usually they’re not concerned about their cholesterol levels.
There are different plant-sterol enriched foods available in the supermarket. Plant sterols can be added to milk, margarines, breakfast cereal and yoghurts. Check the nutrition panels as they are added in different amounts with varying number of serves required each day to meet the effective dose of 2–3g plant sterols.
5. Aim for more soluble fibres
Soluble or viscous fibres are components of plants that create a gel like texture when soaked or cooked. Some food examples include oats, barley, eggplant, legumes, psyllium husks, chia seeds, and linseeds (or flaxseeds). These fibres also help catch cholesterol in your gut, preventing it from being absorbed into your bloodstream. Studies show that about 10g of viscous fibres each day can lower LDL ‘bad’ cholesterol by around 3-5%.
Key ways to include more soluble fibres include:
add 1 tbs of ground linseeds, chia seeds, or psyllium husks to your cereal each morning
use oats in your cereal, smoothie, or in homemade muffins or breads
add barley to soups or use instead of rice with some meals like risotto
add cooked legumes like lentils, chickpeas, or red kidney beans to your salads, soups and stews regularly · use hummus on sandwiches and wraps (made from chickpeas)
use baba ganoush (made form eggplant) as a dip or spread
aim to include a variety of fruits (2 serves) and vegetables (5 serves) daily.
6. Eat soy
Soy foods including soy beans, soy milk, tofu and tempeh are heart healthy foods. The soy protein, fibre, omega-3 fatty acids, and isoflavones in soy foods can help to lower your cholesterol, improve blood pressure, and help keep your blood vessels flexible.
Consuming as many as 1-3 serves of soy per day (about 25g of soy protein), as part of a healthy balanced diet, can help lower your LDL ‘bad’ cholesterol by around 3-5% and improve heart health.
Boost your daily soy intake by:
adding calcium fortified soy to your cereal, porridge or smoothies every morning
order soy milk based coffees or turmeric lattes
use soy and linseed breads
add firm tofu or tempeh to stir-fries or curries
make chia seed puddings with soy milk
Soy protein content in soy foods
Soy protein content*
Soy beans (cooked)
1 cup (150g)
Soy milk, fortified or flavoured
1 cup (250mL)
1 small tub (200g)
*Source: NUTTAB 2010, Food Standards Australia and New Zealand
7. Munch on nuts and peanuts
Nuts and peanuts contain important amounts of fibre, polyunsaturated fats, magnesium, and vitamin E, which are all important for protecting your heart. If you consume ¼ cup (about 30g) of unsalted nuts each day, you can reduce your risk of heart disease by up to 27%! Or by 31% if peanuts are consumed. When it comes to nuts and cholesterol, about a ¼ cup can help lower your LDL ‘bad’ cholesterol near to 3-5%.
Add some nuts to your meals:
have a handful of unsalted nuts as a midmorning snack
make your own trail mix
add them to your breakfast cereal, salad, stir-fry, or muffin mix
make a creamy nut pesto
use lightly baked nuts as delicious crunchy topping on yoghurt
enjoy natural peanut butter or other nut paste in a smoothie or on brown grainy bread or wholegrain breakfast biscuits.
8. The portfolio foods
The portfolio foods include all the key dietary foods mentioned above (plant sterols, soluble/viscous fibres, soy protein, and nuts) which have an additive effect at lowering cholesterol when eaten in combination (over the course of a day).
These were first discovered by Professor David Jenkins at the University of Toronto, Canada. He showed that when those with high cholesterol ate a controlled low saturated fat diet it lowered their LDL ‘bad’ cholesterol by 9%, but when they ate a low saturated fat diet with portfolio foods, their LDL ‘bad’ cholesterol was lowered by 30% within 4 weeks!! Which provides the same effect as a low dose statin.
So eating a low saturated fat diet with a combination of portfolio foods (plant sterols, viscous fibres, soy protein, and nuts), will provide an additional benefit to lowering your cholesterol than attempting any of these dietary measures alone.
And if you’re on statin medication already, eating portfolio foods - especially plant sterols - will allow your medication to work more efficiently.
Estimated LDL cholesterol lowering effect of the portfolio diet
Estimated LDL cholesterol lowering effect
Reducing saturated fat and adding in healthy fats (PUFA MUFA)
< 7% of total energy from saturated fat
Unsalted nuts and peanuts
Total estimated reduction in LDL cholesterol
9. Reduce salt
High salt intake can increase your heart disease risk by increasing your blood pressure levels.
While limiting the amount of salt you add to your food is important, most of your salt intake can come from processed foods. Read your food labels regularly and aim for foods with less than 400mg of sodium per 100g.
Tips to reduce your salt intake:
avoid highly processed foods like processed snacks and chips
gradually decrease the amount of salt added during cooking, so that your taste buds will adjust · use reduced salt or no added salt stock cubes
use tomato pastes and purees to add flavour
add a variety of herbs and spices to flavour your meals, including garlic, ginger, turmeric, pepper, coriander, parsley, oregano, basil, thyme, sage, rosemary, saffron, chives, mint and cinnamon
10. Be active!
Regular physical activity will increase your HDL ‘good’ cholesterol and keep your heart fit and strong, as well as helping you feel more energetic, happier and relaxed. Try to be physically active most days of the week for at least 30-40 minutes.
11. Keep a healthy body weight
Losing excess weight will help to improve your cholesterol levels, reduce blood pressure, and reduce inflammation. Try to keep your weight within the healthy weight range for your height. Speak to your health practitioner and dietitian for support.
12. Reduce alcohol and avoid tobacco
If you drink alcohol try to minimise the amount and keep to 2 standard drinks on any occasion. Like alcohol, smoking is very harmful for your heart and greatly increases cholesterol and your heart disease risk. If you’re a smoker, speak to your doctor on how to quit.
You can get more information and support on protecting your heart from the Heart Foundation New Zealand.
The Complete Health Improvement Program (CHIP) provides a comprehensive series of workshops that help educate and empower individuals and teams to take better care of their heart and lifestyle. CHIP is offered in a variety of community and work based settings around Australia and New Zealand. If you or your workplace would like to be involved, contact the CHIP team.
Want more information?
Our nutrition fact sheets, created by accredited dietitians, provide the latest nutrition and lifestyle information to help you understand which foods are the best to eat. Click here to see the heart health nutrition fact sheets.
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