How to Eat Your Way to a Healthier Heart

By Dr. Mercola

Your cardiac muscles are rather specialized. While similar to your skeletal muscles in that they’re striated, their functionality more closely resembles your smooth muscles, as the continuous contraction of your heart is involuntary.

Every minute, your heart pumps about 5 liters (1.3 gallons) of blood throughout your body, and for optimal health, it’s imperative your heart continues its duty without interruption for the duration of your life.

As all other muscles in your body, your cardiac muscles need a constant and consistent supply of certain nutrients and their cofactors to operate properly.¹

Interestingly, part of the energy your body requires can be obtained from sunlight, but you must expose your skin directly to it. The ultraviolet (UV) radiation increases nitric oxide (NO) release, which can direct more than half your blood flow to your skin.

Once your blood is exposed to the sun it can absorb UV and infrared radiation, which can help to structure the water in your cells and energize your mitochondria, and your heart has the largest concentration of mitochondria.

Heart Problems Are Often Related to Nutrient Deficiencies

Chronic nutrient deficiencies can lead to a number of heart problems, such as cardiomyopathy (a condition characterized by inflammation, loss of elasticity and enlargement of your heart), heart valve diseases, arrhythmia (irregular heartbeat) and heart failure.

Examples of nutrients that are important for heart health include (but are not limited to) B vitamins (including folate or B9 and B12), carnitine, taurine, coenzyme Q-10 (CoQ10), magnesium, vitamin K2, vitamin D and animal-based omega-3.

All of these also play important roles in keeping your mitochondria working properly. Antioxidant polyphenols are also important for combatting inflammation and damage caused by free radicals.

That said, nutrients rarely work in isolation; rather, they work in synergy with other nutrients, which means supplementing with one without taking care of other deficiencies may not produce beneficial results.

For example, vitamins D, K2, magnesium and calcium work as a synergistic team, and if one is missing, the others will not perform well.

Your best bet is to eat a varied diet of whole foods, rich in fresh fruits, berries and vegetables. For example, recent research suggests a Mediterranean-style diet — rich in fiber and polyphenols — may be more helpful than statin drugs for heart health.

Mediterranean Diet Outperforms Statins for Heart Health

As reported by CNN:²

“The observational study was presented at the European Society of Cardiology conference.³ It showed that the people who have had a history of cardiovascular disease and stuck closest to the diet had a 37 percent lower risk of death compared with those who didn't stick with it.

A Mediterranean diet is one that is heavy on vegetables and legumes, fish, fruit, nuts and whole grains … Carnivores can keep poultry and lean cuts of meat on their Mediterranean menu. Red meat, processed food and sugar are off of it.”

CNN cites statin research showing these cholesterol-lowering drugs reduce your risk for heart problems by about 24 percent, so the Mediterranean diet outperforms these drugs by a significant margin. Other studies have also linked the Mediterranean diet to a lower risk of heart attack and stroke,⁴ and increased longevity.

Originally, Mediterranean Diet Was Actually a High-Fat Diet

Unfortunately, the commonly referred to "Mediterranean diet" actually vilifies healthy saturated fats. Foods like red meats and eggs, according to most reports of the diet, should be eaten sparingly.

However, the truly traditional Mediterranean diet was by no means low in saturated fats. Homemade sausages, raw full-fat milk and cheeses, eggs and, when they could be found, meats like lamb were commonly enjoyed.

So Mediterranean populations were actually eating a high-fat diet for generations, one rich in full-fat animal foods, and still experienced the low rates of heart disease the area is known for. Even today, these foods are quite healthy for you as long as they’re organic and grass-fed or pasture-raised.

Also, many recommend cooking with olive oil rather than butter, which is a terrible recommendation as olive oil will oxidize at high heat. Only eat olive oil cold, drizzled on salads, and make sure it’s  non-adulterated olive oil, as many are mixed with cheaper rancid omega-6 oils.⁵

Butter, coconut oil or lard are best used for cooking, as these can safely withstand heat without oxidizing or going rancid. Definitely avoid processed vegetable oils and margarines.

Paleo Diet Also Reduces Your Risk of Heart Disease

Recent research also suggests switching to the Paleo diet for at least eight weeks can benefit your heart. The preliminary findings were reported at the American Physiological Society's Inflammation, Immunity and Cardiovascular Disease Conference in Westminster, Colorado.

Healthy adults who temporarily traded their typically Western diet (high in processed foods; low in fruits, vegetables and fish) for the Paleo diet saw a 35 percent increase in interleukin-10 (IL-10) levels, which is associated with a lower risk for cardiovascular disease and heart attack. As reported by Medical News Today:⁶

“The Paleo diet is based on foods believed to have been consumed by our hunter-gatherer ancestors, including fruits, vegetables, nuts and seeds, fish, lean meats, and plant-based oils — such as olive oil.

Processed foods, dairy products, potatoes, salt, refined sugar, grains, and legumes should be avoided, as should coffee and alcohol.”

It’s hard to argue against replacing modern processed foods with whole foods from nature. But critics argue that the Paleo Diet may be too restrictive, putting strict followers at risk of nutritional deficiencies and proving to be unrealistic to follow for the average American.

Why Critics Don’t Like Paleo

The criticism largely surrounds the diet’s restriction of grains and dairy, the former of which is actually one of the key reasons why Paleo eating is far healthierthan the average American diet!

In short, the key to a Paleo diet is UNPROCESSED food, which means most grains and bread are out of the picture. Ditto for pasteurized dairy products.

Clearly, the food industry has a stake in dissuading people from eating nothing but whole, unprocessed foods, and if you really think about it, it’s hard to imagine getting FEWER nutrients from whole foods than a processed food diet.

Another oft-cited criticism of the Paleo diet is minimal research supporting its benefits, although there are clinical trials (albeit small ones) that do support its use. For instance, a study⁷ by researchers from the University of California had out-of-shape volunteers eat a Paleo diet for just two weeks.

In that time, their blood pressure levels decreased, as did their levels of cholesterol, by an average of 30 points, which the researchers compared to “the type of drop you get by taking statins for six months.” Their levels of triglycerides also improved.

Another study⁸ published last year found the Paleo diet improved glucose control and lipid profiles in type 2 diabetics, compared to those who ate a diet based on recommendations by the American Diabetes Association (ADA) containing moderate salt intake, low-fat dairy, whole grains and legumes.

On the whole, science backs up the use of diets where the focus is on real food, be it Mediterranean or Paleolithic in style.

Not only do these diets do away with processed fare, which is a key factor for any healthy diet, they also focus on foods high in naturally-occurring antioxidants, which help combat the root of most chronic illness, namely inflammation.

While Paleo is a great start in the right direction, it is missing some key components and the primary one for most versions is a failure to appreciate the importance of avoiding excessive protein.

Too much protein stimulates mTOR and decreases autophagy, thereby increasing your risk of cancer and heart disease. A far better strategy is nutritional ketosis.

The Importance of Antioxidants 

Antioxidants as a group help protect the cells in your body from free radical damage, thereby controlling the rate at which you age. If your body does not get adequate protection, you can generate excessive free radicals, which degrades cellular function and increases your risk for not only heart disease but also cancer and neurological dysfunction. Antioxidants can be divided into three major groups:

• Carotenoids, previtamin A found in plant foods, discussed in greater detail in my "Basic Vitamin A Primer"

• Allyl sulfides, found in garlic and onions

• Polyphenols, which can be further broken down into four subcategories: flavonoids, stilbenes, lignans and phenolic acids.

Polyphenols give fruits, berries and vegetables their vibrant colors and contribute to the bitterness, astringency, flavor, aroma and oxidative stability of the food. There are over 8,000 identified polyphenols found in foods such as tea, wine, dark chocolate/cacao, fruits, vegetables and extra virgin olive oil, just to name a few, and they play an important role in maintaining your health.

Polyphenols Help Protect Your Heart

The research supporting polyphenols in the prevention and treatment of cardiovascular disease is well documented.⁹ For example, one recent study¹⁰ found that higher intakes of fruit-based flavonoids (specifically anthocyanin-rich foods — fruits and berries with a blue, red or dark purple hue — and those high in flavanones, particularly citrus fruits like grapefruit, lemons and oranges) decreased the risk of nonfatal myocardial infarction and ischemic stroke in men.

Keep in mind that in order to reap these benefits, you need to eat the whole fruit, NOT fruit juice, which is simply too high in fructose. Excessive fructose is associated with insulin resistance and associated health problems, including diabetes and heart disease. Here’s a sampling of other studies showing the benefits of antioxidants on heart health:

• Research published in the British Journal of Nutrition — a systematic review of 14 studies — found that intake of six classes of flavonoids: flavonols, anthocyanidins, proanthocyanidins, flavones, flavanones and flavan-3-ols, can significantly decrease your risk of heart disease¹¹
• Researchers have puzzled over how flavonoids help prevent heart disease, but one recent study¹² suggests it has to do with the fact that metabolism of flavonoids enhances their bioactivity in endothelial cells, which form the lining of your blood vessels
• Flavonoids also help to reduce the clumping of platelets in your blood.¹³ Platelet clumping is one potential precursor in heart attacks and angina
• As antioxidants, polyphenols scavenge free radicals and reduce inflammation in your body
• Polyphenols also inhibit vascular endothelial growth factor (VEGF), which causes complications with atherosclerotic plaques in the arteries, a factor in cardiovascular disease¹⁴

Other Health Benefits Associated With Polyphenol-Rich Diet

Besides protecting your cardiovascular system and promoting normal blood pressure, polyphenols also help:^15,16

✓ Fight cancer cells and inhibit angiogenesis (the growth of blood vessels that feed a tumor)	✓ Protect your skin against ultraviolet radiation
✓ Fight free radicals, and reduce the appearance of aging	✓ Promote brain health and protect against dementia
✓ Reduce inflammation	✓ Support normal blood sugar and lipid levels; citrus flavanones specifically have been shown to help prevent obesity-related diabetes, non-alcoholic fatty liver disease (NAFLD) and heart disease linked to the Western-style diet17,18,19

Vitamin B9 May Protect Against Congenital Heart Defects

Recent research also suggests folic acid — a B vitamin typically recommended for pregnant women to protect the growing fetus from neural tube defects — can help prevent congenital heart defects.^20,21 Data from nearly 6 million Canadian births between 1990 and 2011 was analyzed for this study.

Folic acid food fortification was made mandatory in Canada in 1998, so the study was set up to examine the effect of folic acid fortification on specific congenital heart diseases.  After confounding factors were eliminated, children of women who ate folic acid fortified foods had:

• An 11 percent lower rate of congenital heart defects
• 27 percent lower rate of severe heart outflow tract abnormalities
• 23 percent reduction in narrowing of the aorta
• 15 percent lower rate of atrial and ventricular septal defects

Ideally, you would get your B9 (folate) vitamins from naturally-occurring folate in plant foods. Folic acid is the synthetic form of B9 used in supplements. (To remember this difference, think “folatecomes from foliage,” i.e., edible leafy plants.) For folic acid to be of use to your body, it must first be activated into its biologically active form: L-5-MTHF.

Many have difficulty converting folic acid into the bioactive form due to a genetic reduction in enzyme activity. For this reason, if you take a B vitamin supplement, make sure it contains natural folate rather than synthetic folic acid.

Nutritional yeast is an excellent source of folate. ²² Other good sources include fresh, raw and organic leafy green vegetables, especially broccoli, asparagus, spinach and turnip greens, and a wide variety of beans, especially lentils, but also pinto beans, garbanzo beans, navy beans, black beans and kidney beans.²³

Omega-3 Fats Reduce Heart Attack Mortality

Omega-3 fats are essential to your overall health, including your heart health. A recent analysis of 19 studies confirms that regular consumption of fish and other omega-3 rich foods, including certain plant-based sources, may lower your risk of a fatal heart attack (myocardial infarction) by about 10 percent.^24,25,26 Other studies have found even more significant effects.

One large Italian trial found that heart attack survivors who took 1 gram of omega-3 fat each day for three years had a 50 percent reduced chance of sudden cardiac death.²⁷ Omega-3 fats benefit your cardiovascular health in a number of different ways. In addition to lowering your blood pressure and triglyceride concentrations and improving endothelial function (a major factor in promoting the growth of new blood vessels), research has demonstrated omega-3s are:

• Antiarrhythmic: counteracting or preventing cardiac arrhythmia
• Antithrombotic: tending to prevent thrombosis (a blood clot within a blood vessel)
• Antiatherosclerotic: preventing fatty deposits and fibrosis of the inner layer of your arteries from forming
• Anti-inflammatory: counteracting inflammation (heat, pain, swelling, etc.)

However, it’s crucial to understand that not all omega-3 fats are identical, and that omega-3s from plant and marine sources are not interchangeable. To learn more about this, please see my previous article, “How Good Fats Prevent Heart Disease,” which delves into the differences in greater detail, explaining why animal-based omega-3 is so important and why it cannot be replaced by plant-based omega-3. In summary:

• Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) found in marine animals are structural elements with many biological effects, most notably anti-inflammatory activity and communication within the cell and between cells.

DHA is one of the most important biological molecules we have, as it is responsible for converting light into electrons that nourish your heart. This is why when you consume DHA, your body plugs it into your cell membranes, which is unlike nearly every other fat. Making certain that you have enough DHA, in my view, is one of the most vital eating decisions you can make. The ideal source is healthy seafood.

• The alpha-linolenic acid (ALA) found in plants is a precursor to EPA and DHA. However, an enzyme is required to convert ALA into the longer-chained omega-3s. Don’t fool yourself, as it is nearly impossible for anyone to convert enough ALA to DHA; it simply doesn’t happen. You need healthy seafood. Remember, most all restaurants sell unhealthy farmed fish.

For a Healthy Heart, Eat Real Food  

One of the easiest ways to ensure good heart health is to eliminate processed foods, which are high in all things detrimental to your health: sugar, net carbs, especially processed fructose, and dangerous types of fats (such as processed vegetable oils). Replace these foods with REAL FOOD, rich in healthy fats and important heart-healthy vitamins and minerals, some of the most important of which are: 

• B vitamins, especially folate and B12
• CoQ10 (if you’re over 40, I recommend using the reduced version, ubiquinol)
• Combo of magnesium, calcium, vitamins D3 and K2. It is also key to understand that you were designed to get your vitamin D from solar exposure and when you don’t, you seriously compromise your body’s ability to optimize health. You need all the wavelengths in balanced proportion to stay healthy.  UV and infrared rays are essential for your health.
• Marine-based omega-3 fat, found in fatty, cold-water fish such as wild Alaskan salmon, herring, sardines, anchovies, fish roe and krill oil
• Antioxidant polyphenols found in richly-colored vegetables, fruits and berries

Also make sure to get sufficient amounts of healthy fats in your diet, including saturated animal fats. These tips can help ensure you’re eating the right fats for your health:

• Use organic butter (preferably made from raw milk) instead of margarines and vegetable oil spreads. Butter is a healthy whole food that has received an unwarranted bad rap. Most health food stores can direct you to sources for locally made butter. If this is not possible and your only choice is a conventional grocery store, then Kerry Gold is probably your best choice.
• Use coconut oil for cooking. It is far superior to any other cooking oil and is loaded with health benefits. (Remember that olive oil should be used COLD, drizzled over salad or fish, for example, not to cook with
• Be sure to eat raw fats, such as those from avocados and raw dairy products
• Following my nutrition plan will automatically reduce your unhealthy fat intake, as it will teach you to focus on healthy whole foods instead of processed junk food

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