We often define our diet by what we’re not eating rather than the foods that make up most of our daily meals and snacks. I’ve found this to also be true after clients have heart attacks. Understandably, many people don’t want to eat after a cardiac event because they’re fearful of triggering another one. 

What you’re eating is a crucial component of your heart health no matter what your concern may be. For instance, research shows nutrient deficiencies are common among adults with heart failure. One 2018 paper from the Journal of the American Heart Association found that more than 20% of this population has a low dietary intake of vitamin A, calcium, magnesium, selenium, and iodine, while nearly three-quarters don’t get enough vitamin D. 

On top of this, with the countless options for convenience items around us, it’s easy to fall into the standard American diet trap or get confused by diet advice that promotes the extreme restriction of all sorts of foods. Unfortunately, this can lead to a situation where your diet lacks quality nutrients that support heart health. 

Put these factors together and you’ve got a recipe for poor nutrition, which isn’t just detrimental to your heart health, but your overall well-being. In this article, I want to explore the link between nutrient-dense food and heart health, including how to improve the nutrient density of your diet.

Key Nutrients for Heart Health

A heart-healthy diet includes a combination of macronutrients and micronutrients. Let’s take a closer look at the roles these play in your cardiovascular function. 

Macronutrients

The macronutrients include fats, protein, and carbohydrates, which you need in larger amounts to support optimal health. We often hear about why we should limit one or more of these in our diet, but they’re all important. Here is the role that each one plays: 

• Fat: Fat is needed to absorb fat-soluble vitamins A, D, E, and K and antioxidants like fat soluble carotenoids. Healthy fats, found in foods like nuts, seeds, avocados, and fatty fish, provide essential fatty acids like omega-3s. These help reduce inflammation and lower the risk of heart disease. Excessive intake of saturated and trans fats, commonly found in ultra-processed foods and fried items, can raise LDL. Saturated fats are also found in seemingly healthy foods like coconut oil (which is mostly saturated fat!).
• Protein: Protein helps preserve lean body mass. Lean sources of protein, like poultry, fish, legumes, and nuts provide amino acids for building and repairing tissues. High-quality protein also promotes satiety and supports healthy weight management, which reduces the risk of heart disease.
• Carbohydrates: Carbs are your body’s preferred energy source. Complex carbohydrates from whole grains, fruits, vegetables, and legumes offer fiber, vitamins, and minerals. They help regulate blood sugar, promote healthy digestion, and contribute to satiety and weight management. Choose fiber-rich complex carbs over refined sugars and processed grains. 

Micronutrients

Micronutrients (vitamins and minerals) are needed in small amounts compared to macronutrients but are still important for maintaining a healthy heart. The best way to get them is by eating fruits, vegetables, whole grains, lean proteins, nuts, and seeds. Below are some of the most important for heart health.

• Selenium is an antioxidant and reduces inflammation. It’s needed for the proper function of enzymes involved in managing oxidative stress and the glutathione pathway, which indirectly affects cardiovascular function.
• Iodine is essential for thyroid hormone production, which is crucial for maintaining heart rhythm and regulating blood pressure.
• Vitamin C acts as an antioxidant. It also reduces inflammation and supports collagen synthesis, which is important for maintaining the integrity of blood vessel walls.
• Vitamin D helps regulate blood pressure, support immune function, reduce inflammation, and prevent atherosclerosis and heart failure.
• Vitamin K2 helps direct calcium away from your arteries and into your bones, which can reduce the risk of arterial calcification.
• Zinc acts as an antioxidant, reducing inflammation, supporting immune function, and playing a role in regulating blood pressure and cholesterol.

Nutrimetabolomics

Relative to understanding the importance of a nutrient-dense diet for your heart is something called nutrimetabolomics. This is an evolving field of research combining principles of nutrition and how it impacts the function of your body systems.

Nutrimetabolomics seeks to understand how the vitamins, minerals, and other aspects of our diet interact with metabolism to influence health and disease. While more research is needed,  the study of nutrimetabolomics could help find compounds in nutrient-dense foods that protect health. For example, identifying foods rich in phytochemicals that target inflammation and oxidative stress — reducing the risk of disease.

For example, a 2024 study published in The Journal of Nutrition examined salmon food-specific compounds and how they changed certain metabolites in the body when people consumed a salmon-containing Mediterranean-style diet. Similar research has found that bioactive compounds in olive oil and quinoa, like phenolic compounds and oleic acid, have specific benefits for cardiovascular health. 

What we’re eating impacts us at a cellular level. Knowing this can be motivating for increasing our intake of the most nutrient-dense foods.

Creating a Nutrient-Dense Diet for Your Heart

Nutrient-dense foods provide a high amount of nutrients — like vitamins, minerals, fiber, and other compounds — relative to their calorie content. On the other hand, nutrient-poor foods tend to be high in calories but low in overall nutrients (think ultra-processed foods and sugary sodas).

When creating a diet that prioritizes the most nutrient-dense foods, keep these in mind:

• Whole grains, like barley, quinoa, and oats, are slowly digested complex carbs and high in fiber
• Lean proteins like fish and plant-based proteins like beans, peas, lentils, nuts, seeds, and soy foods
• Healthy fats and omega-3s from foods like salmon, tuna, mackerel, avocados, ground flax seeds, walnuts, and olive oil
• Colorful fruits and vegetables rich in antioxidants, such as berries, leafy greens, sweet potatoes, bell peppers, cruciferous vegetables, and citrus fruits
• Low-fat dairy products and dairy alternatives made from plants like soy, oats, or cashews

Practical Tips 

Changing your diet can feel overwhelming, especially if you have an increased risk of a previous heart attack. Here are some practical tips to help you take it one step at a time. 

1. Identify specific areas for improvement. Start with 1-2 things you can do right now. Start by evaluating your typical diet in a week, for example. Where could improvements be made? Maybe there’s an opportunity to increase the fiber content of your breakfast by adding nutrient-dense whole grains to a meal or adding more servings of vegetables to your day. 

2. Make a habit of meal planning. Carve out some time to plan meals and snacks for the week, shop accordingly, and prepare some things ahead of time. Consider how you can batch prep certain things, like a pot of rice for the week or chopping vegetables to be used in recipes. 

3. Start reading packaged food labels. This helps you make informed choices, especially when examining things like added sugar, sodium, and net carbohydrate content. 

4. Increase the diversity of your diet. The more variety in your diet, the more nutrients. Aim to incorporate fats, protein, and carbs at each meal. Add more color to your plate, particularly from fruits and vegetables.

5. Practice portion control and mindfulness. If you have a habit of snacking out of the bag or eating meals in front of the TV, you’re not alone. Start by reducing distractions and being more intentional about what’s on your plate. 

6. Stay hydrated. Drink water throughout the day. This helps maintain adequate blood volume and supports circulation and delivery of oxygen and nutrients to your heart and other organs. Hydration is important for regulating blood pressure and removing waste from your body. 

Client Success Story: Turning Fear into Success

A 50-year-old woman came to see me two weeks after she had a massive heart attack. Her heart attack was complicated by pericarditis and she was having a hard time catching her breath. She was overwhelmed with the diet information out there. She was scared to eat in fear that she would have another heart attack and it would exacerbate her pain.

She joined my VIP program and we worked closely together to optimize her lifestyle and diet through science-based nutrition. She had no recent blood work since she hadn’t gone for a physical in several years. 

She had clear underlying inflammation, a trigger for the cardiac event. The evidence of inflammation included an increased waist circumference of 44 inches, pericarditis, and a complete blockage in the LAD artery.

We worked on reducing inflammation, oxidative stress, and insulin resistance, and optimizing all potential risk factors to reduce her risk of any future cardiac complications. She decreased her waist circumference by 4.5 inches in 1 month. Her shortness of breath resolved. Her lab results also improved (LDL was 67mg/dL (target post heart attack <70mg/dL), non-HDL cholesterol which assessed more for atherogenic plaque potential was 81mg/dL (target post heart attack <80-100mg/dL).

Let’s Optimize Your Heart Health

Optimizing your cardiometabolic risk factors requires taking a comprehensive look at your everyday lifestyle habits and overall diet. In addition to things like adequate sleep, hydration, stress management, and exercise, eating nutrient-dense foods is essential. 

Many individuals need a personalized plan to achieve these nutrients in the right doses for their body to achieve therapeutic results in their labs and their cardiovascular health. If you are looking for a cardiovascular dietitian to improve your heart health through science based nutrition, consider scheduling a 1:1 counseling session with me or joining my group Heart Health Optimization program. 

Resources

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8. Hariri E, Kassis N, Iskandar JP, et al. Vitamin K2-a neglected player in cardiovascular health: a narrative review. Open Heart. 2021;8(2):e001715. doi:10.1136/openhrt-2021-001715

9. Knez M, Glibetic M. Zinc as a Biomarker of Cardiovascular Health. Front Nutr. 2021;8:686078. Published 2021 Jul 30. doi:10.3389/fnut.2021.686078

10. Hill EB, Reisdorph RM, Rasolofomanana-Rajery S, et al. Salmon Food-Specific Compounds and Their Metabolites Increase in Human Plasma and Are Associated with Cardiometabolic Health Indicators Following a Mediterranean-Style Diet Intervention. J Nutr. 2024;154(1):26-40. doi:10.1016/j.tjnut.2023.10.024

11. Berman R. Scientists find compounds in salmon that may lower cholesterol, heart disease risk. Medical News Today. Published 5 Feb 2024. Available: https://www.medicalnewstoday.com/articles/unique-compounds-salmon-lower-cholesterol-heart-disease-risk#What-is-nutrimetabolomics?

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