A stent is a tube surgically placed into your arteries (which take blood from your heart to the rest of your body) to keep them open. When clogged with plaque the artery becomes more stiff, narrow, and rigid which is coronary artery disease (CAD). This can ultimately cause a blood clot that triggers a heart attack. 

While a stent may prevent or stop a heart attack, it’s not a CAD cure. Other lifestyle changes — like a nutrition overhaul — are critical for continued health. In this article, we’re focusing on what to avoid after stent placement in your diet. 

First, a Success Story

Nutrition plays an enormous role in heart attack and post-stent recovery and in the prevention of further heart health complications. As a cardiology dietitian, I’ve met with countless individuals in this situation. When a stent is placed or you experience a heart attack, it can feel like information overload. 

I continue to be mind-blown by my clients’ results, like this one. 

​​​​A 44-year-old gentleman came to see me after three heart attacks and six stent placements. He had changed his diet on his own multiple times but was confused about what he was “doing wrong”.​​​​​​​​ His doctor had him preparing to return in a month for his 7th stent.

We began working together to optimize his labs. He started with an LDL cholesterol of 95mg/dL (which should be less than 50mg/dL in a heart attack survivor on a statin). He also had a non-HDL cholesterol (an indication of atherogenic apoB cholesterol) of 113mg/dL (which should be less than 80 mg/dL).

To target these labs, we added therapeutic foods to optimize his blood vessel health and reduce inflammation. After 1.5 months, his doctor said he no longer needed that 7th stent!

His new lab results showed a LDL of 41mg/dL and a non-HDL cholesterol of 54mg/dL, ideal numbers for this high risk individual. My client stated how much more energy he has now. He doesn’t remember ever feeling this good — and I am so proud of him. 

Diet After Heart Attack and Stents: The Goal

My aforementioned client had tried making nutrition changes on his own. While his intentions were good, he ended up having several heart attacks despite taking all of his prescribed medications. What was he doing wrong?

First, what are the goals of a diet after a heart attack? A nutrient-sufficient heart-healthy diet goals should focus on the following: 

• Stabilizing the plaque already present in your arteries
• Preventing further promotion of plaque
• Reducing the stress on the heart so it can function optimally to prevent heart failure, heart enlargement, and heart pumping complications
• Optimizing all the risk factors you may have, such as lowering LDL, apoB, and non-HDL cholesterol, hs-CRP inflammation markers, insulin resistance, and waist circumference
• Addressing the underlying root causes of heart disease, like inflammation, oxidative stress, insulin resistance, overweight or obesity, and plaque buildup 

The diet changes my client made before meeting with me didn’t work because he didn’t do any of the things on this list. In fact, those previous changes made all of these factors worse, furthering the progression of his plaque buildup and arterial blockages, leading to another heart attack. 

What to Avoid After Stent Placement

As with any other health goal or condition, there’s not any one single food or ingredient that makes all the difference. What matters most is understanding how the nutritional quality of your overall diet is benefitting or causing harm to your heart health — and doing what you can to minimize the latter. 

1. Refined carbohydrates 

First of all, cutting carbs isn’t the answer. Low-carb diets ignore that carbs are super important for your health — it’s just that people aren’t eating many of the right ones. 

The problem is that most modern carb-containing foods we’re surrounded by are ultra-processed and refined. This means they offer little to no fiber and are typically high in added sugar. Think pastries, donuts, potato chips, and cookies. 

These carbs leave us dissatisfied and reaching for more without contributing essential heart-healthy nutrients. They also take up space for healthier carb sources in our diet. 

On the other hand, complex carbs provide energy and fiber, an important nutrient (which most people lack) that can help reduce high cholesterol and heart disease risk. These include fruits, starchy vegetables, whole grains, and legumes. 

2. Foods cooked at high temperatures

Common high-heat cooking methods include grilling, frying, and broiling. Foods cooked at high temperatures produce various compounds that can threaten heart health, including: 

• Heterocyclic amines (HCAs)
• Polycyclic aromatic hydrocarbons (PAHs)
• Advanced glycation end products (AGEs)

These compounds are formed when meat, poultry, fish, or tofu are cooked at high temperatures (above 300°F), particularly when they come into direct contact with an open flame or hot surface. Research suggests that consuming foods containing high levels of HCAs, PAHs, and AGEs may increase the risk of cardiovascular diseases by promoting inflammation and oxidative stress, which are linked to the development of heart problems. 

Swap high-heat cooking for healthier methods like stewing, braising, and roasting on low to medium temperatures.

3. Red meat and TMAO

Red meat consumption has been linked to an increased risk of heart disease due to several factors. One of these is the production of trimethylamine N-oxide (TMAO) in the body, a compound formed by the liver when gut bacteria metabolize certain nutrients in red meat, particularly carnitine and choline. 

Elevated levels of TMAO have been associated with a higher risk of cardiovascular events, like heart attacks and strokes, by promoting inflammation, impairing cholesterol metabolism, and promoting atherosclerosis. 

More heart-healthy protein choices are lean proteins like omega-3 fatty fish, poultry, and plant-based options like legumes, nuts, seeds, and tofu. 

4. Sugary beverages

Consuming sugary beverages regularly has been strongly associated with an increased risk of heart disease. Soda and similar drinks provide calories from added sugar but no real nutrition. 

Over time, regularly consuming them can contribute to weight gain and obesity, which are significant risk factors for heart problems. Sugary drinks can raise levels of triglycerides and LDL cholesterol.

Excessive added sugar intake can also promote elevated blood sugar levels and insulin resistance, which are linked to increased inflammation and risk of heart attacks and strokes. 

What to choose instead? Prioritize water, herbal teas, or unsweetened seltzers.

5. Ultra-processed foods

Surveys have found that at least 60% of the calories Americans consume today are from ultra-processed foods. These foods tend to provide “empty calories” or calories without beneficial nutrients. 

Ultra-processed foods are made with no or minimal whole foods ingredients and have undergone significant processing to make them convenient, hyper-palatable, and appealing. Frequent consumption can cause high levels of cystatin C, a protein used as a biomarker for kidney function and premature cardiovascular death.

Examples include prepared soups, sauces, ready-to-eat meals, frozen pizza, store-bought cookies, and more. 

Designing a Heart-Healthy Diet After Heart Attack and Stent

The right diet after a heart attack and stents will follow the recommendations above. To experience success like my clients, a personalized plan will also account for your lifestyle, cultural preferences, and individual factors to encourage long-term sustainability. It’s important to understand the science-based nutrition behind your diet plan. 

Need some support and guidance? Join my 6-week Heart Optimization Group Program! If you want a more personalized approach, learn more about my 1:1 counseling here and schedule a complimentary discovery call to discuss further.

References

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