Heart disease is the leading cause of death for both men and women in the United States, and according to the Centers for Disease Control and Prevention (CDC), one person dies every 36 seconds in the U.S. from cardiovascular disease. These statistics are staggering: That’s why doctors say it is important to take control of your heart health with a healthy diet. However, knowing exactly how to do that can sometimes be overwhelming and confusing.
“There are a lot of reasons Americans struggle with cardiovascular disease, which are multifaceted, complex, and ingrained in cultural factors and subconscious decisions that are very difficult to unpack,” explained Dr. Brittany Owen, assistant professor of cardiovascular disease with McGovern Medical School at UTHealth Houston who is affiliated with Memorial Hermann-Texas Medical Center. “In addition to that, the continued evolution of information and the stream of misinformation only add to the confusion for the general public.”
Dr. Owen used the example of eggs to illustrate how much the field continues to change as researchers learn more about what is truly healthy for the heart.
“When I was growing up, eggs were considered incredibly unhealthy because they contain cholesterol,” Dr. Owen said. “Now we know that, in moderation, eggs are actually good for you. It’s a constantly evolving field, like all of science and medicine.”
So what, exactly, is considered a heart healthy diet and lifestyle? Below, Dr. Owen breaks down the most common heart health myths vs. facts.
MYTH: If I lose weight on the latest fad diet, it will decrease my risk of developing heart disease.
FACT: The truth is, the vast majority of these diets are not clinically proven to promote cardiovascular health, and more often than not, fad diets will lead people to ultimately rebound to their old habits and gain back more weight than they originally lost. There are actually only a few diets that are clinically proven to help individuals lose weight and improve their cardiovascular health. One is the DASH diet, which is especially helpful for individuals with salt sensitive hypertension. The DASH diet is rich in vegetables, fruits and whole grains and it limits foods that are high in saturated fat, including red meats and full-fat dairy products. The Mediterranean diet has also been shown to be beneficial for reducing risk of cardiovascular disease, especially in patients who have high cholesterol or who have already been diagnosed with coronary artery disease. The Mediterranean diet is inspired by the eating habits of populations who live near the Mediterranean Sea and who tend to have very low incidences of heart disease. This diet is comprised mostly of plant-based foods including vegetables, fruits, whole grains, legumes, nuts and seeds.
Ultimately, if a person wants to lose weight it is typically achieved through portion control and being mindful of your calorie intake. Exercising is also extremely beneficial for a person’s heart health and something we always recommend.
It is also important to note that even losing a little weight can be beneficial to a person’s heart health. We know that many people feel overwhelmed when they begin their weight loss journey because it can seem like an insurmountable task to reach their ideal weight, but studies have shown that even after just 10 pounds of weight loss, there can be a measurable improvement in cardiovascular function and overall health.
MYTH: All fats are bad for your heart.
FACT: This is not true, as not all fats are created equal. In fact, fat is a necessary element in any balanced diet. Still, some fats are better than others, including unsaturated fats, which can help improve cholesterol levels by decreasing LDL cholesterol (known as the “bad” cholesterol) and increasing HDL cholesterol (the “good” cholesterol). Olive oil, which is a staple in the Mediterranean diet, is a great example of an unsaturated fat. Saturated fats, which are found in butter, palm and coconut oils, cheese and red meats, should be limited for a heart healthy diet. Trans fats, which are common in highly processed foods, are the worst kind of fat and should be avoided as much as possible.
MYTH: If I walk 10,000 steps a day, that is equal to 30 minutes of dedicated cardiovascular exercise.
FACT: Although it is important to your overall health to be active, walking 10,000 steps a day is not enough exercise to prevent cardiovascular disease. Research has shown that individuals should complete approximately 30 minutes of cardiovascular exercise most days each week to improve their heart health. A good measure for whether you are achieving a cardiovascular benefit during exercise is if your heart rate goes up and you are able to break a sweat. If this is not something you currently do, I recommend that you work with your doctor to slowly increase your fitness level until you can reach this goal.
MYTH: Vaping is better for your heart health than smoking.
FACT: This is simply not true. Inhaling hot air is never good for your lungs, no matter if it is coming from a cigarette, a vape pen, or any other method. Vapor is damaging to your lungs, period. Even more, people who vape are also inhaling toxic chemicals and oils that scar the lungs. For individuals who vape with nicotine, they are also raising their blood pressure, which can lead to hypertension. While I support individuals who are trying to quit smoking, vaping is not a healthy alternative. I would encourage anyone who is trying to quit to speak to his or her health care provider, as there are many healthier alternatives to breaking this addiction.
MYTH: Older Americans should take an aspirin a day to prevent heart attacks.
FACT: Although aspirin has been shown to prevent heart attacks, it also carries with it an added bleeding risk. Recent research has now led to a reversal in this recommendation, and cardiologists are now recommending that patients work closely with their providers to discuss whether they should engage in a daily aspirin regimen based on their risk factors and health history. According to the U.S. Preventative Services Task Force, people ages 40 to 59 who are at a higher risk for cardiovascular disease and do not have a history of cardiovascular disease should work with their physicians on this decision, and people age 60 or older should not start taking aspirin for heart health or stroke prevention.
MYTH: Good cholesterol can offset bad cholesterol.
FACT: Unfortunately, this is not true. High levels of the good cholesterol (HDL) do not offset high levels of the bad cholesterol (LDL). Ideally, a person’s LDL numbers should be lower than 70, and their HDL should be higher than 40 but lower than 90. Olive oil, fruits high in fiber, nuts and avocados are all good sources of HDL, or good cholesterol.
MYTH: Sea salt is better than table salt when it comes to heart health.
FACT: The truth is, sea salt and table salt are processed in your body the same way, so they have the same effects on your cardiovascular health. We recommend limiting salt intake to avoid high blood pressure.
MYTH: Organic foods are healthier than non-organic foods.
FACT: When it comes to heart health, this is, by and large, not true. Organic cheddar cheese and non-organic cheddar cheese are both high in saturated fat and not considered “heart healthy.” The same can be true for all foods; putting the “organic” label on anything does not automatically change its component and make it healthy, it is simply a descriptor for how it was made or grown.
MYTH: Only eat egg whites and not the yolks to improve heart health.
FACT: The idea of egg whites goes back to the myth that eggs were bad because they contained cholesterol. Egg whites are pure protein, but they do not contain any other significant nutrients, whereas, egg yolks are comprised of important nutrients, including lutein, choline, folate, vitamin B12, and fat-soluble vitamins A, D, and K, among others. The yolk also does contain some fat and cholesterol, but a whole egg, white and yolk together, is considered a nutrient-dense food and is heart-healthy when consumed in moderation.
MYTH: Coconut oil is a heart-healthy cooking alternative
FACT: When it comes to heart health, nothing seems to beat olive oil. Not only is it a staple of the heart-healthy Mediterranean diet, but it has been shown to lower cholesterol, whereas, coconut oil is known to raise cholesterol.
MYTH: The caffeine in coffee is bad for the heart.
FACT: Although studies have varied quite a bit when it comes to coffee and caffeine consumption, the current consensus is that two to three cups of coffee a day has been associated with overall better heart health. With that said, if you have arrythmia or extra heart beats in the form of premature atrial contractions (PVCs) or premature ventricular contractions (PACs), the caffeine in coffee can stimulate or worsen palpitations and should be avoided.
MYTH: As long as I keep the recommended dietary allowance of alcohol, I can drink without worrying about its effects on my heart health.
FACT: The science behind alcohol and heart health seems to be evolving by the day. Although many studies have shown that red wine can be beneficial to heart health, that is not necessarily the entire story. As with most things, alcohol must be consumed in moderation, and even in moderation, there are negative risks associated with alcohol consumption. I would encourage anyone with a heart condition or who is at risk for cardiovascular disease to work closely with their doctor to determine whether it is safe to consume alcohol.
Dr. Owen added that although the information surrounding heart health can seem confusing, individuals can always reach out to their health care providers for guidance and clarity. Ultimately, she said that if a person lowers his or her intake of foods containing saturated and trans fats, engages in cardiovascular exercise for 30 minutes a day, and loses excess weight, they have already made potentially lifesaving improvements in their heart health.