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Three Strategies for Heart Healthy Eating

Last updated: 7/12/21
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By Constance Brown-Riggs

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of several nutrition books for people with diabetes.

​Nutritionist and educator Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, discusses the relationship between food and heart health, and how you can make eating choices to prevent heart disease.

If you have diabetes, you are at a much higher risk for heart disease. The good news is, there are steps you can take to lower your risk. What you eat is one of the most important steps to managing diabetes and reducing your chances of heart complications. What are the three main ways to do this? Choose heart-healthy fats, heart-healthy carbs, and reduce sodium in your diet.

Many people find that changing eating behavior is very hard. But it doesn’t have to be that way – not if you take the right approach. Some people use a food tracker to see how much of certain nutrients like carbohydrates, fat, salt, they are eating. And research shows that making small, gradual changes works best. Rather than drastically changing your eating habits in a day, start with setting just a few small, achievable goals that you can stick with. To help you get started, you will find tips and “small wins” throughout this article – these step-by-step changes can make your meals and recipes healthier for your heart.

Education is key to managing diabetes and heart health. Click here to learn about Diabetes Self-Management Education and Support (DSMES) services to help you live well and navigate your diabetes journey – and check out the Diabetes Food Hub for even more resources.

1: Choose Your Fat Wisely

Dietary fat often gets a bad rap. So, it might surprise you to know that fat plays a vital role in our health. We need fat to insulate our body, protect our vital organs, and transport and absorb vitamins A, D, E, and K.

Fat is also the most concentrated energy source for the body, providing nine calories per gram, more than double what is found in carbohydrates and protein. And when it comes to food, there is no denying fats’ ability to make food taste good.

Fats are made up of fatty acids that are linked together. There are three types of fatty acids: saturated, monounsaturated, and polyunsaturated. The predominant type of fat in a food determines which category the food falls into:

  • Saturated fat is usually solid at room temperature and is found mainly in foods that come from animals, such as meat, lard, bacon, poultry, dairy products, and eggs. Coconut oil, palm kernel oil, and palm oil are also saturated fats. This type of fat can cause your body to produce too much cholesterol (a natural substance that the body needs, but in limited quantities – read all about cholesterol here).

  • Monounsaturated fat is usually liquid at room temperature. Monounsaturated fat is mainly found in vegetable oils such as canola and olive oils, avocadoes, and peanuts. Monounsaturated fats are often called heart-healthy fats because they don't cause higher cholesterol levels.

  • Polyunsaturated fats are usually liquid or soft at room temperature. Polyunsaturated fat is found mostly in vegetable oils such as safflower, sunflower, corn, and flaxseed. It’s also found in walnuts and fish like salmon, albacore tuna, herring, and mackerel. Polyunsaturated fats are also heart-healthy fats because they don’t increase cholesterol levels.

  • Trans fats are polyunsaturated fats that have been chemically changed to make them stay solid at room temperature. Hydrogenated vegetable oils such as vegetable shortening and margarine contain trans-fatty acids – as do the foods you make with these oils. Trans fats act like saturated fat in the body, raising your cholesterol levels. The American Diabetes Association recommends avoiding foods with trans fats as much as possible.

When it comes to the heart, monounsaturated and polyunsaturated fats are much better for you. Read “Dietary Fat: The Good, The Bad, and The In-Between” to learn more. Here are some tips for adding more heart-healthy fats to your diet:

Small Win:  Shift the fat you use from saturated to healthy oils, like olive and canola. Chef Wesley McWhorter, spokesperson for the Academy of Nutrition and Dietetics, says, “Don’t forget to add healthy fats in your recipes from things like avocado, beans, nuts, and seeds – which will also keep you full longer and prevent overeating.”

Small Win: Try a “protein flip.” Chef McWhorter suggests you keep the animal proteins and their fats that you love but shift the proportion of the ingredients. For example, instead of an all-beef burger, make a half vegetable burger by adding beans and veggies or mushrooms. “Blended burgers are great because the moisture from the mushrooms actually makes your burger taste better,” says McWhorter.

Tips for Choosing Heart-Healthy Fats

Instead of…

Try:

  • Butter, margarine, or solid shortening
  • Vegetable oils such as canola, olive, avocado, or peanut oil
  • Beef, pork, or poultry with skin
  • Organ meats like liver or kidney
  • Poultry without skin
  • Lean beef, pork, or venison
  • Fish and seafood
  • Chips, crackers, snack foods
  • Raw or unsalted nuts and seeds or nut butter
  • Hummus with vegetables
  • Avocado on toast
  • Coconut oil and palm oil
  • Liquid vegetable oils: corn, canola, olive, soybean, and safflower oils
  • Whole milk, cheese, yogurt, and ice cream
  • Low-fat (or skim) milk, cheese, and ice cream, and non-fat yogurt

Remember: Choose low-fat and reduced-calorie foods wisely because they can contain more added carbohydrate than the full-fat version.

2: Opt for Heart Healthy Carbohydrates

There are three main types of carbohydrates: sugar, starch, and fiber.

  • Sugar is called by many names – simple sugar, table sugar, cane sugar, brown sugar, turbinado, demerara, maple syrup, molasses, honey, and high-fructose corn syrup. Simple sugars are often referred to as fast-acting because they rapidly raise blood sugar levels. Sugars may be added to foods or occur naturally, like the fructose in fruit and lactose in milk.

Foods made with added sugars tend to have little or no nutritional value and are usually high in calories and fat. Simple sugars, especially high fructose corn syrup, raise triglyceride levels which is associated with heart disease. And when it comes to blood sugar levels, foods with added sugar like cookies, donuts, and cakes lead to blood sugar levels spiking which, when treated with insulin, can cause large, unpredictable blood sugar swings – also not good for the heart.

  • Starch is a complex carbohydrate. It’s made from lots of simple sugars that are linked together in long chains. Complex carbohydrate foods include whole-grain bread and cereal, starchy vegetables (green peas, corn, lima beans, potatoes), and dried beans (pinto beans, kidney beans, black-eyed peas, and split peas). Unlike fast-acting carbohydrates, starches are slowly broken down during digestion, resulting in a lower, steadier release of sugar into the bloodstream. 

  • Fiber is also a complex carbohydrate. Fiber is the indigestible part of any plant food, including the leaves of vegetables, fruit skins, and seeds. Fiber helps to move food waste out of the body and may help lower cholesterol and keep your blood sugar in range. Dietary fiber is found in foods that come from plants, including fruits, vegetables, nuts, seeds, avocados, beans, peas, lentils, and whole grains.

Increase Fiber

Fiber is important for heart health and keeping your blood sugar in range. The American Diabetes Association recommends that people with diabetes eat at least 14 grams of fiber per 1,000 calories – or about 28 grams of fiber per day for women and 34 grams of fiber per day for men. However, increasing fiber too quickly can cause gas, bloating, and constipation. Before increasing your fiber intake, figure out approximately how much fiber you are currently eating.

Aim to increase your daily fiber intake slowly – on week one, increase your daily fiber intake by two or three grams, then the following week increase it by two to three more, until you've reached your goal. In addition, increase the amount of water you drink. This will help prevent constipation. If you begin to experience gas or bloating, slow down – instead of changing every  week, change your daily fiber by two to three grams every other week.

Small Win: McWhorter suggests swapping processed grains like pasta for whole grains like farro, millet, quinoa, or bulgur. Fiber is one of the best things for your heart, and whole grains are a great way to get more of it,” says McWhorter. “The good thing is there are so many delicious, whole grains out there.”

Tips for Choosing Heart-Healthy Carbs

Instead of…

Try:

  • Bread or crackers
  • Biscuits, cornbread, and other “quick” breads
  • Bakery products, such as doughnuts, biscuits, croissants, pastries, pies, cookies
  • Breadcrumbs or stuffing mix from a store
  • Whole wheat bread
  • Whole grains like barley, rye, and buckwheat
  • Fresh fruit (instead of bakery products)
  • Fresh veggies (as snacks)
  • Cereals (hot or cold)
  • Steel-cut oats
  • Potatoes, noodles, rice
  • Packaged starchy foods – noodle or rice dishes, stuffing mix, macaroni and cheese
  • Brown rice, quinoa, or wild rice
  • Sweet potato, beans, hummus

3: Slash the Sodium in Your Food

Your body needs sodium (or salt) for normal muscle and nerve functions and to keep your body fluids in balance. But, too much sodium in your diet can lead to high blood pressure, heart disease, and strokes, as well as bloating, puffiness, and weight gain. Most people eat about 3,400 mg of sodium a day – almost double what’s recommended by the American Heart Association. People with diabetes and prediabetes are encouraged to consume less than 2,300 mg of sodium per day – that’s about one teaspoon of table salt – to care for their hearts.

Despite what you may think, over 70% of dietary sodium comes from eating packaged and prepared foods – not from table salt added to food when cooking or eating. Reading the nutrition facts label on packaged and prepared foods is the best way to make informed decisions about how much sodium you eat.

Small Win: McWhorter suggests building flavor throughout the cooking process. “It’s important to focus on how to add flavor through herbs, spices, acid, and texture, which can help you reduce the sometimes, excessive saturated fat, sugar, and salt in your dishes. Don’t be afraid to experiment with new seasonings and get away from the typical ‘salt and pepper’ approach. Trust me – flavor matters,” McWhorter says.

Tips to Reduce Sodium

Instead of…

Try:

  • Processed carbs like breakfast cereals, packaged baked goods, snack crackers, and prepared grains
  • Whole grains: whole wheat, barley, rye, buckwheat, corn, teff, quinoa, millet, amaranth, brown or wild rice, sorghum, and oats
  • Processed red meats, such as bacon, sausage, ham, pepperoni, hot dogs, corned beef, cured or smoked meats, canned meat, sardines, and spam
  • Deli meats, such as pastrami, bologna, or salami
  • Fresh red meat: lean, trimmed cuts of beef, pork, or lamb 
  • Fresh poultry: skinless chicken or turkey
  • Fresh seafood: fish (particularly fish like salmon, herring), shrimp, lobster, clams, and scallops
  • Regular and processed cheese or dairy-based sauces
  • Low-sodium cheeses (Swiss cheese, ricotta cheese, fresh mozzarella, low-sodium cottage cheese)

Remember, homemade food typically contains less sodium than prepared food (whether it’s canned, frozen, packaged, or from a restaurant). This is also true for sauces like pasta sauce, barbeque sauce, teriyaki sauce, ketchup, and salsa. As much as possible, aim to buy fresh, unprocessed ingredients and turn them into your favorite dishes. For heart-healthy recipes, click here.

Overall, the key to a heart-healthy meal plan is variety: fruits and vegetables, lean protein sources, nuts, legumes, whole grains, and healthy fats like avocados or olive oil. When revamping meals, chef McWhorter recommends starting with the whole plate in mind. “Our meals are most often focused on the main protein versus the whole plate. What is left leaves little room for creativity and deliciousness for the fiber-rich and nutrient-dense vegetables, whole grains, nuts, and seeds that we really want (and need) on our plate,” McWhorter says. And remember to start with small wins on your path to heart healthy eating.

Learn more about nutrition here.

This article is part of a series to help people with diabetes learn how to support heart health, made possible in part by the American Heart Association and American Diabetes Association’s Know Diabetes by Heart initiative.

About Constance

Constance Brown-Riggs, MSEd, RDN, CDCES, CDN, is a national speaker and author of Living Well with Diabetes 14 Day Devotional: A Faith Based Approach to Diabetes Self-ManagementDiabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan, and The African American Guide to Living Well with Diabetes. Learn more about Constance and follow her on Instagram , Twitter, and Facebook.

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