Heart disease remains the leading cause of death nationwide. Simple dietary changes can significantly reduce your risk. As a cardiology physician assistant, I discuss with patients how their food choices impact heart health. I am often asked about practical ways to eat better for heart health. Many feel overwhelmed by conflicting nutrition advice, but the principles of heart-healthy eating are more straightforward than you might think.

Understanding heart-healthy eating

Improving heart health starts with small changes that can make a big impact. Think of your heart-healthy diet as adding beneficial foods rather than just restricting “bad” ones. Many of my patients are surprised to learn that heart-healthy eating doesn’t mean eliminating all their favorite foods. Instead, it’s about making informed choices and understanding how different foods affect heart health.

Most dietary experts are shifting their focus to dietary patterns and lifestyles rather than single foods or nutrients. Eating a variety of whole foods that are minimally processed is important for heart health. In the past, we tended to focus on specific nutrients- like reducing cholesterol and sugar or limiting saturated fats. It’s important to recognize that there are healthy fats and how to choose the right kind of carbohydrates to maintain a balanced diet. Plant-based diets and anti-inflammatory foods (fruits, vegetables, and omega-3 fatty acids) are also highly recommended.

Research continues to enhance our understanding of the relationship between diet and heart health. Certain foods actively protect heart health, while others can increase risk factors for heart disease.

Essential components of a heart-healthy diet

A heart-healthy eating plan includes several components, each of which plays a vital role in cardiovascular health. We recommend avoiding trans and saturated fats such as red meat, butter, and fried foods. Monounsaturated fats are “healthy fats” and can actually be good for you in moderation. Examples include avocados, nuts, and olive oil. Look specifically for foods high in fiber and low in sodium, and try to choose whole grains over refined grains when possible.

Fruits and vegetables: Aim for a variety of colors. Each color provides different nutrients your heart needs. Fresh and frozen when possible. These foods provide essential vitamins, minerals, and fiber while being naturally low in calories.

Whole grains provide fiber that helps lower cholesterol and maintain healthy blood sugar levels. Look for products with whole grains appearing first on the ingredient list. Good choices include oats, quinoa, brown rice, and whole wheat products.

Lean proteins: Choose fish rich in omega-3 fatty acids—like salmon and mackerel—skinless poultry, and plant-based proteins like legumes. These provide essential nutrients without excess saturated fat.

A common misconception is that a “heart-healthy” or “low-sodium” product is always healthy. Many of these foods are marketed as “healthy,” but that does not necessarily mean it’s beneficial for your heart. These products often contain added sugars, refined carbs, and artificial additives. I often explain to my patients that “low sodium” choices are a step in the right direction but oftentimes still contain unhealthy amounts of sodium for certain health conditions. Always check your labels and ask your provider about specific restrictions.

Making heart-healthy changes

Gradual, sustainable changes to adopt heart-healthy eating habits will ensure the most success. The best strategy to maintain a healthy diet is to plan your meals ahead of time. Create a menu for the week, make a grocery list, and prep as much as you can ahead of time, so your healthy choices are ready and easily accessible.

Read labels

• Sodium content—aim for less than 2,000mg daily
• Added sugars—limit these as much as possible
• Trans fats—avoid completely
• Fiber content—aim for foods with at least 3g per serving

Plan your shopping

• Shop the perimeter of the store first, where fresh foods are located
• Make a list based on planned meals
• Choose fresh foods over packaged when possible
• Look for foods with simple ingredient lists

Meal planning strategies

• Prep vegetables in advance
• Cook meals in batches
• Keep healthy snacks readily available
• Plan meals around vegetables rather than meat
• Use smaller plates to control portions

Foods to choose and limit

Knowing what foods to choose and what foods to limit can feel overwhelming. These suggestions will help you navigate your food choices.

Best choices

• Leafy greens and colorful vegetables—aim for 5-7 servings daily
• Berries and citrus fruits—rich in antioxidants
• Salmon, mackerel, and other fatty fish—2-3 servings weekly
• Nuts and seeds—in moderation—about 1 ounce daily
• Olive oil as your primary fat source
• Low-fat dairy products for calcium without excess saturated fat
• Legumes and beans for protein and fiber
• Whole grains for sustained energy and fiber

Foods to limit

• Processed meats like bacon and sausage
• Foods high in added sugars, especially sugary beverages
• Excessive salt—particularly in processed foods
• Trans fats found in some processed foods
• Refines carbs like white bread and pastries
• Excessive alcohol
• Fried foods

For individuals with heart disease, we recommend a Mediterranean diet- this includes a variety of fruits, vegetables, whole grains, legumes, and healthy fats. For patients with heart failure and/or high blood pressure, we recommend focusing on a low-sodium diet, which includes avoiding processed foods, canned soups, and salty snacks.

Simple substitutions

Making small swaps can have big benefits. Swapping small things can be easier and more manageable than feeling like you need to change your whole diet.

• Choose olive oil instead of butter for cooking
• Swap fish for red meat twice weekly
• Replace salt with herbs and spices for flavoring
• Choose whole-grain bread over white
• Snack on nuts instead of chips
• Use Greek yogurt instead of sour cream
• Try fruit for dessert instead of processed sweets
• Choose water or unsweetened beverages over sugary drinks

Portion control is just as important as food choice. Even healthy foods can contribute to weight gain if portions are too large. I suggest using smaller plates and bowls, filling half your plate with veggies, limiting meat portions to about the size of your palm, and measuring oils and nuts rather than estimating. Pay attention to hunger and fullness cues to help prevent overeating.

Eating a heart-healthy diet doesn’t mean eliminating all treats. The key is moderation and making primarily healthy choices. Again, small changes, maintained over time, can significantly impact your heart health.

At Mount Nittany Health, our cardiology team works with you to develop practical, sustainable dietary changes that fit your lifestyle. We understand that lasting change comes from realistic goals and individualized approaches.