Most people have a good idea of the best nutrition for health: that is to say, the best foods to eat (or avoid) in order to stay in fine physical condition.
It is no secret that a diet composed largely of fruit and vegetables, with minimal processed carbohydrates or refined sugars, will pay dividends for your wellbeing. However, there may often be a need to tailor your diet for a specific organ.
In this article, we aim to summarise the optimum nutrition for the heart, paying particular attention to the best nutrients, vitamins and minerals for the heart and circulation.
What Does a Heart-Healthy Diet Consist Of?
It’s fair to say that a heart-healthy diet is not radically different from a prototypical healthy diet, in that it prioritises natural foods and permits only small amounts of food or drink which are high in sugar. One organisation which is unfailingly keen to stress the importance of diet for the cardiovascular system is the British Heart Foundation.
The BHF runs an initiative every February to raise awareness about cardiovascular health, and encourage people to make valuable lifestyle interventions to protect their heart. Its advice includes: swapping your typical snacks for healthy alternatives, squeezing 10 minutes or more of exercise into the day and planning a ‘rainbow’ workplace meal by incorporating as many different colours of fruit and vegetables as possible.
It is not difficult to see why the British Heart Foundation runs such a campaign: heart disease and stroke remain the world’s biggest killers, and have represented the leading cause of death globally for well over a decade now.
Worryingly, deaths from ischemic heart disease totalled 9.5 million in 2016, an increase of 19% since 2006.
So which foods are recommended, by the BHF and others, as part of a heart-healthy diet?
• Fruits and vegetables (aim for 10 portions a day)
• Healthy oils (extra-virgin olive oil, coconut, flax)
• Dark chocolate
• Green tea
• Red wine
By no means is this an exhaustive list, but certainly the foods (and beverages) listed above have plenty of evidence to support their inclusion as part of any cardiovascular-focused diet. Indeed, they represent the core of the famously heart-protective Mediterranean diet.
To the list, you can also add eggs. Red meat is fine too, though it's best to avoid processed and choose grass-fed. It would also be prudent to moderate our intake.
However, there is no reason we cannot maintain healthy blood pressure and cholesterol levels while enjoying the occasional steak or sausage. Variety, as ever, is key.
What About Saturated Fat?
According to Victoria Taylor, a dietitian at the British Heart Foundation, it is sensible to “choose lean meat and use healthier cooking methods to cut the fat content. By removing the fat from a steak and grilling rather than frying, you can halve the amount of saturated fat.”
Of course, there are those who believe that saturated fat has been unfairly demonised and indeed there are numerous studies supporting this viewpoint.
One 2017 study published in Nutrition Journal pondered the effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease and found that there were, in fact, no benefits at all. Other studies have refuted the “saturated fat is bad for the heart” claim, including the Minnesota Coronary Survey, the Women’s Health Initiative and the Sydney Heart Study.
Most of the supportive literature for the view that saturated fats are bad for the heart exists in the form of older uncontrolled trials, some of which did not properly account for significant confounding variables. The most recent study was actually conducted in light of these inadequately controlled trials.
Interestingly, coconut oil – which is extremely high in saturated fat (86%) – was shown to increase ‘good’ HDL cholesterol more than extra-virgin olive oil in a 2018 human trial (all without increasing ‘bad’ LDL cholesterol).
In other words, coconut oil had actually reduced participants’ risk of developing heart disease or stroke. Talk about flying in the face of saturated fat dogma.
The merits of saturated fat may be better discussed in a separate lengthy blog, but we can safely say that eliminating trans fats is beneficial for the heart. Many sweet treats are made using oils which contain trans fats, so pay close attention to product labels. The keyword you want to watch out for is “partially hydrogenated.”
Nutrition for the Heart: L-Arginine
Since this is a blog about heart-healthy nutrition, it would be remiss not to mention a key nutrient like L-arginine.
This amino acid is converted in the body to nitric oxide (NO), a famed vasodilator known for improving blood flow by dilating and relaxing the arteries. As such, L-arginine is great for reducing one’s risk of arteriosclerosis and heart attack, improving symptoms of chest pain and helping to lower high blood pressure.
Because it is a precursor to nitric oxide, L-arginine is one of the most popularly recommended heart supplements by cardiologists, usually for patients with coronary heart disease or peripheral vascular disease. L-arginine can also be helpful for clogged arteries, due to NO’s aforementioned vasodilatory ability.
Eating a well-balanced diet should ensure you consume enough L-arginine, since the amino acid is present in foods such as red meat, chicken, fish, nuts and leafy vegetables. However, supplements can prove very useful in some cases.
The Best Vitamins and Minerals for the Heart and Circulation
In this section we’ll list the best heart health vitamins and minerals, nutrients necessary to keep your ticker in good shape. After all, many of the foods mentioned in the bullet points earlier are there precisely because they contain the following nutrients.
Magnesium is one of the most important dietary minerals, involved in over 300 biochemical reactions. No surprise, therefore, that it has a major impact on the heart, principally by maintaining blood pressure and healthy rhythm by ensuring the smooth functioning of the muscles. The heart is, after all, a muscle – and of all the organs, it has the highest magnesium requirement.
According to a 2016 meta-analysis involving over one million participants, increasing dietary magnesium reduces one’s risk of stroke, heart failure and all-cause mortality.
A separate study, published a year later, found that circulating Mg levels were inversely associated with incidence of coronary heart disease and hypertension. In other words, the lower your magnesium intake, the greater your risk for these conditions.
• Vitamin D and Vitamin K
Although it’s good for just about everything (healthy bones and immune system, cell division, strong teeth), vitamin D does not directly affect the heart. However, evidence from both observational and clinical studies suggests the Sunshine Vitamin may be linked to a lower risk of cardiovascular disease.
One oft-cited trial from 2016 showed that vitamin D improved the heart function of heart failure patients in Leeds. Patients were given 100mcg of vitamin D3 (10 times the recommended UK allowance, though less than the 125mcg advised by the Vitamin D Council) daily for a year and ejection fractions measured. Ejection fractions reveal the amount of blood pumped out of the heart’s chambers with each beat. Incredibly, the intervention group’s heart pumping function improved from 26% to 34% – results the research team described as ‘stunning.’
Another study, published in 2018, found that vitamin D could repair damage to endothelial cells in the cardiovascular system – the same cells which suffer extensive damage after heart attack and stroke.
What’s more, researchers learned that vitamin D reduces oxidative stress throughout the cardiovascular system by stimulating nitric oxide.
It is worth noting that vitamin D deficiency (among other vitamin deficiencies) has also been linked with elevated blood pressure, and indeed patients who have heart attacks generally exhibit symptoms of vitamin D deficiency.
Vitamin K, meanwhile, is needed for proper blood coagulation and to prevent calcium deposits in arteries and blood vessels. Just as D3 is the preferred form of vitamin D, K2 is the preferred form of vitamin K. There is plenty of data showing a link between vitamin K levels and cardiac health.
One study, published in 2015, found that vitamin K2 intake both improved arterial stiffness in healthy postmenopausal women and improved vascular elasticity. The population-based Rotterdam study also showed that a high dietary intake of K2 (at least 32µg per day) reduced arterial calcification and cardiovascular risk by 50%.
Interestingly, vitamins D and K actually work in tandem to ensure the proper absorption of calcium.
• Vitamin B3 (Niacin)
No discussion of the best heart health vitamins would be complete without reference to Vitamin B3, also known as niacin.
This one has a series of valuable functions, contributing to energy-yielding metabolism and healthy nervous system function, but relevantly, it helps to lower LDL cholesterol and raise HDL cholesterol.
What’s more, it lowers triglycerides, fats in the blood known to increase the risk of heart disease. Meat and fish are the richest dietary sources, and again, there are special niacin supplements on the market.
These may be of benefit to high-risk individuals and/or those who are intolerant or suspicious of statins.
Omega-3 for Cardiovascular Health
We have written extensively about the benefits of omega-3s for heart health. The Essential Fatty Acids, which comprise eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), support the cardiovascular system in a multitude of ways, not least by reducing inflammation, preventing the formation of clots and helping you maintain healthy blood pressure and blood triglycerides.
Salmon is one of the finest sources of omega-3. In a three-year study published in the highly respected American Journal of Clinical Nutrition, post-menopausal diabetic women who ate salmon twice a week reduced their atherosclerosis risk by an astonishing 60%.
A separate meta-analysis published in JAMA Cardiology in 2018, which included 77,917 participants consuming marine-derived omega-3 supplements, indicated that fish oils made one 7% less likely to die of coronary heart disease and 3% less likely to have a non-fatal heart attack.
Based on population data from the Framingham Heart Study, separate analysis undertaken in the same year found that the Omega-3 Index (i.e. which reflects the relative amount of EPA and DHA in red blood cells) is a better gauge of heart health than cholesterol levels. Those in the highest omega-3 quintile (>6.8%) compared to those in the lowest (<4.2%) had a 34% lower risk of all-cause death and a 39% lower risk for cardiovascular disease.
The American Heart Association currently supports the view that omega-3 fish oil supplements “may help prevent death from heart disease in patients who recently had a heart attack and may prevent death and hospitalisations in patients with heart failure.”
If you want to benefit from heart-protective omega-3s, eat a few portions of fatty fish per week: anchovies, wild salmon, tuna, herring and mackerel are good bets. Vegan sources, meanwhile, include flaxseeds, walnuts and dried seaweed.
A high strength omega-3 supplement may be of particular benefit to those with a history of heart trouble, or those who are averse to eating lots of fish.
Can Probiotics Improve Blood Pressure?
Probiotics have been suggested for many things, but heart health wasn’t one of them – until a few years ago. In 2014, friendly bacteria were shown to moderately reduce blood pressure in a systematic review which looked at the results of nine randomised controlled trials.
So what were the findings exactly? Well, probiotic consumption significantly reduced systolic blood pressure by 3.56 mm Hg (the blood pressure in arteries when the heart beats) and diastolic blood pressure by 2.38 mm Hg (blood pressure in the arteries between heartbeats).
In their conclusion, the researchers noted that “the magnitude of improvement is greater among those with elevated BP, when daily dose of probiotics exceeds 100 billion and when intervention lasts over 8 weeks.”
There are perhaps several reasons for this. For one, a lack of microbial diversity has been observed in hypersensitive rats, indicating that the microbiome has a regulatory effect on hypertension. Moreover, probiotic strains like bifidobacteria and lactobacilli are known to produce SCFAs, CLA, GABA and ACE inhibitory peptides, which are capable of lowering blood pressure.
Since there are many other benefits of probiotics, not least for the digestive and immune systems, it seems reasonable to suggest that probiotic foods and/or supplements (minimum 100 billion CFU per serving) be included in any thorough heart-healthy diet.
The Role of Body pH Balance in Cardiac Health
One factor which isn’t often considered when it comes to heart health is pH balance – odd given the heart is one of the most alkaline-dependent organs in the body.
Ensuring a healthy blood acid/alkaline balance helps to protect us from the inside out, creating conditions unfavourable to the proliferation of damaging organisms. Because all of our metabolic processes function best in a slightly alkaline environment, acidosis – or even a slight deviation towards acidity – can lead to heart disease and stroke, not to mention cancer and arthritis.
Proper pH balance additionally helps the fluidity of blood and oxygen transfer, since acid in the bloodstream reduces blood flow just as easily as ‘bad’ LDL cholesterol.
Limiting your intake of acid-forming foods, and consuming plenty of alkalising vegetables, is an undoubtedly good way of preventing acid accumulation – which many naturopathic doctors contend is the first line of defence against most modern diseases, including heart disease.
The Best Supplements for Heart Health
Non-smokers who consume alcohol sparingly, exercise regularly and follow a heart-healthy diet are unlikely to need supplements. In most cases, food should provide the nutrients you need to keep your heart (and other organs) healthy.
It is sensible, however, to use supplements when required. For example, if you do not eat fish you will struggle to get enough omega-3.
While there are plant sources, they contain the shorter-chain ALA, not the EPA and DHA typically associated with cardiovascular benefits. ALA is actually a precursor to EPA and DHA, but the conversion rate in our bodies is extremely low: often less than 1% is converted into EPA and DHA.
• Fish Oil & Vitamin D
Although dietary sources of heart-healthy nutrition are plentiful, food is also unable to provide the 100mcg (4,000 i.u.) daily vitamin D associated with heart pumping benefits described in the aforementioned Leeds Teaching Hospitals study.
In fact, food is a notoriously poor source of vitamin D, which is why certain foods are ‘fortified’ with the vitamin. The best, most natural source is of course sunlight, but when that’s at a premium supplementation becomes a necessity. For this reason, Public Health England recommend all of us use a daily supplement during autumn and winter.
The best fish oil supplement in the UK, or indeed anywhere else, is UnoCardio 1000. Helpfully, it combines the aforementioned nutrients – omega-3 and vitamin D – in a single, easy-to-take softgel.
Since 2015, UnoCardio 1000 has been independently validated by the American laboratory Labdoor as the world’s best fish oil. Labdoor put supplements through a battery of rigorous quality-control tests to determine efficacy, purity, safety and value.
The most significant gap, in terms of score, between any two products in their rundown of 54 fish oils is between UnoCardio 1000 and the product rated #2. While the category average for ‘Label Accuracy’ is 70, UnoCardio 1000 achieved a score of 99. It also scored 80 for Projected Efficacy, more than double the category average of 39.
Making UnoCardio 1000 your daily fish oil supplement will mean you benefit both from highly pure omega-3 (1200mg per serving) and a good amount of vitamin D3 (1,000 i.u.). If you wish to consume greater amounts of vitamin D, simply add a vitamin D tablet into your heart-health protocol.
• QuattroCardio: The Power of Four
WHC, who make UnoCardio 1000, manufacture a number of top-quality heart-health supplements. One of them, QuattroCardio, integrates four key nutrients, three of which have been covered thus far in this article. They are: omega-3 fish oil (1200mg), vitamin K2 (90mcg), vitamin D3 (1,000 i.u.) and coenzyme Q10 (100mg).
The latter ingredient, coenzyme Q10, is an essential cofactor for energy production and a powerful antioxidant. CoQ10 is a particularly useful option for the effective management of heart failure, with supplementation trials in heart failure patients reporting improvements in “functional parameters including ejection fraction, stroke volume and cardiac output.”
CoQ10 may also improve endothelial dysfunction and enhance cardiac ATP production. It is certainly an antioxidant you want to look closely at. If QuattroCardio isn’t suitable, try WHC’s Ubiqor, which is purely a CoQ10 supplement. Each softgel contains 100mg of ubiquinol, the biologically active form of coenzyme Q10.
• Cardio Renu: A Heart-Healthy Food Supplement
Swallowing capsules isn’t something everyone likes to do; especially if they’re already on medication. For some, it is preferable to mix a powder in water and drink. If this is you, try Cardio Renu by Greens Best. The doctor-formulated food supplement is packed with great nutrition for the heart including L-Arginine, Coenzyme Q10, alkalising greens, fruit rich in antioxidants, probiotics and digestive enzymes to promote nutrient absorption.
Cardio Renu also contains L-Carnitine and D-Ribose, two key nutrients for the heart. The former is an amino acid derivative found in virtually all of our cells. L-Carnitine supplements have been shown to increase exercise capacity in angina patients and, most tellingly, reduce mortality: in one RCT, patients who took L-Carnitine supplements shortly after a heart attack had a 90% decrease in mortality over the next 12 months, compared with those who did not supplement.
D-Ribose, meanwhile, is a naturally-produced, sugar-like molecule the body uses to make ATP, the basic form of biological energy. Less D-Ribose means depleted ATP levels, a major risk factor for heart failure.
Cardio Renu is a blend of dense heart-healthy nutrition which, when paired with a high-quality fish oil and vitamin D supplement (UnoCardio 1000, QuattroCardio), can naturally fortify your heart. The powder is vegetarian-friendly, devoid of preservatives, artificial sweeteners and fillers, and based on the principles of modern science, natural medicine and Ayurveda.
• Alkalising Greens for pH Balance
We mentioned earlier the importance of pH balance for heart health. Eating alkaline foods is a great way of maintaining the body’s pH level and thereby oxygenating the blood and avoiding acid retention.
If you’re eating 10 portions of vegetables and fruit (7:3 or 8:2 is best) per day, and avoiding overly acidic foods, you probably won’t need a supplement. However, green food powders can help others stay in the alkaline range.
pHresh Greens is a combination of nutritious raw greens, from alfalfa sprout and barley grass to wheat grass and spinach. An excellent source of vitamin K (one serving equals 70% of your RDA), the powder is great for neutralising acids in the blood and tissues and detoxifying the body. Add a scoop to a glass of water each day and drink. And yes, you can certainly mix a scoop of pHresh Greens with a serving of Cardio Renu.
To get an accurate measurement of your pH levels, meanwhile, use pH Test Strips. It couldn’t be simpler.
Nutrition for the Heart: Conclusion
Of course, there are many other natural supplements which help the heart. We mentioned earlier magnesium, probiotics and vitamin B3. You may also want to look at red yeast rice, hawthorn, plant sterols, pantethine (the active form of pantothenic acid, a component of CoQ10), folic acid and citrus bergamot.
Folic acid, in particular, has shown promise in clinical trials. In one, published in 2018, supplements of folic acid (0.8mg per day) reduced hypertensive patients' stroke risk by 75%. There was a statistical benefit for low-risk patients too, although it was much more modest (3%).
Before you start obsessively taking supplements, however, do the straightforward stuff. Cut out the trans fats. Maintain good energy levels, exercising regularly and getting enough rest. (Poor sleep puts you at higher risk of cardiovascular disease irrespective of age or diet.)
Make an effort to eat more natural foods – the Mediterranean diet is a perfect template – and spend time in the sunshine. Ditch energy drinks (and all sugary drinks for that matter) and embrace nutritious green smoothies. Get out of the city once in a while and breathe fresh, unpolluted air.
By following these tips and using supplements accordingly, you should ensure the health of your heart for years to come.