The goals of heart-healthy eating include managing your weight, cholesterol levels, and blood pressure. But how do you do this? Health experts continue to fine-tune their recommendations, and here’s what the latest research reveals on fat, carbs, and the worst foods for your heart.

The Skinny on Fat

When fat was first identified as a villain in the development of heart disease, experts recommended that most people get no more than 30 percent, or about one-third, of their calories from fat. This figure was chosen as a reasonable goal for those whose diets contained much higher levels of fat. Soon it became clear, however, that the type of fat in a diet is just as if not more important than amount. With that discovery came the advice to limit or eliminate most saturated fats (when are usually solid at room temperature) from animal foods and trans fats from hydrogenated (hardened) vegetable oils in your diet.

One way the overall advice about dietary fat has changed is to de-emphasize the numbers. We don’t hear about the “30 percent” rule much anymore. But that doesn’t mean the advice is no longer good. It simply means you should be paying attention to the types of foods you eat and don’t eat on a regular basis, rather than focusing on the math, which can ultimately steer you in the wrong direction. That means focusing on healthier forms of fat from plant sources, such as nuts, avocado, olive oil, and other vegetable oils.

Another way early dietary advice for healthy people has changed is the loosening up of restrictions on foods that are high in dietary cholesterol, particularly, eggs. While the effects of dietary cholesterol on blood cholesterol remain debatable, and no one is recommending you go overboard eating eggs, dietary cholesterol is no longer considered a big concern for those with high blood cholesterol, and eggs are no longer on the “don’t eat” list for those who do not have high blood cholesterol levels. If you do have high cholesterol, speak to your doctor or dietitian about the types and amounts of foods you should and shouldn’t include in your diet.

What About Carbs?

With the early advice to cut back on fat came the “fat-free” boom in supermarket products. Many people started filling up on carbohydrate-rich, fat-free and low-fat cookies, cakes, crackers and other commercial food products, believing they were eating healthier foods. Wrong! Not only did many of those products contain trans fats, they were also high in sugar and calories, and lacked fiber and other nutrients found in whole foods.

When experts saw that cutting back on fat did not solve the obesity problem or lower the rates of heart disease in this country, they turned their attention to sugar and other refined carbohydrates such as white flour. Eating too much of these foods can lead to significant weight gain, increased body fat and reduced levels of protective HDL (high density lipoprotein) cholesterol in the blood, all of which are linked to an increased risk of heart disease.

According to cardiologist William Tansey III, MD, of Summit Medical Group in New Jersey, the danger comes more from the fat your body produces than from the fats you eat. “Your body make fats from excess carbohydrates,” he points out. “So watch out for the whites: bread, pasta, rice and potatoes.”

7 Foods to Avoid

The American Heart Association has specific recommendations for heart-healthy eating. These recommendations include limiting or avoiding:

  1. Foods that contains trans fats from partially hydrogenated (hardened) oils.
  2. Foods (and beverages) with added sugar. These include sodas, pastries, cakes, cookies, and candy.
  3. Highly processed and refined foods. Many processed foods, especially bread products made with refined white flour, are high in calories and low in fiber.
  4. Excess alcohol. That means no more than two drinks daily for most men and more than one drink for most women.
  5. Red meat. If you do eat meat, choose lean cuts and use low-fat cooking methods.
  6. Whole-milk dairy products. Instead, choose fat-free or low-fat milk, yogurt and cheeses.
  7. Salty foods, especially if you have high blood pressure. Limit sodium to between 1,500 and 2,400 mg daily.

William A Tansey III, MD reviewed this article.

Sources

Willam A Tansey, MD. E-mail message to author. October 13, 2015.

Eckel, R. Eggs and beyond: Is dietary cholesterol no longer important? Amer J Clin Nutr. July 2015. doi: 10.3945/ajcn.115.116905.

Schwab U, Lauritzen L, Tholstrup T, et al. "Effect of the Amount and Type of Dietary Fat on Cardiometabolic Risk Factors and Risk of Developing Type 2 diabetes, Cardiovascular Disease, and Cancer: A Systematic Review." Food Nutr Res 2014;58.

Yanping L, Hruby A, Bernstein AM, et al. "Saturated Fats Compared With Unsaturated Fats and Sources of Carbohydrates in Relation to Risk of Coronary Heart Disease." J Amer Coll Cardio 2015; 66(14):1538-1548.

Willet WC and Ludwig DS. "Science Souring on Sugar." BMJ 2013; 346:e8077. doi: 10.1136/bmj.e8077.

"The American Heart Association’s Diet and Lifestyle Recommendations." The American Heart Association. Reviewed August 2015.