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Chocolate and the Heart-Healthy Diet

Dark chocolate and cocoa are rich in antioxidants called flavonoids. Research suggests that eating flavonoid-rich chocolate helps to keep blood vessels healthier by improving their ability to expand.

One small study showed that eating high-flavonoid dark chocolate daily helped high blood pressure patients lower their blood pressure and reduce LDL. Patients who ate white chocolate got no beneficial effects.

Eating chocolate in moderation is fine, Lichtenstein says. But be aware that flavonoid levels differ in various chocolate products, so there's no guarantee that you'll get a dose large enough for health benefits. Also, too much chocolate has no place in a heart-healthy diet because the extra calories can lead to weight gain.

Fish Oil and the Heart-Healthy Diet

Eating fish rich in omega-3 fatty acids may help prevent heart disease. Good choices include fatty fish such as salmon, lake trout, mackerel, sardines, and albacore tuna, according to the AHA.

Fish oil contains docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Lichenstein has reviewed many studies on fish oil and cardiovascular disease, and most of the evidence associates DHA and EPA with decreased risk of cardiovascular disease, she says. People who report eating two or more servings of fish per week have a lower risk, she adds.

How do omega-3 fatty acids help to promote heart health? Experts don't know for sure. "It's still open to debate," Lichenstein says.

But whatever the reason, there is evidence that omega-3 fatty acids cut risk of death, heart attack, and dangerous heart rhythms in people with cardiovascular disease, according to the NIH. Omega-3 fatty acids also lower "bad" LDL levels, mildly decrease blood pressure, and lower levels of a blood fat called triglycerides.

Getting omega-3 fatty acids from food is best, the AHA says. It recommends at least two servings of fish per week. But people with coronary artery disease or high triglycerides may want to talk to their doctor about taking a supplement if they're not getting enough omega-3 fatty acids in their diet.

Cholesterol-Lowering Foods and the Heart-Healthy Diet

Cholesterol-lowering margarines that contain plant sterols have been shown to decrease "bad" LDL cholesterol levels. Other foods that are sterol-fortified include some orange juices, chocolate bars, yogurt, and more.

Though these cholesterol-lowering products seem to be effective, they should be part of a comprehensive heart-healthy diet, one that is low in saturated fat and cholesterol, experts say.

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