Skip to content

Eating for Heart Health: Ask the Nutritionist

Registered dietitian Carolyn O'Neil answers your questions about taking care of your heart by eating right.

Question:
I have an apple shape, which I've read is a risk factor for heart disease. Would you recommend I start a diabetic diet to help me lose a few extra pounds?
Answer:

The apple shape torso -- with a larger abdomen and smaller hips -- is associated with an increased risk of both heart disease and diabetes because it often indicates that body fat has collected around the central organs. I recommend you start a weight management program involving cardiovascular exercise to help burn calories and shed excess body fat, in addition to a healthy diet that includes a good mix of healthy foods.

Today, the so called "diabetic diet" is really a diet that we all should be following; a calorie-controlled diet so that we're not consuming more than we need per day. This also means eating a variety of fruits, vegetables, whole grains, lean proteins, and nonfat or reduced- fat dairy.

Proper meal timing -- meaning enjoying breakfast, lunch, dinner, and perhaps an afternoon snack -- can help keep your blood sugar from spiking. Stabilized blood sugars can keep you from getting so hungry that you binge or over-do it on high-calorie snacks.

Question:
What kinds of vegetables are good for heart health?
Answer:

Just about all vegetables help support a healthy cardiovascular system. Veggies which contain deep, dark pigments -- winter squash, dark leafy greens, broccoli, kale, tomatoes, red peppers, and carrots -- are good sources for antioxidant nutrients such as vitamin A and vitamin C and folate. These nutrients help protect the body's cells, including cells in our heart and arteries. Even white-colored vegetables, such as onions and garlic, contain important nutrients for heart health, including a flavonoid called quercetin.

Most vegetables are also a good source of dietary fiber, which is important for digestive health. One word of caution: Dark green, leafy vegetables such as collards, kale, and spinach are an excellent source of vitamin K, which is important for the blood clotting mechanism. But if you're taking drugs such as Coumadin or warfarin to prevent blood clots your doctor may advise you to avoid these kinds of vegetables.

Question:
Heart disease runs on my mother's side of the family. I now have high triglycerides and my bad cholesterol has increased. I'm 5'3" and I weigh147, which is considered overweight. I also have Left Lower Branch Bundle Block (LLBBB) and two types of arthritis, which limits my ability to exercise. I need a list of foods that would be helpful with lowering my triglycerides and cholesterol. Any suggestions?
Answer:

A healthy diet that follows the MyPlate.gov guidelines is a good start. Fill half of your plate with fruit and vegetable servings, one quarter with a serving of whole grains such as brown rice or whole grain bread, and the other quarter with a serving of lean proteins such as chicken breast, fish, turkey, or sirloin steak. Choose fat free or 1% fat dairy products. Avoid sugary soft drinks and other pre-sweetened beverages. Limit your consumption of solid fats such as butter or vegetable shortenings and the foods they're made with.

Question:
In my house we eat vegetables after cooking them in oil. Is this good for your heart, or should we consume only raw veggies?
Answer:

Cooking oil can actually help some of the vitamins in vegetables be better absorbed by the body. Fat-soluble vitamins such as vitamin A, E, and K are found in many vegetables.

Make sure to choose healthy oils such as canola or olive oil to get the heart-healthy benefits of monounsaturated fats. Use oils sparingly when cooking because a little goes a long way. Remember that every tablespoon of oil -- whether heart-healthy or not -- contains about 100 calories.

Some people like to cook with a vegetable oil spray. You can make your own by putting olive oil or canola oil in a spray bottle. Raw veggies are great of course. But, cooked veggies are, too! They both contain the same amount of fiber. Avoid overcooking vegetables and boiling too long. Or you will lose some of the water-soluble vitamins that are heat sensitive, including vitamin C.

Question:
Could eating red yeast rice every day help to lower my cholesterol?
Answer:

It depends on what else you are eating. Adding one healthy food to an otherwise lousy diet won't help in the long run. Oatmeal helps lower cholesterol, but it won't help if you’re sprinkling it on top of prime rib.

If red yeast rice is your choice for a grain, you are adding more fiber to your diet, which could help lower your bad cholesterol. But don't weigh it down with a whole stick of butter.

Question:
My husband's healthy cholesterol is too low. What kind of foods can he eat to increase his healthy cholesterol without raising his bad cholesterol?
Answer:

The so called "good cholesterol" or high-density lipoproteins (HDL) are affected by exercise and alcohol intake. I'm not suggesting that your husband start drinking more alcohol. But red wine and some other alcoholic beverages (not in excess of 1-2 glasses a day) have been shown to raise HDL levels. Regular physical exercise can help too, between moderate to high intensity and duration, meaning jogging on a treadmill, not a leisurely walk in the park.

High-fiber foods are good for improving HDL levels. As are minimally sweetened or unsweetened foods. Avoid foods that contain trans fats, or "partially hydrogenated fats" as they may be listed on nutrition labels.

Question:
I eat grapefruit every day. I think I'm addicted to it. What are the health benefits of eating grapefruit? Should you ever limit your grapefruit consumption?
Answer:

I love grapefruit, too -- ruby red, classic yellow, and pink grapefruit!

Like all citrus fruits, grapefruits are excellent sources of vitamins C and A, fiber, potassium, and many other healthy plant nutrients such as lycopene. Because they are not as sweet as oranges, grapefruits are generally lower in calories and sugar content. A typical grapefruit will contain only about 40 calories. So depending on how many calories you need per day, you can eat a lot of grapefruit and still consume very few calories. Grapefruit juice also contains the fewest calories per servings out of all other fruit juices.

A note of caution: Please check with your health care provider if you are taking pharmaceutical drugs such as statins, calcium channel blockers, the immunosuppressant cyclosporine, estradiol hormone, the antiviral agent saquinavir, or the antihistamine terfanadine. Compounds in grapefruit and grapefruit juice can interact with these drugs.

Question:
Are all pastas high in cholesterol?
Answer:

Pastas are generally made from wheat and do not contain any cholesterol. Some pastas are made with eggs and therefore contain a small amount of cholesterol. Choose whole grain pastas. Enjoy them with a variety of vegetables and avoid sauces made with cheese or cream. Toss in a little olive oil, fresh tomatoes, fresh basil, and perhaps a sprinkling of grated parmesan cheese to enjoy pasta dishes in more healthy ways.

Question:
What should I eat in order to have a normal lipid profile?
Answer:

First of all, visit your health care provider to get your numbers for the good cholesterol (HDL) and the bad (LDL). Keeping track of these numbers is important for managing risk factors for heart disease.

If your physician tells you that your LDL is too high there are several dietary changes you can make to lower that number. You may have heard that eating oatmeal is healthy for good cholesterol. This is because the soluble fiber found in oatmeal can grab onto dietary cholesterol in your body and remove it through waste elimination.

Other foods that contain soluble fibers include apples, okra, and just about all other fruits and vegetables.

Eating more fish can help, too. The USDA's MyPlate.gov dietary recommendations advise us all to eat at least two servings of fish per week. Fatty fish such as salmon, sardines, and tuna are especially good sources of the fish oils that are associated with a decreased risk of cardiovascular disease. And, not only can they help lower LDL levels, but they actually help increase HDL levels.

Lastly, be sure to avoid foods that are high in saturated fats, which can raise LDL levels. These include cream, butter, fatty meats, and whole milk.

Question:
How can the salt content in my husband's diet affect his blood pressure and cholesterol levels?
Answer:

The sodium in sodium chloride (salt) can have an effect on your blood pressure. This is why health care providers advise people with high blood pressure to reduce their salt intake. The American Heart Association recommends sodium intake of less than 1500 milligrams per day. Look for the sodium content on the Nutrition Facts label of your packaged foods.

Question:
Is maintaining a vegan diet healthier for your heart?
Answer:

Vegan diets -- which exclude dairy foods, meats, fish, and eggs -- are low in cholesterol and saturated fats. This helps reduce a person's risk for heart disease. Because they are predominantly made up of plant foods, vegan diets are also higher in dietary fiber, which can also help reduce your risk of heart disease. But, because vegan diets exclude fish and seafood, you could be missing out on the protective effects of fish oils that are also associated with a decreased risk of heart disease.

Question:
As a nurse, I teach patients with cardiac issues to use sugar substitutes instead of actual sugar. But are they really OK to consume when you have heart health problems?
Answer:

It's good for everyone to cut back on the sugar they consume to help control overall calories and better manage weight. Artificial sweeteners are all approved for safe use by the FDA, the World Health Organization, and other major scientific bodies. But, as a dietitian, I caution people not to rely on artificial sweeteners to feed their sweet tooth. I think we should get in touch with the more natural, slightly sweet taste of many foods. Sure, you can bake a cake with sugar substitutes to save calories. But why not learn to enjoy the wonderful flavors of sliced fresh fruit with a dollop of non-fat Greek yogurt instead? Your diet should be about the quality of the calories you’re consuming and the nutrition they provide to help protect your heart and your health overall.

Question:
I recently had two stents placed in an artery due to plaque buildup. What would be the best cooking oil to use in my case?
Answer:

Vegetable oils that contain monounsaturated fats -- such as olive oil and canola oil -- are the best choices to use for cooking oil. But be sure not to overdo it because these oils contain calories, too!

As a dietitian, I love the way a little bit of olive oil helps a salad or steamed vegetables taste so great. And that little bit of oil can also help your body better absorb the vitamins in the vegetables you eat. Bonus!

Canola oil is good, too, because it adds very little flavor to your dishes. So it's a terrific choice when you are cooking foods that you want to maintain their own flavors -- really good for fish.

Question:
I had a stroke 7 months ago and lost 30 pounds afterward. Since future strokes are a concern for me, what can I eat to gain weight?
Answer:

Work with your physician and physical therapist. It's important to regain muscle strength after a stroke, and building muscle is a healthy way to regain body weight. To support this kind of training, you need to maintain a balanced diet that includes healthy carbs such as whole wheat breads, cereals, pastas and brown rice. These carbs will give you the energy you need and provide you a variety of important nutrients. Focus on "quality calories" found in nutrient-dense foods such as eggs, lean meats, milk, and fish.

Question:
What are triglycerides in your body?
Answer:

Triglycerides are a type of fat found in your blood that your body uses for energy. While you need some triglycerides for good health, high triglyceride levels are not healthy.

A fasting blood test can be used to measure your triglyceride levels. You can make diet and lifestyle changes to help lower your triglyceride levels. Stay at a healthy weight, limit fat and sugar intake, be more active, do not smoke, and limit your alcohol consumption.

Question:
Should people with serious heart problems avoid fast food all together?
Answer:

Just because a food is "fast" doesn’t mean it's automatically unhealthy. Many quick-service restaurants today offer whole wheat buns, grilled chicken cuts, salads, and reduced-fat dressings on their menus.

When eating out, avoid fried items and sugary soft drinks. Ask for more lettuce, tomatoes, onions, or whatever kinds of veggies the restaurant has. At sub and sandwich places, go for lean proteins such as turkey or roast beef. Ask for mustard instead of mayo. Avoid adding cheese to sandwiches, which can contain about 100 calories per slice as well as saturated fats, which should be limited for a more heart-healthy diet.

Question:
How rapidly can you lose weight and still be considered healthy?
Answer:

It's generally recommended that losing no more than 2 pounds a week is a safe and effective way to lose weight and keep it off. It may not sound like much, but 2 pounds a week for 5 weeks is 10 pounds! Often, when beginning a weight loss and exercise program, you can lose more weight during the first week -- especially if you are considerably overweight. But don't be discouraged if the weight loss tapers to one or two pounds per week. You are still moving in the right direction.

Thank you for joining us for WebMD Ask the Nutritionist. Be sure to check in on Wednesday, May 9, at 1 p.m. ET, when we will discuss "Nutrition for Seniors." Sign up if you'd like an email reminder the day before the event.

WebMD Ask the Specialist Transcript

Reviewed by Carolyn O'Neil, MS, RD on April 09, 2012

The opinions expressed in this section are of the Specialist and the Specialist alone. They do not reflect the opinions of WebMD and they have not been reviewed by a WebMD physician or any member of the WebMD editorial staff for accuracy, balance or objectivity. WebMD is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your doctor or other qualified health provider because of something you have read on WebMD. 

WebMD does not endorse any specific product, service or treatment. If you think you have a medical emergency, call your doctor or dial 911 immediately.