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In my early career as a Registered Dietitian, the "low-fat revolution" was at its peak, shaping how we defined a heart-healthy diet. At the time, our recommendations centered on reducing dietary fats: switching from whole milk to skim, butter to margarine, and choosing cholesterol-free snacks. This created an entire industry around low-fat and low-cholesterol foods. Looking back, we now see that our focus on eliminating fat led to a widespread increase in processed, sugar-laden foods. We replaced whole foods with highly processed foods.
Despite the promises of the low-fat revolution, rates of heart disease have not improved significantly; it remains the leading cause of death worldwide. One critical factor in heart disease is the integrity of our artery walls. We now understand that it’s not only visible plaques that pose a risk but also soft, vulnerable plaques hidden within arterial walls, which can drive inflammation.
So, what fuels inflammation? Key culprits include sugar, processed foods, sedentary lifestyles, stress, excess calorie intake, and environmental toxins. A landmark 2019 study published in The Lancet identified diet as one of the biggest epigenetic factors linked to mortality, with poor diet quality contributing to an estimated 11 million deaths globally. Diets high in sugar, salt, and processed meats—and low in whole grains, nuts and seeds, fruits, and vegetables—were found to be major contributors.
The Functional Nutrition Guidelines for Heart Health
To support cardiovascular health, functional nutrition guidelines target dietary choices that stabilize blood vessels and manage inflammation levels. Here’s a closer look at each guideline:
Guideline #1: Prioritize Low Sugar Intake
High sugar intake is one of the primary drivers of inflammation, which can lead to damage in arterial walls and lay the groundwork for the buildup of soft, vulnerable plaques. Reducing added sugars in your diet helps stabilize blood sugar, lower insulin levels and reduce inflammatory responses throughout the body.
Avoid sugary drinks, sweets, and processed foods high in added sugars. Instead, opt for whole food sources like fruits, which provide natural sugars balanced with fiber and beneficial nutrients.
Guideline #2: Balance Your Omega-3 to Omega-6 Ratio
Omega-3 and Omega-6 fatty acids are both essential, but the balance is key. Modern diets often contain an excessive amount of Omega-6s, primarily from seed oils like soybean, corn, and sunflower oil, which can promote inflammation when consumed in high quantities. Omega-3s, on the other hand, are anti-inflammatory and support cardiovascular health. Increase Omega-3-rich foods such as salmon, walnuts, chia seeds, flaxseeds and grass-fed animal and dairy products, while reducing the intake of processed foods high in seed oils to achieve a healthier ratio.
Guideline #3: Reduce Chemical Additives and Choose Organic When Possible
Many processed foods contain chemical additives, preservatives and artificial ingredients that can contribute to inflammation. Choosing organic foods, particularly when it comes to produce, meat and dairy, can reduce exposure to these additives, pesticides and other toxins. Organic foods also tend to have higher levels of antioxidants and nutrients, which support the body’s natural detoxification pathways and help minimize oxidative stress.
Guideline #4: Include an Antioxidant-Rich Diet with Polyphenols
Antioxidants, especially polyphenols, are powerful compounds that help neutralize free radicals and reduce oxidative stress. Foods rich in polyphenols—such as olives, fresh pressed extra virgin olive oil, berries, dark chocolate, green tea plus colorful fruits and vegetables—help protect the blood vessels and enhance heart health by reducing the risk of arterial inflammation. Regularly including these foods in your diet can support overall cardiovascular function and help maintain healthy blood pressure.
Guideline #5: Include The Dairy Matrix: Vitamin K2, Magnesium and Vitamin D
These nutrients are essential for managing calcium in the bloodstream and preventing it from depositing in arterial walls, which can lead to plaque formation and stiffness in blood vessels. Vitamin K2 helps direct calcium to the bones instead of the arteries, while magnesium supports muscle relaxation and overall heart function. Foods rich in Vitamin K2 include fermented dairy products, high quality Parmigiano-Reggiano, extra virgin olive oil, sunflower seeds and eggs. Adequate Vitamin D levels also support calcium balance, making these nutrients a powerful matrix for cardiovascular health.
By choosing nutrient-dense foods, minimizing processed ingredients, and focusing on balance in essential nutrients, you build the foundation for better heart health. Small, consistent changes—like reducing added sugars, increasing antioxidant-rich foods, and including functional foods high in omega 3 fats—can make a meaningful difference. Remember, the path to a healthier heart isn’t about restriction; it’s about making mindful, nourishing choices that support your body’s optimal function.
Lesley Nickleson, RD, IFNCP
Reference
Afshin, A., Sur, P. J., Fay, K. A., Cornaby, L., Ferrara, G., Salama, J. S., ... & Murray, C. J. L. (2019). Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 393(10184), 1958-1972. doi:10.1016/S0140-6736(19)30041-8
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