Heart disease is the leading cause of death in America, but many risk factors for heart disease can be reduced or prevented through diet and lifestyle modification. Although some genetic factors may increase your risk of heart disease, studies have shown that healthy habits such as regular exercise and eating a healthy diet can counteract genetic risks.

To lower your risk of cardiovascular disease and associated risk factors, limit your intake of sugar, processed foods, simple carbohydrates, and trans fats. A healthy diet should be high in fruits and vegetables — which contain beneficial polyphenols and antioxidants — as well as healthy fats, which help protect heart health.

Make an effort to include more of these foods in your diet:

  1. Salmon and other fatty fish, such as sardines and mackerel, are an important source of healthy fats. Fish is the primary source of EPA and DHA, two types of omega-3 fatty acids, which have been shown to lower the risk of arrhythmia (irregular heartbeat) and atherosclerosis, a buildup of plaque in the arteries that is a major risk factor for heart disease. Eat fatty fish at least twice a week, but no more than three times due to potentially dangerous mercury levels. If possible, choose wild-caught rather than farm-raised fish. You can also take fish oil supplements to increase omega-3 levels.
  2. Berries, such as blueberries, strawberries, and blackberries, have been shown to have heart-protecting properties. A 2013 study of women between the ages of 25 and 42 found that those who ate three servings of berries a week had a 34 percent lower risk of heart attack. Study authors attributed the benefits to compounds known as anthocyanins, which are antioxidants that may help decrease blood pressure.
  3. Several studies have shown that dark chocolate may benefit the heart. A 2012 study found that eating dark chocolate every day could reduce heart attacks and strokes in people who were at risk. Findings apply only to dark chocolate of at least 60 percent cacao. Dark chocolate contains beneficial polyphenols that may reduce blood pressure and inflammation, but many of the benefits are counteracted by milk, so look for the darkest chocolate you can find, with the lowest amount of sugar.
  4. A 2012 study found that women who consume high amounts of the flavonoids found in citrus fruits like oranges and grapefruits have a 19 percent lower risk of ischemic stroke (stroke caused by a blood clot) than women who don’t consume these compounds. Citrus fruits are also high in vitamin C, which has also been linked to a lower risk of heart disease. Opt for fresh fruit rather than juice, which often contains added sugar, and be aware that grapefruit may interfere with the efficacy of cholesterol-lowering drugs known as statins.
  5. Avocados provide a substantial amount of healthy monounsaturated fats, which can help reduce LDL cholesterol and improve blood glucose control. They contain nearly 20 vitamins and minerals, including potassium, which can help lower blood pressure, and a natural plant sterol called beta-sitosterol, which can help maintain healthy cholesterol levels.
  6. Tomatoes are also high in potassium, and are also a good source of lycopene, an antioxidant that may help reduce LDL cholesterol and lower the risk of heart attack.
  7. Nuts such as almonds, walnuts, pistachios, and macadamia nuts are a good source of vitamin E, which helps lower LDL cholesterol. Walnuts are also high in omega-3 fatty acids. Studies have also found that people who regularly consume nuts are leaner than those who don’t, which also helps lower the risk of heart problems. Look for nuts that don’t have a lot of added salt or flavoring.
  8. Legumes such as beans and lentils are a good source of protein. One study found that individuals who ate legumes at least four times a week had a 22 percent lower risk of heart disease than people who ate legumes less than once per week. Studies show that replacing animal protein with plant-based protein may also help reduce cancer risk, and legumes may help control blood sugar levels in people with diabetes.
  9. In a 2013 study, participants with a high risk of cardiovascular disease were put on one of three diets: a Mediterranean diet supplemented with olive oil, a Mediterranean diet supplemented with nuts, and a control diet that was lower in fat. Both versions of the Mediterranean diet showed protective effects after more than four years, resulting in a 30 percent lower risk in heart attacks and stroke. The low-fat diet resulted in no cardiovascular benefits. Olives and olive oil are both good sources of monounsaturated fats.
  10. Small amounts of red wine — one to two glasses per day — may help protect against heart disease. More than two glasses a day, however, can increase your risk. Resveratrol, a polyphenol found in red wine, may deliver added benefits, including helping the body break down fat.

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