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Confused at the grocery store? This list will help you pick out the best food options for your heart.

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mediterranean broccoli pasta salad
Mediterranean Broccoli Pasta Salad
| Credit: Jennifer Causey

In the United States someone dies every 36 seconds from cardiovascular disease, according to the Centers for Disease Control. The good news is, research suggests that many of these deaths could be prevented with lifestyle changes, including a better diet. Genetics does play a role, as well. Eating for heart health is as much about what you do eat as it is about limiting certain foods and ingredients. Read on for a guide of what foods to buy and what to limit to keep your heart healthy including fruits and vegetables, meat, seafood, grains, desserts, frozen foods and drinks. (Don't miss this list of best and worst foods for heart health.)

Fruits and vegetables

Fruits and vegetables are the foundation of a heart healthy diet. They provide nutrients that are linked to lower blood pressure and cholesterol, including fiber, potassium, magnesium, and phytonutrients. "Don't worry about which ones are 'best' and choose the ones you will actually eat," encourages Lindsey Pine, M.S., R.D.N., C.L.T., owner of Tasty Balance Nutrition. Megan Byrd, R.D. at The Oregon Dietitian adds, "to get the most out of the produce aisle, choose a variety of colors." (Here's why you should eat the rainbow when it comes to fruits and vegetables.)

Frozen fruits and vegetables are just as nutritious as fresh. Just watch out for any added sugars or salt. Canned fruits and vegetables can be part of a heart-healthy diet, but limit ones with added sugar or lots of sodium. Diets high in sugar are linked to increased risk of cardiovascular disease and too much sodium can increase risk of high blood pressure.

Best options:

  • Any fresh fruits and vegetables
  • Avocados, which offer heart healthy monounsaturated fats
  • Fresh herbs, like basil and cilantro
  • Frozen fruits and vegetables
  • Canned fruit in fruit juice
  • No-salt-added canned vegetables or reduced-sodium options

Limit or avoid:

  • Canned vegetables with added salt
  • Canned fruit in heavy syrup or light syrup

Meat, poultry, fish, and plant-based proteins

When choosing heart-healthy proteins, plant-based proteins and fish are best. They are abundant in the Mediterranean Diet, a dietary pattern that has been shown to reduce risk of cardiovascular disease.

Byrd recommends "avoiding high fat and processed meats such as bacon, sausage, and heavily marbled cuts of beef and pork." Processed meats and those with saturated fat are linked to increased risk of cardiovascular disease. But you may even want to give some of the leaner cuts of red meat a second look. Newer research shows that eating any kind of red meat increases a circulating chemical called TMAO, which may also increase your risk of cardiovascular disease. That's not to say you can never enjoy a steak or a hamburger, just choose those less often.

The best protein options:

These have been shown to help prevent cardiovascular disease.

  • Beans (dried or canned with no added salt)
  • Lentils
  • Tofu & tempeh
  • Nuts & seeds
  • Fish, especially salmon, mackerel, and sardines, which are high in heart-healthy omega-3's

Good protein options:

These likely do not increase your risk for cardiovascular disease, but have not been shown to decrease your risk either. Research on dietary cholesterol and cardiovascular disease risk is mixed, but the consensus from the American Heart Association is to focus on dietary patterns rather than eliminating foods with dietary cholesterol like eggs and shellfish.

  • Shellfish
  • Eggs
  • Lean poultry

Limit or avoid these proteins:

These foods are linked to increased risk of cardiovascular disease

  • Red meat
  • Processed meats including sausage, bacon, salami, hot dogs, etc.

Grains

When choosing grain-based products, "it's all about whole grains," says Laura Yetz, R.D. at Being Nutritious. Whole grains contain fiber and phytonutrients linked to reduced risk of heart disease. "Watch out for labels like 'made with whole grains,' which can be misleading marketing claims," adds Yetz. Whole grains are usually in those products, but not necessarily a big chunk of it. There may not be as much beneficial fiber as you might think. Instead, look for the 100 percent whole grain stamp, which indicates that all of the grains in the product are whole. Or, look for products that list a whole grain, like whole-wheat flour, as the first ingredient.

That said, "bread products can be a sneaky source of sodium," notes Pine. Jennifer O'Donnell-Giles M.S., R.D., C.S.S.D. adds to also "watch out for hydrogenated oils and added sugars, which can show up in breads, cereals, and crackers."

"One easy way to identify heart healthy packaged grains is to look for the American Heart Association (AHA) heart check, which signifies it meets specific guidelines outlined by the AHA," says Tejal Pathak, M.S., R.D., L.D. However, not all heart-healthy foods will have this check. For example, bulk whole grains or whole-grain breads from local bakeries are unlikely to have gone through the approval process for the stamp.

Your best bets are going to be whole grains like oatmeal and whole-wheat pasta. If you're buying any packaged or processed grains—like crackers or breads—keep an eye on sodium and added sugars and choose whole-grain options most often.

Best options:

  • Oats and oatmeal
  • Farro
  • Wheat berries
  • Amaranth
  • Barley
  • Rye & rye berries
  • Quinoa
  • Buckwheat
  • Kamut
  • Brown rice
  • Whole-grain bread, pasta, and crackers
  • Whole-grain cereals with < 5g added sugar

Grains to limit:

  • White bread, pasta, and rice
  • Cereals made with refined grains and those with >5g of added sugar
  • Crackers and breads made from refined grains
  • Grain-based cereal bars
  • Grain-based desserts

Dairy and dairy alternatives

Research on dairy and cardiovascular disease is evolving. Recent research suggests that full-fat dairy products might not increase your risk for heart disease as much as we once thought. However, when dairy is replaced with whole grains or plant-based oils, cardiovascular disease risk goes down. The American Heart Association still recommends limiting saturated fat, so choose low-fat or fat-free dairy options most often. (Learn more about the differences between saturated fat and unsaturated fat.)

"Use full-fat dairy products like butter and whole milk where it really counts for flavor, but cook with plant-based oils like avocado and olive oil most often," recommends Pine. Another thing to watch out for in dairy products is sugar, which shows up in many flavored and plant-based alternatives.

Best options:

  • Plain low-fat or fat-free yogurt
  • Plain low-fat or fat-free milk
  • Unsweetened plant-based milks and yogurts
  • Flavorful cheese where a little goes a long way such as Parmesan, sharp cheddar, and blue cheese.
  • Low-sodium cottage cheese

Limit these options:

  • Sweetened yogurts
  • Sweetened plant-based alternatives
  • Heavy cream
  • Butter

Sauces, condiments, and spices

This can be a tricky part of the grocery store for those looking to eat for heart health. But, "a heart healthy diet doesn't have to be bland," says O'Donnell-Giles. Limit products that contain a lot of saturated fat, salt, and added sugar. Christa Brown, M.S., R.D.N. suggests "looking for dressings and condiments made from olive or canola oil, both of which are linked to reduced risk of cardiovascular disease."

You'll also want to consider the rest of your diet. It's recommended you keep sodium intake to less than 2,300 mg per day (under 1,500 mg if you are at high risk for heart disease), and sugar consumption to less than 24g (about 6 teaspoons) per day for women and 36g (about 9 teaspoons) per day for men. This can add up quickly with condiments. Often the best option is to make your own, but read labels and look for low-sodium (<140 mg per serving) and low-sugar (<3g per serving) options.

Best options:

  • Plant-based oils, including olive, canola, avocado, and nut/seed oils Vinegar
  • Spices and dried herbs
  • Mayonnaise made from canola, olive, or avocado oil
  • All natural nut and seed butters made without added sugar or hydrogenated oils

Sauces, condiments, and spices that need a second look:

  • Spice blends that contain salt
  • Soy sauce and other Asian-style sauces high in sodium
  • Tomato sauce
  • Bottled salad dressings
  • Some hot sauces
  • Sauces made with heavy cream
  • Barbecue sauce, ketchup and other sweet sauces
  • Jam and jelly
  • Coconut oil, which is high in saturated fat

The snack aisle

The snack aisle has evolved in recent years and if you know what to look for, you can find heart-healthy options. But sneaky marketing claims can steer you wrong, so read ingredient lists and nutrition facts labels. Yetz recommends "keeping sodium below 140 mg per serving, added sugar under 3g per serving and saturated fat less than 2g per serving." Fresh fruits and vegetables make great snacks but here are some options to choose when you're in the snack aisle. Be sure to read labels.

Best options:

  • Nuts & seeds (choose low-sodium and no-salt-added options)
  • Bars made from dried fruit and nuts or seeds, like Larabars
  • Popcorn
  • Whole-grain crackers
  • Dehydrated fruit and vegetables
  • Roasted chickpeas and other dried bean snacks

Snacks to limit:

  • Crackers, cookies, and bars made with refined grains and added sugar

  • Chips, pretzels, and other salty snacks
  • Fruit snacks and other high-sugar options

Freezer Aisle

Frozen foods have also progressed, with more emphasis on healthy options. However, many are still "high in sodium, sugar, and saturated fat, all of which should be limited on a heart healthy diet," notes Byrd.

Best options:

  • Frozen fruits and vegetables
  • Frozen whole grains, like brown rice
  • Whole-wheat breads and pizza dough

  • Bean and vegetable based vegetarian burgers (watch the sodium)

  • Plain frozen fish

Limit these:

  • Most frozen dinners
  • Frozen desserts

  • Breaded and fried options

Desserts

If you're looking for a sweet treat, dark chocolate, which contains flavonoids, (a phytonutrient linked to reduced risk of heart disease) is a great option (here's more on why dark chocolate is good for you). Fresh fruit is another good bet. Most other desserts contain a lot of added sugar, which is linked to increased risk of cardiovascular disease. So, desserts should be something to enjoy on occasion. Our heart-healthy dessert recipes all have limited saturated fat and sodium and are often made with less sugar and whole grains.

Beverages

You already know that water is one of the best option for overall health, but what about other drinks? Soda and energy drinks are the biggest contributor to added sugar in Americans' diets, and should be limited. Diet sodas, made with sugar substitutes, aren't considered any better for heart health. The research on caffeine and heart health is still up for debate. While too much caffeine can raise blood pressure in some people, coffee and tea contain antioxidants that may be good for your heart.

What about alcohol? Research suggests that people who drink red wine in moderation may be at lower risk for cardiovascular disease, but there isn't evidence to suggest that you should start drinking red wine if you don't already drink alcohol.

Best options:

  • Water
  • Unsweetened seltzers
  • Unsweetened tea or coffee

  • Moderate intake of red wine

Limit or avoid these

  • Sugary beverages

  • Coffee drinks made with cream and sugar or syrups
  • Excessive alcohol

Sarah Anzlovar, M.S., R.D.N., L.D.N. is the owner of Sarah Gold Nutrition, a virtual private practice where she empowers moms to ditch diets and learn to eat to feel their best and feed their families without the stress.