Healthier Heart Challenge: Change Up Your Diet

by Amy Hendel, P.A. Health Writer

If you’ve committed to the Healthier Heart Challenge, then you’ve hopefully met with your doctor for a screening and baseline studies to establish your current state of heart health. You’ve identified any risk factors (including family history) and you’ve started a walking program. Remember that sustaining your exercise commitment requires making it a conscious and mindful daily habit, tracking your heart rate during exercise, and making the effort to increase duration and intensity of your aerobic exercise. Keep building on this progress and move on to the next part of the challenge to improve your diet.

How to follow a heart-healthy eating program

The important components of your heart-healthy eating program include determining total number of daily calories, which requires a calculation of Basal Metabolic Rate (and a focus on portion control) plus choosing mostly food superstars. These foods are considered the “healthiest and most nutrient dense foods” in each food group.

If the goal is to (also) lose weight, you need to calculate the number of calories consumed daily that, taking into account your physical activity, allows for a “weekly deficit,” so that you burn excess fat to make up for that deficit and ultimately begin to shed fat pounds. It’s important to burn fat, not muscle mass. Your doctor or a nutritionist or dietitian can help you to determine the appropriate daily calorie intake. You can also use some basic formulas to calculate your daily calorie needs.

It’s worth mentioning that the yearly U.S. News & World Report review of the 40 best diets continues to rank the DASH Diet and the Mediterranean Diet highly. These two eating programs have ranked high for years, supporting overall health of all age groups. If you add some calorie restriction to either program, then there’s the potential to improve blood pressure and lose weight (DASH), or lose weight and reduce inflammation (Mediterranean). These two eating programs also have the potential to offer a framework of eating for life.

Let’s focus on some specific dietary considerations that are necessary for heart health.


The DASH Diet was actually developed to prevent/address hypertension, lowering heart attack and stroke risk). One major risk factor for hypertension is consuming too much salt or sodium. DASH is high in potassium, calcium, quality proteins and fiber, all elements in the foods emphasized in the diet. Foods emphasized in the diet include fruits and vegetables (aim for ten total servings combined and variety), whole grains (watch portion size), healthy proteins like fish, beans and lentils, tofu, nuts and seeds (the later are high in healthy fat so watch portions), and low fat dairy like Greek yogurt (watch for added sugars). This diet is rich in whole foods so you’re asked to “kick out” the many refined foods that likely pepper your current daily diet. Canned veggies and beans are fine – just rinse them well to remove salt. Aim for 1500 mg of sodium daily if you have hypertension or are “salt-sensitive” and less than 2000 mg of sodium daily if you are otherwise healthy. THAT will be a huge challenge so work towards that goal over time.

Trans and saturated fats

Most food companies have removed the dangerous artery-clogging trans fats from their processed foods, but it still lurks, so read labels and avoid foods with partially hydrogenated fats. Foods from animals (meat, whole fat dairy) are the major sources of saturated fats. There are plenty of foods containing healthy fats, such as avocado, unprocessed nuts, extra virgin olive oil, and fish, many of which are emphasized in the Mediterranean Diet. Studies have shown the heart health benefits of this lifestyle plan, which also emphasizes exercise, fresh produce, and limiting sugar and red meats.

Fish and plant-based proteins

Fish has already been mentioned because it’s a source of omega-3 fatty acids which combat inflammation, a component in heart disease risk. Look for low mercury fish like wild salmon. You can also include a serving of shrimp several times a week – the key is a measured portion since it’s higher in cholesterol. There’s been a general push to get consumers to eat more plant-based proteins which can help you to limit saturated fat while consuming heart-healthy fats. Tofu, tempeh, seitan, beans and legumes, seeds and nuts, Greek nonfat yogurt and the newer high protein pastas made from chickpeas and lentils offer high quality protein sans the saturated fat. Skinless poultry is fine for a meal some days of the week. An egg a day is fine even for individuals with heart disease. Think of red meat like a treat!

Superstar carbohydrates and portion control

We are all eating super-sized portions of unhealthy grain-based foods and we are eating these foods too frequently. Many processed grain-based foods contain heaping amounts of refined sugar which is now considered an inflammatory food and a food that can provoke heart disease. Too many servings of high sugar foods are also likely contributing to weight gain. So let’s be clear – you want to prioritize whole grains and be mindful of portions. This is the food category that gets us into the most trouble.

Meet daily fiber requirements for your age group, and that will nudge you towards healthier grain-based foods. Remember that baked goods are also sources of sodium, so read labels. Think of grains as toppings or ingredients instead of the main star – use healthy cereals as toppings not a main course, add pasta to your heaping plate of grilled or roasted vegetables, crumble a few baked crackers over your soup or salad.

Since fruits and vegetables are also carbohydrates (that naturally come with fiber), create a menu plan featuring a total of ten servings and then add in a few servings of grains. Learn about ancient grains and other delicious healthy grains.

What about drinks?

You need to wean off sugary beverages (soda, energy drinks, and sweetened teas), limit juice (don’t drink your fruit), and limit or remove diet soda since it’s filled with chemicals, usually has some sodium and may actually instigate weight gain. Watch out for smoothies, which are often packed full of calories. Also if you don’t drink wine, the possible heart health benefits do not make it worthy of a new habit. If you do drink alcohol, measured portions and a serving just few times a week is a good goal. Drink one percent or skim milk or some of the calcium fortified alternative milks (soy, pea-protein based) and start choosing these as your coffee creamer.

A day’s worth of eating

Frame this diet habit in the form of a checklist. See if you can aim for a day’s worth:

  • 5 servings of vegetables

  • 3 to 5 servings of fruit

  • 2 servings of low fat or fat free dairy (70 – 80 calories each)

  • 2-3 servings of lean protein (three to six ounces per serving depending on total daily calories)

  • A couple of servings of healthy fat (remember healthy proteins like nuts, seeds, fish contain fat)

  • 3-5 servings of grains (about 50 to 80 calories per serving)

Remember that this framework should work within your total daily calorie allotment.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”