As a cardiologist who has treated thousands of patients, I am often asked about what foods to eat for a healthy heart.
Of course, you don’t need be a nutritionist to know that you won’t benefit from a consistent diet of cheeseburgers, donuts and French fries. But there are a number of popular choices that are not as healthy for your heart as you might think.
Here are five foods I always try to avoid eating in excess — and what I opt for instead:
1. Bread
Many people are surprised to learn that bread and baked goods are some of the biggest contributors of sodium in our diets. High sodium consumption can raise blood pressure, which is a major risk factor in heart disease and stroke.
A plain bagel, for example, can contain 500 milligrams of sodium, which is about a third of what the American Heart Association recommends per day for most adults.
Refined flours in bread can also make our blood sugars spike. And remember, just because it’s brown, that doesn’t make it better.
For fiber content, I try to look for visible grains and seeds all throughout each slice, and I aim for at least three grams of fiber per 100 calories.
2. Margarine
Too much butter isn’t healthy for your heart, but alternatives like margarine aren’t always better.
There used to be more trans-fat — which raises “bad” cholesterol and lowers “good” cholesterol — in margarine before the FDA implemented a ban on partially hydrogenated oils in 2015. But just because the trans-fatty acids are gone, that doesn’t make margarine automatically good for us.
Many on the market are made with palm oil, which contains high amounts of saturated fats that can raise your cholesterol.
Margarine made from olive oil or flax oil are better choices. Olive oil contains only minor levels of saturated fat and no trans fats. Another great substitute for butter that I love is mashed avocado.
3. Skim milk
Milk and dairy products containing milk fat are major sources of saturated fatty acids. And while skim milk may be the better option, I still encourage people to switch it up and try alternatives.
Almond, cashew, and macadamia nut milks are higher in heart-healthy unsaturated fats, as are soy, hemp, and flax milks.
If you’re drinking milk because it’s a good source of calcium, know that calcium can be found in many different foods. Almonds, broccoli, kale, oranges, beans, edamame, figs and canned salmon are all heart-healthy options that can add more calcium to your diet.
4. Diet Soda
It might not contain any sugar, but diet soda can still mess with your biochemistry. Recent studies have revealed that artificial sweeteners found in diet soda can affect the production of important proteins in our gut that protect against obesity and diabetes.
For refreshing beverage options, I like going with tea, which is full of heart-healthy compounds that help fight inflammation and cell damage. Black and green tea have been associated with a lower risk of heart attack and stroke.
Another great option is a glass of sparkling water with some fresh fruit and mint leaves tossed in.
5. Granola Bars
Although they might sound healthy, most granola bars contain much more than just the oats, nuts and fruits typically highlighted on the front of the package.
Many also come loaded with added sugars, artificial sweeteners and other counterproductive ingredients, like palm oil.
I much prefer raw nuts as a satisfying snack on their own. When I eat oats, I typically go for a breakfast of oatmeal, using dried or fresh fruit as the sweeteners.
Dr. Elizabeth Klodas is a cardiologist and founder of Step One Foods. Trained at Mayo Clinic and Johns Hopkins, Dr. Klodas has published dozens of scientific articles throughout her career, authored a book for patients, “Slay the Giant: The Power of Prevention in Defeating Heart Disease,″ and served as founding editor-in-chief of Cardiosmart.org.
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