Inflammation is at the root cause of heart disease. Elevated insulin, elevated blood sugar, inflammatory trans fats, and homocysteine (an inflammatory protein in the blood) irritate and inflame the lining of our blood vessels, or the endothelium. This initiates the process of coronary artery disease. 

Recent evidence shows that atherosclerosis, or plaque formation and calcification of the arteries, is driven by inflammatory cytokines and interleukins.

We know that inflammation is a major driver of heart disease. We also know that diet causes inflammation. The Nurses Health Study I and II followed more than 200,000 men and women and found that diets higher in foods that cause inflammation were associated with a significant 38% higher risk of cardiovascular disease, 46% higher risk of coronary heart disease, and 28% higher risk of stroke. 

What foods contribute to inflammation and thus increase heart disease risk?

• Red meat (especially grain-fed)
• Refined, processed carbohydrates (bread, pasta crackers, cereals)
• Sugar
• Trans fats (partially hydrogenated oils)- found in commercial peanut butter, shortening, fried foods (french fries, fried chicken, doughnuts), and commercial baked goods (cakes, cookies, and pies), frozen pizza, and non-dairy creamer.

What foods are anti-inflammatory and thus reduce heart disease risk?

• Dark leafy greens (kale, spinach, arugula, chard, collards): greens are rich in folate, which reduce homocysteine (an inflammatory protein in the blood that is linked to heart disease and stroke).
• Salmon, sardines, flax, chia, walnuts: rich in omega-3 fatty acids, which are anti-inflammatory fats.
• Organic, unprocessed soy (tofu, tempeh, edamame, miso): rich in isoflavones, which can significantly lower LDL (bad) cholesterol.
• Extra virgin olive oil: rich in monounsaturated fats and phenolic compounds, which improves cholesterol.
• Dark chocolate: improves endothelial function and blood vessel function and dilation. 
• Garlic: improves endothelial function and vascular elasticity. 

Practical tips for incorporating these super-foods in your diet on a regular basis:

• Greens: Eat a salad and/or a green smoothie every day to get a regular dose of greens. Aim for 2 cups/day.
• Salmon: Make salmon at home at least 1x/week. Opt for wild-caught when possible. When you eat out, order salmon on the menu. Even if it is not wild caught, it is still a heart healthy option (compared to a grain-fed burger with trans fat-laden fries!).
• Organic soy: I like the organic sprouted tofu from Trader Joe’s. Cut it in cubes and marinate it with a Primal Kitchen dressing or marinade. Tofu is bland on its own- marinades help “doctor it up.” Bake in the oven or air fryer for 25 minutes until crispy.
• Dark chocolate: Aim for 80% cacao or higher to ensure it is rich in antioxidants and low in sugar. Eat 2-3 squares as a daily treat. Or add 1 TBSP cacao powder to your green smoothie.
• Garlic: Add to soups, stir-fries, and homemade salad dressings. 

Supplements for a healthy heart:

• Fish oil: Omega-3 fatty acids found in fish oil have been shown to reduce the risk of cardiovascular disease by 13% and the risk of dying of it by 35%. Look for a fish oil with a higher EPA:DHA ratio fish oil for heart health.
• Hawthorn: protects the endothelium, reduces blood pressure, and reduces the oxidation of cholesterol.
• Curcumin (turmeric extract)
• Allicin (garlic extract): reduces blood pressure and cholesterol

Related topics:

Assessing Inflammation with these 3 Lab Markers

Fight Inflammation with Food

NMR Lipid Profile: Why you need this blood test to assess heart disease risk

Inflammation Busters: Fish oil vs. Flaxseed

How to Choose a Fish oil: EPA vs. DHA

Supporting your Heart with the Mediterranean Diet

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.