# Nutrition and diet in coronary heart disease
Nutritional choices play an important role in coronary heart disease. They can help keep blood fats in balance, regulate blood pressure and reduce inflammation in the body — all factors that affect the health of the coronary arteries. Research shows that certain eating patterns can reduce the risk of further heart problems.
Mediterranean dietary pattern
ProveniIncluded in official guidelines, or approved by EMA or FDA
This eating pattern is based on traditional meal habits in countries around the Mediterranean Sea. It consists mainly of vegetables, fruit, grains (preferably whole grain), beans, nuts, fish and olive oil. Red meat is rarely consumed; instead, fatty fish species (such as salmon and mackerel) are eaten regularly.
Research shows that patients with coronary heart disease who follow this pattern are more likely to stick with it than with other eating patterns (2026). This pattern also appears to go well with a lower risk of recurring heart events and better overall health. The benefits are partly explained by the abundance of unsaturated fats, fiber and substances that can reduce inflammation.
An important advantage is that this pattern is relatively easy to maintain long-term, because it offers more variety and flavor than strictly restricted diets.
DASH eating pattern (Dietary Approaches to Stop Hypertension)
ProveniIncluded in official guidelines, or approved by EMA or FDA
DASH stands for 'Dietary Approaches to Stop Hypertension' and was specially developed to lower blood pressure. The pattern emphasizes plenty of vegetables, fruit, lean proteins (especially fish and chicken), whole grains, beans and low-fat dairy products. Salt is limited, as are sugar and saturated fats.
Research from 2026 shows that compliance with this pattern over the years is associated with less calcium buildup in the coronary arteries (coronary artery calcification). This is a sign that this pattern can help prevent the narrowing of the arteries from worsening. The pattern works primarily through blood pressure reduction and cholesterol lowering.
Many cardiologists recommend this pattern because it is proven effective and relatively simple to apply in practice.
Protein-rich nutrition
ResearchediPositive results in clinical studies, not yet standard treatment
An eating pattern with more protein — especially from animal and plant-based sources — is being studied in relation to heart health. Proteins can help maintain muscle tissue and increase the feeling of satiety.
However, there is no clear evidence yet that more protein is necessarily better for people with coronary heart disease. It makes a difference which protein sources are chosen: fish and plant-based proteins (such as beans and nuts) are part of eating patterns that support heart health; red meat and processed meat, on the other hand, have adverse effects on coronary heart disease and are discouraged.
Diet high in unsaturated fats
ProveniIncluded in official guidelines, or approved by EMA or FDA
This pattern emphasizes sources of unsaturated fats, such as olive oil, nuts, seeds and fatty fish. These fats help reduce inflammation in the body and can favorably influence blood fats.
Research supports that this pattern is well associated with better outcomes in coronary heart disease. The so-called "Mediterranean diet" pattern (see above) is actually a good example of a diet high in unsaturated fats.
Limiting salt
ProveniIncluded in official guidelines, or approved by EMA or FDA
Lower salt intake helps lower blood pressure and reduces the strain on the heart. This is particularly important in coronary heart disease, where high blood pressure can accelerate the narrowing of arteries.
Many food sources — such as bread, canned soups, cold cuts and ready-made meals — contain a lot of hidden salt. Consciously limiting it is part of the DASH and Mediterranean pattern.
Limiting saturated fats and trans fats
Discouraged (high intake)
Saturated fats (including those from red meat, butter, and full-fat dairy) and especially trans fats (found in many industrially processed products) increase 'bad' LDL cholesterol and increase inflammation. In coronary heart disease, these fats can accelerate deposits in the arteries and increase the risk of heart attack.
This is the main reason why high intake of these fats is discouraged. They should be limited in any diet for heart disease.
Food rich in fiber
ProveniIncluded in official guidelines, or approved by EMA or FDA
Food rich in soluble fiber — from oatmeal, fruit, beans, and vegetables — helps lower cholesterol in the blood and can keep blood sugar more stable. This contributes to better heart health.
This aspect is built into both the Mediterranean and DASH patterns and is generally supported by research.
Limiting sugar and refined carbohydrates
ResearchediPositive results in clinical studies, not yet standard treatment
A diet with less added sugars and less white bread, white rice, and sugary drinks is recognized as beneficial. These products can cause blood sugar spikes and may contribute to overweight and diabetes — both risk factors for coronary heart disease.
However, there is no clear evidence for one 'optimal' limit. Most studies suggest that gradually replacing refined products with whole grain varieties is beneficial.
Periodic fasting
ExperimentaliOngoing in study setting, outcome still unknown
Intermittent fasting (where you don't eat for certain hours or days, or eat very little) is increasingly being studied in heart disease. Some studies suggest that this can improve blood fats and blood sugar and reduce inflammation.
However, there is still insufficient evidence to make this a standard recommendation for coronary heart disease. Some patients taking certain medications (such as blood sugar-lowering drugs) must be careful with fasting. This always requires guidance from a doctor or dietitian.
Ketogenic diet
ResearchediPositive results in clinical studies, not yet standard treatment
This diet severely restricts carbohydrates and increases fat intake. It is being researched for weight loss and blood sugar control, but for coronary heart disease it has not yet been researched as a standard recommendation.
A potential benefit is weight loss; however, many ketogenic diets are rich in saturated fats, which can be harmful. Caution is advised, and it always requires guidance from a cardiologist and dietitian.
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**Food choices are individual.** Each person with coronary heart disease is different: medication use, other conditions (diabetes, kidney problems), preferences, and life circumstances all play a role. A specialized cardiac dietitian can help you put together a nutrition plan that fits your situation and goes along with your treatment. Always speak with your healthcare provider before making major dietary changes.
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._