Diet Plan

General Tips

Need More Help? Ask CardioDiet Coach!

Special Considerations If You Have Other Conditions

👉 Tip: Think of these as add-ons to your main heart-healthy eating plan. Small, consistent changes = long-term results.

Two Diets, One Healthy Outcome 

 Mediterranean-style Diet

Evidence: The American College of Cardiology and American Heart Association recommend a Mediterranean-style diet for patients with heart failure with preserved ejection fraction (HFpEF), including those undergoing high-intensity interval training, to help reverse or stabilize heart disease. This dietary pattern emphasizes higher intake of plant-based foods, whole grains, fruits, vegetables, legumes, nuts, and lean protein sources such as fish, while reducing saturated fat (e.g., red meat) and optimizing caloric intake to support weight loss in overweight or obese individuals. The rationale is that the Mediterranean diet is associated with improved cardiometabolic risk factors, lower rates of cardiovascular events, and reduced all-cause mortality, as demonstrated in multiple randomized trials and cohort studies.[1-2]

 DASH Diet

Dietary Approach to Stop Hypertension

Evidence: The DASH diet emphasizes vegetables, fruits, whole grains, low-fat dairy, lean proteins (fish, poultry), nuts, seeds, and legumes, while limiting sodium, sweets, sugary beverages, and foods high in saturated fat. 

Originally developed to lower blood pressure, the DASH diet has been shown to significantly reduce both systolic and diastolic blood pressure, with the strongest effects seen when combined with reduced sodium intake.⁷ In addition to hypertension control, DASH improves lipid levels, reduces insulin resistance, and supports weight management, all of which are critical in patients with cardiovascular disease.⁶

For secondary prevention in patients with CAD, adherence to the DASH dietary pattern is associated with reduced risk of recurrent cardiovascular events and mortality. Large cohort analyses and guideline recommendations highlight that dietary patterns like DASH—rich in plant-based foods, lean protein, and low sodium—improve long-term outcomes in patients with established coronary artery disease.²

In summary, the DASH diet is a flexible, evidence-based plan that not only lowers blood pressure but also contributes to secondary prevention of CAD, reducing the risk of heart attacks, strokes, and cardiovascular death in patients with established disease.

 Non-Fat Plant Diets

(Unproven)

Evidence: Some cardiology advocates, such as Caldwell B. Esselstyn, Jr., MD, promote strict fat-free, plant-based diets as a way to halt or even reverse coronary plaque progression. While such dietary approaches are not universally accepted or proven in large randomized trials, proponents highlight case series and long-term adherence data suggesting regression of atherosclerosis in select patients. The plan emphasizes whole-food, plant-based eating, completely avoiding animal products, added oils, and high-fat foods.

References:

1. Anderson TJ, Grégoire J, Pearson GJ, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023;81(13):1357-1448. doi:10.1016/j.jacc.2023.04.003
   
   

2. McDonagh TA, Vaduganathan M, Butler J, et al. 2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure: A Report of the American College of Cardiology. J Am Coll Cardiol. Published June 2025. doi:10.1016/j.jacc.2025.04.123  (placeholder DOI until final indexing)
   
   

3. Estruch R, Ros E, Salas-Salvadó J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet (PREDIMED trial). N Engl J Med. 2013;368(14):1279-1290. doi:10.1056/NEJMoa1200303
   
   

4. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Circulation. 2019;140(11):e596-e646. doi:10.1161/CIR.0000000000000678
   
   

5. Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk. Circulation. 2014;129(25 Suppl 2):S76-S99. doi:10.1161/01.cir.0000437739.71477.ee
   
   

6. Mozaffarian D. Nutrition and Cardiovascular Health: A Review of Current Evidence and Future Directions. N Engl J Med. 2023;389(1):74-88. doi:10.1056/NEJMra2211889
   
   

7. Siervo M, Lara J, Chowdhury S, Ashor AW, Oggioni C, Mathers JC. Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Cardiovascular Risk Factors: A Systematic Review and Meta-analysis. Nutrients. 2024;16(2):348. doi:10.3390/nu16020348
   
   

8. Schwingshackl L, Chaimani A, Hoffmann G, Schwedhelm C, Boeing H. Impact of different dietary approaches on blood pressure in hypertensive and pre-hypertensive patients: Network meta-analysis. Nutrients. 2017;9(8):790. doi:10.3390/nu9080790
   
   

9. Esposito K, Maiorino MI, Bellastella G, Panagiotakos DB, Giugliano D. Mediterranean diet for type 2 diabetes: Cardiometabolic benefits. Endocrine. 2017;56(1):27-32. doi:10.1007/s12020-016-1018-2
   
   

10. Rees K, Takeda A, Martin N, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2019;3(3):CD009825. doi:10.1002/14651858.CD009825.pub3
    
    

11. Martínez-González MA, Gea A, Ruiz-Canela M. The Mediterranean Diet and Type 2 Diabetes Prevention. Nutrients. 2019;11(11):2629. PMCID: PMC6245208
    
    

12. UpToDate. Healthy diet in adults: Overview of the role of diet in cardiovascular disease prevention. Accessed August 2025. https://www.uptodate.com
    
    

13. Schwingshackl L, Bogensberger B, Hoffmann G. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies. J Acad Nutr Diet. 2018;118(1):74-100.e11. doi:10.1016/j.jand.2017.08.024