Widespread consumption of highly processed, carbohydrate-loaded, nutrient-poor foods has led to an epidemic of overweight and obesity in America - one of the main factors underlying the high incidence of insulin resistance, type 2 diabetes and heart disease.

Increasing fiber intake, eating whole grain foods, cutting down on butter and other saturated fats, eating lean chicken and fish instead of beef, exercising and giving up smoking have been shown to reverse coronary artery atherosclerosis within a single year. Fresh fruits and vegetables, beans and legumes, fatty fish, nuts and teas are rich in macro- and micronutrients that have been shown to protect arteries. For instance, a 1996 study monitored the diet of over 10,000 vegetarians for 17 years found that their overall death rate was half that of the general population, likely because of their daily consumption of fresh fruit.

Weight-loss programs such as the Atkins, Zone, Weight Watchers and Ornish diets are all intended for weight loss and any benefits for heart health are secondary.

The Mediterranean diet is characterized by the use of olive oil and is typically rich in fruits and vegetables, beans, nuts and seeds, whole grain bread and unrefined cereals. Dairy products, eggs, fish and poultry are consumed in low to moderate amounts, with little or no red meat along with moderate consumption of wine.

In 2004, the HALE study reported the effects of the Mediterranean diet on death rates in elderly European men and women aged 70-90 years. Combined with a healthy lifestyle - increased physical activity, moderate alcohol consumption and not smoking - this diet lowered death rates caused by heart disease by 50%.

The Lyon Diet Heart Study directly tested the effectiveness of a Mediterranean-type diet in people who had already suffered a first heart attack. This diet was so beneficial that the study was stopped after the first year. During a 4-year follow up period, patients following this diet showed a 50-70% reduction in risk of recurrent heart disease.

How Can Diet Protect Heart Health?

Free radicals attack LDL cholesterol, known as the ‘bad’ cholesterol, but actually a harmless molecule in itself. It is only when LDL is ‘oxidized’ by free radical attack that it becomes dangerous, damaging arterial cell walls.

Exhaust fumes, particulate matter, and cigarette smoke are full of free radicals. Overly processed, hydrogenated and sugary foods also shuttle them into the body. The immune system responds by sending white blood cells to neutralize the harmful oxidized version of LDL cholesterol and engulf it, the first step that leads to heart disease.

The following 12 macro- and micronutrients in food affect this process in multiple ways:

1. Dietary monounsaturated fats such as those found in olive oil, most notably oleic acid, reduce heart disease risk. In the US, olive oil producers are allowed by law to claim that 2 tablespoons daily may reduce coronary heart disease risk based on clinical data. Extra virgin or virgin olive oil also contains monounsaturated fatty acids and antioxidants (for example, vitamin E) and polyphenols, which make LDL cholesterol more resistant to oxidative damage and prevent formation of plaques. Olive oil also has anti-inflammatory, antithrombotic, antihypertensive and vasodilatory effects.

2. Countless studies have established a link between higher omega-6 fats and rising rates of heart disease. A recently concluded meta-analysis found that giving omega-3 dietary supplements for at least 1 year significantly reduced risk of death by heart disease in over 39,000 patients with heart problems. In fact, an earlier study had shown that omega-3 fats were more effective than statin drugs in reducing heart disease-related deaths. Found in: cold water algae and oily fish such as sardines, wild salmon, herring, mackerel and tuna that feed on these plants, walnuts and flax seed.

3.. Vitamin B-9 (folate) is important for heart health because it lowers levels of harmful homocysteine. Vitamins B-6 and B-12 are also involved in homocysteine metabolism - vitamin B-6 also further protects against blood clots and atherosclerosis. Niacin or vitamin B-3 increases HDL or ‘good’ cholesterol. Vitamin B-9 is found in spinach, broccoli, strawberries, blueberries, oranges, red bell peppers, oranges, tomatoes, black and kidney beans, walnuts, tuna, tofu and soy milk. Vitamin B-6 is found in beef liver, baked potatoes, beans, watermelons and bananas. Vitamins B-3 and B-12 are found in milk, soy milk, rice, meats, fish, spinach, red bell peppers, beans, eggs and cheese. Vitamin B-3 is also found in tuna, tofu, nuts, and oat bran.

4. Dietary fiber decreases heart disease risk by binding to cholesterol and removing it from the body.  Found in: oatmeal, beans and legumes, almonds, walnuts, whole grains, carrots, spinach, broccoli, sweet potato, bell peppers, asparagus, oranges and apples.

5. Carotenoids are heart-protective antioxidants. Found in: carrots, blueberries, spinach, broccoli, sweet potato, red bell peppers, asparagus, oranges, tomatoes, acorn squash and other fruits.

6. Vitamin C is a powerful antioxidant that recycles vitamin E and assists it in preventing oxidation of LDL cholesterol. Vitamin E is a powerful antioxidant that protects LDL cholesterol from oxidation. Regular intake of vitamin E supplements reduces heart disease rates by up to 40%. Vitamin C, alpha-lipoic acid and glutathione are all required to recycle vitamin E. Vitamin C is found in: oranges, blueberries, broccoli, sweet potatoes and tomatoes.

7. High levels of lycopene are associated with reduced risk of heart disease. Found in: tomatoes, red carrots, watermelons and papayas.

8. Reservatrol prevents LDL oxidation and platelet aggregation. Found in: grape skins, red wine and peanuts.

9. Polyphenols are antioxidants that reduce LDL cholesterol, protect blood vessels and lower blood pressure. Found in: red wine, grapes, blueberries, soy milk, dark chocolate and green tea.

10. Magnesium reduces risk of heart disease and type 2 diabetes, a major risk factor for heart disease. Found in: spinach, whole grains and nuts.

11. Potassium helps to regulate blood pressure. Found in: bananas, peaches, oranges, tomatoes, cantaloupe, papaya, baked potatoes, broccoli, winter squash, regular and dried apricots and raisins.

12. Calcium helps to regulate blood pressure along with magnesium and potassium. Found in: dairy, soy milk, broccoli, almonds, papaya, acorn squash, spinach, beans and tofu.