The diet after heart attack or stroke: what should you eat after a cardiac event?

A heart attack or stroke is a serious medical incident that cuts off oxygen to the tissues (heart and brain) – and without oxygen, these tissues die. Recovery takes time. It begins immediately, in hospital, and depending on the severity, can continue for weeks and months later when you are home. Make sure you keep a long-term perspective with your dietary changes and think about changing your habits in a sustainable way.

After experiencing a traumatic event like a heart attack or stroke, it’s tempting to start cutting foods out of your diet, especially when lots of blogs, websites and programs recommend you do so. This is generally unsustainable for you to manage long term and also unnecessary. Good cardiovascular health requires you to eat well long term. If you can’t sustain your new strict regime, you may not receive the benefits.

Your body needs nutrients, so instead of focusing on the foods you shouldn’t eat, turn your attention to the foods you should eat. Here are some foods to focus on including in your diet every day.

Choose whole grains to boost your dietary fibre intake

It's recommended adults have 25–30g fibre per day.¹ Dietary fibre helps to reduce our LDL “bad” cholesterol,² manage our weight, moderate our blood sugar levels, and keep us feeling full and satisfied. Whole grains include:

• oats
• pearled barley
• brown rice
• all bran cereal (and other high fibre cereals)
• rye and grainy breads
• wholemeal pasta, etc.

Eat plenty of fruit and vegetables

Packed full of nutrition and dietary fibre, fruit and vegetables are a vital part of long-term health and need to be eaten daily. Here are some tips.

• Eat whole fruit instead of fruit juice. It has more dietary fibre and will keep you feeling fuller for longer.
• Sauté or simmer vegetables to preserve the micronutrients (without adding any fat, sugar or salt to the cooking process).

Have a handful of nuts a day

There is good evidence for the daily consumption of nuts. They are rich in nutrients and heart-healthy fats, and they are perfect to snack on. Around 20 – 30g unsalted nuts can improve blood lipids.²

Include protein from lean meats, seafood or vegetarian options

Choose lean meats with trimmed fat, or poultry without the skin. These are much better choices than processed meats such as schnitzel, salami, ham and bacon.

Fish is a great source of lean protein, and the fatty fish species like salmon and tuna are rich in omega-3, heart-healthy fats. Aim to include 2 – 3 serves of fish per week.

Good vegetarian sources of protein include:

• Eggs
• Dairy: milk, yoghurt, cheese
• Soy: milk, beans, tofu, tempeh
• Legumes: beans, lentils, chick peas
• Nuts: peanuts, cashews, almonds, walnuts, macadamias.

A good protein-packed snack is yogurt topped with nuts and seeds.

Once you have a good idea of what to eat to boost your nutrition and aid your recovery, it’s time to turn your attention to reducing ultra-processed foods and making them an occasional treat. These foods are often high in energy, salt, fat and sugar, and because of this, they are ‘moreish’ and easy to overeat.

• Limit high sugar foods like chocolate, lollies, ice cream and custard.
• Limit fried or baked foods, especially chips, biscuits, cakes and other baked products.
• Always choose water first and avoid sugar sweetened drinks. Tea and coffee can be enjoyed in moderation.
• Avoid adding salt to food. Choose ‘no added salt’, ‘low-salt’ or ‘salt reduced’ foods where possible.

…but isn’t chocolate good for my heart?

The high cocoa percentage in some dark chocolate products may offer more antioxidants than milk chocolate, however there is not enough evidence to suggest that consumption of dark chocolate offers benefits to heart health.²

Here are some heart-healthy swaps to get you started.

• Swap plain corn flakes for a cereal such as Kellogg’s Guardian, which has more fibre and contains psyllium and barley to help reduce cholesterol.
• Swap 30g of salted nuts to 30g unsalted nuts, as they contain much less sodium.
• Swap white bread for a wholegrain and oats bread, as this contains less sodium, more fibre and betaglucans to help reduce cholesterol.
• Swap regular stock cubes for a reduced salt chicken stock.
• Swap regular tasty cheese for a light tasty cheese to cut down some saturated fat intake.
• Swap butter and mayonnaise for a spread of avocado on sandwiches or wraps.

While it’s always important to limit intake of salt, sugar, saturated fats and alcohol for your heart health, it is doubly so after a stroke.

Be aware that after a stroke, you may be at risk of poor nutrition and excessive weight loss that can delay recovery. You may have difficulty swallowing, problems with using your hands to feed yourself, forget to eat or have a lower appetite. In addition, you must be wary of any nutrients that may interact with your medications. Speak to your GP about management of such issues.