The good news is that heart-healthy meals don’t have to be bland or boring. In this article, we provide practical tips and strategies to help you make heart-healthy choices without sacrificing flavor. With insights from Gabrielle Gambino, MS, RD, CDN, CNSC, a senior clinical dietitian with NewYork-Presbyterian/Weill Cornell Medical Center’s Advanced Heart Failure Service, we’ll explore how to prepare delicious meals at home, dine out wisely, and plan your menus to support a healthy heart.

What Does a Heart-Healthy Meal Look Like?

A heart-healthy meal is rich in healthy fats, fiber, and lean proteins. Here’s how you can incorporate these components into your daily diet:

• Healthy fats: Use olive oil, canola oil, or flaxseed oil for cooking and dressings.

• High fiber: Include whole-grain breads, brown rice, and sweet potatoes.

• Lean proteins: Opt for chicken breast, tuna, salmon, or tofu.

Enhance the flavor of your meals with herbs and spices such as cayenne pepper for vegetable-based dishes, onion powder or garlic for egg-based recipes, and oregano or rosemary for chicken dishes. These not only add zest to your dishes, but also eliminate the need for excessive salt. “Herbs and spices are fantastic alternatives to salt, allowing you to enjoy flavorful meals while keeping your heart healthy,” says Gambino.

Meal Planning and Preparation

Planning and prepping meals in advance can help to maintain a heart-healthy diet:

• Weekly meal planning: Plan lunches for the week to avoid sodium-packed processed foods at home or high-fat convenience foods away from home.

• Batch cooking: Cook in bulk, and freeze individual portions. This ensures that there is always a heart-healthy entrée ready to be defrosted.

“Batch cooking on Sundays can set you up for a successful week. Prepping proteins, vegetables, and grains in advance makes it easy to assemble healthy meals quickly,” says Gambino.

Dining Out and Celebrations

Even when dining out or celebrating, manage portions and choose wisely.

• Portion control: Share entrees with a friend, or save half for later.

• Healthier sides: Opt for a side salad or steamed vegetables.

• Sauces on the side: Request sauces on the side to control sodium intake.

• Read the menu in advance: Peruse the menu online and decide what you’ll order before leaving the house.

“Dining out doesn’t have to derail your heart-healthy diet,” says Gambino. “It’s all about balance and making smart choices, like choosing fiber-rich sides and limiting high-sodium condiments.”

Heart-Healthy Recipe Modifications

Include family-friendly comfort foods in your plan for days when a lean protein and vegetable seem unappetizing. For instance, with some simple modifications you can turn pasta with tomato sauce and meatballs into a heart-friendly meal:

• Homemade sauce: Use homemade, rather than jarred, tomato sauce to control the sodium level (see recipe above).

• Pasta options: Whole-wheat pasta and chickpea pasta are flavorful and heart healthy.

• Lean meat alternatives: For meatballs, use ground turkey instead of beef.

• Bake instead of frying: Bake meatballs in the oven or cook them in an air fryer instead of frying them in oil, to reduce fat content.

• Vegetable additions: Add bell peppers, onions, and other vegetables to your sauce for extra antioxidants and fiber.

• Cheese alternatives: Skip cheese, use low-sodium cheese, or try nutritional yeast, which is a vegan substitute with low sodium and probiotic benefits. Sprinkle it on foods for an added flavor similar to parmesan cheese.

Mindful Dietary Choices

Adopting a heart-healthy diet is a journey that involves making mindful choices both at home and when dining out. By incorporating healthy fats, fiber, lean proteins, and flavorful herbs into your meals, you can enjoy delicious and nutritious food. Meal planning and batch cooking can further support your goals by ensuring you have healthy options readily available throughout the week.

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Sugar substitutes don’t raise your blood sugar or cause tooth decay the way sugar (sucrose) does, but that may be the extent of their health benefits.

Health Impact.

Sugar substitutes are typically used to replace sucrose in processed foods. “The consumption of sugar-sweetened foods (and beverages in particular) has been consistently linked with increased risk for a number of disorders,” says Alice H. Lichtenstein, DSc, Gershoff Professor at the Friedman School and editor-in-chief of this newsletter, “including type 2 diabetes, coronary heart disease, hypertension, excess body weight, and possibly even frailty. Use of beverages and foods made with sugar substitutes, if successful in reducing the intake of added sugars, could result in health benefits. However, the jury is still out on how successful their use is in accomplishing this goal and what the health impact will be.”

Dental Health: It is generally accepted that replacing sucrose with sugar substitutes reduces the risk of developing cavities. Some data even indicate that the sugar alcohol xylitol in chewing gum may play an active role in cavity prevention.

Weight Loss: It’s difficult to determine if sugar substitutes help with weight loss. Long-term studies are lacking, but short term randomized controlled trials (which can establish cause and effect) have shown that providing beverages sweetened with sugar substitutes in place of those sweetened with sucrose has a beneficial effect on body weight. But in one trial, a beverage sweetened with the artificial sweetener sucralose was reported to increase food cravings more than a sugar-sweetened beverage, especially in women and people with obesity.

Some observational studies (in which researchers compared people’s reported food intake to their weight) have suggested that consumption of foods made with sugar substitutes may actually be associated with higher body weight. “However, these studies cannot determine whether the sugar substitutes themselves lead to excess weight gain or if individuals with overweight or obesity are just more likely to choose products containing sugar substitutes,” says Lichtenstein. “Additionally, if low-sugar or sugar-free products are added to a high calorie diet, rather than replacing sugar-containing products, weight loss will not occur.”

Diabetes: If cutting calories by using sugar substitutes does lead to weight loss, it could help treat or decrease the risk of developing type 2 diabetes. Additionally, sugar substitutes raise blood sugar levels much less than sucrose—if at all. The American Diabetes Association cautions that some research indicates even sugar substitutes may be associated with some rise in blood sugar. “Foods and beverages made with sugar substitutes are a better option than those with added sugar for people with diabetes,” says Richard Siegel, MD, co-director of the Diabetes and Lipid Center at Tufts Medical Center, “but I encourage my patients to focus on nutrient-dense foods, like fruits, vegetables, and nuts instead of low-calorie or low-sugar versions of cookies and candy.”

Even if foods made with sugar substitutes do have some health benefits when used in place of sugar-sweetened foods, Lichtenstein says it’s best to limit their intake anyway. “Foods containing these compounds are almost always ultraprocessed,” she says, “and we know dietary patterns high in ultraprocessed foods are associated with negative health outcomes.”

Safety Concerns.

There is a large body of research looking at potential health hazards from consuming sugar substitutes, but there has yet to be any conclusive proof of danger from any products currently on the market.

Plant-derived noncaloric sweeteners (sugar alcohols, stevia, monk fruit extracts, and allulose) fall under the U.S. Food and Drug Administration (FDA) category “Generally Recognized as Safe,” or GRAS. This means experts have concluded that the substance is safe under the conditions of its intended use in the quantities typically consumed.

Artificial sweeteners (synthetic, or man-made, compounds) are regulated as food additivies and must meet a higher standard of proof of safety. The FDA establishes an acceptable daily intake (ADI) level for all artificial sweetners. An ADI is the amount of a substance that is considered safe to consume each day over the course of a person’s lifetime. Artificial sweeteners are 200 to 20,000 times sweeter than sucrose, so very little is needed to make foods taste sweet. Even people who consume a lot of these man-made sweeteners are unlikely to exceed the ADIs.

Cardiovascular Disease: Recent studies involving participants in the U.S. and Europe found that high blood levels of the sugar alcohols erythritol and xylitol were associated with increased risk of heart attack and stroke, but these findings need confirmation. At this time, there are no established links between sugar substitutes and cardiovascular disease.

Cancer: Federal legislation prohibits the approval of any compound established to cause cancer. Overall, the results of the large number of studies looking for a link between sugar substitutes and cancer have been inconsistent. A 2023 review that looked at all available data concluded that evidence associating artificially sweetened beverage intake with cancer was weak. An observational study published in 2022 found the highest reported intake of artificial sweeteners was associated with a small increase in cancer risk compared to the lowest reported intake. While there is limited evidence (not convincing) that aspartame may increase cancer risk, experts agree this artificial sweetener is likely safe at the levels at which it is typically consumed.

Looking at the body of research to date, sugar substitutes (in reasonable quantities) appear to be a safe alternative to added sugars, and may reduce tooth decay and help manage blood sugar levels—but the truly healthy choice is to cut back on ultraprocessed sweet foods. Drinking mostly water and getting one’s sweet fix from nutrient packed fruits is truly a “sweet” choice.

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The Centers for Disease Control and Prevention (CDC) recommend that all Americans over the age of six months get an updated COVID-19 vaccine when these become available this fall. By now, nearly all Americans have had a COVID infection, gotten a COVID vaccine, or both, but the updated vaccines offer a timely boost as immunity wanes and the virus continues to mutate. While mutations are thought to help COVID variants evade immune defenses and spread faster, there is no evidence they cause more severe illness. Even so, people ages 65 and older remain at great risk of COVID-related complications—they account for two-thirds of COVID hospitalizations and 82 percent of in-hospital deaths, according to the CDC. Only about 40 percent of Americans in that age group were immunized with the COVID vaccines that were offered last fall. You can visit the CDC’s dedicated COVID vaccine website for more information (http://tiny.cc/CDCCovid).

Plant-Based Meats May Reduce Cardiovascular Disease Risk

Plant-based meat alternatives often are marketed as being low in harmful saturated fat compared with “real” meat—however, up to now it hasn’t been clear if the products reduce the risk of cardiovascular disease. A recent review from researchers at the University of British Columbia, in Vancouver, suggests that they do even though they are classified as ultra-processed foods. The review (Canadian Journal of Cardiology, June 25) looked at studies published from 1970 to 2023, and found that cardiovascular risk factors like total cholesterol, LDL (“bad”) cholesterol, and body weight all improved when people substituted plant-based meat alternatives for real meat in their diets. Compared with real meat, plant-based meat products tend to be higher in sodium, which contributes to high blood pressure. However, the review did not find that the meat substitutes raised blood pressure.

Ultra-Processed Food Harms

A recent study underlines the mortality risks associated with diets that are high in ultra-processed foods. The National Cancer Institute study looked at data from more than 540,000 people who provided information about their eating habits and health in the mid-1990s, when they were ages 50 to 71. Over half of the participants have since died. The researchers analyzed overall rates of death among those who were in the 90th percentile for consumption of ultra-processed foods at the start of the study versus those in the 10th percentile. Processed foods were defined according to a standard classification system, and included deli meats, snacks, ready meals, fast foods, and soft drinks. People who ate the greatest amounts of ultra-processed foods over the median 23-year follow-up were 10 percent more likely to die early than those who ate the least. The study was presented at the annual meeting of the American Society for Nutrition in June.

Stroke Mortality Worse for Black People

Overall rates of long-term survival following stroke are getting better—but not for Black people, according to a new University of Cincinnati study (Neurology, July 15). Researchers identified 8,428 cases of ischemic stroke (the type caused by a blood clot) and 1,501 cases of intracerebral hemorrhage (a less common and more severe type of stroke caused by bleeding in the brain). Among participants with ischemic stroke, five-year survival decreased from 53 percent in 1993-94 to 48 percent in 2015. There were no changes in five-year survival following an intracerebral hemorrhage. While the overall numbers improved, Black study participants were found to be 20 percent more likely to die within five years after an ischemic stroke than white people. Long-term social, economic and environmental inequities likely contribute to the disparity. See this month’s From the Editor for stroke-prevention advice.

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A: A food matrix refers to the complex physical and chemical structure of a food. It includes the way nutrients and other compounds are organized and may interact within the food. This overall structure impacts how nutrients are digested, absorbed, and metabolized by the body. For example, the matrix found in whole foods (like fruits and vegetables) is often more complex than in processed foods, affecting the release and the availability of nutrients.

The food matrix can also impact the sensory traits of food, including texture, flavor, and appearance, which in turn may influence consumer preferences and eating behaviors. The matrix also affects food processing and preservation, as the matrix may influence how foods respond to cooking, drying, or freezing.

It is important to understand the food matrix because it provides insight into how different foods may exert varying health effects, even though their nutritional content may be similar.

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Common Shortfall Nutrients. The U.S. Dietary Guidelines identify several nutrients that are often lacking in the average diet. These include:

Calcium: Vital for bone health and muscle function, calcium is often underconsumed, which can lead to osteoporosis and higher fracture risk.

Vitamin D: Essential for calcium absorption and bone health, vitamin D deficiency is widespread due to limited dietary sources and insufficient sunlight exposure. It plays a crucial role in immune function and inflammation reduction.

Potassium: This mineral helps regulate blood pressure and fluid balance. Most people do not consume enough potassium which can contribute to hypertension and cardiovascular issues.

Fiber: Dietary fiber is often lacking in diets dominated by processed foods. Adequate fiber intake supports healthy bowel movements and can help manage cholesterol and blood sugar levels.

Iron: Essential for producing hemoglobin and red blood cells, iron deficiency can lead to anemia, fatigue, and impaired cognitive function.

Next Steps. To help meet the recommended intake of these nutrients, consider the following ideas:

Diversify Your Diet: Consume a variety of fruits, vegetables, whole grains, lean proteins, and dairy or alternatives to ensure a broad intake of nutrients.

Focus on Nutrient-Rich Foods: Choose foods that are naturally high in shortfall nutrients. For example, opt for leafy greens, nuts, and seeds for calcium and vitamin D, and include bananas or potatoes for potassium.

Consider Supplements: Supplements may help meet nutritional needs. Consult with a healthcare professional before starting any new supplement.

The Bottom Line. Understanding and addressing shortfall nutrients is key to preventing deficiencies and supporting long-term health. Aim for a balanced and varied diet to help ensure that your body gets the nutrients it needs.

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1.Embrace a Mediterranean Diet. The Mediterranean diet, rich in fruits, vegetables, whole grains, olive oil, and lean proteins like fish, has been extensively studied for its health benefits, including its positive impact on brain health. A study published in the journal Neurology found that adherence to the Mediterranean diet is associated with a reduced risk of developing cognitive decline and Alzheimer’s disease. The diet’s high content of antioxidants, healthy fats, and anti-inflammatory compounds helps protect brain cells from damage.

Tip: Incorporate foods like leafy greens, tomatoes, nuts, seeds, and fatty fish such as salmon and sardines into your meals.

2.Include Omega-3 Fatty Acids. Omega-3 fatty acids, particularly EPA and DHA, are essential fats that play a critical role in brain function. They are key components of cell membranes in the brain and have anti-inflammatory effects. Research published in the American Journal of Clinical Nutrition indicates that omega-3 fatty acids can enhance memory and slow age-related cognitive decline.

Tip: Aim to consume fatty fish like salmon, mackerel, and sardines at least twice a week. If you’re not a fan of fish, consider omega-3 supplements derived from algae or fish oil.

3. Prioritize Antioxidant-Rich Foods. Oxidative stress is a major factor contributing to brain aging and cognitive decline. Antioxidants help combat oxidative stress by neutralizing free radicals. Foods rich in antioxidants, such as berries, dark chocolate, and nuts, can support brain health.

Tip: Enjoy a variety of berries like blueberries, strawberries, and blackberries, which are high in flavonoids—potent antioxidants linked to improved cognitive function.

4. Stay Hydrated. Dehydration can impair cognitive function, leading to difficulties in concentration, short-term memory, and alertness. The brain is highly sensitive to changes in hydration status, so maintaining adequate fluid intake is crucial for optimal brain performance.

Tip: Drink plenty of water throughout the day. Herbal teas and water-rich foods like cucumbers and watermelon can also contribute to your hydration needs.

5. Get Enough B Vitamins. B vitamins, including B₆, B₁₂, and folate, are essential for brain health. They are involved in the production of neurotransmitters and play a role in reducing homocysteine levels, an amino acid linked to cognitive decline and brain shrinkage. A study in the journal Proceedings of the National Academy of Sciences found that high doses of B vitamins can slow brain shrinkage in areas particularly affected in Alzheimer’s disease.

Tip: Incorporate foods like leafy greens, eggs, legumes, and fortified cereals to ensure adequate intake of B vitamins.

6. Incorporate Healthy Fats. Healthy fats, particularly unsaturated fats, are crucial for brain health. They help build cell membranes and support the overall structure of brain cells. Diets high in healthy fats, like those found in avocados, nuts, and olive oil, have been associated with improved brain function.

Tip: Use olive oil as your primary cooking oil and snack on nuts and seeds for a boost of healthy fats.

7. Limit Processed Foods and Sugars. Diets high in processed foods and sugars have been linked to impaired brain function and an increased risk of neurodegenerative diseases. These foods can lead to inflammation and insulin resistance, both of which negatively impact brain health.

Tip: Focus on whole, unprocessed foods, and minimize the intake of sugary snacks, beverages, and refined grains.

8. Embrace Intermittent Fasting. Intermittent fasting, which involves cycling between periods of eating and fasting, has shown promise in supporting brain health. Research published in the Journal of Neuroscience Research suggests that intermittent fasting can enhance brain function, promote neuroplasticity, and reduce the risk of neurodegenerative diseases.

Tip: Consider incorporating a daily fasting window, such as the 16/8 method, where you fast for 16 hours and eat during an 8-hour window.

9. Maintain a Balanced Diet. Ultimately, maintaining a balanced diet that includes a variety of nutrients is key to supporting brain health. While specific foods and nutrients play critical roles, a holistic approach ensures that your brain receives all the essential components it needs to function optimally.

Tip: Plan meals that incorporate a diverse range of foods, ensuring you get a balance of carbohydrates, proteins, and fats along with vitamins and minerals.

The Bottom Line. Eating to support brain health involves making conscious choices that prioritize nutrient-rich, whole foods. By incorporating these science-based tips into your daily diet, you can help protect your brain, enhance cognitive function, and potentially reduce the risk of neurodegenerative diseases. Remember, it’s not just about individual foods but the overall pattern of your eating habits that makes the most significant impact on brain health.

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What is a Low Carbon Diet? A low carbon diet focuses on reducing the carbon dioxide (CO2) emissions associated with the production, transportation, and consumption of food. Food production is a significant contributor to greenhouse gas emissions, with agriculture alone accounting for about 10 percent of total emissions in the U.S. A low carbon diet aims to lower these emissions by choosing foods that have a smaller environmental impact.

Key Components of a Low Carbon Diet:

Plant-Based Foods. These are generally less resource-intensive to produce than animal-based foods. Fruits, vegetables, grains, nuts, and seeds typically have lower carbon footprints.

Local and Seasonal Foods. Foods grown locally and in season require less transportation and energy for storage, thus reducing emissions.

Minimized Food Waste. Reducing food waste can significantly decrease the carbon footprint associated with food disposal and production.

Sustainable Farming Practices. Supporting organic and sustainably farmed products can lower the environmental impact of food production.

Benefits of a Low Carbon Diet

Environmental Impact. Adopting a low carbon diet can substantially reduce your personal carbon footprint. According to a study published in Environmental Research Letters, shifting to a plant-based diet can reduce food-related greenhouse gas emissions by up to 73 percent per person. This reduction helps mitigate climate change and its associated impacts.

Health Benefits. A low carbon diet often aligns with dietary recommendations for health. Plant-based diets are linked to lower risks of heart disease, hypertension, diabetes, and certain cancers. Emphasizing fruits, vegetables, and whole grains can improve overall health and longevity.

Economic Savings. By focusing on seasonal and locally produced foods, you can often save on grocery bills. Additionally, reducing food waste means you get more value, as less food ends up in the trash.

Supporting Biodiversity. Choosing foods from sustainable sources helps protect ecosystems and supports biodiversity. Sustainable farming practices preserve soil health and protect natural habitats, supporting a healthier planet.

How to Follow a Low Carbon Diet

1.Increase Plant-Based Meals. One of the most effective ways to reduce your carbon footprint is by eating more plant-based meals. This doesn’t mean you have to become vegetarian or vegan overnight. Start by incorporating a few meatless meals each week, focusing on legumes, grains, and vegetables.

Try it! Prepare a vegetable stir-fry with tofu or a hearty lentil soup as alternatives to meat-based dishes.

2. Choose Local and Seasonal Foods. Shopping at local farmers’ markets or joining a community-supported agriculture (CSA) program ensures that you’re consuming foods with a lower carbon footprint. These options reduce the distance food travels and support local farmers.

Try it! In the summer, enjoy fresh tomatoes, cucumbers, and berries from nearby farms instead of imported produce.

3.Minimize Food Waste. Plan your meals to use all the ingredients you purchase. Store foods properly to extend their shelf life, and consider composting food scraps to reduce waste.

Try it! Keep a list of meals for the week to avoid overbuying and use leftovers creatively, like turning roasted vegetables into a soup.

4.Opt for Sustainable Seafood. If you consume seafood, choose options that are sustainably sourced. Look for certifications like the Marine Stewardship Council (MSC) label, which ensures that the fish was caught responsibly.

Try it! Enjoy sardines or mussels, which generally have lower carbon footprints than larger fish or shrimp.

5. Reduce Processed Foods. Processed and packaged foods often require more energy for production and packaging, leading to higher emissions. Focus on whole foods that require minimal processing.

Try it! Choose whole oats over instant oatmeal packets and fresh fruit over fruit-flavored snacks.

6. Grow Your Own Food. If possible, consider growing your own vegetables and herbs. This not only reduces your carbon footprint but also provides fresh produce at your fingertips.

Try it! Start with easy-to-grow plants like tomatoes, herbs, and leafy greens in your backyard or on a balcony.

7. Be Mindful of Packaging. Reduce your use of single-use plastics and packaging by buying in bulk and using reusable bags and containers.

Try it! Bring your own bags to the grocery store and choose bulk bins for grains and nuts.

The Bottom Line. A low carbon diet offers a simple way to support a healthier environment while also reaping personal health benefits. By focusing on plant-based foods, choosing local and seasonal produce, minimizing food waste, and supporting sustainable practices, you can make a significant impact. Small changes in eating habits can lead to a healthier planet and a healthier you. Adopting a low carbon diet is not only a personal choice but also a step toward global responsibility.

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In this Q&A, Dana Hunnes, RD, MPH, PhD, Senior Dietitian Supervisor, UCLA Medical Center, provides insights on dietary choices that can help us potentially live longer and also live better.

What does the phrase “food is medicine” mean?

“This phrase means that what we eat has the ability to protect our health, as medicine can,” explains Hunnes. “When we use food to protect our health, we are eating in a way that lowers our risk for chronic conditions. Or if we already have chronic conditions, eating healthfully may help manage them or control them better. If we are fortunate, a heathy diet can possibly reverse them.”

For example, research published in the Journal of Clinical Endocrinology & Metabolism found that study participants who followed an intermittent fasting regimen achieved complete diabetes remission, defined as maintaining an HbA1c level of less than 6.5% for at least a year without diabetes medication.

Why is eating whole foods so beneficial?

“There are many nutrients in whole foods that work synergistically with each other that make the “whole” greater than the sum of its parts,” says Hunnes. “By that I mean, we reap so many more benefits from eating a whole raspberry with all of its fiber and seeds. We gain more antioxidants, anthocyanins, micronutrients, and other anti-inflammatory compounds than we can ever get from eating one isolated nutrient extracted from said raspberry. When we eat ultra-processed foods or isolated nutrients, we are not getting that synergy. We are only getting single nutrients that likely don’t have the same effects.”

A good example of this is taking fish oil supplements for heart health. Numerous studies have shown that fish oil supplementation makes little to no difference in reducing the risk for heart attacks and stroke. But eating fish high in omega-3 fats may reduce risk of heart disease.

Why the  buzz around adhering to a mostly plant-based diet?

“Whole plant foods are filling, lower in calories, nutrient dense, and are associated with lower risk for disease and disability. That doesn’t mean no risk. It just means reduced risk,” she explains. “Plants have naturally occurring compounds that protect them against disease and pests which are also healthful to humans. For example, there are bitter compounds in sulphorphane vegetables (e.g., broccoli, Brussels sprouts, cauliflower) that protect them against pests, but are extremely anti-inflammatory and healthful to humans. Fiber also helps clean out the toxins from our digestive tracts, which is good. We don’t want to keep too much waste in our digestive tracts for long periods of time.”

Though eating these veggies raw provides the most nutrients, not everyone enjoys them raw. Steaming for a minute or two, lightly sautéing or even blanching helps maintain nutrients. Definitely avoid boiling because that method destroys valuable nutrients.

Can foods replace medicines and even cure diseases?

“While I’ve heard of these so-called miracles, they are relatively few and far between,” says Hunnes. “Certain chronic conditions such as diabetes or heart disease can be relieved, reduced, and possibly even reversed (sort-of like cured) by an extremely healthy diet. Other diseases, such as certain types of cancer, far less so, though (again) not impossible. With that said, it’s much easier to decrease the risk of ever developing these diseases, which are food/diet associated, than it is to try to correct/treat them after you have them. Healthy diet is always to our benefit.”

What are some simple ways to incorporate heathy foods daily?

“For easy snacks, keep sliced jicama, carrots, bell peppers, or other favorite veggies with hummus or pureed beans in the fridge,” she suggests. “For sweet treats, make your own trail mix of dried fruits and nuts, or enjoy fresh fruit such as blueberries, raspberries, or other blackberries with walnuts or almonds.”

Another strategy Hunnes suggests is to have a variety of whole and minimally processed foods in your kitchen. Also, be sure to stock canned and frozen healthy foods to ensure that you always have nutrient-rich foods available, regardless of the season. Leave the ultra-processed foods at the store and make rich desserts something you go out for as a special treat. 

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What Is Inflammation?

Inflammation is a natural bodily response that can be beneficial. For instance, if you accidentally prick your finger on a rose bush while gardening, your immune system triggers inflammation to aid healing. However, there are instances where inflammation starts without a clear reason and persists; this is known as chronic inflammation. “Chronic inflammatory responses can develop when immune or nonimmune cells in the body start to release bioactive molecules that can promote hallmarks of inflammation including swelling, redness, and heat,” says David Artis, PhD, director of Weill Cornell Medicine’s Friedman Center for Nutrition and Inflammation and Director of its Jill Roberts Institute for Research in Inflammatory Bowel Disease.

Inflammation and Brain Function

Scientists have discovered a connection between inflammation in the body and how well our brains work. When markers of inflammation—like C-reactive protein (CRP) and interleukin-6 (IL-6)—are elevated, studies show an escalation in memory loss and dementia. Research also shows that inflammation plays a role in disrupting the blood-brain barrier—a protective wall in the brain that controls what can enter and exit. When inflammation weakens the wall, it allows harmful immune cells in, thereby provoking further inflammation.

Diet and Cognition

Consuming a diet abundant in processed foods and saturated fats can trigger inflammation, and there is growing scientific evidence of a link between a high intake of sugar and processed foods and an increased risk of Alzheimer’s disease and cognitive decline. Conversely, studies show that embracing a nutrition plan rich in fruits, vegetables, grains, fish, nuts, lean protein, and low-fat dairy can counteract inflammation and potentially safeguard against cognitive deterioration. The MIND diet, which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay, is a hybrid of the Mediterranean and DASH diets, and is specifically designed to promote brain health. The MIND diet emphasizes anti-inflammatory foods such as leafy greens, berries, nuts, and whole grains, while discouraging the intake of red meat, butter, and sweets. It has been shown to lower the odds of developing conditions like Alzheimer’s disease and dementia. In fact, one study found that those who followed the MIND diet strictly cut their chances of developing Alzheimer’s by more than half.

“Adopting a diet rich in certain fibers and grains, vitamin C, beta-carotene, and lycopene, while limiting foods high in fat, salt, and sugars, can contribute to limiting the magnitude of chronically inflammatory responses,” says Artis. A cup of strawberries or broccoli provides enough vitamin C for the day. The recommended daily amount of vitamin C for women is 75 milligrams. There is no official recommendation for daily lycopene or beta-carotene intake, but some studies suggest that 8 to 21 milligrams of lycopene per day and 6 to 15 milligrams of beta-carotene per day may be beneficial. Foods rich in beta-carotene include carrots and sweet potatoes, and those high in lycopene include tomatoes and watermelon.

Exercise and Stress

Regular physical activity enhances blood flow to the brain and promotes the release of chemicals such as brain-derived neurotrophic factor (BDNF) that support brain health. BDNF plays a crucial role in neuroplasticity, or the brain’s ability to adapt and form new connections, and this is essential for maintaining cognitive function. Exercise also helps diminish chronic inflammation by decreasing the production of cortisol in your body. Elevated cortisol can trigger inflammatory pathways, leading to detrimental effects on cognitive health.

Healthy Choices for Brain Function

Recognizing the connection among lifestyle choices, inflammatory processes, and cognitive function may be the incentive needed to welcome healthy nutrition, exercise, and stress reduction behaviors into your life.

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As health and nutrition experts have been saying all along, it’s always best to stick with whole foods (like vegetables, nuts, fruits, etc.) and eschew most items with lengthy, hard-to-pronounce ingredient lists. “We’ve shown that increased intake over time of ultra-processed foods can impact the two most common and significant causes of neurologi­cal disability—stroke and cognitive impairment. The good news is that even modest cutbacks in consump­tion of UPFs are associated with meaningful brain health benefits,” says the study’s senior author, W. Taylor Kimberly, MD, PhD, chief of the Division of Neurocritical Care at Massachusetts General Hospital (MGH).

Processed vs. Ultra-Processed

Processed foods have long been considered dietary no-no’s, items that may be tasty and convenient, but shouldn’t be taking the place of healthier whole foods at mealtime or snack time. But in recent years, nutrition experts have been sounding the alarm regarding ultra­processed foods, which may have you asking: “What’s the difference?”

In simple terms, processed foods are those that have undergone some type of change from their natural state. The change could be minimal, leaving the food’s nutritional value intact. Think frozen vegetables. But processed foods also may contain other ingredients that may raise some health concerns. Think canned vegetables preserved with hundreds of milligrams of sodium.

Ultra-processed foods, as you might imagine, include products that are a long way from their natural state. Ultra­processed foods are often made up of substances extracted from whole foods or derived from food constituents, leaving little actual whole food intact. Examples of ultra-processed foods include soda, hot dogs, cookies, and most boxed or bagged snack foods and sweets.

“It’s important for individuals to pay attention to not just what foods they eat, but how those foods are processedbefore they eat them,” Dr. Kimberly says. Ultra-processed foods often contain fats, starches, sugars, salts, and hydrogenated oils to boost their flavor and extend their shelf-life. Over time, however, these added ingredients may not be doing the same for your own life. In many cases, the more ingredients a product has, especially if those ingredi­ents are chemicals and preservatives, the more likely it is to fall into the ultra-­processed category.

PFs and the Brain

Numerous studies in recent years have established a strong associa­tion between the consumption of ultra-processed foods and increased risks of conditions such as cardiovascular disease, diabetes, obesity, and even cancer.

In the MGH study, researchers analyzed 10 years worth of data from REGARDS, a stroke research project based at the University of Alabama Birmingham (UAB) School of Public Health and involving more than 30,000 adults. Researchers found that increased consumption of UPFs was associ­ated with a 9 percent increased risk of stroke and a 12 percent increased risk of accelerated cogni­tive decline. The study findings, published recently in the journal Neurology, also suggest that the association between UPFs and stroke is stronger among Black adults, possibly because of the higher incidence of hypertension in that population.

Researchers also looked at how specific diets, such as the Mediterranean, DASH (Dietary Approaches to Stop Hypertension) and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) might affect stroke and cognitive decline risk. Those diets emphasize vegetables, fresh fruits, whole grains, lean proteins, and healthy fats (such as olive oil), while minimizing red and processed meats, and foods with added sugars and unhealthy fats.

Study authors found those diets were independently associated with reduced risk of stroke and cognitive decline. The findings also suggest that the degree of food pro­cessing plays a key role in overall brain health and function. They also underscore the degree to which other dietary patterns doc­tors often recommend, such as Mediterranean, DASH and MIND eschew ultra-processed foods and include only processed foods that are still rich in health benefits.

Next Steps

Researchers at MGH and UAB say it’s now important to learn more about the biological mechanisms that link UPFs to poorer brain health and to better understand the role of the gut microbiome in metabolizing the foods we eat. Dr. Kimberly explains that such research could lead to the discovery of biomarkers in the blood that measure UPF intake, which could then be used to develop personalized medicine plans to help individuals decide ifmchanging their diet could help them improve their brain health or at least reduce the risk of cognitive decline or stroke.

“While our study clearly sounds a warning, it also provides hope that there are things we can do as individuals and which policymakers can do on a national scale to reduce UPFs from our daily diets,” Dr. Kimberly says. “As we found, even incremental changes are associated with a significant difference in improving our brain health, along with lowering our risk for stroke and cognitive decline.”

Health experts often recommend making slow, small dietary changes in order to establish a healthy eating pattern that will stick. To that end, opt for a small bowl of berries for dessert instead of cookies or other sweets. Try sparkling water instead of soda and raw vegetables with hummus instead of chips or crackers. Aim for making one or two changes a week, rather than trying to overhaul your diet in a day.

The next time you go shopping, take a moment before buying ultra­processed products and think about healthier alternatives. And if the idea of making major dietary changes seems overwhelming on your own, talk with your doctor about prescribing the services of a registered dietitian to help you plan meals and snacks.

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