Diet Changes After a Heart Attack.

Part of the post heart attack anxiety series

My first cardiologist asked what my typical diet consisted of. To be honest, as a family I thought we were and are pretty healthy. We didn’t really keep snack foods in the house, still don’t. We always ate a lot of vegetables and chicken mainly. But. BUT. Several buts: we liked to eat out. Especially Mexican or pizza (easy with the kiddos), I’d travel a lot for work (why do clients always want the steak house?), and we loved to visit my family on the coast (hello fried sea food).  These things add up, and put them all together and it’s not great. I tried a few different ways of eating after my heart attack. Cut this out completely, add that in, follow this plan for six weeks. Most of it didn't last because it felt like punishment, and punishment doesn't stick.

I actually remember talking to my cardiologist about this, this was about seven years ago now. He told me straight up, one of the healthiest things you could do is go vegan. Then in almost the same breath he said, but I know that's not going to work for you, so let's find something else. I've always appreciated that. He wasn't handing me the theoretically perfect answer and walking away. He knew the perfect diet on paper doesn't matter if you can't actually live on it. There's still plenty of debate about whether vegan is the right call for heart health, (and we can talk about lack of b12 which is critical for heart health in another post) but that's not really my point here. My point is he cared more about what I'd actually stick with than what looked best in a textbook.

What actually stuck was something closer to how people eat around the Mediterranean. Heavy on vegetables and fruit, legumes (lentils, chickpeas, white beans etc.) and whole grains, olive oil instead of butter, fish and poultry more than red meat. Nothing off limits entirely, just way less of the processed stuff and more of the real stuff, most of the time.

Basically what I like about this approach is that it doesn't feel like a diet in the restrictive sense. Nobody's handing me a list of forbidden foods. I still eat well, I just eat differently than I used to.

A lot of cardiac dietitians actually push back on the massive overhaul approach for exactly this reason. Go too extreme too fast and it usually doesn't stick, no matter how good it looks on paper. Small changes you can actually keep up with tend to win out over the perfect plan you abandon in three weeks.

There's a decent amount of research behind the Mediterranean approach too, and I'd encourage you to go look into it yourself rather than take my word for it. The short version, from what I've read, is that this style of eating tends to go hand in hand with lower inflammation and better outcomes for people already managing cardiovascular risk, especially alongside prescribed medication like statins. It's not framed anywhere I've seen as a replacement for what your doctor has you on. It's more like it works alongside it.

If it were me talking to someone just starting out, I wouldn't say overhaul your kitchen overnight. But I’d make a few ctritical changes. Swap butter/margerine for olive oil. Add a vegetable to a meal that didn't have one (throw a handful of spinach in the past sauce etc.)cut up peppers and carrots as extra snacks. Small, boring changes, repeated consistently, are what actually held up for me. The dramatic overhauls never did.

This connects to everything else I've talked about. Cardiac rehab. Getting moving again. Finding the right doctor. Sleeping better. None of it works in isolation. They all build on each other. You're not trying to fix one thing. You're trying to get your whole self back, a little steadier, one manageable change at a time.

Go try to see what fits your life and your specific health situation, because everyone's starting point is different. But if you're looking for a place to start, this is where I did, and it's the one that actually stuck.

Because you only get one heart. ‘Til next time, Stephen.