I love avocado, and it's a good thing. Avocado is great for your heart. I didn't always love it.
I had to teach myself. And avocado has its problems, too. Even its dark side. Before we start, let me share a personal story about how I developed this list of foods. It was the year 2014. I was in the same position as a lot of people in the U.S., Mexico, Brazil, other places in the world.
I thought I was healthy. I was thin. I was running marathons and eating what I thought were the right foods at the time. It was a low-fat diet.
It was what I'd been taught. I ran the program in prevention at Johns Hopkins, and that was the best that we knew at that point. I avoided medications and supplements. I thought supplements were just expensive urine.
or pee. But one thing happened that made me question my healthy lifestyle. In my late 50s, I developed high blood pressure. I got tested using a CIMT and found out I was building arterial plaque.
Now, let me tell you, that's scary. With all the work that I was doing, and I practiced what I preached, I still was developing plaque. As I dug deeper, I found I'd been making some errors in my health habits. It was like thinking I was growing a beautiful garden, only to realize I'd been watering the weeds the whole time.
The weeds! After years of experience, going through the research, going through my own story, I wanted to share with you these top five foods everybody should eat to avoid a heart attack. Let's get started.
Now, which would you rather eat? A bowl of cereal or an avocado? If you chose avocado, you're right, obviously.
This is the first food everybody should eat to avoid a heart attack. Studies show that eating half an avocado twice a week reduces the risk of death by heart attack up to 16% and the risk of arterial plaque buildup by 21%. But why are avocados so special?
They're full of nutrients. Those right there. A bunch of vitamins and minerals, choline, and many healthy fats.
Avocados can lower your triglycerides and increase your HDL. Both things are critical to avoiding heart attacks. But as I mentioned, avocados do have their problems. First, avocados can be pricey, especially with tariffs and some of the fights that go on politically over them.
You might have heard of the avocado crisis in 2022 in Texas. That year, guacamole became a luxury item during COVID. the Super Bowl. Second, they can rot quickly. A ripe avocado can go bad in a couple of days.
They might lose nutrients and their taste changes. And let's be honest, most people just don't like avocados to start with. They've got that waxy consistency.
They are an acquired taste for most of us. I didn't like them at the beginning and I learned to by eating them. Now, if you want fresh avocados...
Because they rot so quickly, that means multiple trips to the grocery store during the week. And then, in addition, there's a very dark side behind the avocado industry. It seems that exploitation is involved. Poor work conditions, inappropriate payment of workers, and even child labor. You know, where there's money, there is conflict and abuse.
So, what to do about this? Well, first the problem with freshness. So the industry realized freshness was a problem, and they came up with their own solution, a plastic vacuum pack.
Now, that plastic vacuum pack will keep the avocado fresh for weeks, especially in the fridge. Now, have you ever heard the phrase, every solution creates a whole new problem or even set of problems? Well, here's the next problem with that solution. Have you heard of... microplastics.
So again, a lot of challenges, but I still eat avocados. Here's what I do. I try to eat avocados as often as I can, despite the problems. I eat some slices or guacamole on bacon in a salad, sometimes with beans. I get fresh avocados when I can, and I just cut them in half and just spoon it out of the peel.
I can also buy some ripe and some unripened avocados to have at home. and the unripened ones last a few days longer again especially in the fridge i just don't try to solve the ethical concerns i don't know how If you live near a farm, you can make sure to source ethically. You can try getting some from a local farm if you have that available. Now, enough about avocados.
Let's go to the next one. How about yogurt? Greek yogurt versus kefir.
If you chose Greek yogurt, you might be right and wrong at the same time. In the past, I've made the same choice for years. It was my go-to breakfast.
But... Let me explain. Most Greek yogurts are actually deceiving.
Once you look at the labels, you find that most Greek yogurts, especially the, quote, healthy low-fat yogurts, end quote, replace fat with sugar. That's the opposite of what we need, as well as other chemicals from food processes. Now, Greek yogurt can be really healthy. There's evidence it can improve biomarkers such as glucose, triglycerides, and cholesterol. So I'll go with both healthy Greek yogurt and healthy kefir, as well as other fermented foods like natto and kimchi.
My favorite go-to is actually sauerkraut. You can find more discussions about natto and kimchi in some of our other videos. And if you're wondering about fermented foods to begin with, here's the thing. Fermentation is a process in which yeast and bacteria break down sugars.
Fermented foods are those that have undergone this controlled microbial growth fermentation. Greek yogurt and kefir are fermented milk. They're using colonies of yeast and bacteria to do the fermentation, in which that the sugars are eaten by the bacteria and mostly the yeast. Kimchi is a Korean dish made out of fermented vegetables, mostly cabbage and radish.
Natto is fermented soybean. Sauerkraut is fermented cabbage. Evidence shows fermented foods can improve cardiovascular risk markers, decrease inflammation, and reduce risk of heart attacks.
Well, what's so special about fermented foods? This neglected player that we haven't discussed yet. It's involved in heart attacks and strokes.
And it's called the gut biome. You see, inside our intestines, we have about 1 trillion bacteria. So you're not eating for one, you're eating for one trillion. That bacteria, those microbes are more important than you think.
They help produce multiple vitamins, nutrients. They keep your body safe from harmful bacteria. And they help with fat metabolism and a thing called neurotransmitters.
You remember we mentioned that beautiful garden earlier? That's the gut biome. We really are walking around with a garden inside. You need to take care of it.
And anytime you eat processed junk, you're causing a fire, burning all the healthy bacteria and watering the weeds. We call that dysbiosis. Dysbiosis is the growth of unhealthy bacteria and other microorganisms.
It's very common in people with prediabetes and diabetes. And it leads to inflammation, arterial plaque buildup, and heart attacks. That's why fermented foods are so good.
For preventing heart attacks, you eat fermented foods, you feed the good bacteria, you promote anti-inflammatory effects, and produce healthy micronutrients. You're watering your garden and removing the weeds, and in the process, escaping a heart attack. But just like with avocados, there are problems with fermented foods as well.
First... Similar to commercial Greek yogurt, some other fermented foods like kefir or kombucha might have a lot of sugar. Most of the time, they add the sugar back after the fermentation process. Why would they do that?
Well, fermented foods also are an acquired taste. Most people don't grow up or naturally like them. They have sugar, but most of the sugar has already been consumed by the yeast, so they add that sugar back.
The second problem is amines. Amines are compounds related to ammonia and related to proteins. Examples include histamine, tyramine. You might not have heard of putrescine or cadaverine, but yes, those are present as well.
These last two are ones that give rotten food its unique smell. And sometimes you can smell that with fermented foods. When amines are consumed in excess, they can mix with nitrogen oxide and turn into nitrosamines. Nitrosamines have actually been linked to cancer. Some research suggests fermented foods might have high levels of amines.
Really, that's only true for some fermented foods, like fermented fish, red meat, and some cheeses, like mish, which is a salty Egyptian cheese, parmesan, which is a very popular cheese, and other hard cheeses. Not so much in kefir, kimchi, or Greek yogurt. Now, there's another problem, salt. You might hear that a large amount of salt can actually increase your blood pressure.
Well, there may be some truth to that. It's been the prevailing wisdom for decades. But newer research is indicating that actually salt may not be so much the problem as insulin. This means that the sodium in fermented foods like natto and kefir, sauerkraut, might not be as big a problem as you think. Another problem is bloating, gas, even diarrhea.
In my opinion, this has more to do with that change in the gut biome. People who have dysbiosis. Remember that geeky term? People with unhealthy bacteria will experience this, but it's usually temporary and is part of replacing an unhealthy gut biome.
If you think, gosh, this just sounds like too many problems. Again, slow down. Let me tell you what I do. I'm careful to read labels.
If I buy kefir at the store, I avoid eating it. or drinking it if it smells sour or rancid, or if it has some clumping or clear liquid in it. And this also applies if you make your own kefir. I often use natto canace powder, and as I said before, I eat a lot of sauerkraut. And usually when I eat sauerkraut, I'll eat it with pecorino cheese, pecorino romano.
It thickens that sauerkraut, puts some butter on that, and I love it. Now, back to the amines. You remember those things?
This can be a problem for some people with allergies to these foods, but allergies to amines are really not that common. I recommend introducing fermented foods slowly in small portions once or twice a week. Increasing it slowly avoids bloating or gas.
Let me know in the comments if you have tried any of these foods, and if so, how you do it. I used to eat Greek yogurt for breakfast every day for years, and it turned out that the yogurts that I liked had way too much sugar. I quit eating them for years, but again, with the evidence supporting fermented foods, I'm going back to those. Now, let's go to another quiz. Which one would you choose for your heart?
A protein bar or nuts? Just to continue the trend of misleading labels, there's a lot of unhealthy protein bars out there that are full of sugar and preservatives. I'm not saying never eat any protein bar.
There are some good options, but most of them are not. I have to go nuts for this one. Pun intended.
Research has shown a decrease in heart attacks. The best options include almonds, hazelnuts, Brazil nuts, walnuts. pistachios, and even peanuts. My favorites, my go-to, are walnuts, almonds, and especially macadamia nuts, and most of all, pecans.
I live in southeastern U.S., and pecans are grown here, so I can get and eat a lot of pecans. Macadamias and pecans are very, very good for a low-carb diet as well. So why are nuts in general so good for heart attack prevention? Well, they have plenty of beneficial components from healthy fats, omega-3 fatty acids, fiber, plant sterols, choline, and even L-arginine.
Now, that's an amino acid. It's well known to help produce nitric oxide and therefore opening blood vessels, reducing blood pressure, and boosting vascular health. You may have guessed by now, there are some downsides to going completely nuts, at least all the time. Some people have described bloating, weight gain, even poisoning from selenium.
Nuts have their own dark side, yes. Cashew nuts have been linked to exploitation of people, of workers in Kenya. So, let's address all of these real quick. Bloating is actually a side effect of improvement in the microbiome. Nuts can help build that healthy bacteria and the healthy gut biome.
Is it possible to gain weight with nuts? You've heard people say, oh, if I eat too many nuts, I'll gain weight. They're just fat bombs. Ask those people what else they eat.
You usually don't hear that in someone who's on a low-carb or keto diet. Most people blame the fat in nuts and neglect to tell you they're eating a lot of sugar. Now, let's talk about selenium and cyanide. Selenium poisoning might actually be a thing.
I don't recommend eating more than two Brazil nuts in a day. Cyanide poisoning, maybe not so much, but still at least limit your almonds to 10 to 15 a day. And again, selenium and cyanide will not be an issue for you. If you really love cashew nuts... Try thinking about ethical sourcing.
And again, I don't eat cashew nuts for that reason, because I can't figure out a way to ethically source cashews here. I get mostly walnuts from Amazon. I eat a lot of those.
I prefer raw walnuts, but dry burnt ones are good too. I just don't get those very often. Avoid any sugar-coated walnuts or other types of processed nuts.
Now, there's one more food that has even more omega-3 fatty acids. It's a food I've recommended for years, and it was one of the foods I've come to really appreciate once I made my change from low-fat to low-carb. So we have another decision to make. Real quick, don't think about it for very long.
Apples or salmon? If you chose apples, Let me tell you, years ago, I would have chosen that as well. I liked them.
They were nice and sweet. They had a nice crunch. And again, it took me a while to learn to love salmon. And we always used to hear, an apple a day keeps the doctor away, right? So they had to be healthy.
Apples did. Well, there's a problem with that. Despite all their nutrients, apples have a lot of sugar. They're not packed with enough fiber to counteract that sugar. And I'm not saying don't eat apples.
I eat maybe a slice or two a month. Just don't eat a lot of them. If you do eat apples, make sure that you either eat fiber or meat before the apple.
Measure your glucose levels. And just don't drink apple juice. And drinking apple juice is like almost pure fructose.
And it's just like drinking... non-diet sodas. The same thing applies to oranges and most fruits, unfortunately.
But we're not comparing apples and oranges here. We're comparing apples and salmon. Salmon wins this one.
Okay, I know salmon can be expensive. I recognize that. So that's why I give you a couple of alternatives in a few minutes that are just not that expensive.
But why even consider salmon or other fish to begin with? Just eating fish has been shown to reduce cardiovascular death by about 5%, and that increases for every 5 grams you eat, especially for those fish with high omega-3 fatty acids. Omega-3 fatty acids are the healthiest fats. They include geek alert, EPA or icosapentaenoic acid, DHA, docosahexaenoic acid. Again, I hate that one.
And there's a third one, ALA. We've mentioned it before when we're talking about nuts. We'll mention it again a little bit later.
These omega-3 fatty acids have been found to be very protective for cardiovascular health. Now, guess which fish has the most omega-3? If you guess something like tuna or swordfish, you may be right.
Those are followed by salmon with 2.5 milligrams for every 100 grams. Kippers or kippered herring, almost as much as salmon, and sardines at 1.6. So, wait a minute. I said salmon at the beginning.
What's the problem with tuna or swordfish? I used to love tuna or swordfish until we found out the biggest problem with fish products. These top predator fish, like tuna and swordfish, run high in mercury. And again, especially true for tuna and swordfish.
Mercury poisoning can be a serious issue. Do you remember Alice in Wonderland? You remember that story and you remember the mad hatter? That was a real thing. That story was written in England a couple of hundred years ago at a time when hats were very, very popular and especially a specific hat called a beaver felt hat.
Those beaver felt hats were made using mercury. So, hatters were often crazy. So, to go back to modern days, we have since discovered that mercury exposure can cause problems.
Kids have low IQ, walking problems, problems talking. even personality problems and memory problems like the mad hatter. Additionally, other fish have been shown to have more nutrients than tuna, so that's why I prefer to recommend salmon first, tuna, and again, my old favorite, swordfish last.
Salmon's not free of its own problems. We mentioned cost, we mentioned mercury, and then you have microplastics, which, due to water pollution, it's been seen that fish with significant amounts of plastic being eaten and end up in your arteries, causing inflammation. There's another major problem associated with salmon, and that is how you access it.
You have wild salmon, which is very expensive, and farm salmon, which is less expensive. Wild salmon are caught in their natural environment, such as oceans, rivers, and lakes. They have more natural diets.
They have less exposure to animals, to drugs. They've been found to have a better nutrition profile. Farmed salmon is raised in captivity by farmers.
They control its breeding, its feeding. They're given medications, including antibiotics. And guess what?
75% of salmon consumed is farmed. So when it comes to this question, what can you do with this information? Let's just boil it all down.
And let me just tell you what I do. I obviously prefer wild-caught salmon. I try to eat it at least a couple of times a week.
I used to eat it four and five times a week, but I've changed some of my habits now. I'm not worried so much about mercury with salmon or microplastics. Not because they're not a problem. They might be, but eating fish, even with these challenges, has been shown to be a much better bet than not eating fish. I don't eat tuna and swordfish anymore.
I hate that. I used to love it. Now, when you cook the salmon like this, it's a delicious option.
I also supplement with omega-3s. That's another option. It won't include plenty of the other nutrients that you find in fish.
And as you know, omega-3 supplementation has its own set of problems, which I'm not going to go down, other than to say you've heard of supplements going rancid. So you have to make sure. to focus on the type of supplement you use if you supplement with omega-3s. Now, if you don't like meat and you want to add another omega-3 source that doesn't involve supplements or meat, there's another option.
What do you think that is? How about canola oil or flaxseed? If you chose flaxseed, you're right. Canola oil is a type of seed oil.
Seed oils are plant-based foods derived from plant seeds. And although some studies suggest canola oil can improve cardiovascular markers, the major improvement is seen in LDL cholesterol. Now, LDL cholesterol used to be thought of, used to be considered the number one risk factor for heart attack and stroke.
That LDL theory is coming under a lot of scrutiny these days. The evidence is beginning to show something very different. In fact, I don't worry too much about LDL. If you have more interest on it, we've got a video on the worst lie about cholesterol. You can also see our perspective on seed oils in this video.
But let's talk a little bit more about the winner, flaxseed. I know flaxseed might be the preference of a lot of people. There are challenges with it, though, and I understand, but allow me to elaborate. Flax seeds or linseeds are small seeds from the Middle East. They're packed with nutrients, especially ALA.
You remember that omega-3 acid? It's called alpha-linolenic acid. It also has EPA.
Both of these are, again, those omega-3 fatty acids. The seed can be hard to digest. You have to ground it into a powder. I know many people recommend a Gansflax seed because the conversion of ALA is very low. In fact, ALA is considered to be one of the required fatty acids.
And that's because with ALA, your body can make the other two omega-3s, and that is EPA and DHA. Now, regardless, for those that do use flaxseed, I use flaxseed as well. I use it as a powder on my salads.
About four to five tablespoons a day is the goal. And it is a great option. But there's another problem.
Again, another problem with flax seeds. For those of you who are familiar with it, you may already be thinking about it. Flax seeds full of plant estrogens.
Estrogen is a female hormone. It helps maintain female body characteristics. Lack of estrogen is a major cardiovascular risk factor for women. So it's no surprise that heart attacks in women can happen during menopause. That's when they happen.
And in fact, just as many women die of heart attacks as men. They just die a little bit later, usually a few years to a decade after menopause. Now, flaxseed has those phytoestrogens or plant estrogens.
Do they really impact humans to begin with? And if so, is it really a problem? The answer is yes. Flaxseed does have those phytoestrogens.
They've been shown to increase estrogen levels in postmenopausal women, which in turn combines with the benefits of omega-3 fatty acids. And it can provide cardiovascular protection, that is, fewer heart attacks for women. It's great for postmenopausal women who are at big risk. for heart attacks.
But what about men? Can men get the same benefits, or is it bad for men to eat these types of phytoestrogens? For men, testosterone is the most important male hormone.
One of the biggest problems you see online with flaxseed is this high amount of estrogen in flaxseed, lowering testosterone levels and causing problems for men. Problems like difficulty building muscle, sexual performance, maybe some getting blamed for hair loss, even depression and sleep issues in men. Now, is that the truth?
Well, when you look at the evidence, there are two small studies suggesting that this might be a problem for men. But there's a lot more stronger evidence out there that really doesn't indicate that. I've not seen evidence of a problem.
And as I mentioned, I do eat some flaxseed on my salads. It's safer for men than what social media might tell you. In the end, it's up to you.
There are other sources, as we've already mentioned. Salmon, kippers, sardines, even chia seeds, which we didn't discuss. There are other options there for omega-3s.
Now, I do have a bonus food on the list just for you. Let's see if you can choose correctly. Would you rather eat margarine or...
Eggs. Well, the right answer, most of you know, is eggs. The result of the Attica study showed that eating an average of one to three eggs a week can decrease the risk of heart attack and stroke by 45%. Another meta-analysis, again a study of studies, involving 21 studies, showed that eating more than one egg a day was associated with less arterial plaque build up. There's a clear reason for why eggs are healthy.
They have no sugar. They're rich in plenty of nutrients, including things like choline, vitamins, and healthy fats. Now, there are studies that show other things.
There's one meta-analysis showing an increased risk of heart attacks when eating eggs, but you got to dig deeper in any of these studies when you look at them. The problem with this study was that The authors assumed that higher LDL means more risk, and that was how they based their conclusion. As we've said before, LDL being the major risk for heart attack and stroke, that may have been the biggest cholesterol lie in history.
Yes, scientific evidence has not shown that saturated fats, which many label as unhealthy fats, are actually harmful. That's why I think foods like free-range chicken eggs and unprocessed meats are great for metabolic health. Now, a paradigm shift is necessary to prove that eating red meat and eggs is not dangerous, as you've been told time and time again. Without going further on the vegan versus carnivore controversy, I do believe as long as you avoid sugar and processed and ultra-processed foods, you can achieve a healthy metabolism.
Now, I've covered a whole lot. Let's recap real quick, and then we'll talk about why the list makes sense. The top five foods. First of all, let's run through the list. Everybody should eat these foods to avoid heart attack.
Avocados, fermented foods like healthy Greek yogurt, kefir, kimchi, natto, sauerkraut, nuts. fish like salmon, herring, kippers, sardines, back to nuts, macadamia nuts, almonds, pecans. and especially walnuts, flaxseed, eggs as a bonus.
But did you notice something about all these that they have in common? Yes, these foods are all high in fat and low in sugar. That's the major lesson that changed my life. See, my problem is, and what I discovered when I was creating that plaque was, my body cannot process carbs. That happens to all of us.
as we age. It happened to me in my mid to late 50s. I found out I had prediabetes.
Not eating sugars and carbs is key for me. Right now in America, millions of Americans have been doing the exact opposite. Low fat, high carbs.
The base of the food pyramid is grains. But the problem is over half of American adults have prediabetes. Once you get into your 50s and 60s, that increases to 70 to 85 percent.
Ultra-processed garbage food is high in sugar, low in healthy fats, high in unhealthy fats like trans fats, very low in nutrients. And it leads to the current diabetes and obesity epidemic. It actually stimulates the insulin that we want to decrease. It results in heart attacks. That's why heart attacks are the number one cause of death.
There's another group of people who are living healthier lives, avoiding fats, and still eating lots of carbs, sometimes even processed sugar, and thinking that because they're thin, they are healthy. That was me a couple of decades ago. The problem is, they still think that cholesterol is what causes heart attacks. But that's just not true.
The problem is metabolic disease, or... prediabetes and diabetes, or as the doctors call it, insulin resistance. Speaking of doctors, why haven't doctors helped us out with this problem? Well, you know, I mentioned over half of adults in the U.S. have this problem, but 90% that have it don't know it.
Unfortunately, it's because the doctors, the primary care doctors, family practitioners, internists, and cardiologists. Three-quarters of them don't know how to diagnose insulin resistance. So again, that's where I was about a decade ago, eating a low-fat diet, healthier than most people by staying thin but still developing arterial plaque.
So the key message here, the current dietary recommendations are just wrong. Grains should not be the base of the food pyramid. Put in grain products like bread, cereal, and rice.
and pasta as the base of the food pyramid, and demonizing fats is what got us to the point where we are now. Half of us are obese, pre-diabetic. The healthiest foods to avoid a heart attack share the opposite in composition. They're low in carbohydrates or sugars, high in healthy fats, not processed, and rich in omega-3 fatty acids.
If you don't know what's healthy to eat, look for the characteristics that we just described that made up this list, the patterns, low carbs, higher fats. To know more about arterial plaque, how to find it, and how to prevent it, check out how I reversed my own plaque right here.