What Should You Eat For Optimal Heart Health? What a Cardiologist Actually Eats

🎁 Learn more about Dr. Mona Shah: www.drmonashah.com

Eat the butter. Don't eat the butter. Cholesterol doesn't matter. Cholesterol is everything. Go carnivore. Go vegan. No wonder you're confused. The diet world contradicts itself every single day, and it should be the easiest place to protect your heart, not the most confusing.

In this episode, I'm going to cut through the noise on fat, cholesterol, keto, and carnivore, and show you exactly what actually lowers the numbers that build plaque in your arteries.

⏱️ TIMESTAMPS 
0:00 What Should You Eat For Optimal Heart Health? What a Cardiologist Actually Eats
0:59 The best diet is the one you can sustain 
1:32 Why the Mediterranean pattern wins 
2:10 The 80/20 rule for eating out 
3:05 Is fat actually bad for your heart 
4:19 The truth about dietary cholesterol 
5:19 Why some people are hyper absorbers 
6:19 ApoB versus LDL explained 
7:00 The portfolio diet that lowers ApoB 23% 
9:34 How to actually read food labels

❓ QUESTIONS ANSWERED 

Is cholesterol in food actually bad for your heart? 
For most people, dietary cholesterol has a limited effect because 80 percent of your body's cholesterol is made by your liver. About 30 percent of people are hyper absorbers who take in far more cholesterol from food, so checking your ApoB is the only way to know which group you fall into.

What is the best diet for heart health? 
The strongest evidence supports a Mediterranean pattern leaning toward pescatarian or vegetarian, built on vegetables, whole grains, nuts, fish, and low added sugar. Adding the portfolio diet, which includes plant proteins, viscous fiber, and plant sterols, can lower LDL by about 30 percent and ApoB by about 23 percent.

Does saturated fat matter more than protein source? 
Yes. Research shows that eating high saturated fat keeps ApoB elevated regardless of whether your protein comes from animals or plants. The only combination that lowered ApoB was low saturated fat paired with more plant protein.

📱 RESOURCES 
Website: www.drmonashah.com 
IG: https://www.instagram.com/drmonashahmd/ 
Blog: https://drmonashah.wordpress.com/

🔔 Subscribe for weekly content on what preventive cardiology actually looks like, including the tests, labs, and conversations most cardiologists never start.

ABOUT DR. MONA SHAH: 
Dr. Mona Shah is a triple board-certified cardiologist in cardiology, holistic medicine, and coronary CT. After 20 years inside conventional cardiology, she left to build a practice that does what the standard system rarely does: look inside the artery wall before something goes wrong. She uses advanced imaging, including coronary CTA with AI analysis, to give patients a real picture of their cardiac risk. She specializes in patients with a family history of heart disease, elevated ApoB or Lp(a), and anyone who has been told they're fine but still isn't sure.

#HeartDisease #PreventiveCardiology #CoronaryCTA #HeartAttackPrevention #HolisticCardiologist

Transcript

SPEAKER_00 0:00

Eat the butter, don't eat the butter, cholesterol doesn't matter, cholesterol is everything, go carnivore, go vegan. No wonder you're confused, right? You change your diet every single day, so it should be the easiest place to affect change for your heart. Instead, it's the most confusing. I'm Dr. Mona Shah, preventive cardiologist. I'm passionate about early detection, whole heart care, longevity, and changing outcomes. I spend 60 to 90 minutes with my patients literally pulling their food up on a big screen and reading the labels together. Because unfortunately, marketing has made it really hard to know what you're actually eating. So let me cut through the noise. I'm gonna answer the two questions I get asked the most. Is fat bad? Is cholesterol bad? I'm gonna tell you the truth about keto and carnivore, and then I'm gonna give you what actually lowers the numbers that build plaque in your heart arteries. Let's get into it. Here's the first thing I tell every patient. The best diet out there is the one that's sustainable for you. I don't believe in diets, fad diets, extremely restrictive diets don't work. Plain and simple. They might work for a few weeks, but after thousands of patients, I've watched them almost consistently fail every time. The keto weight comes off, and 99% of the time it comes right back the minute you stop. So instead of a diet, we build a pattern of eating you can actually live with and that's sustainable. And the pattern that science keeps landing on is a Mediterranean lifestyle. It's been studied for generations. The PREDIMED study and others show it cuts heart disease risk by about 30%. That is equivalent to what we see with some medications, just from how you eat. I like to think of it as a triangle: Mediterranean, leaning towards pescatarian, leaning towards vegetarian. Lots of vegetables, fruit, whole grains, nuts, seeds, some wild fish, low sugar, low refined carbs. And you don't have to be perfect. I tell people 8020, if most of your meals are whole, real food, then go out on a Friday or Saturday night and just enjoy yourself. To be honest with you, restaurants don't really care, majority of them, about what they're putting and what kind of oils they're using when they cook food. Of course, they're a business. They want it to taste good. So when you go out to eat, you really don't have an idea of what they are actually putting in my food. And of course, if this is once or twice a week, it's not gonna break the bank. But if you're eating out five to six times a week, then you might be really affecting your heart arteries and affecting your numbers and inflammation. So nobody's gonna be perfect. And the people who try to be are so stressed out about it that it works against them. Progress, not perfection. Okay, so with that foundation, let's tackle the fights, starting with fat. Fat is not the enemy. But not all fat is the same, right? Here's how I want you to think about it. Roughly two-thirds of your fat should be unsaturated, and about a third or less should be saturated. The unsaturated fats are the ones that actually help you. Monounsaturated fats, olive oil, avocado oil, avocados, nuts, seeds, they help lower your numbers and lower inflammation and even your blood pressure. And the omega-3s in fish, walnuts, chia seeds, and flax seeds are really anti-inflammatory. The one to keep an eye on is saturated fat. That's your butter, your red meat, your eggs, your processed meats, your heavy whipping creams. And I'll show you in a minute why saturated fat matters more than most people think. One trap. When something says low fat on the front, flip it over, and a lot of the time when they take out the fat, they replace it with sugar. So low fat becomes higher in sugar. And now you've traded one problem for another one. So fat itself, not bad. It's a type and the portion. Like everything else, it's a portion that matters. Now, the bigger fight, cholesterol. This is where the internet loses its mind. One side says eat all the cholesterol you want, it doesn't matter. The other side says cholesterol is a whole problem. And honestly, the truth is somewhere in between. About 80% of the cholesterol in your body is actually made by your liver. Only a smaller amount comes from your food. And of the cholesterol you eat, a normal person absorbs about 40% of it. So dietary cholesterol, the cholesterol in food itself, is only a really partial player, which is why a lot of people say it doesn't matter how much cholesterol you eat. What really drives your numbers up is a saturated fat. But here's the catch. And this is why I never like to give just one blanket answer and tell everyone that they should be eating one way. 30% of people are what we call hyperabsorbers. So instead of absorbing 40% of the cholesterol they eat, they absorb 60 to 80%. So some people really can eat the eggs and the high cholesterol foods and be fine. But about a third of people absolutely cannot. So when someone tells me their carnivore or keto diet is totally safe because cholesterol doesn't matter, I always say maybe, maybe not. You don't know which one you are until you check. And the number to check is not just your LDL, it's your APOB and your inflammation markers. You've already heard me explain this in my cholesterol video, but here it is again because it's everything. Think of the particles that carry cholesterol like trucks on the road. LDL is just one of the trucks, but there are small trucks and wide trucks and big trucks too. And every single one of them can dump plaque into your artery wall. APOB counts all the trucks. That's why I say LDL is in my side mirror. Of course I'm paying attention to it, but APOB is front and center. Risk follows APOB. So the real test of your diet isn't how it makes you feel, it's what it does to your APOB and your inflammation markers. If you eat that high-fat diet and your APOB stays low, okay, maybe you're one of the lucky ones. If it's climbing, you're building plaque while someone on the internet tells you you're fine. So how do we actually eat to drive the numbers down? Let me show you. If this is the kind of straight no hype answer you've been looking for, subscribe. Every week I put out videos on what the conventional system misses about your heart and what you can actually do about it. Okay, let's put this all together because this is the part that changes your arteries. Start with the Mediterranean base we talked about. That's your foundation. Then, if you really want to drive the numbers down, there's an add-on called the portfolio diet. It has four pieces: plant proteins like lentils, pure soy, nuts, and viscous fiber like oats, barley, and psilium. And plant sterols. Stack those on top of the Mediterranean, and studies show your LDL drops by 30% and your APOB by 23%. And your inflammation markers come down too. That's real change from food. Now here's a study I love because it really settles a lot of arguments. It's called the Krauss study. They looked at protein and saturated fat together, and here's what they found. If you eat a high saturated fat, it almost doesn't matter whether your protein is animal or plant. Your APOB doesn't improve. But when they combined low saturated fat with plant protein, that was the only group whose APOB actually went down. So it's two levers working together. Lower the saturated fat and lean more of your protein towards plants. It's also trying to find a balance, right? If you don't want to be vegetarian or vegan, that's fine. But have a balance. Don't just eat one type of protein, red meat or chicken. Mix in some fish. Mix in some plant-based proteins. Have a variety so you're not just stuck with one thing. Now, what about fiber? I cannot oversell fiber. Aim for about 30 grams a day. Most people are deficient in fiber and getting enough fiber. Three servings of whole grains a day is linked to about a 30% lower cardiovascular risk. And there's strong data tying higher fiber to lower heart disease deaths. Whole grains, beans, vegetable, that's your fiber. And then cut the added sugar. Keep it under 25 grams a day. Sugar is sneaky because it drives up both your inflammation and the particles that build up plaque. It's not just about your waistline. And what about the processed meats? The bacon, the cold cuts, the deli meats, those are very inflammatory. They're loaded with sodium and they carry both heart and cancer risk. That's a category I'd pull back on first. So now you know some of what to eat. Here's how to actually pull it off in real life. None of this works if you can't live it. So here's how I coach my own patients. First, become a label reader. This is the biggest one. The front of the package doesn't tell you everything. It may say heart healthy, low fat, all natural, even vegan. And then you flip it over and it's full of artificial flavor, artificial sugars, processed oils. My rule is simple. The fewer the ingredients, the better. There's even an app called Yucca, Y-U-K-A, that can help you. It scans the food for you and helps you tell you if this is a good food to choose or not. Second, do the swaps. Don't chase perfection. Try to work on more unsaturated fat, less saturated fat, more plants, fewer processed meats, whole grains instead of refined, more fiber, less added sugar. You don't have to flip your whole life in a day. You just start building the pattern. Third, and this is the part most people skip. Know your numbers so you can actually see it working. Get your APOB checked, get your inflammation markers checked. Because we're not doing this just to make numbers look pretty on a piece of paper. We're doing this to affect change inside your arteries. When you eat this way for a few months and your APOB drops, you know it's working. That's precision. That's the whole point. So is fat bad? No. Is the type and the portion? Is cholesterol bad for some people more than others? And you don't know which one you are until you check your APOB. And the diet wars, mostly noise. The answer has been sitting in plain sight the whole time. Mostly plant-based Mediterranean pattern, low in saturated fat, low in added sugar, and high in fiber. And also find what's sustainable. If you like to eat animal products, try to do it with low saturated fat. Food really is medicine. You just have to know what you're looking at. I keep coming back to one number that decides whether your diet is actually protecting you or not. And that's your whole cholesterol picture. If you want to understand why your LD alone has been lying to you, watch my video on everything you've been told about cholesterol. It's on your screen right now.