Which foods or supplements improve the health of veins and blood vessels and reduce the risk of cardiovascular disease in adults?

Three dietary patterns have the strongest and most consistent evidence for reducing the risk of cardiovascular disease: the Mediterranean diet, the DASH diet, and broader plant-based dietary patterns. Of the three, the Mediterranean diet is the most thoroughly researched. Randomised trials and observational studies show that it improves blood lipids, inflammatory markers, and the waist-to-hip ratio, and also reduces hard outcomes such as mortality and cardiovascular events. The protection is comparable to that of established preventive medications, and works in part through inhibition of chronic inflammation and favourable effects on gut bacteria, independent of weight loss or changes in cholesterol. The DASH diet is specifically aimed at lowering blood pressure, one of the most important risk factors for cardiovascular disease, and is recommended in international guidelines.

Plant-based dietary patterns rich in minimally processed vegetables, fruit, and wholegrains consistently reduce the risk of cardiovascular disease. A fully vegan diet offers no demonstrably additional benefit over vegetarian or Mediterranean variants. The protective effect of these patterns is independent of the choice of a specific label: what matters is the quality and degree of processing of food, not the exclusion of certain animal products as such.

On the other hand, dietary patterns rich in ultra-processed products, meat, salt, sugar, and saturated fat increase the risk of cardiovascular disease. Salt has a specifically harmful effect on the cardiovascular system. Potassium from food, such as that found in vegetables, legumes, and fruit, is associated with a lower risk in healthy people. This applies, however, to dietary potassium, not automatically to potassium supplements.

Anyone hoping to protect the heart with individual vitamins or minerals should be aware that the evidence for doing so is lacking. No benefit has been demonstrated for vitamin or mineral supplements, including calcium and selenium, for cardiovascular health. Potassium in pill form is not automatically exempt from this either. The advice is therefore: focus on the overall dietary pattern, not on individual supplements.

One factor that also operates through diet is the level of LDL cholesterol in the blood. Elevated levels of harmful blood lipids are a causal factor in the development of atherosclerosis and cardiovascular disease. The earlier in life optimal blood lipid values are achieved, the greater the cumulative protective effect over the life course. Dietary choices that lower LDL, such as reducing saturated fat and increasing fibre intake, contribute directly to this.

Two popular dietary approaches deserve some nuance. Coffee in moderate amounts does not increase cardiovascular risk, but does not actively protect against it either. One alcoholic drink per day is associated with a slightly reduced risk in observational studies, but the evidence is limited and alcohol carries other health risks that are separate from this. The ketogenic diet and intermittent fasting sometimes show promising short-term results on risk factors, but there are insufficient long-term data to draw conclusions about their effect on actual cardiovascular disease. Finally, people who already have risk factors such as high blood pressure or disturbed blood lipids, and who have difficulty adjusting their dietary and lifestyle habits, may benefit from structured behavioural support. The United States Preventive Services Task Force actively recommends this on the basis of moderate evidence for a net positive effect.