More fruits and vegetables help prevent second heart attack, research shows
New research indicates that a healthy diet can significantly reduce the risk of a second heart attack for survivors, with more fruits, vegetables, legumes, and whole grains proving particularly beneficial. While medication plays a critical role in post-heart attack recovery, changing one's eating habits is just as crucial in improving long-term outcomes, according to Esther Cruijsen, a nutrition scientist at Wageningen University & Research.
Cruijsen's study, based on medical data of patients who survived heart attacks, suggests that adopting a healthier diet improves the likelihood of survival after an initial infarction. She emphasized that it is never too late to make changes. “Even after a heart attack, eating healthy is worthwhile. It’s never too late,” Cruijsen concluded in her doctoral thesis, "Habits for a Healthy Heart," which she defended this week.
For her research, Cruijsen analyzed data from tens of thousands of heart patients. Her findings indicate that consuming a plant-based diet—rich in fruits, vegetables, legumes, and whole grains—helps improve patients’ recovery and prolong life. On the other hand, reducing the intake of red and processed meats, salt, and sugars also contributed to better outcomes.
“The group of patients who survive heart attacks is growing,” Cruijsen said. “Acute care has improved, and for many, a heart attack is no longer a death sentence.”
Henk Koerting, 69, one of the patients featured in Cruijsen’s research, provides a personal example of the benefits of diet changes post-heart attack. Four years ago, Koerting was hospitalized after an unexpected heart attack. “I woke up as a healthy man, and the next day I was in intensive care,” Koerting recalled. He admits his lifestyle was unhealthy—his daily routine consisted primarily of coffee, and he drank heavily in the evenings. “I wasn’t paying attention to my diet,” he said.
Following his heart attack, Koerting’s doctor emphasized the importance of improving his nutrition. “My internist was shocked, having just checked on me. I had to make a change in my diet,” Koerting said.
Since then, Koerting has made several changes to his eating habits. “I eat a lot less meat now, and I include more vegetables and fruits. I’m not perfect, though. I still enjoy a snack like fries or chips every now and then,” he admitted. Cruijsen supports a balanced approach to eating, acknowledging that occasional indulgence is acceptable as long as it is not excessive. “It’s about maintaining a balanced diet,” she said. “Occasional treats are normal, and that’s how people can sustain healthier habits.”
Adopting a healthier lifestyle, however, is no easy task. Koerting has cut down on alcohol, opting for one bottle of beer, and despite his efforts, he still struggles with smoking. “It’s a monster inside me that I can’t seem to quit,” Koerting explained. He has managed to quit smoking for a few months in the past but fell back into the habit. “The only way a nicotine patch would help is if I put it on my mouth,” he joked.
Cruijsen was straightforward in her assessment: “Smoking increases the risk of new heart problems,” she said. Koerting, who is committed to quitting, has also been making small changes, such as keeping apples and nuts in his car as a healthier alternative to cigarettes.
Cruijsen acknowledges the challenges patients face in making lasting lifestyle changes, but she is optimistic that it is possible. “Healthy choices are often limited and expensive,” she said. Koerting agreed, noting that children should be taught to enjoy healthy foods like fruit. “It should be normal for children to eat fruit,” he said.
Cruijsen nodded in agreement, adding that a healthier food environment in society could reduce the incidence of heart disease. “If the overall availability and consumption of healthy food in society increases, the risk of cardiovascular diseases will decrease,” she said. Unfortunately, the reality is different, with studies showing that around 80 percent of supermarket offerings are unhealthy. The RIVM (Dutch National Institute for Public Health and the Environment) has also warned that obesity rates are rising, contributing to an increase in chronic diseases.
While doctors focus on medications and acute treatments, Cruijsen believes they should also guide patients toward better nutrition. “I understand that doctors often don’t have the time to give detailed advice, but referrals to dietitians or lifestyle coaches are helpful,” she said.
As Koerting left the research building, he promised to follow Cruijsen’s advice and try switching to whole-grain bread. However, he noted that he wouldn’t entirely give up white rolls. “I’ll try, but I won’t give up my white rolls,” he said.
