Heart Disease, Cholesterol & Your Paleo Diet

February is Heart Health month and cardiovascular disease (which includes coronary heart disease, hypertensive heart disease, and stroke) is a global killer. Approximately 84 million Americans suffer from cardiovascular disease with approximately 655,000 deaths annually from heart disease alone. By the year 2030, over 23.6 million people are expected to die annually from one of these conditions. 

Unfortunately, the advice coming from governments in the form of their respective dietary guidelines and various other health sources seems conflicting, and you may be left confused as to what helps and what hurts your cardiovascular health. 

As with most things regarding physiology and nutrition, there is no simple answer. We are each genetically individual and unique, bearing our own personal set of genetic risks. Some people may be more prone to heart disease than others due to family history, lifestyle, and other variables. Other people will have lower risk of cardiovascular events, but may still be concerned about maintaining cardiovascular health and longevity and how diet can impact both

One of the biggest controversies surrounding cardiovascular disease is its apparent association with cholesterol. Unfortunately, cholesterol is surrounded by much myth and misinformation and may actually not be as bad as you may have believed.

What Is Cholesterol?

Cholesterol is a molecule found in every cell of your body but is mostly associated with heart disease and triglyceride issues. In fact, cholesterol is essential for all animal life, and has several critical functions throughout your body

  • Forms and maintains cell walls, including in the digestive system, which may help with gut issues
  • Converts sunlight into vitamin D
  • Helps absorb fat-soluble vitamins A, D, E, and K
  • Necessary for bile production, which helps in the digestion of fats
  • Creates hormones (specifically sex hormones)
  • Every cell in your body (especially cells of the liver, intestine, adrenal glands, and reproductive tissues) produces cholesterol to maintain adequate blood levels which are required for survival.

A common misconception regarding cholesterol is that it only comes from food. In reality, your liver produces the majority of the cholesterol found in your body, while only receiving a small amount daily from food. Your body will also compensate its cholesterol production based on how much you are consuming from food. Eating more cholesterol will result in your body will produce less cholesterol. This is also why restricting or increasing cholesterol consumption in your diet is often ineffective.

For over 50 years conventional, advice has been that the lower your cholesterol levels are, the better.

Unfortunately, modern research is finding results that contradict this advice: lower cholesterol levels are actually associated with an increase in mortality, and keeping levels low does not necessarily prevent disease.

  • 75% of those having a cardiovascular incident (and a heart attack) present with “normal” cholesterol levels.
  • Low serum cholesterol levels are associated with higher mortality.
  • Lower cholesterol levels are associated with an increased risk of dementia.
  • Low LDL cholesterol levels (commonly referred to as ‘bad’ cholesterol) are associated with an increased cancer risk.

Recent studies have shown that inflammation, along with metabolic syndrome and insulin resistance, could be overall contributing factors to developing heart disease.

Furthermore, science is beginning to understand that following a Paleo diet reduces blood pressure, total cholesterol, LDL cholesterol, triglycerides, BMI, waist circumference, and hip-to-waist ratio. A Paleo diet also boosts HDL (the ‘good’ cholesterol) and improves elasticity in your arterial walls as well as reducing other risk factors by increasing weight loss, regulating blood sugars, restoring insulin sensitivity and other markers of inflammation.

A Paleo Diet For Heart Health

A well formulated Paleo diet (one based on whole, minimally processed foods) naturally eliminates many of the inflammatory triggers for cardiovascular issues. Even within these guidelines, there are specific diet and lifestyle modifications that can offer some great benefits for the heart and the cardiovascular system.

Include Omega-3 Rich Foods. 

Across numerous studies, omega-3 fats are consistently associated with a reduced risk of cardiovascular disease (as well as reduced mortality from sudden cardiac death). These essential fats promote cardiovascular health in a variety of ways, including by lowering triglycerides, reducing inflammation, and providing important micronutrients to support vascular function.

Focus On Fiber. 

The fiber in vegetables, fruits, nuts and seeds can protect the cardiovascular system. Fiber consumption is associated with lower risk of stroke and heart disease, and some types of fiber can reduce LDL cholesterol, lower blood pressure, and promote healthy body weight.

Do Not Fear Saturated Fats

The idea that high-saturated fat animal foods cause heart disease has been discredited, and eating naturally occurring saturated fats (like those found in well-raised, pastured animals) is not detrimental to your heart health. Certain genetic factors, however, may make some people more sensitive to the LDL-raising properties of some forms of saturated fat. Always focus on saturated fats in their whole-food form (such as fatty cuts, organ meats and eggs), while also getting a variety of monounsaturated fats (avocado, olive, macadamia nut) and omega-3s from your diet.

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Foods To Include


These fat-filled fruits are already a Paleo favorite. They are rich in heart-healthy monounsaturated fats along with numerous vitamins and minerals that help keep the cardiovascular system strong, namely vitamin K (aids in proper blood clotting), magnesium (promotes muscle relaxation and electrolyte balance), and potassium (helps to regulate blood pressure). Eating an avocado daily may help to maintain normal serum total cholesterol. More evidence that good Paleo fats are good for you in every way.

Brussels Sprouts

Nutrients in Brussels sprouts help to lower systemic inflammation and reduce arterial plaque buildup, along with improving blood vessel function.


Blueberries are rich in anthocyanins and flavonoids which are antioxidants that can decrease blood pressure and dilate blood vessels reducing the risk of cardiovascular disease.


High in flavonoids that are linked with a reduced rate of ischemic stroke caused by blood clots, and rich in vitamin C which has been associated with lower risk of heart disease, like atherosclerosis, adding more citrus to your diet can boost your heart health. Furthermore, adding citrus to your dark leafy greens will almost quadruple the amount of iron you absorb.

Dark Chocolate

In humans, foods like cacoa which are high in flavonols counteract lipid peroxidation and, therefore, lower blood plasma levels and support heart health. When consuming ensure to choose a product that is as close to the whole food, 100% cacao as you can find!

Extra Virgin Olive Oil

EVOO may help lower your risk of heart disease by improving related risk factors. High quality Extra Virgin Olive oil is rich in monounsaturated fats which have been found to lower your total cholesterol and low-density lipoprotein cholesterol levels. Promote your heart health by upping your intake of this delicious fat in favor of relying too heavily on nuts.


Wild caught Salmon is one of the best sources of anti-inflammatory omega-3 fatty acids which can lower the risk of irregular heart beat as well as reducer plaque buildup in the arteries. Salmon is a superfood for the cardiovascular system because of these essential polyunsaturated fats. When consumed regularly, salmon can help to reduce blood pressure, lower resting heart rate, and improve vascular flow. Make sure it’s wild-caught, though, or the full nutritional benefits will not be realized as farmed fish are lower in nutrients and higher in toxins.


This dark, leafy green is loaded with lutein (a carotenoid), B-complex vitamins, folate, magnesium, potassium, calcium and fiber. Lutein is found in beneficial HDL cholesterol and may prevent LDL cholesterol from oxidizing and promoting heart disease.


Cardio-protective functions provided by the nutrients in tomatoes may include the reduction of LDL cholesterol, homocysteine, platelet aggregation, and blood pressure. Because tomatoes include several nutrients associated with these effects and are widely consumed year-round, they may be considered a valuable component of a cardio protective diet.

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Lifestyle Factors For Heart Health

You can eat all the right foods but without addressing certain lifestyle factors, you may still have inflammatory markers that are high.


Sleep deprivation is a major contributor to cardiovascular disease risk, and is associated with higher blood pressure, weight gain, obesity, and greater rates of heart disease and stroke. Getting less than 6 hours of restorative sleep a night doubles the risk of stroke, heart attack, and coronary heart disease, while also raising risk of congestive heart failure.

Manage Stress

Stress is a larger predictor of cardiovascular disease than other diet or lifestyle factors. Make a conscious to reduce the avoidable stressors in your life, or to manage existing chronic stress (through meditation, taking walks, getting time in


Make the commitment to engage in gentle movement throughout the day. Although chronic over-training can actually harm the cardiovascular system by raising cortisol and inflammatory markers, frequent gentle movement helps improve insulin sensitivity and circulation.


Get your daily dose on vitamin D. In a number of studies, vitamin D deficiency has been strongly associated with an increased risk of heart disease, stroke, and high blood pressure. Whether getting daily sun exposure is or is not an option, eating vitamin-D-rich foods like fatty fish and egg yolks, as well as supplementing when needed, can help protect against the cardiovascular-harming effects of deficiency.

Quit Smoking 

If you smoke, quit! Smoking is a powerful risk factor for cardiovascular disease. If you are a smoker, even the most nutritious Paleo diet and aggressive lifestyle modification will fail to offset the damage and disease risk created by smoking.

The topic of heart health can be incredibly confusing thanks to much myth and misinformation. It is, however, clear that by emphasizing these components of a Paleo diet and lifestyle, you can add dramatic protection for your cardiovascular system and your overall health!

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