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Paleo Diet After A Heart Attack? What You Need To Know

Paleo Diet After A Heart Attack? What You Need To Know

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The Paleo diet (or hunter-gatherer diet) has lost its marketing momentum, but it’s still on the diet radar even now in 2024. If you’ve had a heart attack, you might be scared, confused, and searching for answers. You know you’ll probably have to make lifestyle changes, but is the Paleo diet an effective way to reduce your risk of having another heart attack heart attack?

A lot of fad diets prey on the insecurities and vulnerabilities of heart patients wanting to improve their health and general well-being.

If you’ve experienced a heart attack or stroke and are overweight, your doctor will often suggest lifestyle modifications to reduce your risk of further cardiac events.

Lifestyle modifications may include losing weight, quitting smoking, reducing alcohol consumption, and regular exercise to reduce your risk of another heart attack or stroke.

Losing body fat isn’t easy and trying to navigate through popular food fads, confusing nutrition labels, and online misinformation can be frustrating

So let’s set the record straight: there are many ways to eat healthy.

Healthy diets can range from vegan to meat eating or raw versus cooked food – there really isn’t a perfect or ideal one-size-fits-all diet.

The truth about dietary guidelines

Dietary guidelines have copped a lot of heat from self-styled health gurus and social media influencers, but are they actually as sinister as they say?

Maybe you’re thinking, “well, the dietary guidelines claim to be one-size-fits-all,” but actually this is not the case.

You need to bear in mind that dietary guidelines:

  • Are government recommendations set for a respective country according to cultural taste preferences and current research.
  • For populations are very different to individual eating styles especially when you are managing a chronic health condition like heart disease.
  • Are merely a framework for healthy populations on what foods can be included in an individual diet.
  • Do not take into consideration health conditions, metabolic rate, physical activity levels, or individual food tastes and preferences.

If the dietary guidelines aren’t necessarily the end-all-be-all nutrition gospel, then is there anything wrong with trying the Paleo diet if you have heart problems?

Paleo diet benefits after a heart attack

The Paleo diet at face value promotes the consumption of fruit, vegetables (preferably organic), lean game meats such as rabbit, kangaroo, free-range poultry, grass-fed beef and fish, and nuts and seeds, all of which are heart healthy foods.

There is no restriction on the amount of food you are allowed to eat.

As long as you omit dairy, grains, legumes, sugar, and processed food, then you are free to eat until you’re full.

The diet is naturally low in added sugar, carbohydrates, and processed foods.

This is good because after a heart attack, it is generally recommended to reduce your intake of processed, high-calorie foods high in refined sugar.

This type of eating style can be beneficial for some people, however there are healthy food groups that are missing, which may be difficult and unnecessary to restrict yourself from – such as dairy, whole grains, and legumes.

In addition, after a heart attack there are other nutrients you should also be eliminating that the Paleo diet does not enforce – such as sodium, trans- and saturated fats.

Paleo diet downsides after a heart attack


No diet is without limitations and the Paleo diet is no exception.

As mentioned above, the Paleo diet omits food groups such as dairy, grains, legumes, and vegetable oils, all of which are healthy foods and the basis of many known healthy heart-protective diets like vegetarian, Mediterranean, and Nordic diets.

Specifically, the Paleo diet is a higher fat diet due to its high allowance of animal fats. It contains more trans and saturated fats because of the high consumption of beef, lamb, and goat, which can increase heart disease risk. We’ll look at this in more detail later.


For some people on the lower end of the income scale, the cost of eating the Paleo way may pose a problem.

The Paleo diet promotes the consumption of many food products that tend to be expensive– i.e., organic and grass-fed meat, organic vegetables, and nuts and seeds.

Luckily, it’s not imperative that you eat organic produce or grass-fed beef to improve your heart health.

Is dairy bad for my heart?

Despite the bad wrap dairy gets from Paleo proponents, this is unfounded and it can be included in a heart-healthy diet.

Low fat diary products such as milk, cheese, and yogurt have never been associated with heart disease risk.

In fact, quite the contrary, a 2022 meta-analysis concluded that the calcium content found in dairy products has a protective effect on heart health and that any detrimental effects may depend on more on the type of dairy.

Moreover, if you are trying to lose or maintain weight to improve your heart health, research shows that dairy products can fit into a healthy diet without causing weight gain.

Can I eat grains after a heart attack?

Grains are a highly nutritious food source and are included in many heart protective traditional diets like the Mediterranean diet.

A 2023 meta-analysis concluded that diets containing high whole grain intakes were associated with a reduced risk of coronary heart disease (while refined sugary junk food can cause problems).

Whole grain sources include wild rice, quinoa, seeded or rye bread, whole wheat, spelt, millet, oats amaranth, corn, buckwheat, and barley.

Including whole grains in your diet daily may help reduce cholesterol due to their high fiber (and low fat) content which can, in turn, reduce your risk of heart disease.

Be aware that whole grains are different to processed and refined versions of grains found in cakes, biscuits, pasties, bars and white bread.

Processed grains are typically found in packaged food products with added salt, sugar, or fats, all of which could plausibly increase your cardiac risk.

Is there a benefit to turning vegetarian?

Although vegetarian and vegan diets have often been associated with better health amongst lay people, a 2014 report in the International Journal of Cardiology found that a vegetarian diet resulted in a small cardiovascular benefit, but no clear reduction in overall mortality.

Similar improvements can be seen in diets that contain small amounts of animal protein such as in the Mediterranean and Nordic diets.

Eating more vegetables and whole grains will certainly improve your health, but you don’t need to entirely give up meat – if that’s what trips your trigger.

If you tend to consume a lot of animal products you may benefit from swapping some meat for vegetarian alternatives.

You might want to try a few meat-free days in an attempt to reduce trans and saturated fat and calorie intake.

The benefit of vegan and vegetarian diets is that they promote a high consumption of nuts and legumes as protein alternatives, which has been shown in a 2014 report published in the American Journal of Clinical Nutrition to reduce the risk of ischemic heart disease.

Can a Paleo diet prevent another heart attack?

No diet guarantees 100% protection against having another heart attack. A 2019 systematic review and meta-analysis found that although the Paleo diet has favourable effects on cardiovascular disease risk factors, the evidence is not conclusive and more well-designed trials are still needed. It’s not to say it’s worthless, but it’s important to remember that diet is only one piece of the overall lifestyle puzzle.

A number of other factors besides diet can influence the likelihood of cardiac events:

  • Genetics
  • Age
  • Gender
  • Lack of physical activity
  • Associated medical conditions like high blood pressure, diabetes, or elevated lipids
  • Obesity (particularly visceral fat around your organs
  • Smoking and high alcohol consumption
  • Stress

Coconut oil and heart attacks

Paleo diets tend to advocate for coconut oil, but is this really something you should be eating after a heart attack?

It’s not always a clear-cut win-win, so here are some things to bear in mind.

Coconut oil is classified as a saturated fat, however it has now been identified as a special type of fat known as medium chain triglycerides (MCT). This means it’s easier to break down and be used for quick release energy.

However, as of 2023, the research surrounding coconut oil and heart disease is still mixed, noting that its popularity as a health food is driven by online health misinformation from social media networks. So there is not enough research to unequivocally advocate that it’s safe to consume liberally for heart patients.

The current dietary recommendations suggest swapping saturated fat for mono- or poly-unsaturated fat sources. A 2015 Cochrane Review concluded that swapping saturated for polyunsaturated fat can help reduce cardiovascular health risks.

The best type of fat to cook and use as salad dressings is olive oil, followed by other vegetable oils such as canola, nut, avocado and sunflower oil.

As the Mediterranean diet has been widely studied, research supports the benefits of olive oil and the heart protective benefits of monounsaturated fats.

Is salt bad for you after a heart attack?

Salt has been dubbed the silent killer because its effects on the cardiovascular system.

The chemical name for salt is sodium and it is often found in processed foods, sauces, stocks, bread, sodas and takeaway food.

Sodium can contribute to fluid retention which, in some salt-sensitive people, can increase blood pressure and place additional stress on the heart and blood vessels.

How much salt?

On average western diets typically provide 3000-4000mg of sodium daily.

This is well above the recommended 2000mg daily limit.

In order to reduce your sodium intake, aim to choose packaged products consisting of < 250mg of sodium per 100g. Or better yet, nix the packaged food all together.

A diet rich in vegetables and fruit will help balance sodium content.

For example, fruits and vegetables are also high in potassium which can help balance out high sodium intakes and improve blood pressure.

This is one of the reasons why plant-based diets such as Mediterranean and vegetarian diets are so successful in reducing heart disease.

Paleo diet and salt intake

A comprehensive 2009 meta-analysis in the British Medical Journal concluded that high salt intake is associated with a significantly increased risk of stroke and cardiovascular disease and called for a reduction in salt intake.

A Paleo diet is generally low in processed foods, many of which contain salt.

So if you follow Paleo diet principles and don’t add extra salt to your meals, then this can help reduce your risk of a second heart attack.

Paleo diet, meat intake, and cholesterol

There are similarities between the Paleo diet and the Mediterranean diet, but there are also distinct differences.

When it comes to what to put in your mouth after a heart attack you want to make sure you have all the facts before you get started on your healthy eating regime.

The Paleo diet tends to be high in protein, offering up generous serves of meat and animals fats, with the majority of meals comparatively low in carbohydrate.

Although, some people improve their health by switching to Paleo, it is not necessary to omit grains or dairy.

Moreover, in some people, over consumption of red meat can adversely affect cholesterol levels.

Paleo diet advocates tend to disregard high cholesterol as a contributing factor to heart disease risk, however this is a little misguided.

Yes, there is still a raging debate over whether or not cholesterol causes heart attacks, but whether or not it’s the cause, we do know that it’s at the scene of the crime and is found in atherosclerotic plaques.

Research has shown that your cholesterol profile – i.e., the levels of good (HDL) and bad (LDL) cholesterol – are important risk factors which, when controlled, may give you an improved chance of avoiding another heart attack. 

A study published in Circulation underscores the growing understanding of the role of inflammation in the oxidation of LDL in the coronary arteries.

If you are very overweight and consume a diet comprised primarily of processed food and then switch to a Paleo diet, you will naturally see a reduction in weight and possible improvement in blood biomarkers, sometimes even an improvement in your cholesterol profile.

This is because you have switched to whole foods, which naturally tend to promote a reduced energy intake with greater nutrient density.

This keeps you feeling fuller for longer and therefore less likely to overeat.

There is no additional benefit from omitting grains, legumes or dairy.

All three-food groups are healthy and nutritious. It’s easier to switch to a whole food diet rather than going Paleo.

The Mediterranean diet

The Mediterranean diet is known globally for its positive effects on heart health and many other chronic health conditions like diabetes and cancer.

A 2010 meta-analysis and systematic review in the American Journal of Clinical Nutrition confirmed the significant and consistent protection provided by adherence to a Mediterranean diet in relation to the occurrence of major chronic degenerative diseases.

The diet entails eating plenty of vegetables and whole grains, including the use of legumes wheat and barley.

There is a predominance of use of monounsaturated fats in the form of olive oil, lean meats, seafood, and nuts and seeds.

Nutrition scientists believe that the combination of unsaturated fats and high fiber intake is what makes Mediterranean diet heart protective.

Heart disease is also associated with high homocysteine levels, an inflammatory compound that’s thought to be a contributing factor to heart attacks and strokes.

Unsaturated fats like monounsaturated fats found in olive oil, avocado, nuts and seeds and omega-3 polyunsaturated fats helps to bring down homocysteine levels.

Bottom line: should you eat a Paleo diet to avoid a heart attack?

If you have a junk food diet and decide to take on board the principles of the Paleo diet, you will probably improve your heart health – but remember it’s not the only way to get healthy.

A less restrictive, proven diet for lowering heart disease risk is the Mediterranean diet, which is less expensive, easier to follow, and has proven benefits to overall health.

Ultimately, an eating style should be chosen according to your taste preferences and your likelihood of sticking to it for the rest of your life.

Your heart health is dependent on you keeping healthy for years to come, not a short stint on a fad diet.

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Wednesday 31st of January 2018

I don’t think you did enough research on the paleo diet - it does restrict salt intake and doesn’t promote an over abundance of meat (especially fatty meats). the bottom of the paleo food pyramid is vegetable. As for the legumes and dairy - they are known to cause systemic inflammation. Systemic inflammation leads to metabolic disorders and other diseases. They also aren’t good for gut health, which also is linked to cardiovascular health, amongst other things. Vegetable oils aren’t great for you as they are typically genetically modified and are loaded with trans fats. I think you need to look again without bias and rethink what you view as ‘healthy’. Paleo is ok with grass-fed dairy, by the way.

Bob Geary

Saturday 1st of April 2017


Finding this article over a year after it was published (since I hadn't had a heart attack a year ago ;-)) - don't know if anybody's looking at comments or anything...

On the whole, the article was impressively even-handed. People say "Eat a heart-healthy diet" as if that was a known scientifically-proven and -calibrated thing, when it's clearly not. (Even worse are the people who say, "Just eat a Mediterranean diet - you know, lots of salmon from the North Atlantic and New World grains!")

However, one sentence did jump out at me: you implied that the Paleo diet includes more saturated *and trans* fat than other options, because it involves so much red meat. Saturated, yup - absolutely. But the only "trans" fats that red meat contains are trans-rumenic and trans-vaccenic acids - neither of which are at all harmful, and generally thought to be heart-protective. The "bad" trans fats that everybody should avoid are those that result from hydrogenation, and red meat (especially when it's free-range and organic) doesn't have any of that.

And the article you link to about the dangers of red meat has nothing to do with saturated OR trans fats - it's about how the carnitine in red meat is converted to TMAO in your gut, and TMAO is correlated with heart disease. What the article DOESN'T mention is the foods that will raise your TMAO levels many times more than beef will: mushrooms and soy raise it just about the same, and oily fish such as mackerel can raise it by 100 times as much.

Otherwise, though, very good article - thank you!