So much has been written about how to eat for a healthy heart that most of us know the basics by now.
Eat more fruits and vegetables. Choose whole grains. Get plenty of fiber. Include nuts, legumes and omega-3-rich foods.
But there may be a problem with that advice.
You can follow those rules, eat what looks like a very healthy diet and still fall short on a group of plant compounds linked to important cardiovascular benefits.
They’re called flavanols.
And according to new research, most of us aren’t getting nearly enough of them.
The heart-protective compounds most people are missing
Flavanols are naturally occurring plant compounds found in certain fruits, vegetables, tea, cocoa and legumes.
They’re part of the larger family of polyphenols that have been linked to heart and brain benefits, which is why scientists have become increasingly interested in how much we’re actually consuming.
That question led researchers from the University of Reading, Harvard Medical School, the University of California, Davis, and Mars, Inc. to examine the diets of more than 30,000 people in the United States and United Kingdom.
And they didn’t rely only on people remembering what they had eaten.
Researchers also used biomarkers that gave them a more objective picture of flavanol intake.
What they found was surprising.
Fewer than one in five people were consuming enough flavanols to reach levels previously associated with meaningful cardiovascular benefits.
And many of the people falling short were already meeting standard recommendations for fruit and vegetable intake.
In other words, eating your fruits and vegetables is important.
But when it comes to flavanols, which ones you choose matters.
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Why 500 mg matters
The researchers were especially interested in whether people were reaching about 500 mg of flavanols per day.
There’s a good reason for that number.
In the large COSMOS clinical trial, more than 21,000 older adults were randomly assigned to take a cocoa extract containing 500 mg of flavanols daily or a placebo.
Over a median follow-up of 3.6 years, the group receiving the cocoa flavanols experienced a 27 percent lower risk of dying from cardiovascular disease.
The trial’s primary measure of total cardiovascular events did not reach statistical significance overall, but the reduction in cardiovascular death was significant, and additional analyses also supported potential cardiovascular benefit.
That makes the finding from this newer study especially important:
Most people weren’t coming close to 500 mg a day — even when their overall diet looked healthy.
Five a day may not tell the whole story
It’s easy to assume that if you eat plenty of produce, you’re covered.
But flavanol content varies enormously from food to food.
Dr. Javier Ottaviani, the study’s lead author, explained that simply eating a large quantity of fruits and vegetables doesn’t necessarily guarantee a high flavanol intake.
The specific foods you choose can make a much bigger difference.
That doesn’t mean the familiar advice to eat five servings of fruits and vegetables a day is wrong.
Far from it.
But as Professor Gunter Kuhnle of the University of Reading pointed out, we may need to think more carefully about which five.
Some fruits and vegetables simply deliver far more flavanols than others.
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How to get more flavanols
The good news is that some very familiar foods can supply substantial amounts.
Among the flavanol-rich foods highlighted by the researchers are:
- Green tea: about 200 mg per 8.5-ounce cup
- A medium apple with the skin: about 110 mg
- Blackberries: about 250 mg in 7 ounces
- Cranberries: about 300 mg in 8.8 ounces
- Plums: about 450 mg in 17.6 ounces
- Fava beans: about 140 mg in a small handful
- Strawberries: about 90 mg in 7 ounces
- Blueberries: about 80 mg in 5.3 ounces
- Pinto beans: about 70 mg in two tablespoons dry
Some of those quantities are larger than what most of us would eat at one sitting, so don’t look at this as a prescription to eat nearly a pound of plums.
The more practical takeaway is that flavanols add up.
A cup of green tea, an apple with the skin and a serving of berries during the day could make a meaningful contribution toward that 500 mg level.
That’s a lot more realistic than trying to get your entire day’s flavanols from one food.
Your healthy diet may have one blind spot
The most interesting part of this research isn’t that fruits and vegetables are good for your heart.
We already knew that.
It’s that general healthy-eating advice may not tell us enough about the plant compounds that help make certain foods especially beneficial.
You could be eating plenty of produce and still be getting very little of the flavanols associated with cardiovascular protection.
So keep eating your fruits and vegetables.
But consider giving the flavanol-rich ones a little more room on your plate — and in your cup.
When it comes to protecting your heart, what you choose may matter just as much as how much you eat.
Sources:
Adhering to dietary guidelines does not yield flavanol intake levels associated with beneficial cardiovascular effects — Food & Function
Your Diet Could Be Missing the Key Ingredient for Heart Protection — SciTech Daily
Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial — The American Journal of Clinical Nutrition
FAQ: What to know about flavanols and heart health
What are flavanols?
Flavanols are naturally occurring plant compounds found in foods such as tea, apples, berries, cocoa and certain legumes. They belong to the larger flavonoid family and have been studied extensively for their effects on blood vessels and cardiovascular health.
How many flavanols should you get each day?
Researchers focused on an intake of about 500 mg of flavanols per day, a level previously associated with meaningful cardiovascular benefits. The new research found that fewer than one in five people were reaching that amount.
What foods are highest in flavanols?
Green tea, apples with the skin, blackberries, cranberries, plums, strawberries, blueberries and fava beans are all good sources. Because flavanols add up throughout the day, eating several different flavanol-rich foods may make it easier to reach higher intake levels.
Can I get enough flavanols just by eating five servings of fruits and vegetables?
Not necessarily. The research found that even many people who met standard fruit and vegetable recommendations still failed to reach higher flavanol intake levels. That’s because flavanol content varies considerably depending on which fruits and vegetables you choose.
Are flavanols good for your heart?
Research has linked higher flavanol intake with cardiovascular benefits. In the large COSMOS clinical trial, adults who consumed cocoa extract providing 500 mg of flavanols daily had a significantly lower risk of cardiovascular death, although the trial’s primary measure of total cardiovascular events was not significantly reduced overall.
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