Supporting heart health through food: practical guidance for care settings
Why heart health matters
As we age, our risk of heart disease increases – a reality we cannot control, just like our genetics. Fortunately, many other factors, such as diet, activity levels, and smoking, can be modified to reduce cardiovascular risk. Tess Warnes, allmanhall’s Registered Dietitian, outlines practical dietary strategies to support heart health in older adults, especially in care home environments.
Understanding the risks
Coronary heart disease (CHD) is the most common type of heart disease. According to the NHS, heart disease risk factors include high blood pressure, high cholesterol, smoking, diabetes, obesity, inactivity, and excessive alcohol consumption. Managing these risk factors can significantly lower the chances of a heart attack or stroke.
Heart health is especially crucial in older adults, who may also experience malnutrition, a condition that can further compound cardiovascular risk. Encouraging a healthy diet and active lifestyle, even in later years, contributes to improved quality of life and reduced illness.
The Mediterranean diet
The Mediterranean diet is widely recognised for its heart-protective benefits. Inspired by the traditional eating patterns of countries like Spain, Italy, and Greece, this diet is linked to lower rates of heart disease, stroke, and type 2 diabetes.
Key elements of the Mediterranean diet include:
- Plenty of fresh fruit and vegetables
- Wholegrains such as oats, barley, and brown rice
- Oily fish (e.g. salmon, mackerel, sardines)
- Unsalted nuts and seeds
- Lean meat and poultry
- Low-fat dairy products
- Unsaturated fats (e.g. olive and rapeseed oil)
Foods to reduce or avoid:
- Saturated fats (e.g. butter, lard, full-fat dairy, visible fat on meat)
- High-fat, high-sugar foods (e.g. cakes, biscuits, chocolate, pastries)
- Trans fats (often found in fast food and some margarines)
Other heart-healthy foods
Certain foods directly influence cholesterol levels – a key marker of cardiovascular health.
Foods that help lower cholesterol and reduce cardiovascular risk
- Monounsaturated fats such as avocados
- Polyunsaturated fat found in sunflower, corn and rapeseed oils, nuts and seeds
- Wholegrains such as those found in wholegrain bread, brown rice, quinoa, barley, high fibre breakfast cereals and oats
- Oily fish rich in omega-3 fats – mackerel, sardines, trout and salmon
- Plant stanols and sterols which can be found in cholesterol-lowering products such as Flora ProActiv and Benecol. NB – these must be consumed daily in sufficient quantities to be effective
A note on malnutrition
Older adults, particularly in care settings, are at heightened risk of malnutrition. This can lead to weakened muscles (including the heart), reduced immunity, frailty, and increased risk of hospitalisation. In such cases, ensuring adequate nutrition takes priority.
Focusing on foods that are nutrient dense instead of calorie dense (sugar/ fat) can help the consumption of a wider range of nutrients including energy, protein, vitamin, minerals, and fibre, whilst still being heart protective.
An easy way to identify if a food is nutrient dense is whether it is something designed by nature to support a new life e.g. an egg (which could potentially ‘grow’ a baby bird), whole seeds or nuts (from which a new plant could potentially grow) or milk (which would potentially ‘grow’ a baby animal). If the answer is yes, then this is likely to be a nutrient-dense ingredient.
Foods to include for those who may be malnourished or at risk of malnutrition include nut butters, skimmed milk powder, ground almonds, olive oil, Greek yoghurt.
Catering for heart health in care homes
Practical tips for catering teams:
Include plenty of fresh (or frozen) fruit and vegetables in meals – beetroot, spinach and kale are full of nitrates, which help to improve blood flow by relaxing the blood vessels; garlic contains allicin, which helps lower blood pressure and arterial plaque.
- Prioritise wholegrains such as oats, barley, and wholemeal bread – when your residents eat wholegrains they get fibre, polyphenols, vitamins and healthy fats, all of which are important for heart health.
- Offer oily fish once or twice a week. Regularly eating oily fish has been linked to a lower risk of heart disease. The omega-3 fats can help lower blood pressure and a type of fat in the blood called triglycerides. They also help prevent blood clots, improve circulation and maintain a healthy heart rhythm.
- Limit processed foods. Research has shown that people who eat the most ultra-processed food are 24% more likely to experience serious heart and circulatory events including heart attacks, strokes and angina.
- Reduce salt in your residents’ dishes – use aromatic herbs and spices as flavourings instead. If too much salt is eaten, water is pulled back into the bloodstream and the more water there is in blood vessels, the higher blood pressure gets.
- Swap out some red meat for plant-rich proteins like beans and lentils or use 50/50 recipes – this doesn’t just improve your residents’ heart health, but it benefits the planet too. allmanhall’s Hero Recipes provide a nutritious and cost-effective starting point.
- Incorporate heart-healthy ingredients into desserts and snacks, for example oat-based fruit crumbles and flapjacks.
- Follow Eatwell Guide principles to plan balanced, portion-controlled meals – you can find it here.
Even small adjustments to menus can significantly improve cardiovascular outcomes. For help implementing these tips, speak to our dietetic specialists or explore allmanhall’s Hero Recipes and seasonal menu guides.
Here are a couple of delicious, heart-healthy recipes...
Sardine & pea fishcakes
“These fishcakes are a great way to introduce oily fish into care home menus in a form that residents enjoy. Sardines and pilchards are rich in omega-3 fatty acids, which are important for heart health” – Tess Warnes, Registered Dietitian
Serves: 12 portions | Prep time: 25 minutes
Ingredients:
- 1.5kg loury potatoes (e.g. Maris Piper), peeled and chopped
- 4 x 120g tins sardines or pilchards in tomato sauce (about 480g drained weight)
- 300g frozen peas
- 2 medium onions, finely diced
- 3 tbsp sunflower or rapeseed oil (plus extra for baking/greasing)
- 2 tbsp fresh parsley, finely chopped
- 2 medium eggs, beaten
- 150g wholemeal breadcrumbs
- ½ tsp black pepper
- 1 tsp dried mixed herb
Method:
- Boil the potatoes in lightly salted water for 15 minutes until tender. Drain well and mash until smooth. Allow to steam off and cool slightly.
- Drain the sardines or pilchards, mash lightly with a fork, and stir through the mashed potato.
- Stir in the peas, onions (sautéed lightly if preferred for sweetness), parsley, pepper, and mixed herbs. Mix thoroughly.
- Divide into 12 large or 16 smaller patties. Chill for 15 minutes in the fridge to firm up.
- Dip each patty in beaten egg, then coat in the wholemeal breadcrumbs. Place on a greased baking tray.
- Brush lightly with oil and bake at 200°C / 180°C fan for 20–25 minutes, turning once, until golden and piping hot.
Rich beetroot & dark chocolate brownies
“Beetroot is naturally rich in nitrates, which improve blood flow by relaxing blood vessels and lowering blood pressure – potentially reducing heart disease and stroke risk. The beetroot flavour is subtle, which may reassure residents unfamiliar with the ingredient.” – Tess Warnes, Registered Dietitian
Serves: 12 portions | Prep time: 20 mins | Cook time: 25 minutes | Total time: 45 minutes
Ingredients:
- 660g raw beetroot, peeled and chopped
- 100g unsalted butter (plus extra for greasing)
- 160g dark chocolate (70% cocoa solids)
- 1 tsp vanilla extract
- 180g soft light brown sugar
- 3 medium eggs
- 90g plain flour
- 30g cocoa powder
- Pinch of sea salt
Method:
- Preheat the oven to 180°C (160°C fan). Grease and line a 20 x 30cm baking tin with parchment paper. Steam or boil the beetroot pieces for 15–20 minutes, until tender. Drain well, then blend into a smooth purée.
- In a heatproof bowl set over a pan of gently simmering water, melt the chocolate and butter together until smooth. Remove from the heat and stir in the vanilla.
- In a large bowl, whisk the eggs and sugar until thick and pale. Stir the beetroot purée into the melted chocolate mixture, then gently fold this into the eggs using a large metal spoon.
- Sift in the flour, cocoa powder, and salt. Fold gently until combined.
- Pour into the prepared tin and bake for 25–30 minutes, or until the top is set but the centre still has a slight wobble. Leave to cool completely in the tin before slicing into squares.
By making thoughtful, evidence-based food choices, care homes can play a vital role in protecting the heart health of residents – improving wellbeing, supporting independence, and reducing the risk of cardiovascular events. With a little creativity in the kitchen and a focus on fresh, wholesome ingredients, it’s possible to serve meals that are not only delicious but truly life-enhancing.
For more support and tailored guidance, please get in touch with our Nutrition & Dietetics team.
