Two people with same lifestyle can have different heart health? Doctor shares diet for genetic variations

Heart risks prevail because of major genetic variations, going beyond lifestyle. Doctor reveals gene variations and what should be the diet for them.

Heart diseases are growing at an alarming pace around the world. As per a World Health Organisation report from July 31, 2025, 19.8 million people died from cardiovascular disease just in 2022. Moreover, heart ailments are no longer a concern only for middle-aged adults, as they are affecting young adults too, as early as their 20s and 30s. This has increased awareness about following healthy diets and exercising regularly. But are these protective measures enough to keep your heart safe? Apart from lifestyle, genes are also vital in determining heart health.

Dr Aparna Bhanushali, director of medical genetics at HaystackAnalytics, told HT Lifestyle that even if two people have similar lifestyles, they may still have very different heart health. According to her, how the body processes cholesterol, sugar, and fats depends on the gene. She opined, “While lifestyle choices certainly impact heart health, genetic variations can influence factors such as how efficiently the body regulates these substances, ultimately affecting the risk of heart disease.”

Major genetic variations that increase heart disease risks

The real answer to heart risk often is in your DNA. Certain genetic variations may make you predisposed to heart disease. Dr Aparna Bhanushali named high blood pressure, atherosclerosis, and arrhythmias to be one of the common cardiovascular conditions which are affected by DNA variations. In fact, the risk of developing these diseases can appear long before any symptoms show up.

Dr Bhanushali identified 4 major genetic variations and which heart conditions they may trigger:

1. LDLR gene: Responsible for low-density lipoprotein (LDL) cholesterol metabolism, it can lead to familial hypercholesterolemia, a genetic condition that causes high cholesterol levels from a young age and increases the risk of heart disease.
2. KCNQ1 gene: This is associated with a higher risk of arrhythmias, particularly in individuals with long QT syndrome, which affects the heart’s electrical system and can lead to sudden cardiac arrest if left untreated.
3. APOE (apolipoprotein E): It can increase the risk of heart disease by influencing lipid metabolism and cholesterol levels.
4. Certain variations of APOE gene: Elevated risk of developing coronary artery disease despite having a healthy lifestyle, as their bodies process fat and cholesterol differently.

Specific diet for those at genetic risk

People with the APOE-ε4 gene benefit from the Mediterranean diet. (Unsplash)

The same type of heart-healthy foods may not be as effective, especially for those with genetic predispositions. This is why Dr Bhanushali urged a diet that has specific gene considerations.

She shared these diet specifications:

1. APOE-ε4 carriers can benefit by limiting intake of saturated fat, preferring a Mediterranean-style dietary pattern (plant-based, fish, olive oil, nuts), increasing soluble fibre intake (legumes, oats) and regular monitoring of lipids.
2. APOA5, LPL, ANGPTL4 (influencing triglyceride metabolism) can benefit by limiting intake of refined carbohydrate and added sugar, increasing consumption of omega-3 fatty acids and dietary fibres.

Fish contains omega-3 fatty acids, good for APOA5, LPL, and ANGPTL4 gene carriers. (Freepik)

Similarly, if one is aware they are predisposed to high cholesterol, perhaps seen in the family often, the doctor may note a genetic predisposition and recommend focusing on reducing saturated fats and increasing fibre intake. Similarly, those who may be at risk of arrhythmias might benefit from regular heart health checkups.

General preventive measure: Exercise

Cycling is a good exercise. (Freepik)

While genetic factors may vary, there are some proven steps that you can follow to protect your cardiovascular health. One of the most prominent ones is exercising.

Elaborating about the physical activities, the doctor said, “When it comes to exercise, individuals at higher cardiovascular risk should engage in at least 150 minutes of moderate-intensity exercise per week, which can include activities such as brisk walking, cycling, or swimming. A combination of cardio and resistance training is especially beneficial, as it helps improve cardiovascular health, maintain a healthy weight, and regulate blood sugar and cholesterol levels.”

For example, someone with a genetic predisposition to high cholesterol might focus more on reducing saturated fats and increasing fibre intake, while someone predisposed to arrhythmias might benefit from regular heart health checkups and activities that promote cardiovascular endurance. For treatment, Dr Bhanushali highlighted precision medicine, which takes genetics into account.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.