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And, it's not just the things you should be avoiding -- such as salt and trans fats -- that are contributing to these deaths. The excess deaths may also be caused by what's missing in your diet -- namely, nuts and seeds, vegetables and whole grains, the researchers said.
"Cardiovascular disease is the number one cause of death in the United States, killing more people in 2015 than any other cause," said lead researcher Dr. Ashkan Afshin of the University of Washington in Seattle. He's an acting assistant professor of global health at the university's Institute for Health Metrics and Evaluation.
Debates on dietary policies in the United States tend to focus on cutting out unhealthy foods and nutrients, such as trans fats, salt and sugar-sweetened beverages. But this study shows that a large number of heart-related deaths may be due to a lack of healthy foods, Afshin reported.
"This study highlights the urgent need for implementation of policies targeting these unhealthy food groups as well healthy foods, such as nuts, whole grains and vegetables," he said.
The study data came from the U.S. National Health and Nutrition Examination Survey from 1990 to 2012. The researchers also used food availability data from the Food and Agriculture Organization of the United Nations and other sources.
Looking at deaths in the United States from heart and blood vessel diseases for 2015, the investigators found unhealthy diet choices and lack of eating healthier foods had a part in the deaths of more than 222,000 men and over 193,000 women. The study could not, however, prove a direct cause-and-effect relationship.
Low intake of nuts and seeds likely accounted for nearly 12 percent of deaths. Too few vegetables probably contributed to as many as 12 percent of the heart disease and stroke deaths. And, low intake of whole grains may have been responsible for more than 10 percent of those deaths. Too much salt likely accounted for 9 percent of deaths, Afshin said.
Samantha Heller, a registered dietitian, said, "If someone's diet is low in nuts, seeds, fruit, fiber, whole grains and vegetables, then they are likely replacing those foods with less healthy options, such as deli meats, cheeseburgers, fried chicken, sodas, boxes of mac-and-cheese, sugar-sweetened beverages and other highly processed, junk, fast and prepared foods." Heller is a senior clinical nutritionist at NYU Langone Medical Center in New York City.
"A crummy diet means the body has to work at Mach-10 to battle the onslaught of biochemical, physiological and inflammatory consequences. No wonder so many of us complain about being exhausted all the time and suffer from very serious and oftentimes preventable cardiovascular diseases," she said.
A more plant-based, whole-food approach to eating reduces internal inflammation, which in turn helps protect and heal "gunked up" arteries and an overworked heart. It also enhances the immune system, improves gastrointestinal and brain health, and boosts energy, Heller explained.
Heller recommends simple swaps, such as: sliced avocado, tomato and hummus on whole grain bread instead of a ham and cheese sandwich; a veggie burger topped with salsa instead of a cheeseburger; brown rice, vegetable-edamame paella instead of mac and cheese; a salad pizza instead of a pepperoni pizza.
"The good news is it is never too late or too early to ditch unhealthy foods, dig into a plate of vegetables, legumes, fruits, nuts, seeds and whole grains, and watch how our bodies respond by getting healthier and happier," Heller said.
The study was funded by the Bill and Melinda Gates Foundation. The findings were scheduled to be presented Thursday at the American Heart Association meeting in Portland, Ore. Study results presented at meetings are typically viewed as preliminary until they've been published in a peer-reviewed journal.
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