Heart Disease in Men: Can Nutrition Make a Difference?

Heart disease kills more men than any other condition. Most men know this intellectually. Most are also convinced there's nothing they can actually do about it. That assumption is costing lives.

The truth is more nuanced. Heart disease isn't inevitable. It's not purely genetic. Nutrition plays a role that extends far beyond simple cholesterol numbers, and the foods you choose today directly influence your cardiovascular risk years from now.

Why men are at higher risk

Men die from heart disease at younger ages than women, often in their 50s and 60s when women of the same age have another decade or more of protection. The gap narrows sharply after menopause, when women's oestrogen declines. This tells you something important: hormones matter profoundly, but so does nutrition, stress, and lifestyle.

Testosterone, the defining hormone of male physiology, offers cardiovascular protection when it's in the right range (400 to 700 ng/dL). It promotes healthy blood vessel function, reduces inflammation, and supports metabolic health. But chronic stress, poor diet, excess weight, sedentary behaviour, and alcohol consumption all suppress testosterone and raise cortisol. Cortisol is catabolic. It promotes inflammation. It damages the endothelial layer (the innermost layer of arteries). Over years, this shifts the hormonal landscape in a direction that accelerates atherosclerosis.

Men also tend to ignore early warning signs longer than women do. Chest discomfort gets dismissed as indigestion or muscle strain. Shortness of breath gets attributed to being out of shape. Fatigue gets blamed on work stress. By the time a man actually seeks help, significant arterial damage has often already occurred. Prevention, not treatment, is the only sensible strategy.

The men with the best outcomes aren't the ones waiting for symptoms. They're the ones rebuilding their cardiovascular resilience before anything goes wrong.

The CoQ10 story

CoQ10, also known as ubiquinone, is produced by your body and concentrated heavily in the heart. It's essential for energy production in cardiac cells (your heart beats 100,000 times daily and needs fuel). CoQ10 also has antioxidant properties that protect against the oxidative damage that drives atherosclerosis (plaque formation).

Here's the problem. CoQ10 production declines with age. By your 50s and 60s, your body is making significantly less of it than it did at 30. Mitochondrial function declines. Energy production declines. Oxidative protection declines. Simultaneously, these are the years when heart disease risk accelerates. It's terrible timing. A 65-year-old man's heart is producing 50% less CoQ10 than a 35-year-old man's heart, yet his cardiovascular demands are higher because his arteries are stiffer and his blood pressure is higher.

Statin drugs, commonly prescribed to lower cholesterol, actively deplete CoQ10. The mechanism is direct: statins inhibit the enzyme pathway that produces CoQ10. Men taking statins often experience muscle pain, fatigue, and weakness.¹ These symptoms often resolve when CoQ10 supplementation or increased dietary CoQ10 is added. This isn't coincidence. The depletion is real, measurable, and consequential.

The richest food sources of CoQ10 are organ meats. Beef heart, pork heart, and beef liver all contain exceptional amounts. A 100-gram serving of beef heart provides approximately 11mg of CoQ10², which exceeds most commercial supplement doses. The irony is that the foods modern low-fat dietary guidelines have discouraged (organ meats) are the exact foods a man's cardiovascular system desperately needs.

• Beef heart (100g): 11 mg CoQ10, plus carnitine for energy
• Pork liver (100g): 3 to 4 mg CoQ10, high micronutrient density
• Herring (100g): 3 mg CoQ10, plus omega-3s
• Sardines (100g): 0.6 mg CoQ10, bioavailable fats
• Grass-fed beef (100g): 0.2 mg CoQ10, varies by cut

Omega-3 balance matters more than you think

The conversation around omega-3s has been oversimplified to the point of uselessness. Men have been told to take fish oil supplements and eat more fish, both reasonable recommendations, but the real issue is balance. Supplementing omega-3s into a diet high in omega-6 is like bailing water out of a boat with a hole in it. The ratio determines everything.

Modern diets are drowning in omega-6 fats from seed oils (sunflower oil, soya oil, canola oil, vegetable oil), processed foods, and grain-fed animal products. The ideal ratio of omega-6 to omega-3 is somewhere between 1:1 and 4:1. Ancestral diets maintained this balance. Most modern men are eating at ratios of 15:1 or higher³, some even 20:1. This imbalance is fundamentally inflammatory because omega-6 fats in excess promote the production of inflammatory molecules, whilst omega-3 fats inhibit them.

Omega-3 fats, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) from fish and other marine sources, actively reduce inflammation throughout the body, support healthy heart rhythm stability, thin blood slightly to improve flow, and protect the endothelial lining of arteries. But they only work effectively when the overall fat balance is corrected. You can't supplement your way out of a bad diet.

This means two critical things. First, increase omega-3 sources: fatty fish like mackerel (2.3g omega-3 per 100g), sardines (1.5g), herring (1.7g), and wild salmon (1.5g), but also oysters and other shellfish. Second, and equally important, dramatically reduce omega-6 sources. Cut seed oils from your kitchen entirely. Cook with butter, ghee, coconut oil, or olive oil instead. Reduce processed foods. Prioritise grass-fed and pastured animal products where the fat balance is healthier (grass-fed beef has a 1:2 omega-6 to omega-3 ratio, whilst grain-fed beef is 5:1).

Fish oil supplements won't fix a diet built on seed oil and processed foods. The ratio matters more than the absolute amount.