Blueberries, blackberries, cherries, purple grapes and other anthocyanin-rich foods representing research on anthocyanins, heart health and cardiovascular disease prevention.

The Heart Health Benefits of Anthocyanins: Why You Should Eat More Red, Blue, and Purple Foods

There is no shortage of complicated advice about how to improve cardiovascular health. Eat this exact diet. Avoid this food. Take this supplement. Track these biomarkers. Sometimes we make nutrition considerably harder than it needs to be.

One of the simpler things you can do may be to eat more deeply colored plant foods.

Blueberries, blackberries, cherries, purple grapes, red cabbage, and similar foods contain natural pigments called anthocyanins. These compounds give many fruits and vegetables their red, blue, and purple colors, but they may do considerably more than make food look good.

A large 2026 systematic review and meta-analysis published in The American Journal of Clinical Nutrition brought together both long-term observational research and randomized controlled trials examining anthocyanins in generally healthy adults. The results suggest that people who regularly consume more anthocyanins tend to have a lower risk of cardiovascular disease, heart attacks, hypertension, and type 2 diabetes. Controlled trials also provide a possible explanation: anthocyanins appear to improve how well our blood vessels function.

That doesn't mean blueberries are medicine or that eating purple food guarantees you won't have a heart attack. But it does add to an increasingly convincing argument that regularly eating anthocyanin-rich foods is a pretty good idea.

TLDR

Anthocyanins are plant compounds responsible for many of the red, blue, and purple colors in fruits and vegetables. A large systematic review combining long-term population studies and randomized controlled trials found several potentially important cardiovascular benefits.

Higher habitual anthocyanin intake was associated with a 26% lower risk of cardiovascular disease.
Higher intake was associated with an 18% lower risk of coronary artery disease or heart attack.
Cardiovascular mortality was 9% lower among people consuming more anthocyanins.
Risk of developing type 2 diabetes was 11% lower.
Risk of developing hypertension was 8% lower.
Randomized trials found meaningful improvements in flow-mediated dilation, a measure of how well blood vessels expand.
Anthocyanins did not consistently lower blood pressure, cholesterol, blood glucose, body weight, or several inflammatory markers in otherwise healthy people.
Benefits were observed in studies providing at least 50 mg of anthocyanins per day, an amount that can realistically come from food.
Good sources include blueberries, blackberries, raspberries, cherries, purple grapes, plums, red cabbage, and other dark red, blue, and purple plant foods.

The bigger takeaway isn't that you need another supplement. It's that regularly eating colorful fruits and vegetables may quietly improve cardiovascular health over years, even when the effects aren't obvious on a standard blood test.

What Are Anthocyanins?

Anthocyanins belong to a large family of plant compounds called flavonoids.

They're pigments produced by plants and are responsible for the dark red, purple, and blue colors found in many fruits and vegetables. If you've ever crushed a blueberry between your fingers and ended up with purple fingertips, anthocyanins are partly responsible.

Plants don't produce these compounds for our benefit. They serve several functions for the plant itself, including helping protect against environmental stress and attracting pollinators and animals that spread seeds.

Fortunately, we get something out of the deal too.

Anthocyanins and the compounds produced when our bodies and gut bacteria metabolize them appear to interact with several biological systems involved in cardiovascular and metabolic health.

There are multiple individual anthocyanins, including cyanidin, delphinidin, malvidin, pelargonidin, peonidin, and petunidin. Different foods contain different combinations.

That's one reason I prefer thinking about anthocyanins as a reason to eat a variety of colorful foods rather than trying to identify one magical berry.

What Foods Contain Anthocyanins?

The easiest rule is color.

Look for naturally dark red, blue, and purple plant foods.

Common sources include:

Blueberries
Blackberries
Black raspberries
Red raspberries
Cherries
Purple and red grapes
Plums
Black currants
Elderberries
Cranberries
Pomegranates
Red and purple cabbage
Purple corn
Purple potatoes
Black rice

The exact anthocyanin content can vary substantially depending on the food variety, growing conditions, ripeness, storage, processing, and serving size.

That's another reason it doesn't make much sense to obsess over hitting exactly 73 mg of anthocyanins every day.

A better strategy is simply to make anthocyanin-rich foods a regular part of your diet.

What Did the Research Find?

What makes the new analysis interesting is that the researchers didn't look at just one type of study.

They combined evidence from 18 prospective cohort studies reported across 27 publications with 65 randomized controlled trials.

Those two types of research answer slightly different questions.

Prospective cohort studies follow large groups of people for years and ask whether people with different dietary habits eventually develop different health outcomes.

Randomized controlled trials are much shorter but allow researchers to deliberately give people anthocyanin-rich foods or extracts and measure what happens to things like blood-vessel function, insulin, cholesterol, and blood pressure.

Using both gives us a more complete picture.

The long-term studies tell us whether eating more anthocyanins is associated with less disease.

The randomized trials can help us understand why that association might exist.

26% Lower Risk of Cardiovascular Disease

One of the largest findings involved cardiovascular disease itself.

Across four prospective cohorts involving more than 92,000 people, those consuming higher amounts of anthocyanins had a 26% lower relative risk of cardiovascular disease compared with people consuming lower amounts.

That's a substantial association.

But notice the wording: relative risk.

It doesn't mean 26 out of every 100 people who eat blueberries will avoid cardiovascular disease.

Imagine a hypothetical population where 10 out of 100 people develop cardiovascular disease. A 26% relative reduction would reduce that risk to approximately 7.4 out of 100.

The absolute difference would therefore be around 2.6 percentage points.

The actual absolute benefit depends on someone's baseline risk.

That's an important distinction whenever you see percentages describing disease risk.

Heart Attack Risk Was 18% Lower

The researchers also analyzed five cohorts involving more than 526,000 participants.

Higher anthocyanin intake was associated with an 18% lower risk of coronary artery disease or nonfatal myocardial infarction, better known as a heart attack.

The evidence supporting cardiovascular disease and heart attack incidence was rated moderate, making these among the stronger long-term findings in the review.

Again, this doesn't prove anthocyanins themselves prevented the heart attacks.

People who eat a lot of berries and colorful plant foods may also exercise more, smoke less, eat more fiber, maintain healthier body weights, or have other behaviors that influence cardiovascular risk.

Researchers try to statistically adjust for those differences, but observational research can never completely eliminate them.

Fortunately, the randomized trials give us another piece of the puzzle.

Blood Vessels Seem to Respond to Anthocyanins

One of the most consistent findings involved something called flow-mediated dilation, or FMD.

The name sounds complicated, but the concept isn't.

The inside of your blood vessels is lined with a thin layer of cells called the endothelium. These cells help regulate whether blood vessels tighten or relax.

Healthy blood vessels should be able to expand when more blood flow is needed.

FMD measures how well an artery performs that job.

You can think of it as a basic stress test for your blood vessel wall.

When researchers pooled randomized trials, anthocyanin intake improved FMD both shortly after consumption and after repeated intake over several weeks.

Acute intake improved FMD by roughly 1.4 to 1.5 percentage points, while longer-term supplementation or food intake produced an improvement of roughly 1.4 to 1.6 percentage points, depending on the analysis.

That might sound small.

For endothelial function, it isn't necessarily small at all.

FMD is considered an important marker of vascular health, and poorer endothelial function is associated with greater cardiovascular risk.

Anthocyanins May Help Your Body Make Better Use of Nitric Oxide

One possible explanation involves nitric oxide.

Nitric oxide is a signaling molecule produced within blood vessels. One of its main jobs is telling the smooth muscle surrounding blood vessels to relax.

More relaxation means the vessel can expand.

This helps regulate blood flow and vascular function.

Anthocyanins and their metabolites may influence pathways involved in nitric oxide production and availability. They may also influence oxidative stress, platelet activity, inflammatory signaling, and other processes affecting vascular health.

This is particularly interesting because improved endothelial function showed up consistently even when traditional markers such as blood pressure didn't change.

In other words, your blood vessels may become healthier before you see anything dramatic happen to the numbers on your annual physical.

Blood Pressure Didn't Significantly Improve

This is where the study becomes more useful than a typical "berries are good for your heart" headline.

Across 22 randomized controlled trials, anthocyanin interventions did not significantly reduce systolic or diastolic blood pressure overall.

That might sound contradictory.

If blood vessels work better, shouldn't blood pressure drop?

Not necessarily.

Most participants in these trials were generally healthy. If someone's blood pressure is already normal, there simply isn't much room for improvement.

This is something you'll see frequently in nutrition research.

A supplement or dietary intervention might produce a large improvement in someone with high cholesterol, high blood pressure, insulin resistance, or another abnormal measurement but produce almost no change in someone whose numbers are already good.

You can't fix something that isn't broken.

The researchers also pointed out that standard office blood-pressure measurements may not detect subtle changes as well as 24-hour ambulatory monitoring.

Cholesterol Didn't Improve Either

Another surprising finding was the lack of a major overall effect on cholesterol.

Across randomized trials, anthocyanins didn't significantly change:

Total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, apolipoprotein A1, or apolipoprotein B.

Again, that doesn't mean they aren't beneficial.

It tells us that their cardiovascular effects may not primarily occur through lowering cholesterol in healthy people.

This is worth remembering because cardiovascular health involves much more than LDL cholesterol.

Blood-vessel function, arterial stiffness, glucose regulation, inflammation, platelet activity, blood pressure, smoking, physical activity, genetics, body composition, and many other factors contribute to cardiovascular risk.

Anthocyanins appear particularly interesting for vascular function.

There Was an Interesting Effect on Insulin

The randomized trials also found a small reduction in fasting insulin.

Across six trials providing approximately 68 to 715 mg of anthocyanins per day, insulin concentrations decreased by about 2.24 pmol/L compared with control.

However, fasting glucose, HbA1c, and HOMA-IR didn't significantly improve overall.

That doesn't give us enough evidence to claim anthocyanins dramatically improve blood sugar control in healthy people.

But the long-term population data are interesting.

Across cohorts involving more than 235,000 participants, higher habitual anthocyanin intake was associated with an 11% lower risk of developing type 2 diabetes.

Once again, we have a situation where subtle physiological changes over years may matter even if someone's fasting glucose doesn't suddenly drop after eight weeks of eating blueberries.

Hypertension Risk Was 8% Lower

The cohort research also found that people consuming more anthocyanins had an 8% lower risk of eventually developing hypertension.

Among women specifically, the reduction was approximately 9%.

That's interesting when you compare it with the randomized trials, where blood pressure generally didn't change.

It illustrates an important difference between preventing disease and treating disease.

Eating anthocyanin-rich foods for years might help maintain healthier blood-vessel function and slightly reduce the probability that hypertension develops.

That's very different from expecting a bowl of blueberries to lower someone's blood pressure tomorrow morning.

Nutrition often works like that.

The effects are small from day to day.

They can become meaningful when repeated for decades.

Cardiovascular Mortality Was 9% Lower

Ten cohort studies involving more than 560,000 people examined cardiovascular mortality.

Higher habitual anthocyanin intake was associated with a 9% lower risk of dying from cardiovascular disease.

The evidence for this particular outcome was rated more cautiously than the cardiovascular disease and heart attack findings, so I wouldn't treat the number as a precise prediction.

But it points in the same general direction.

People who regularly consume more anthocyanin-rich foods appear to have better long-term cardiovascular outcomes.

What About Stroke?

Not every outcome improved.

The researchers found no significant association with overall stroke risk.

That's important to include because nutrition research gets distorted when we only talk about the positive findings.

If anthocyanins reduced cardiovascular disease, heart attack risk, hypertension, diabetes risk, and cardiovascular mortality, it's tempting to assume they must reduce every cardiovascular outcome.

They didn't.

At least not based on the available evidence.

Some Anthocyanins May Work Better Than Others

One of the more interesting parts of the analysis involved individual anthocyanins.

Remember, anthocyanin isn't one molecule.

It's a family of related compounds.

Two stood out: cyanidin and delphinidin.

Cyanidin-rich interventions improved chronic flow-mediated dilation by approximately 1.62 percentage points.

Delphinidin was associated with improvements in both acute and chronic FMD. It also produced small improvements in arterial stiffness, insulin concentrations, and triglycerides in subgroup analyses.

This raises an interesting possibility.

Different anthocyanins may have slightly different biological effects.

But I wouldn't use that as a reason to start shopping for isolated delphinidin capsules.

Foods naturally contain mixtures of anthocyanins and many other potentially beneficial compounds.

A blueberry isn't just a delivery vehicle for one flavonoid.

It also contains fiber, vitamins, minerals, other polyphenols, water, carbohydrates, and hundreds of compounds that interact with each other.

That complexity may actually be part of the benefit.

How Much Anthocyanin Do You Need?

This is where the research becomes especially practical.

The randomized trials included interventions providing at least 50 mg of anthocyanins per day.

That's not some pharmaceutical-level dose that requires swallowing ten capsules.

It's achievable through food.

The researchers deliberately chose the 50 mg threshold because previous population research had suggested intake around this level was associated with cardiovascular benefits.

Across the randomized trials, doses varied enormously, from 50 mg to 3,300 mg per day.

Importantly, the researchers didn't find a clear dose-response relationship across the outcomes they examined.

So there isn't good evidence that:

100 mg is good, therefore 1,000 mg must be ten times better.

Biology rarely works that way.

The practical goal should be regular intake, not chasing the largest possible number.

What Does 50 mg of Anthocyanins Look Like in Food?

This is difficult to answer precisely because anthocyanin concentrations vary dramatically between varieties and even between different batches of the same fruit.

But you don't need to calculate every milligram.

A normal serving of deeply pigmented berries can provide meaningful amounts of anthocyanins, with blueberries, blackberries, black raspberries, cherries, and similar fruits among the more practical sources.

Instead of tracking anthocyanins in an app, I'd use a much simpler rule:

Try to eat something naturally red, blue, or purple most days.

Add blueberries to oatmeal.

Throw frozen berries into a smoothie.

Eat cherries when they're in season.

Use red cabbage instead of green cabbage occasionally.

Snack on dark grapes.

Mix blackberries or raspberries into Greek yogurt.

None of that requires turning breakfast into a chemistry experiment.

Frozen Berries Are Completely Fine

People sometimes assume fresh berries are automatically healthier than frozen berries.

That's not a rule I'd worry much about.

Frozen berries are often harvested when ripe and frozen shortly afterward. They're convenient, considerably cheaper during parts of the year, and don't turn into fuzzy science experiments in the back of your refrigerator after four days.

Processing and storage can influence anthocyanin concentrations, but that doesn't make frozen berries nutritionally worthless.

If frozen berries make it easier for you to eat berries regularly, use frozen berries.

Consistency matters considerably more than whether your blueberries came from the produce section or freezer aisle.

Should You Take an Anthocyanin Supplement?

Probably not my first choice.

The research included both anthocyanin-rich foods and extracts, so we can't say supplements have no effect.

But if the goal is general cardiovascular health, I'd rather get anthocyanins from food whenever practical.

You get the anthocyanins plus fiber and the rest of the nutrients and phytochemicals naturally present in the food.

There's also no convincing evidence here that extremely high supplemental doses are necessary.

Remember, one of the interesting aspects of this research is that the investigators specifically included randomized trials starting at 50 mg per day because that amount can realistically be achieved through diet.

That's a feature, not a limitation.

There may be situations where standardized extracts are useful for research or where someone simply doesn't eat anthocyanin-rich foods.

But for most people, I'd start in the grocery store.

Don't Turn This Into Another "Superfood" Story

Blueberries are healthy.

They're not magic.

Neither are cherries, blackberries, purple cabbage, or any other anthocyanin-rich food.

One of the biggest mistakes we make in nutrition is taking evidence about a healthy dietary pattern and turning one component into a miracle food.

If you eat blueberries every morning but smoke, rarely exercise, chronically sleep five hours per night, and consume a generally poor diet, the blueberries aren't going to rescue your cardiovascular system.

Anthocyanins should be viewed as one useful component of an overall healthy diet.

The good news is that adding them doesn't require a major lifestyle overhaul.

A cup of berries is a pretty low-effort intervention.

Association Isn't the Same as Causation

The long-term numbers in this research are impressive, but they need context.

The 26% lower cardiovascular disease risk, 18% lower heart attack risk, 11% lower diabetes risk, 9% lower cardiovascular mortality, and 8% lower hypertension risk came from prospective observational studies.

Those studies can identify associations.

They cannot definitively prove that anthocyanins caused the lower risk.

People who eat lots of berries and colorful vegetables may differ from people who don't in dozens of ways.

The researchers statistically adjusted for many of those factors, but no statistical model can perfectly account for everything.

What strengthens the argument is that randomized trials show real physiological effects on vascular function.

That gives us a plausible bridge between the dietary association and the disease outcomes.

It's still not proof that eating 50 mg of anthocyanins per day will reduce your personal heart attack risk by exactly 18%.

Nutrition isn't that precise.

The Most Interesting Finding May Be the One You Can't Feel

If you start eating blueberries tomorrow, you're probably not going to wake up Thursday feeling like your endothelial function improved by 1.5%.

That's the problem with preventive nutrition.

Most of the benefits aren't immediately noticeable.

Blood vessels don't send you a notification saying:

"Congratulations. Your flow-mediated dilation improved today."

You eat reasonably well, exercise, sleep, don't smoke, maintain a healthy body composition, manage blood pressure and cholesterol, and repeat those behaviors thousands of times.

The payoff may be what doesn't happen 20 years later.

That's considerably less exciting than a supplement promising to transform your health in 30 days.

It's also much closer to how preventive health actually works.

A Simple Way to Put This Research Into Practice

I wouldn't start counting anthocyanin milligrams.

I'd simply look at your normal diet.

If most of your fruits and vegetables are beige, pale green, or nonexistent, add some color.

Keep frozen blueberries and mixed berries around. Buy cherries when they're available. Add blackberries to yogurt. Eat dark grapes as a snack. Use red cabbage in tacos or salads. Rotate different colored plant foods throughout the week.

You don't have to eat all of them.

You don't even have to eat berries every day.

The goal is simply to make anthocyanin-rich foods a regular part of an already good diet.

That's a recommendation that's easy to follow, inexpensive, and supported by a surprisingly large amount of research.

The Bottom Line

Anthocyanins are the pigments responsible for many of the dark red, blue, and purple colors in fruits and vegetables, and the evidence supporting their role in cardiovascular health is becoming increasingly interesting.

Long-term population studies show that people consuming more anthocyanins tend to have lower rates of cardiovascular disease, heart attacks, hypertension, type 2 diabetes, and cardiovascular mortality.

The strongest associations included a 26% lower risk of cardiovascular disease and an 18% lower risk of coronary artery disease or heart attack.

Randomized controlled trials give us a possible explanation.

Anthocyanins consistently improved endothelial function, meaning blood vessels became better at expanding in response to increased blood flow. Interestingly, these benefits occurred even though traditional measures such as blood pressure, cholesterol, glucose, body weight, and several inflammatory markers generally didn't change in otherwise healthy people.

That might be the most important lesson from this research.

A food doesn't have to dramatically change your cholesterol or blood pressure in eight weeks to contribute to better cardiovascular health over decades.

And you probably don't need an anthocyanin supplement to take advantage of it.

Eat blueberries. Eat blackberries. Eat cherries. Eat dark grapes. Eat red cabbage. Mix things up.

There are plenty of complicated things you can do for your health.

Eating more red, blue, and purple foods isn't one of them.

About the Author

Matt Mosman, MS, CISSN, CSCS, is the founder and Chief Science Officer of Simply Good Supplements. With a background in exercise science, sports nutrition, and strength and conditioning, Matt focuses on turning research into practical advice that athletes, parents, and everyday active people can actually use.

References

Avendano EE, Ellingson H, Digga E, Velasco Nieves AM, Chen L, Wu M, Setty SH, Morley S, Curtis P, Nirmala N, Cassidy A. Dietary intakes of anthocyanins and cardiometabolic health: a systematic review and meta-analysis of randomized trials and prospective cohort studies in healthy participants. The American Journal of Clinical Nutrition. 2026;124:101304. doi:10.1016/j.ajcnut.2026.101304.