The worst offenders are probably not what you’d expect.

Heart disease is the number one killer of American adults; it takes the lives of 610,000 people each year, which is more than lung cancer, breast cancer, and skin cancer combined. Although heart disease and related complications can be genetic, your heart health is greatly impacted by lifestyle factors -- especially by what you eat.

Most people assume dietary cholesterol is the number-one heart offender — after all, keeping your “bad” cholesterol (LDL) down and your “good” cholesterol (HDL) is essential for heart health — but recent research proves there’s no correlation between eating cholesterol and the levels of cholesterol in your blood. Instead, there are plenty of other foods that could be taking a heavy toll on your heart health without you realizing. Here are some of the biggest offenders, and be sure to avoid these 20 Worst Habits for Heart Health.

1. Added sugar

The sweet stuff that’s lurking in everything from candy to pasta sauce to ketchup is one of the worst offenders for your heart. “I am on a crusade against sugar,” says Adam Splaver, MD, clinical cardiologist and co-founder of NanoHealthAssociates. “Anything that has glucose, fructose or any sort of sugar is bad for your heart as it increases inflammation and inflammation begets cardiovascular disease.”

The FDA recommends people no more than consume 50 grams of added sugar a day, but the American Heart Association recommends no more than 36 grams of added sugar for men and 25 grams for women for optimal heart health. 

2. High Fructose Corn Syrup

Sugar, in general, is bad for your heart, but high fructose corn syrup could be one of the worst offenders. Dr. Splaver warns that fructose can overload your liver and cause insulin resistance. This can lead to metabolic disorders such as type II diabetes. Check your labels, and be sure to avoid these 23 Shocking Foods with Hidden Corn Syrup.

3. Baked goods

“Baked goods have a double whammy of sugar and hidden saturated fat,” Dr. Splaver says. “[They] generally have no nutritional value and often contain hidden saturated fat and hydrogenated shortenings, which may raise your bad cholesterol (LDL).” Some hydrogenated shortenings contain trans fats, which have been shown to raise cholesterol levels.

4. Soda

It’s not just all the sugar that makes soda a problem, it’s the fact that it’s liquid sugar. “Drinking soda has serious consequences,” Dr. Splaver warns. “Regular soda promotes an insulin spike, which leads to weight gain and can cause a host of metabolic disorders. Beyond the sugars, soda has phosphoric acid which can promote osteoporosis and may be a cancer-causing agent. And the sugar can lead to inflammation which causes cardiovascular disease.”

5. Diet Soda

Think diet soda is a better alternative to the regular stuff? Think again. “Artificial sweeteners can lead to the same spike and risk of metabolic disease; a recent study indicated that excessive drinking can counterintuitively lead to weight gain,” Dr. Splaver says. “Consuming diet soda will tell your pancreas to make more insulin, which will increase your adiposity (fat deposits) and risk of cardiovascular disease.” Swap your soda (or diet soda) for sparkling water with a squeeze of fresh fruit.

6. Fruit Juice

Sure, even the purest fresh-squeezed fruit juice contains necessary vitamins and minerals, it’s also packed with heart-destroying sugar — one 8-ounce glass of orange juice has more than 20 grams of sugar. “Fruit juices are basically sugar and should be avoided,” Dr. Splaver says.

7. Vegetable Shortening

Although dietary cholesterol doesn’t impact blood cholesterol, saturated fat does. “Saturated fats like vegetable shortening increase inflammation and have a negative impact on your cholesterol parameters, which can cause cardiovascular disease,” Dr. Splaver says. Vegetable shortening is found in lots of packaged food, including wraps, tortillas, and baked goods. Be sure to read your labels for this dangerous saturated fat.

8. Margarine

Along the lines of vegetable oil, margarine is another common saturated fat that can increase inflammation, Dr. Splaver warns. Margarine and butter alternatives were traditionally made with partially hydrogenated oils, which are the most common sources of trans fats and have been linked to heart disease. However, the FDA have deemed trans fans no longer generally recognized as safe, and have ordered all companies to remove trans fats from their food by 2018. Still, margarine is still made mostly of vegetable oils, which could be worse than sugar.

9. Coffee creamer

Even if you’re trying to stay away from dairy, nondairy coffee creamers are not the way to go. They are a common source of hydrogenated oils, aka trans fats. Not only are trans fats inflammatory, but they’ve also been linked to heart disease. Even if all coffee creamers remove their trans fats by 2018, they’re still chock-full of chemicals and sometimes added sugars. Instead, we recommend Coffee Mate's Natural Bliss creamers or Nutpods dairy-free creamers; they come in delicious flavors and no scary ingredients.

10. Full-fat cheese

Sure, cheese is delicious. But it should be enjoyed in moderation, especially when it comes to your heart health. “Dairy products should be limited because consumption increases inflammation,” Dr. Splaver warns. “In addition, many adults adults have lactose intolerance or sensitivity which can cause gastrointestinal issues.” Full-fat cheddar cheese on average contains about 113 calories and 9 grams of fat (6 grams saturated) per ounce (about a slice).