The best diets for heart health
An evidence-based analysis of 10 popular diets shows that some promote heart health better than others.
"The good news for the public and their doctors is that there are several dietary patterns that allow for greater flexibility in following a heart-healthy diet—DASH, Mediterranean, vegetarian," wrote Christopher Gardner, PhD, of Stanford University in California.
The group rated on a scale of 1 to 100 how well 10 popular diets align with the AHA's (American Heart Association) dietary advice for heart-healthy eating.
The AHA's advice includes consuming a wide variety of fruits and vegetables; choosing primarily whole grains instead of refined grains; using liquid vegetable oils instead of tropical oils; eating healthy sources of protein such as vegetables, seafood, or lean meats; minimizing added sugars and salt; limiting alcohol consumption; choosing minimally processed foods instead of ultra-processed foods; and following this guidance wherever foods are prepared or consumed.
The 10 diets evaluated were: DASH, Mediterranean style, pescatarian, ovo-lacto vegetarian, vegan, low-fat, very low-fat, low-carbohydrate (paleolithic), and very low-carbohydrate (ketogenic).
Only the DASH eating plan achieved a perfect score of 100. This eating pattern is low in salt, added sugars, tropical oil, alcohol, and processed foods, and high in non-starchy vegetables, fruits, whole grains, and legumes. Proteins are primarily plant-based, such as legumes, beans, or grains, along with fish or seafood, poultry and lean meats, and low-fat or fat-free dairy.
The Mediterranean dietary pattern achieved a score of 89 because, unlike DASH, it allows for moderate alcohol consumption and does not address added salt.
The other two top-ranked dietary patterns were pescatarian, with a score of 92, and vegetarian, with a score of 86.
Vegan and low-fat diets (each scoring 78) fell into the second tier. While these diets emphasize fruits, vegetables, whole grains, legumes, and nuts, limiting alcohol and added sugars, the vegan diet is so restrictive that it can be difficult to follow long-term or when eating out and may increase the risk of vitamin B12 deficiency, which can lead to anemia. There are also concerns that low-fat diets treat all fats equally, whereas AHA guidance calls for replacing saturated fats with healthier fats, they point out.
The third level includes a very low-fat diet (score 72) and a low-carbohydrate diet (score 64), while the paleo and very low-carbohydrate/keto diets fall into the fourth level, with the lowest scores of 53 and 31, respectively.
Gardner said it's important to note that all 10 dietary patterns "share four positive characteristics: more vegetables, more whole foods, less added sugars, and less refined grains."
Source: https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000001146
