You asked: What’s the best diet for heart health?
While some diets may sound too good to be true, the truth is that they probably are. There are 2 ways to think about the word diet: 1) a strict set of rules you need to follow in order to accomplish a specific goal, usually over a short term (such as weight loss, blood sugar control, blood pressure control, etc); or 2) a general gestalt – or lifestyle change – regarding your eating habits in order to maintain a certain goal, usually over a longer term. Regardless of which definition you like to use, the key thing to keep in mind is that you should think of different diets as being tools in order to achieve different things. Food is enjoyable, but it can also be medicine.
As an extreme example, starving yourself to the point of eating 0 calories each day would certainly be the fastest way to lose weight. However, doing this is certainly not healthy and over longer periods can be dangerous or harmful. Likewise, eating only a few vegetables that you think might be healthy may at first seem ideal if sustainable, but may leave you deficient in certain nutrients required for health. With these points in mind, here are the evidence-based recommendations on the best diets for heart health: a low fat vegetarian diet and a Mediterranean style diet.
Like a challenge? The low-fat vegetarian diet was made popular by Dr. Dean Ornish, who postulated that adhering to a vegetarian diet that contains less than 10% of your calories from fat, along with exercise and stress reduction, can actually reverse coronary artery disease – blockages in the arteries going to the heart. He published a series of articles, mostly in the 1990s, that demonstrated this in various ways. Results like these are comparable, if not better, than what we would expect from the best medications out there. However, following a diet this strict is not realistic for many.
General takeaways from this evidence though are that changing your diet toward including less meat products, more vegetables, and less fat is probably a good thing. No change is too small or too large and a larger benefit toward this plant-based diet is probably seen the more strictly you stick with it. For example, a large study called the PURE Study showed estimates that for each additional serving of red meat someone eats per day, they increase their risk of dying from heart disease by 16%! You can imagine that with each change you make to your diet, you make incremental improvements toward a healthier you!
The Ornish diet, like other heart-healthy diets, also emphasizes increasing the amount of fiber in your diet. Fiber tends to be higher in foods that are healthier, which makes it a quick and easy litmus test for heart-healthy foods. High-fiber foods tend to be foods that include whole grains, fruit, vegetables, and other complex carbohydrates (i.e. not refined or processed sugars). Better yet, fiber is something that gives you a feeling of being full, which will help you want to eat less of the unhealthy stuff. Shooting for 30 grams of fiber per day is a good number to promote a heart-healthy menu for yourself.
If your diet prefers long walks on the beach, fresh fruits and vegetables, tree nuts, fish, and olive oil, you’re in luck! This is precisely what a Mediterranean diet consists of and there’s decent evidence that it can actually help you live longer. In the PREDIMED Study, which had updated results in 2018, researchers followed several thousand people at higher risk for heart disease and compared how often 3 different groups had heart attacks, strokes, or died from heart disease: 1) One group was given olive oil and encouraged to eat >4 tablespoons per day; 2) One group was given 30 grams of mixed nuts (walnuts, hazelnuts, and almonds) per day to eat; and 3) One group was given non-food gifts and was the group to which they compared the people eating Mediterranean diets. The people receiving olive oil and nuts also got training sessions about a Mediterranean diet, which included encouraging them to eat lean white meats, fatty fish, tree nuts, olive oil, and avoid soda, red meat, and processed foods. The people in the control group – or comparison group – received information on a typical low-fat diet.
The results are astounding and actually showed that the people in the Mediterranean diet groups reduced their likelihood of having a heart attack, stroke, or even dying from heart disease by about 30%! Important to realize is that they didn’t have any guidelines in the study of how much to exercise or how many calories to eat.
Also to note from these two evidence-based diets are that the most effective diets for heart-health are more targeted at whole lifestyle changes with what you’re eating rather than focusing on one entity, such as avoiding fat or carbs. Whether it’s clearly stated or not, both of these diets to improve heart health include foods that are fresh, unprocessed, and generally high in fiber.
If you’re looking to change your diet to improve your heart health, remember that choosing a diet is all about what your goals are. Diets that result in lifestyle changes are most likely to work long-term.
If you have questions about diets, heart health, or other lifestyle changes, ask us here!