The best diets for heart health, according to experts

  • The American Heart Association (AHA) has analyzed the most popular diets out there for heart-healthy properties.
  • The DASH and Mediterranean diets were among the healthiest.
  • The AHA advises against keto and paleo diets for heart health.

Heart disease is the leading cause of death in the United States, and with that, many people want to do what they can to improve their heart health. Now, the American Heart Association is breaking down the most heart-healthy diets out there, and the organization has even named some popular diets that they say aren’t doing your heart any favors.

The scientific statement, which was published in the AHA journal Circulation, says there is a “proliferation of nutritional misinformation and misplaced emphasis” with several meal plans popular right now. criteria, to determine the clinical and cultural factors that influence long-term adherence and to propose approaches for the adoption of healthy dietary patterns. Basically, the organization wants to make it easier for people to choose heart-healthy diets from the most popular options out there.

The AHA then ranked the popular diets, designating the Dietary Approaches to Stop Hypertension (DASH) diet as the winner. This diet is 100 percent aligned with the AHA’s goals for healthy eating, the organization notes. Also in the mix: the wildly popular Mediterranean diet, along with vegan and low-fat diets.

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“The epidemiology research into DASH and the Mediterranean diets is what informed the AHA’s guidance in the first place, so it stands to reason those would have scored the highest,” says Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy.

But the AHA pointed out that two diets, keto and paleo, “align poorly” with the organization’s dietary guidance for a heart-healthy diet. “Restrictions on fruits, whole grains and legumes can lead to decreased fiber intake,” the AHA explained in a news release. “Plus, these diets are high in fat without restricting saturated fat. Consuming high levels of saturated fat and low levels of fiber are both linked to the development of cardiovascular disease.

Here’s what you need to know about the best diets for heart health, plus how experts recommend choosing one that’s right for you.

First, what are the characteristics of a heart-healthy diet?

The AHA released a statement in 2021 that analyzed the key characteristics they believe make a diet heart-healthy. Those recommend looking for an eating plan that does the following:

  • Balance your food and calorie intake with physical activity to maintain a healthy weight
  • Includes a wide variety of fruits and vegetables to get a full range of nutrients from food (instead of supplements)
  • Choose whole grains and other foods that consist primarily of whole grains
  • Include healthy sources of lean and/or high-fiber protein such as nuts and legumes, fish or seafood, low-fat or fat-free dairy products, and lean cuts of meat, limiting red and processed meats
  • Use non-tropical liquid vegetable oils such as olive or sunflower oils
  • Choose minimally processed foods over ultra-processed foods as much as possible
  • Minimize your intake of drinks and foods with added sugar
  • Choose or prepare foods with little or no salt
  • Limit your alcohol consumption
  • Use this guide no matter where your food is prepared or consumed

What are the best diets for heart health?

The AHA has categorized the most popular diets out there into “levels,” with level one as the highest and level four (keto and paleo) as the lowest. The wildly popular Mediterranean diet didn’t pan out, but it came close. These are the best diets, ranked highest to lowest, according to the AHA.

First level

DASH diet

The Dietary Approaches to Stop Hypertension (DASH) diet was originally designed to help lower blood pressure. It provides daily and weekly nutritional goals and encourages people to focus on the following foods, according to the National Institutes of Health (NIH):

  • Vegetables, fruit and whole grains
  • Fat-free or low-fat dairy products, fish, poultry, beans, nuts and vegetable oils
  • Limit foods high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils
  • Limit drinks and sugary sweets

DASH earned a perfect score from the AHA for meeting all of the organization’s guidelines.

Mediterranean diet

A Mediterranean diet is based on people living in the Mediterranean region. It focuses on plant-based foods and whole grains, along with healthy fats, according to the Cleveland Clinic. But the Mediterranean diet allows for one glass of wine a day and doesn’t address salt consumption, which is why the AHA says it’s been ranked below the DASH diet.

“Mediterranean eating style is my go-to for everyone I see, and then we customize as needed,” says Kate Cohen, RD at the Ellison Clinic at Providence Saint John’s Health Center in Santa Monica, California. “The Mediterranean diet is the most evidence-based plan out there. It’s heart-healthy and sustainable because it’s not about eliminating food groups or deprivations. It’s built on a foundation of whole, unprocessed, anti-inflammatory, and fat-free plant foods.” healthy, including greens, fruits, legumes, nuts, seeds, and of course, cold-pressed extra virgin olive oil.It leans into cold-water fish, but that’s not a requirement if fish isn’t your jam, plus it includes smaller amounts of meat, eggs, cheese and yogurt.

Pescatarian diet

A pescatarian diet is a plant-based eating pattern that includes fish. It allows followers to eat dairy products, eggs and seafood, but not meat or poultry.

Ovo-lacto-vegetarian diet

This form of vegetarianism allows dairy products and eggs. The AHA states that ovo-vegetarian diets (which allow eggs), lacto-vegetarian diets (which include dairy products), and ovo-lacto vegetarian diets are all included in this group.

Level two

Vegan diet

Vegan diets focus on eating plant-based foods and avoiding animal products.

“I see vegetarian and vegan diets gaining popularity,” says Molly Rapozo, RDN, senior nutrition and health educator at the Pacific Neuroscience Institute in Santa Monica, California.When they focus on whole foods and plant-based proteins, these diets are a great source of nutrient-dense foods that are easier on the environment.

The AHA notes that vegan diets were ranked lower because dietary restrictions can make it difficult to stick to them long-term or when dining out. “Following a vegan eating pattern can increase the risk of vitamin B-12 deficiency, which can cause red blood cell abnormalities leading to anemia; therefore, supplementation may be recommended by physicians,” says the AHA.

Low fat diet

Low-fat diets limit fat intake to less than 30 percent of total calories and include the volumetric diet and lifestyle change (TLC) therapy plan.

The AHA says these diets have been classified in tier two because they treat all fats equally, while the AHA recommends replacing saturated fats with healthier fats like mono- and polyunsaturated fats. The AHA also worries that people on low-fat diets may have too many carbohydrates, such as added sugars and refined grains.

Third level

Very low fat diet

A very low-fat diet is one that limits fat intake to less than 10% of total calories. This includes diets such as the Ornish, Esselstyn, Pritikin, McDougal, Physicians Committee for Responsible Medicine (PCRM) diets. These tend to be vegan diets, says the AHA, noting that some studies have shown their potential to slow the progression of artery fatty buildup. It’s in tier three, however, because it restricts certain AHA-recommended food groups.

Low carbohydrate diet

This includes diets that limit carbohydrates to 30-40% of total calorie intake. These include the South Beach diet, the Zone diet, and low glycemic index diets. The AHA says these diets fall into tier three because they limit fruits, grains, and legumes.

“Low-carb diets are usually low in fruits, vegetables, and whole grains because these foods contain carbohydrates,” says Deborah Cohen, RDN, associate professor in the department of clinical and preventive nutrition sciences at Rutgers University School of Health Professions. “They also limit their intake of nuts and seeds, both of which are good sources of monounsaturated fatty acids.”

People also tend to have less fiber while eating more saturated fat on these diets, which contradicts the AHA’s guidance.

Fourth level

Keto and Paleo diets

These diets were rated low by the AHA for avoiding the organization’s recommended food groups and for promoting foods that the AHA discourages people from eating in large quantities. “Keto and Paleo both encourage the consumption of red meat and other high-fat foods,” says Deborah Cohen. “Excess red meat can contribute to the development of cardiovascular disease due to its high saturated fat content.”

Both diets limit fruits and vegetables and “therefore are lower in fiber and phytochemicals,” she says. “Moreover, it has been shown that long-term compliance on a Keto is very difficult and when the goal is to prevent cardiovascular disease, which is a chronic disease, one food style must be respected for a long time,” she adds. .

How to choose the right diet for you

It can be overwhelming choosing an eating plan, but experts say it’s important to select one you know you can stick to. “Choose a diet that is manageable over the long term, one that provides you with a baseline of all foods that will keep your body healthy and yourself happy,” says Keatley.

Rapozo also recommends thinking about the foods you’re currently eating and enjoying, and trying to eat healthier from there.

Kate Cohen says it’s important to think about why you want to change your meal plan, too. “You need to know your ‘why’ to keep the changes going for the long haul,” she says. “It won’t always be easy, so you need to know what it is for you. Are you trying to lose weight to lower your cholesterol and reduce your risk of cardiovascular disease? Do you want to feel better, have more energy and look better in your clothes? You are much more likely to be successful if you have clear goals and understand what motivates you.

If you’re still not sure, Deborah Cohen suggests consulting a dietitian if possible. They can “obtain a comprehensive nutritional and dietary assessment and make personalized recommendations based on an individual’s current and past health, family history, current eating habits, physical activity, allergies and intolerances, food preparation skills, on weight history and financial considerations”. she says she.

Headshot of Korin Miller

Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamor, and more. She has a master’s degree from American University, she lives on the beach and hopes to own a tea pig and a taco truck one day.

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