The best and worst for heart health

Do you know which diets are heart-healthy and which, on the contrary, pose a risk to heart health? Contradictory messages about nutrition and diet abound on social networks and confuse the population. Now a report from the American Heart Association discusses the benefits and risks for heart health of 10 dietary patterns, taking into account factors such as the consumption of fruits and vegetables, whole grains versus refined ones, protein and vegetable oils, unprocessed foods, and salt, among others. His conclusions have been published in the scientific journal Circulation.

“The number of different and popular dietary patterns that has proliferated in recent years and the abundance of misinformation about them on social media has reached critical levels,” he said. Christopher D. Gardner, Chairman of the Writing Committee for the new scientific statement and Professor of Medicine at Stanford University in California. “The public, and even many health professionals, may rightly be confused about a heart healthy eating, and they may feel they don’t have the time or training to evaluate different diets. We hope this statement will serve as a tool for clinicians and the public to understand which diets promote a good cardiometabolic health”.

Cardiometabolic health includes risk factors for developing heart disease such as glycemia (blood sugar), cholesterol, triglycerides, blood pressure, and body weight, which when not well controlled increase the chances of heart problems, especially especially if the levels of more than one of these factors are abnormal.

Heart-healthy diets and worst diets for your heart

The committee was made up of a team of nutrition and dietetic scientists, cardiologists and other health professionals, who reviewed the defining characteristics of 10 types of diets to determine which are best and worst for the heart. These were the 10 categories analyzed:

  • The DASH Diet, from English Dietary Approaches to Stop Hypertension or Dietary approaches to stop hypertension. Prioritize the consumption of vegetables, fruits, whole grains, legumes, nuts and seeds, and low-fat dairy products and include lean meats and poultry, fish, and non-tropical oils. The Nordic and Baltic diets are another type of this dietary pattern.
  • Mediterranean diet: highlights the consumption of vegetables, fruits, whole grains, legumes, nuts and seeds, fatty fish and extra virgin olive oil, includes moderate consumption of red wine and limits dairy products.
  • Vegetarian-Pescetarian Diet: A plant-based eating pattern that includes fish.
  • Lacto-ovo vegetarian diet: Plant-based eating patterns that include eggs (lacto-ovo vegetarian), dairy (lacto-vegetarian), or both (lacto-ovo-vegetarian).
  • Vegetarian/Vegan Diet: A plant-based eating pattern that includes fish.
  • Low Fat Diet: Limit fat intake to less than 30% of total calories.
  • Very Low Fat Diet: Limit fat intake to less than 10% of total calories, including Ornish, Esselstyn, Pritikin, or McDougal diets.
  • Low Carb Diet – Limit carbohydrates to 30-40% of total caloric intake and include the low glycemic South Beach and Zone diets.
  • Paleolithic diet or Paleo diet: excludes whole and refined grains, legumes, oils and dairy products.
  • Ketogenic diet or keto/Atkins diet: very low carbohydrate, limiting intake to less than 10% of daily calories.

Each of the diets was evaluated based on how well they matched 9 of the 10 heart-healthy eating guidelines from the American Heart Association, which are based on the results of scientific studies. Diets received points depending on their adherence to each guideline: a maximum of 1 if fully compliant and 0 if not compliant. The scores obtained were adjusted to achieve a score between 0 and 100, where 100 is the closest compliance with the dietary guideline.

The lowest scores were assigned to some of the most popular and promoted diets on social networks to lose weight and defended by many ‘influencers’

  • Los four top-rated eating patterns or Level 1 (scores greater than 85 points) were the DASH diet (with 100 points), the pescatarian (92 points), the Mediterranean diet (89 points) and the vegetarian (86 points). This is not surprising considering that they are the most varied and balanced of all and share aspects such as promoting the consumption of fresh produce, whole grains, legumes, vegetables and whole foods. “The bottom line we come to between these diets is that they’re all good and very consistent with a heart-healthy diet,” says Gardner.
  • In Level 2 (score 75-85) are vegan and low-fat diets, which are based on the consumption of vegetables, fruits, whole grains and legumes. Although these foods are healthy, the Association explained that they are quite restrictive and many people may find it difficult to follow them. Specifically, he pointed out that a vegan diet may increase the risk of developing a vitamin B12 deficiency and other problems.
  • Very low-fat and low-carbohydrate diets were placed in Tier 3 (scores 55-74) because they do not include food groups highlighted in the Heart Association guideline. For example, they have no nuts, no vegetable oils, no vitamin B12, no essential fatty acids, no protein, and the low-carb ones do not contain fruit either.
    The lowest scores were assigned to some of the most popular and social media promoted diets for weight loss and advocated by many influencersamong which very low carbohydrate eating patterns such as the Atkins and ketogenic diets (31 points) and the paleo diet (53 points) stand out.

The keto diet, one of the worst for the heart

Very-low-carb diets can help with weight loss and improve some markers of metabolic health, some studies have shown, but the experts who wrote the report note that these improvements are usually short-lived and often cause a increased LDL (the ‘bad’) cholesterol which, in turn, can increase the risk of heart disease.

A study was recently presented at the World Congress of Cardiology indicating that keto-like diets can double the risk of developing cardiovascular diseases, such as clogged arteries, myocardial infarction, or stroke. According to the new report, the Atkins and keto or ketogenic diets call for restricting many “healthy” carbohydrates that adhere to the Heart Association’s dietary principles.

In the case of the paleo diet, which excludes foods that were not eaten by our Paleolithic ancestors, who were hunter-gatherers and had no access to cereals or other foods that are grown today, there is a danger of abusing Red meat.

Mercedes Sotos-Prieto, nutritional epidemiologist at CIBERESP and IMDEA Alimentación, Ramón y Cajal researcher at the Autonomous University of Madrid and associate professor at the Harvard School of Public Health, highlighted that “this study is also highly relevant because it evaluates certain dietary patterns popular in which, sometimes, the main objective is short-term weight loss; and shows that, with the indicators presented, they do not meet the criteria to be considered heart-healthy diet patterns. Such is the case of the ketogenic diet or the Atkins diet, which are popular low-carbohydrate diets and limit the consumption of foods that we already know are beneficial to health, such as fruits, legumes, or whole grains. I believe that disseminating this information to the population is important since, as I have commented, there is misinformation and many people get carried away by these diets that are impossible to sustain in the long term ”, according to her statement to SMC Spain.

Nutritional recommendations to take care of your heart

The report’s findings also note that while some diets scored poorly, they all had four positive things in common: they encouraged the consumption of whole foods and non-starchy vegetables, and they limited added sugars and refined grains.

The Association’s recommendations for healthy eating focus on eating a wide variety of fruits and vegetables, whole grains, lean meats, vegetable oils such as olive oil, and foods rich in protein and omega 3 fatty acids, such as shellfish and oily fish. . In addition, it advises limiting highly processed, salty and sugary products such as white bread, non-whole-grain pasta, pastries, cakes and cookies, and processed meats and sausages, such as sausages. And, of course, consult a specialist before starting any type of diet to assess our needs individually.


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