The American Heart Association (AHA) recently released a scientific statement looking at the heart healthiness of popular diets. The report discusses how misinformation about different dietary trends has reached "critical levels" and many people, including healthcare professionals, are confused about heart-healthy eating. They looked to determine how these popular diets meet the AHA's dietary guidance and if they could be determined to be heart-healthy eating patterns.
The American Heart Association dietary guidelines are focused on improving cardiometabolic health which refers to a group of factors that affect metabolism and the risk of heart and vascular disease. According to the report, these factors include blood pressure, cholesterol and other lipids, blood sugar, and weight. Having a healthy diet that addresses all these areas of health improves cardiovascular and metabolic health as well as Type 2 diabetes and obesity.
Let's take a look at how some of today's popular diets (and Seattle Sutton's Healthy Eating) ranked!
DASH, Mediterranean Diet, Pescatarian, and Vegetarian Diets
The DASH diet (Dietary Approaches to Stop Hypertension) received a perfect score for meeting all of the AHA's guidelines. This plan is low in salt, added sugar, alcohol, saturated fat, and processed foods while emphasizing plant-based foods such as vegetables, fruits, whole grains, and legumes. The Nordic and Baltic diets are other examples of eating patterns that follow the DASH diet recommendations.
The Mediterranean Diet is rated highly as well. It only received a lower score because it doesn't specifically address salt and limiting alcohol. This diet also emphasizes plant-based foods and heart-healthy fats.
Vegetarian and pescatarian diets are broader with their recommendations for individual nutrient recommendations but encourage intake of plant-based proteins and avoidance of animal proteins, while the pescatarian plan includes regular intake of fish. These diets tend to be lower in saturated fats since the intake of animal proteins which can contribute to more saturated fats is restricted.
The focus on flexibility and the wide range of healthy foods to choose from were common features of the top-rated diet. These diets also allow for easy adaptation based on cultural practices, food preferences, and budgets which means that they are easier for people to follow and maintain long-term.
Vegan, Low- and Very-Low Fat, and Low-Carb
The diets rated in the middle for their heart-health qualities emphasize more vegetables, fruits, whole grains, legumes, and nuts while limiting foods and beverages with added sugar and alcohol which all match up with the AHA’s recommendations. The team pointed out that vegan diets may be hard to maintain over time and may require supplementation due to the risk of deficiencies in certain nutrients. A vegan diet would limit all animal products including eggs, dairy, and more. There is a higher risk of vitamin B-12 deficiency among individuals following a vegan diet, which may lead to red blood cell abnormalities and anemia.
The writers also expressed that those eating a low-fat or very low-fat diet may overeat added sugars and refined grains. Examples of low-fat diets included Volumetrics and the Therapeutic Lifestyle Change (TLC) plans.
They suggested that low-fat and low-carb diets often restrict food groups that are encouraged in their guidance such as nuts, avocados, fruits, and whole grains. They also do not encourage replacing saturated fats with healthier fats such as mono- and polyunsaturated fats, which is recommended by the Heart Association. Instead, these diets only focus on cutting back on all fats. Examples of very low-fat diets included Ornish, Esselstyn, Pritikin, McDougal, and the Physicians Committee for Responsible Medicine (PCRM) diets.
Low-carb diets, such as South Beach, Zone, and low glycemic index diets, may result in lower fiber intake while higher intakes of saturated fats. These diets often restrict fruits, grains, and beans, which are all emphasized for heart health by the AHA.
Paleolithic (Paleo) and Very Low-Carb/Ketogenic
"These two eating patterns align poorly with the Association's dietary guidance," says the report. They do point out that there are strengths of these eating patterns including consuming non-starchy vegetables, nuts, and fish while limiting adding sugar and alcohol. However, improvements made at 6 months are often no different at one year to less restrictive diets. They suggest that low fiber intake and high intake of fat without limiting saturated fat are both linked to cardiovascular disease. "There really isn't a way to follow these diets as intended and be aligned with the AHA's Dietary Guidance."
The report discusses how both of these diets are highly restrictive and can be hard to stick to long-term. For a heart-healthy diet, it needs to be sustainable.
At Seattle Sutton's Healthy Eating, we are proud that our meal plans meet all of the guidelines from the American Heart Association and would align with the highest-rated diets in this report. We follow the basic principles of the Mediterranean Diet, offer a vegetarian plan, and our 1200-calorie plan would meet the DASH diet guidelines.
Are you looking to follow a heart-healthy diet to help reduce your risk for cardiovascular disease or improve your heart health? You can feel confident our plans are a good choice for you and offer highly rated nutrition and taste!