- An American Heart Association report analyzed 10 popular dietary patterns, ranking them for heart health.
- The DASH and Mediterranean diets scored high on the list while the keto and paleo plans scored poorly.
- In general, nutritionists and dietitians recommend a diet high in whole grains, non-starchy vegetables, and lean meat and fish while avoiding saturated fats, refined sugars, and processed foods.
- They say it’s healthier in the long run to find a sustainable diet pattern rather than a “quick fix” crash diet.
An analysis from the American Heart Association (AHA) has taken a close look and ranked some of today’s most popular dietary patterns.
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Christopher Gardner, PhD, the chair of the writing committee for the statement and a professor of medicine at Stanford University in California, told Medical News Today that the statement is intended to provide guidance not just for people looking to change up their eating habits but physicians as well.
“We thought this paper would be practical for clinicians and medical doctors, as they don’t necessarily get much nutrition training,” Gardner explained. “We have a whole section explaining questions a doctor might want to ask a patient, including common misunderstandings that can be cleared up.”
A guide to heart health
In line with the AHA’s recommendations, the research assesses diets for heart health, specifically rating dietary patterns for their impact on cardiometabolic health.
The highest-rated eating plans included DASH-style diets, which are low in salt, added sugar, alcohol and processed foods with an emphasis on whole grains, legumes, fruit and veggies. Meat can be part of a DASH-style diet, but lean meats and seafood are generally recommended.
Mediterranean-style diets are similar, but allow for alcohol consumption and don’t address saturated fats, so although it ranked highly, it did not top the list.
“It’s agnostic about saturated fat and as much as the AHA has praised the diet for its unsaturated fat, olive oil, avocados, nuts and seeds, [the AHA] is still very compelled by the evidence that saturated fat, especially for heart disease, is really bad for LDL cholesterol,” Gardner said.
A range of low-fat and low-carb diets made up the middle of the ranking, while the paleo, very low-carb, and ketogenic diets were at the bottom of the list for their restrictions on fruit and whole grain along with high levels of saturated fat.
“Certainly, the AHA is opposed to sodium for high blood pressure and sodium is an important part of a ketogenic diet,” Gardner said. “Keto in particular really missed the mark on the majority of the data points and paleo missed the second-highest amount.”
Dietary patterns versus crash diets
While assessing the various dietary patterns available might seem overwhelming, it isn’t necessary to strictly follow one diet.
Gardner says there are a number of things that heart-healthy diets all tend to have in common.
“Eating whole foods, non-starchy vegetables, and cutting back on your refined grain and sugar are all important. The thing I think is actually so striking about the average diet is how many calories come from fine grains and added sugar, so that’s a huge opportunity for change,” he said.
It’s also important to recognize the difference between adopting a new dietary pattern that can be maintained versus going on a crash diet for a few weeks or a few months.
Change can happen, but asking your body to do too many things in too short a period of time — which generally happens with crash diets — can be a recipe for eventual failure, according to experts.
“We know from research around behavior changes that people are more successful when working on two to four changes at a time,” said Molly Rapozo, a nutritionist, registered dietitian and senior nutrition and health educator at Pacific Neuroscience Institute in Santa Monica, California.
“Changing your meal plan to something dramatically different results in much more than just a handful of changes, which may result in burnout and discouragement,” Rapozo told Medical News Today. “Taking small, obtainable steps toward the goal of a balanced diet can be enjoyable and sustainable.”
To that end, Rapozo says, it’s worth looking at what you’re currently eating to figure out what you’re already doing well.
“First, I like to get a good idea of what my clients are currently eating. I often find they are already making healthful choices to celebrate and build on,” she said. “With that baseline information, I seek opportunities to make supportive shifts which can be anything from experimenting with a new food to ordering prepared meals.”
Julianna Coughlin, a nutritionist and registered dietician based in Massachusetts, told Medical News Today that changing eating patterns is akin to changing the body’s default settings.
“By this I mean we need to think about the things that you do every day that affect your health day after day after day and see how we can change those to affect your health in the long term,” she explained. “Essentially that is prioritizing lifestyle changes over quick craft, diets, and things like that.”
“I like to say that one step in the right direction is one step in the right direction, no matter how small, so take everything one step at a time,” she added.