Health & Wellbeing

Ten popular diets ranked for heart health

Ten popular diets ranked for heart health
The AHA emphasizes the importance of looking at an overall dietary pattern rather than “good” or “bad” individual foods.
The AHA emphasizes the importance of looking at an overall dietary pattern rather than “good” or “bad” individual foods.
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The AHA emphasizes the importance of looking at an overall dietary pattern rather than “good” or “bad” individual foods.
The AHA emphasizes the importance of looking at an overall dietary pattern rather than “good” or “bad” individual foods.

There are few areas of health with as much conflicting information as diet and nutrition. In an effort to simplify advice, the American Heart Association (AHA) has offered a no-nonsense assessment of 10 popular dietary patterns specifically for how well they can improve cardiometabolic health.

"The number of different, popular dietary patterns has proliferated in recent years, and the amount of misinformation about them on social media has reached critical levels," said AHA’s Christopher D. Gardner, Rehnborg Farquhar Professor of Medicine at Stanford University.

"We often find that people don't fully understand popular eating patterns and aren't following them as intended," he added. "When that is the case, it is challenging to determine the effect of the 'diet as intended' and distinguish that from the 'diet as followed.' Two research findings that seem contradictory may merely reflect that there was high adherence in following the diet in one study and low adherence in the other."

Experts assessed the diets against nine of the 10 recommendations the AHA provides to eat for heart health. Those guidelines include well-acknowledged aspects of healthy eating: consuming a wide range of fruit and vegetables, whole grains over refined grains, healthy sources of protein such as from plants, minimizing sugar and salt, and limiting alcohol, among others.

The diets were then rated on a scale of one to 100 and divided into four tiers.

The scorecard was as follows: DASH eating plan (100), pescatarian diet (92), Mediterranean diet (89), vegetarian diet (86), vegan diet (78), low-fat diet (78), very low-fat diet (72), low-carb diet (64), paleolithic diet (53) and very low-carb/ketogenic diet (31).

DASH (Dietary Approaches to Stop Hypertension) came out on top, due to it being low in salt, added sugar, alcohol and processed foods, while high in non-starchy vegetables, fruits, whole grains and legumes. Proteins mostly come from plant sources, such as legumes, beans or nuts, and seafood.

The Mediterranean diet ranked lower than DASH because of its moderate alcohol consumption and no guidelines as to salt intake. Pescatarian and vegetarian eating patterns also made the top-tier grade.

Some patterns, such as a vegan diet, lost points for there being some health risks such as vitamin B-12 deficiency, while very low-fat and low-carb diets were third-tier plans due to their respective restrictions for things like nuts, healthy plant oils, fruits, grains and legumes.

Rounding out the bottom tier were paleo and keto diets, which received a poor rank both due to nutrient restriction and sustainability.

"[These] are highly restrictive and difficult for most people to stick with long-term,” Gardner said. “While there will likely be short-term benefits and substantial weight loss, it isn't sustainable. A diet that's effective at helping an individual maintain weight-loss goals, from a practical perspective, needs to be sustainable."

Researchers did not assess commercial dietary programs or eating patterns such as intermittent fasting, or any plans that addressed non-cardiovascular health issues.

While intended to be a simpler, flexible guide for improved heart health, the AHA hopes it will also be handy for healthcare professionals. Many studies have revealed that medical schools, internationally, don’t pay a lot of attention to nutrition in the curriculum.

"The public – and even many health care professionals – may rightfully be confused about heart-healthy eating, and they may feel that they don't have the time or the training to evaluate the different diets," Gardner said. "We hope this statement serves as a tool for clinicians and the public to understand which diets promote good cardiometabolic health."

Cardiometabolic health refers to the processes that affect metabolism and the risk of heart and vascular disease. It encompasses blood glucose, cholesterol and other fats, blood pressure and weight. If several of these markers are of concern, the risk of heart disease increases.

While there’s no shortage of information on paleo, keto, low-carb, low-fat and Mediterranean eating lifestyles, this latest study is the first of its kind to measure them against heart health factors, and aims to weed out conflicting advice.

The AHA also acknowledges the need for these guidelines to also take into consideration cultural differences, food security and food deserts that restrict access to healthy food, and to be inclusive of historically marginalized groups.

"If implemented as intended, the top-tier dietary patterns align best with the American Heart Association's guidance and may be adapted to respect cultural practices, food preferences and budgets to enable people to always eat this way, for the long term," Gardner said.

The research was published in the journal Circulation.

Source: American Heart Association

The diet I thrive on is Whole30. Oddly, with tens of millions of people who have tried it, it wasn't even on AHA's list.
True, it's an elimination diet, but a large percentage of people stay on it after the month, once they've found
which foods negatively affect them.
What a load of hogwash. The top "approved" diets are not sustainable. The insulin spikes from the approved diets alone will cause weight gain due to lack of satiation. The ketogenic and carnivore, or proper human diet, is effective and working. Animal fats are your friend. The evidence is piling up.
Is there a number greater than infinity?
Answer "Yes" The number of weight loss diets for people you can eat anything
that want. The simple solution is don,t eat anything with processed sugar in it
and don,t eat anything with flour in it. You WILL have withdrawal symptoms
for the first week. After that the above is not appealing.
This sort of research is good for people who are heavier than they should be, don't exercise enough, drink like fish, eat fast food and don't play a sport. All my adult life I have been 65kg, had a DASH-like diet, played non-contact (no injury) sport and don't drink alcohol, but at age 65 I needed a triple-bypass because my main arteries were buggered. Turned out my problem was poor genes, so no matter how healthy I tried to be, my timer was running in the background.
I think it is an error to refer to this report as "The research was published in the journal Circulation."

There is no actual research done here, it is simply measuring diets against the current opinions about what we should eat. The actual research would require much more work and, so, is avoided. There are far too many variables -- exactly what was eaten, when, in what quantities, combined with what genetics, exercise, sleep, and all that goes into a human life. So, it is convenient to simply decide these things are good and those things are bad. Recall that the USGovernment assured us that cutting out fat would improve health -- and then 30 years later discovered this wasn't really supported by scientific study. In the 1860s, sugar was considered a health food and doctors taught that fruit should never be eaten raw. The fresh fruit and fiber in muesli was condemned as disastrous for health. Science and nutrition advice are far apart.
Buy a blood glucose meter.
That will rapidly tell you that eating more than a small mount of carbohydrates is a bad thing.
Then avoid highly processed foods, and you can't go far wrong.
They didn't assess my intermittent fasting regimen,which I have been on for ~ 6 years. My doctor told me my blood work was better than his when I had my checkup blood tests,and he is in his late 30s, early 40s,and I am in my 70s.
The problem with this type of analysis is that it is not based on whole of life evidence. There is no longitudinal study that supports the approach. It is not really a study but a retrospective fit to different independent studies that were of various quality. The Dietician world has been full of these studies, which they invariably back away from over time. Does it mean that you will live a happier longer life if you DASH? Where does exercise and joie de vie come into it?
Some facts -
From an actual study of 243,00 people >45 over 6 years
Following extensive adjustment for potential confounding factors there was no significant difference in all-cause mortality for vegetarians versus non-vegetarians. There was also no significant difference in mortality risk between pesco-vegetarians or semi-vegetarians versus regular meat eaters. We found no evidence that following a vegetarian diet, semi-vegetarian diet or a pesco-vegetarian diet has an independent protective effect on all-cause mortality.
We should use all these factors when deciding what to eat:
1. Which items are better for our health?
2. Which items are better for animal welfare?
3. Which items are better for our environment?
It is extremely short-sighted to not consider all three factors. The horrible treatment of a large percentage of animals being grown for food is a real thing. The horrible treatment of our environment to grow and/or over-harvest animals for food is a very real thing, and is unsustainable. The Amazon rainforest being cleared for animal grazing is massively-problematic:
I highly recommend the book "How to Eat" by Dr. David Katz. It's responsible for eliminating my need for cholesterol medicine!
18 arguments for eating meat debunked:
Climate change myths:
This pretty much aligns with the yearly U.S. News diet rankings.
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