From the ketogenic (aka the keto) diet to the Paleolithic (aka the paleo) diet and the Mediterranean diet, plus countless weight-loss regimens that have grabbed people’s attention over the years, ardent followers swear by their favored approach’s ability to slim and trim. But which trendy diet most benefits the heart?
“It’s quite confusing for consumers and any of us to figure out all these diets and all these [abbreviated diet names] that stand for different things to figure out which way to go,” says Armin Helisch, MD, a cardiologist at Dartmouth-Hitchcock’s Heart and Vascular Center, especially as we wade through an ever-churning news stream of changeable and contradictory diet recommendations.
In truth, there are useful pointers to be gleaned from some of today’s (and yesterday’s) popular diets. For example, while shunning grains à la the paleo diet is not necessary for health or weight loss, limiting consumption of refined carbohydrates is definitely a smart move. Refined carbohydrates such as white bread, white rice and pasta, pastries, and many breakfast cereals and sweets score high on the glycemic index, meaning that they cause blood glucose, or blood sugar, to quickly rise and remain elevated for a time, which is not good for cardiovascular health. Plus, such foods typically leave the eater hungry for more.
The role of carbohydrates in our diet is “very important,” Helisch says. Eating the same amount of instant oats rather than steel-cut oats, for example, will cause “a much more sudden blood sugar increase,” Helisch says, because instant oats are more processed, making “the carbohydrates inside them … much more quickly accessible by the body.” The more we incorporate whole grains and less-processed food in our diet, Helisch says, the better for our heart health and weight control.
It’s important to look “beyond just the weight-loss aspect to what the overall health effects” of the diet will be, especially over the long term.
In general, “[our] diet should emphasize vegetables, fruit, legumes, nuts and seeds, whole grains and fish,” Helisch says, while replacing saturated fat with monounsaturated or polyunsaturated fat. (Saturated fat is found in red meat, butter and other foods; monounsaturated or polyunsaturated fat is present in fish, olive oil, and more.) Adopting this way of eating has been shown “in many studies,” Helisch says, “to reduce our cardiovascular risk.”
Add it all up, and you’ve got a diet that pretty closely mirrors the Mediterranean diet. Helisch confesses he might be biased (“my significant other … is Italian,” he says), but “the strongest data” points to Mediterranean-style eating as an effective way to lower the risk of heart attack and stroke — and to help keep off excess weight.
Hannah Greulich, RD, LD, a clinical dietitian at the Elliot Center for Advanced Nutrition Therapy and Diabetes Management, agrees. Many of the well-known diets such as the keto and paleo and South Beach “can show short-term weight loss,” she says, but it’s important to look “beyond just the weight-loss aspect to what the overall health effects” of the diet will be, especially over the long term.
“There are a lot of diets out there,” Greulich says. “A lot of the trendy ones are promoting weight loss — not focusing on overall health. The keto, for example, is extremely high fat, extremely low carbs, and we know for general heart health that the type of fat we’re eating really makes a difference, and the [type of] carbohydrates really make[s] a difference, too.” Vegetables, fruits, and whole grains, for example, provide beneficial nutrition along with carbohydrates.
“The Mediterranean [diet] has been shown again and again as having benefits for heart health,” Greulich says, “[and] what I like about [it] is it’s not really a set, restrictive diet. … It’s more of a dietary pattern that promotes certain types of foods.”
Whether your goal is to lose weight, safeguard your heart, or both, the diet you choose must be sustainable, Greulich says. Over-restriction can lead to binge eating and make it less likely that you will stick with the diet. The diet must be compatible with your lifestyle and take into account health conditions that you have.
“Be a knowledgeable consumer,” Greulich advises. If you read on social media about the latest diet, or hear people at the gym talk about how many pounds they’ve lost through a particular eating plan, do your homework to determine whether the diet would be sustainable for you, promotes long-term health, and is backed by sound research that supports the diet’s effectiveness and safety. “Focus more on what’s going to offer some sort of benefit [beyond weight loss],” Greulich says. And rather than concentrating only on a list of foods that you must eliminate or reduce, find out what you can add to your diet to improve your health.
Lastly, don’t overlook a key piece to the puzzle. “It’s not just the food we eat,” Helisch says. “It’s also whether we move, and whether we move enough, which is important for weight control but also for cardiovascular health.”
For dietary guidance, Armin Helisch, MD, a cardiologist at Dartmouth-Hitchcock’s Heart and Vascular Center, recommends that his patients read “Always Hungry,” a book by Harvard endocrinologist David Ludwig. “I think he’s done wonderful research on the subject,” Helisch says, “and is a true researcher but also writes books for the general public,” complete with recipes. Helisch also gives a thumbs-up to Ludwig’s subsequent book, “Always Delicious,” for more recipes, noting that Ludwig’s advice is grounded in science, and acknowledges the important role that carbohydrates play in our diet.
For more nutrition advice, see the website of the American Heart Association.