Heart association ranks DASH, Mediterranean diets as most heart-healthy

April 27 (UPI) -- The American Heart Association has rated the DASH-style and Mediterranean diets as the healthiest according to its guidelines, while low-carbohydrate ones like the South Beach, Paleo and ketogenic ranked low after its researchers studied them.

The association's examination of 10 popular diets was posted Thursday in the latest edition of its peer-reviewed journal, Circulation.


The group said it completed its dietary research on the different diets based on 10 key factors that improve cardiometabolic health, with an emphasis on limiting unhealthy fats and reducing excess carbohydrates.

The guidelines also seek to optimize cardiovascular and general metabolic health and limit the risks of other health conditions, such as Type 2 diabetes and obesity, that may result from excess consumption of processed carbohydrates and sugar-sweetened beverages. Both are associated with increased risk of cardiovascular disease.

The new scientific statement is the first to analyze how popular dietary patterns adhere to those heart-healthy features and are adaptable to individual budgets, as well as personal and cultural preferences.


The Dietary Approaches to Stop Hypertension, or DASH, diet emphasizes vegetables, fruits, whole grains, legumes, nuts and seeds, as well as low-fat dairy and lean meats and poultry, fish and non-tropical oils. The association said the Nordic and Baltic diets follow similar eating patterns.

The study's authors said the Mediterranean-style diet ranked just below the DASH diet. It limits dairy products while emphasizing vegetables, fruit, whole grains, legumes, nuts and seeds, fatty fish and extra virgin olive oil. It also promotes moderate drinking of red wine.

"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 Christopher D. Gardner, chair of the writing committee for the new scientific statement and the Rehnborg Farquhar Professor of Medicine at Stanford University.

"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 in a news release.

"We hope this statement serves as a tool for clinicians and the public to understand which diets promote good cardiometabolic health."

The diet the heart association ranked lowest included a very low-carbohydrate, ketogenic regimen, which limits carbohydrate intake to less than 10% of daily calories. The popular Atkins diet, ketogenic and well-formulated ketogenic diets fall in this category.


Ranked just slightly better than the Keto-type diets are low-carbohydrate diets that limit carbohydrates to 30% to 40% of total calorie intake, which includes the South Beach and Zone diets and similar low-glycemic-index diets.

Paleolithic, or Paleo diets, which exclude whole and refined grains, legumes, oils and dairy, also ranked low.

"Cardiometabolic health refers to a group of factors that affect metabolism (the body's processes that break down nutrients in food and build and repair tissues to maintain normal function) and the risk of heart and vascular disease," the researchers wrote.

"These factors include blood glucose, cholesterol and other lipids, blood pressure and body weight. While abnormal levels of one factor may increase the risk for heart disease, abnormalities in more than one factor raise the risk even more, and for more severe disease."

The highest-ranking reviewed diet after DASH and the Mediterranean diet included a plant-based vegetarian-style/pescatarian one that includes eating fish; a vegetarian-style/Ovo/Lacto diet that includes eating eggs, dairy products or both; and a vegetarian-style/vegan one that excludes all animal products.

Behind the vegetarian diets were ones that limit fat intake to less than 30% of total calories: the Volumetrics eating plan and the Therapeutic Lifestyle Change plan.


Then came very low-fat diets that limit fat intake to less than 10% of total calories which include the Ornish, Esselstyn, Pritikin, McDougal and Physicians Committee for Responsible Medicine diets.

The association did not review other commercial dietary programs, such as Noom or Weight Watchers, noting that those are designed to be followed for fewer than 12 weeks.

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