There’s been a long-standing debate about which diets are best for your heart health. But, for the first time ever, experts with the American Heart Association have ranked the top 10 diets in the US based on how well they meet heart-healthy guidelines. Their goal was to help provide some clarity to both those inside the medical profession and beyond about which popular diets are the best for promoting heart health.
Continue reading below as we explore the diets the AHA recommends and the reasoning behind their rankings.
Which Are the Most Heart-Healthy Diets?
According to the AHA, these are the most heart-healthy popular diets in the US:
- DASH-style eating
- Mediterranean-style diet
- Pescatarian diet
- Vegetarian diet (including eggs & dairy)
These four eating styles were ranked in the top tier of heart-healthy diets by AHA experts, with the DASH-style eating plan receiving a perfect score based on their criteria. They found that these diets each offer flexible food options and a wide variety of foods to choose from, in addition to other heart-healthy attributes like being low in salt, added sugar, alcohol, and processed foods.
Plus, these Tier 1 diets are deemed more heart-healthy than others by incorporating whole grains, legumes, non-starchy vegetables, fruits, seafood, lean poultry, and meats, low-fat or fat-free dairy products, and plant-based proteins.
Professor of Medicine at Stanford University, Christopher D. Gardner, Ph.D., FAHA, was the chair of the writing committee for this new statement, explaining:
“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.”
Following behind were Tier 2 diets, which include:
- Vegan diet
- Low-fat diet
These diets’ emphasis on eating fruits, vegetables, whole grains, legumes, and nuts earned them a higher ranking. However, the experts determined the restrictions on these diet patterns, particularly vegan diets, may make them more difficult to follow over the long term, among other reasons. Plus, the AHA’s guidance on replacing saturated fats with mono- and polyunsaturated fats may be overlooked in low-fat diets that treat all fats the same.
Which Diets Aren’t as Heart-Healthy?
On the lower end of the AHA’s rankings are Tier 3 and 4 diets. Here is a summary of their Tier 3 diets that have low to moderate alignment with AHA heart-healthy guidelines:
- Very low-fat diet
- Low-carb diet
They explain that though these diets can help slow the progression of fatty artery build-up, aid in weight loss, and support better blood pressure, blood sugar, and cholesterol, they both restrict certain food groups that the Association recommends. This includes the restriction of nuts and healthy plant oils in the very low-fat diet plan and the fact that low-carb diets restrict fruits, grains, and legumes, among other factors.
The Tier 4 diets that scored the lowest on the AHA’s criteria for meeting heart-healthy guidelines include:
- Paleolithic diet
- Ketogenic diet
Heart experts make it clear that these diets may help with weight loss, but they align poorly with AHA dietary guidelines for long-term heart health. Specifically, they explain that diets containing high levels of unhealthy oils and saturated fats and low levels of fiber, like keto and paleo, can result in a higher risk of heart disease–despite possible weight loss benefits in the short term.
A big part of the AHA’s rankings of these diets was the sustainability to promote good heart health and weight loss over a person’s lifespan. They point out that even though each of these diets can offer short-term benefits, the diets they ranked highest are the most aligned with their heart-healthy guidelines and offer more flexibility and food options that make it easier for people to follow year after year.