Paleo and keto diets may be trending, but these diets are less recommended for heart health. This is the conclusion reached by a US team of cardiologists, nutritionists and other health experts compared various popular diets to dietary guidelines for heart health. Like the group now in the journal circulation reported, they also took into account for their ranking how easily and well the different meal plans can be followed in the long term.
Coronary heart disease is the leading cause of death not only in Germany but worldwide. There are ways to reduce the risk, such as regular exercise or not smoking. Another big factor is diet. A group led by Stanford University physician Christopher Gardner, on behalf of the American Heart Association (AHA), has now examined ten popular diets to see how they meet the AHA guidelines. These guidelines recommend limiting unhealthy fats and excess carbohydrates for heart health, among other things.
The clear winner is the DASH diet (“Dietary Approach to Stop Hypertension”). Animal fats are avoided to a large extent, instead fats from nuts and oilseeds as well as lots of vegetables, fruit, whole grain products and fish are on the menu. In addition, the salt intake is reduced and preference is given to low-fat dairy products.
Vegan diet only ends up in the middle
The experts also gave the pescetarian diet, which does not eat meat but eats fish and other animal products, a good rating. Vegetarian diets that include eggs, dairy, or both also fared well. The Mediterranean diet recommended by the German Heart Foundation also landed in the top group. This includes lots of vegetables, fruit and legumes, high-fiber whole grain products and nuts, fish and high-quality oils.
“If implemented as intended, the top tier diets are most consistent with American Heart Association guidelines and can be adjusted to accommodate cultural practices, food preferences and budgets so that people can continue to eat this way over the long term,” says lead author Gardner. According to the experts, veganism and a low-fat diet are less easy to implement than these four forms of nutrition: The restrictions on the former would make it more difficult to follow them in the long term, and the risk of vitamin B-12 deficiency is also increased. And the low-fat diet, in turn, does not differentiate between healthy and unhealthy fats.
A very low-fat diet, in which fat accounts for less than 10 percent of total calories, and a low-carbohydrate diet, in which carbohydrates are reduced to 30 to 40 percent, were even less consistent with the AHA guidelines. The paleo and keto diets brought up the rear – both are forms of nutrition that have been promoted on social networks such as TikTok or Instagram for some time.
The ranking list is also intended to provide orientation for doctors
While the Paleo diet is modeled after what was believed to be food available in the Stone Age and excludes whole grains, refined grains, legumes, oils and dairy products, the ketogenic diet limits carbohydrates to less than 10 percent of daily calories. Instead, fats from animal sources are used. In particular, the experts are critical of the restrictions on the consumption of fruit, whole grain products and legumes in these two forms of nutrition with a view to heart health. “They’re very restrictive and difficult for most people to sustain,” Gardner explains. Short-term benefits and significant weight loss, while likely with both the paleo and keto diets, are not sustainable: “A diet that helps individuals maintain their weight loss goal must also be sustainable from a practical standpoint.”
Overall, the authors hope, their scientific statement will provide guidance when it comes to heart-healthy nutrition. “The various popular diets have proliferated in recent years, and the amount of misinformation about them on social media has reached critical proportions,” notes Gardner. This leads to confusion not only in the general public, but even among people in health care professions: “You may feel that you do not have the time or the training to evaluate the different diets.” Here the statement can serve as a kind of cheat sheet: “We hope that it will serve as a tool for physicians and the public to understand which diets promote good cardiometabolic health.”