Dietary Options To Consider When Maintaining a Healthy Heart

By ErinRose Baldry

Dietary Options To Consider When Maintaining a Healthy Heart

CVD is a generic term that covers a number of conditions including coronary heart disease (CHD), coronary artery disease (CAD), heart attacks, heart failure, stroke, arrhythmia and heart valve problems. You or a loved one managing their CVD may have heard the names of various different dietary plans and regimes, but do they actually help with your specific needs and ultimate health goals? Given it’s proclivity to yield potentially dangerous consequences for those living with CVD, methods to achieve health and wellness are booming. One of the primary factors to minimize the risk of complications due to CVD is a healthy, balanced diet. Insight is provided below on the top dietary options to consider when determining which route may help you.*

*Always consult with your medical professional specialist before introducing any changes to your clinical plan or including dietary and lifestyle changes. 

Mediterranean Diet

What is it?

The Mediterranean diet is not a single diet but rather an eating pattern that takes inspiration from the diet of southern European countries. There is an emphasis on plant foods, olive oil, fish, poultry, nuts, legumes and grains. Key ingredients of the diet include fresh fruits and vegetables, unsaturated fats, oily fish, a moderate intake of dairy, and a low consumption of meat and sugar. 

Pros

Studies suggest that people who follow the Mediterranean diet have up to a 28% lower risk of various diseases, including CVD, obesity, diabetes and cancer. They are also more likely to enjoy a longer life compared to individuals in other regions globally. This dietary lifestyle is therefore linked to very positive health outcomes.

Cons/Risks

N/A

Where to start?

  • Prioritize a daily intake of:
    • fruits and vegetables
    • healthy fats: olive oil, avocados, nuts, seeds (avoid other processed oils/butter)
    • whole grains
  • Use herbs and spices when cooking for flavor
  • Consume legumes at least 3x/week
  • Eat seafood or fish at least 2x/week (especially healthy fatty fish: salmon, sardines, herring, tuna)
  • Have a moderate intake of poultry, eggs, and naturally lower-fat dairy
  • Occasional red meat and sweets (less than 2x/week), limit portion size and frequency
  • Prioritize drinking more water daily
  • If consuming alcohol, opt for red wine (max 2 glasses/day for men, 1 glass/day for women) 
  • Avoid sugar sweetened beverages, processed meat, refined grains, highly processed foods
  • Participate in daily physical activity

AHA Low Fat Diet

What is it?

The American Heart Association (AHA) makes recommendations to consume a low fat and lower calorie diet using the “DASH” eating plan (Dietary Approaches to Stop Hypertension). The focus is on eating a variety of nutritious foods from all the food groups while keeping a close check on total calorie consumption (especially if focused on weight loss goals). 

Pros

This is among the top diets to reduce the risk of CVD, lower hyper-tension, reduce BMI/obesity, improve insulin sensitivity (lower risks and complications related to type 2 Diabetes). Health outcomes strongly improve with this diet.

Cons/Risks

N/A

Where to start?

  • Prioritize a variety of fruits and vegetables
  • Consume whole grains daily (brown rice, barley, millet, quinoa, buckwheat, farro, spelt, oats etc)
  • When using oils, focus on unsaturated fat sources (flaxseed oil, sunflower oil, oily/fatty fish, chia seed, walnuts)
  • Consume plenty of monounsaturated fats (olive oil, olives, nuts, seeds, avocados)
  • If consuming dairy, focus on low-fat dairy products
  • Focus on skinless poultry and fish as the primary sources of protein, also beans and legumes
  • Consume less sodium (ideally less than 1500mg daily to lower hypertension)
  • Limit alcohol consumption (no more than 1 unit daily for women, 2 units daily for men)
  • Focus on total calorie consumption each day (based on your age and physical activity level and whether you're trying to gain, lose or maintain your weight, for weight loss, target a calorie deficit of 500 calories per day) 
  • Eat less nutrient-poor foods (junk food, processed food, high fat foods)
  • Limit the amount of saturated fat and trans fat consumed 
  • Read nutrition labels carefully, be an informed consumer
  • Aim for at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week (or an equal combination of both) 

Paleo

What is it?

The primary focus of a paleo diet, commonly referred to as the “Caveman” or “Stone Age” diet, is to focus on mostly plant based foods, less meat, and absolutely zero processed/junk foods. The concept evolved from the idea of “hunter gatherer” style eating of our ancestors, where humans consumed mostly plants, berries, natural plant based foods and occasionally lean, whole natural meat/protein sources.

Pros

This diet can significantly assist with weight loss when followed properly as part of a calorie deficit plan, thus helping to reduce BMI and risk of complications as a result of CVD. There are trial and experimental studies supporting these conclusions, but data is limited. For individuals living with gut/inflammatory issues, this diet can be extremely beneficial, as it eliminates all potential gut aggravators.  

Cons/Risks

The clinical and scientific data is inconclusive and unclear of the specific heart related benefits of eating a purely paleo diet. There are also unanswered clinical questions regarding the complete elimination of all grains (including whole grains), dairy and legumes.

Where to start?

  • Eat plenty of vegetables and fruits
  • Consume nuts and seeds
  • Consume healthy lean cuts of meats, eggs
  • Avoid processed foods, artificial fats/sweeteners 
  • Avoid all grains, dairy, legumes, simple sugars
  • Avoid nightshades (potatoes, peppers, tomatoes, eggplants)
  • Avoid added salt and sugar

Vegan Diets

What is it?

A vegan diet is a very strict vegetarian, plant based diet that restricts the consumptions of all animal and animal bi-product food items. 

Pros

If well followed, ie. a large focus on vegetables and fruits and not starches, grains, pasta, bread etc, this diet can result in significant weight loss, which in turn may result in benefiting CVD related complications and risks. 

Cons/Risks

A diet as restrictive as this can result in deficiencies in protein, good fats, essential amino acids, vitamins and minerals. This may potentially result in higher risk to those with underlying coronary artery disease (a form of CVD). Furthermore, veganism does not appear to provide significant added benefit when compared with the AHA‐recommended DASH or Mediterranean diets in terms of weight loss, glycemic control, or lipid profile improvement. 

Where to start? 

  • Focus on eating plenty of fruits and vegetables
  • Eat legumes (eg. peas, beans, and lentils), nuts and seeds
  • Eat breads, grains, rice, and pasta
  • Consume dairy alternatives such as coconut milk and almond milk
  • Use vegetable oils
  • Avoid processed foods
  • Strictly no animal product, or animal by-product of any kind, including meat, fish, eggs, cheese, dairy 

Keto/Atkins

What is it?

When you first start either the Keto or Atkins diets, they are essentially the same, extreme carbohydrate restriction, with a focus on fat and protein. The main difference with Aktins is, once your target weight is achieved, the ultimate goal to slowly reintroduce carbohydrates, albeit in a highly restricted manner. At the start of the Atkins diet, you must consume less than 20 net carbs daily (not taking carbs as a result of fiber into account). This is in stark contrast to the AHA guidelines suggesting 100-130 net carbs per day for an average adult. With Atkins, total fat comprises approximately 60% of daily calories, much higher than the recommended total fat/protein intake of approximately 25% for adults (by the AHA).

Whereas, with Keto, the goal is to achieve, and remain in a ketosis state, never reintroducing carbohydrates to your diet. By restrictively limiting carbohydrates from your diet, you are able to more efficiently burn fat and convert fat into usable energy. You also tend to fill up more quickly due to the high fat content of the foods consumed. Whereby the body essentially uses fat to gain “fuel” or energy (glucose in the bloodstream) indefinitely. Some people stay on keto indefinitely, whereas others cycle in and out.

Pros

Either diet can result in rapid weight loss. Limited data and studies have also concluded that a severe carbohydrate restrictive diet can potentially benefit individuals with the following conditions: metabolic syndrome, insulin resistance, type 2 diabetes, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer's, Parkinson's, and Lou Gehrig's disease.

Cons/Risks

There are limited long term proven health benefits of a very low carbohydrate diet. The high fat, high protein content can be potentially adverse to those with CVD, as the total calorie consumption is relatively high as compared to other dietary options and is likely to increase cholesterol levels. It can also prove to be adverse to those living with pancreas or kidney conditions. 

Given it’s highly restrictive in nature, many people find it hard to comply with the rigidity of this diet. If you choose to reintroduce carbohydrates, rapid weight gain can occur. The lack of fiber and carbohydrates can also result in “keto flu” (feeling of being unless), constipation, bad breath, sleepiness and/or sugar cravings.

Where to start?

Foods to focus eating include:

  • red meat, steak, pork, ham, sausage, bacon, chicken and turkey
  • fatty fish (salmon, trout, tuna and mackerel)
  • eggs pastured, or omega-3 whole eggs.
  • butter and cream, grass-fed when possible
  • unprocessed cheese (cheddar, goat, cream, blue or mozzarella)
  • nuts and seeds
  • healthy oils (primarily extra virgin olive oil, coconut oil and avocado oil)
  • whole avocados or freshly made guacamole
  • low-carb veggies (most green veggies, tomatoes, onions, peppers, etc)
  • use salt, pepper and various healthy herbs and spices for flavor

Foods to avoid eating:

  • sugary foods (soda, fruit juice, smoothies, cake, ice cream, candy, etc)
  • grains or starches
  • fruit, except small portions of berries 
  • beans or legumes
  • root vegetables and tubers 
  • low-fat or diet products (these are usually highly processed and often high in carbs)
  • condiments or sauces containing sugar and processed/artificial ingredients
  • unhealthy fats (vegetable oils, mayonnaise, etc)
  • alcohol (due to high carb content)
  • sugar-free diet foods (these are often high in sugar alcohols, which can affect ketone levels in some cases, they also tend to be highly processed)

Where to start?

When interpreting so many different dietary options, it can be overwhelming and frustrating. The best starting point is to first assess your optimal health goals (eg. weight loss, reduce cholesterol levels, lower HbA1c, etc). Next, speak with your doctor about the best ways to obtain your goals given your health, lifestyle and medical needs. Most likely, you find yourself seeking out a healthy hybrid of one or a few of the above dietary options. The ultimate goal is to find a healthy, realistic, attainable lifestyle that suits you and that does not limit or restrict you. If you approach your choice as an overall healthier way of living, with this mentality, you will no doubt succeed in reaching your ultimate goals.

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Orignially published on September 30, 2020, updated on September 30, 2020

Topic: CVD

ErinRose Baldry

About ErinRose Baldry

ErinRose Baldry is an ACE Nutrition Specialist and Certified Personal Trainer. She integrates her knowledge in fitness, wellness, cooking and nutrition to offer dynamic, engaging, relevant information for her clients and in her writing. She provides effective, manageable guidance and tips for all populations who aim to be the best version of themselves both in health and fitness. In addition, she advocates for local charities and educates families on the importance of healthy eating, nutrition and exercise.