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Reaction: ten popular diets evaluated against heart-healthy criteria

A new scientific statement from the American Heart Association published in the journal Circulation analyzes how several diets (including Mediterranean, Paleo, and ketogenic) fit into the guidelines for a heart-healthy diet. The ketogenic and 'paleo' diets were not classified as heart-healthy.

27/04/2023 - 11:00 CEST
Expert reactions

Mercedes Sotos - dietas cardio EN

Mercedes Sotos-Prieto

Nutritional epidemiologist at CIBERESP and IMDEA Alimentación, Ramón y Cajal researcher at the Autonomous University of Madrid and adjunct professor at the Harvard School of Public Health

Science Media Centre Spain

This study is a scientific statement that has evaluated and scored ten known dietary patterns based on criteria agreed upon by scientific evidence that define heart-healthy diets and that were published in 2021 by the American Heart Association. What they have done is to make a ranking of these popular diets according to the fulfillment of each of these criteria (for example: to consume preferably whole grains instead of refined ones or to use liquid oils of vegetable origin such as olive oil and not tropical oils such as coconut oil or animal fats such as butter).  

This is a study that may have great relevance, since there is a lot of misinformation about certain fad diets that offer short-term benefits. Knowing that, for example, the Mediterranean diet is among the four most highly valued dietary patterns, reinforces previous knowledge and the robust scientific evidence on its heart-healthy benefits. Other patterns include the DASH diet (developed primarily to lower blood pressure), or vegetarian diets (both those in which only fish is consumed and those that include eggs and dairy products). Thus, everyone can choose what best suits their dietary, cultural or monetary preferences, while sharing common characteristics (consumption of fruits and vegetables, legumes, nuts or vegetable oils). It is worth mentioning that these four patterns, having a reduced meat intake, have less environmental impact and are more sustainable than, for example, the ketogenic diet.  

This study is also of great relevance because it evaluates certain popular dietary patterns in which, on occasions, the fundamental objective is short-term weight loss; and demonstrates that, with the indicators presented, they do not meet the criteria to be considered heart-healthy dietary patterns. Such is the case of the ketogenic diet or the Atkins diet, which are popular low-carbohydrate diets and limit the consumption of foods that we already know are beneficial to health, such as fruits, legumes or whole grains. I think it is important to disseminate this information to the population because, as I said, there is misinformation and many people get carried away by these diets that are impossible to sustain in the long term. 

One of the highlights of this study is the opportunity to intervene in health equity, as it recognizes the importance of the social determinants of health in the consumption of healthy dietary patterns. For example, social relationships and social support, family, traditions, etc., have an important influence on how we eat and it is important to have programs that support this.  

This study has evaluated ten known dietary patterns on the basis of a few criteria and, therefore, there are others that could not be included in this evaluation, such as, for example, patterns to treat gastrointestinal conditions or allergies.

The author has not responded to our request to declare conflicts of interest
Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association
  • Report
  • Peer reviewed
Publication date

D. Gardner et al.

Study types:
  • Report
  • Peer reviewed
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