Pound for Pound – Which Diet Measures Up?



hey are certainly out there – all kinds of diets, especially at this time of year, when many people want to get the new year off to a fast and promising start by shedding unwanted pounds in hopes of shaping bold new bodies.

Today's diets range from quick-fix fads to those more focused on form and function. Unfortunately, diets can also include some that are more hype than help.

With all of that said, which diets go beyond the glow of outward appearances to provide the added benefits of long-term heart health?

"As a cardiologist and heart doctor, I think it makes much more sense for people to use a diet that becomes part of the way they live than to use something out of a book simply because it may be a wildly popular idea that offers quick results, such as the Atkins Diet and the South Beach Diet," says Timothy Shapiro, director of the cardiac catheterization laboratory at Lankenau Hospital, part of the Main Line Health System.

"On the other hand, the Mediterranean Diet, which really reflects a new choice in lifestyle and a basic change in eating habits, has been shown to be heart-healthy," he adds, citing a study conducted among 605 heart patients in Lyon, France, in the late 1980s.

"Half of them ate what their doctors thought was prudent, which was consistent with the American Heart Association's traditional diet that limits saturated and total fats; while the other half ate the Mediterranean Diet, with its emphasis on good fats, such as olive and fish oils, limited amounts of simple carbs and lower amounts of saturated fats," he explains.

"When the study ended two years later, those who had followed the Mediterranean Diet showed a remarkable 76 percent reduction in cardiovascular events, such as stroke, heart attack, heart failure and death," says Shapiro.

With that study and its results in mind, he recommends that the best kind of diet for heart health is one, like the Mediterranean Diet, that's low in saturated fat; that fosters the use of good fat, such as the monounsaturated and polyunsaturated varieties found in olive oil and fish; that's high in fiber, thanks to the large amounts of fresh fruits, vegetables and the whole grains it incorporates; and also permits lean meats and even wine in small amounts.

This is corroborated by Michele MacDonnell, a registered dietitian at Lankenau who counsels many of the hospital's heart patients, and who agrees that a diet low in fat and high in fiber – and one that limits processed foods and their dangerous hydrogenated oils – is best for maintaining a healthy heart.

In comparison to the Mediterranean Diet, the famous Atkins Diet gained national and international notoriety through the radical notion that eating fat wasn't so bad after all, since it offered and achieved rapid weight. The nearly equally famous South Beach Diet, named after a super-trendy area of Miami, also cuts carbs and calories drastically in its initial stage, Dr. Shapiro says, while actually closely paralleling the Mediterranean Diet in its third and final stage.

A problem with Atkins, South Beach and other fads, he continues, is that once they get the weight off – and they can do so rather quickly since they eliminate calorie-charged carbohydrates as a first step – most people stray from their guidelines of reduced carbs and increased fats of all kinds.

As Always, Moderation's Key 
For Helene Glassberg, M.D., director of the Lipid Center, Temple University School of Medicine and Hospital, the best heart-healthy diet is one that's balanced in its ingredients and based on moderation, especially portion sizes. "The best advice I can give is for people to use common sense when deciding what to eat, including making the protein and fat they consume healthy choices. Studies show that the omega-3 oils found in fish, for example, have proven benefits that include fewer heart attacks," states Glassberg.

A major area of concern with the Atkins Diet, she notes, is that with its prescribed intake of fats, including saturated fat, there's the unknown toll these may take on heart health in the long run.

"The AHA recommends that 30 percent of calories come from fat, and that saturated fat accounts for no more than 10 percent of total calories, while Atkins says that 70 percent of calories should come from fat. With what that might mean to heart health, low-carb, high-fat Atkins still has to be proved," she says.

To complement and complete the right heart-healthy diet, people also should exercise.

However, notes Glassberg, "it's worth finding one [style of exercise] that fits, since the benefits for heart health are significant."

As a way to illustrate that bad eating habits are linked directly to heart health, David H. Wiener, M.D., clinical professor of medicine at Jefferson Medical College of Thomas Jefferson University, and director of clinical operations at the Jefferson Heart Institute, points out that obesity is rampant in the United States largely because people are eating larger portion sizes.

"Having taken that step back to establish that obesity – and the heart conditions related to it – is a major issue, it makes sense for people to eat a diet that doesn't add extra weight and that promotes a healthy heart, such as the Mediterranean Diet and the DASH Diet, which has been around for from five to 10 years."

Dietary Approaches to Stop Hypertension – or DASH – "has heart benefits independent from the foods it lists, such as lower blood pressure. It's also is low in fat," he acknowledges.

And with any heart-healthy diet, he concludes, comes the absolute need to exercise, which can be something as simple as walking daily.



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