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A heart-healthy diet doesn’t need to be low in fat But the source of the fats you choose — and the rest of what you typically eat — make a big difference.
Recently, a Harvard Heart Letter reader emailed us to say he was puzzled by a statement in our July issue — namely, the one saying that low-fat diets don’t seem to prevent heart disease. “Don’t most major health organizations, including the American Heart Association, recommend a low-fat diet?” he asked.
Yes, they did — for more than 40 years. But over the past decade, the American Heart Association, the federal dietary guidelines, and other nutrition authorities have shifted away from advising people to limit the total amount of fat in their diets. “Instead, the focus is on an overall healthy dietary pattern. That means an eating style that emphasizes vegetables, fruits, whole grains, and beans, along with only modest or small amounts of meat, dairy, eggs, and sweets,” says Dr. Eric Rimm, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health.
The reality is that eating more whole or minimally processed, plant-based foods will naturally lower your intake of fat, especially saturated fat. Found mainly in meat and dairy products, saturated fat can boost levels of harmful LDL cholesterol, a key contributor to heart disease. But simply cutting back on all types of fat does not necessarily translate into a diet that lowers cardiovascular risk.
Low-fat diet fails
Starting in the 1980s, when food manufacturers and consumers cut the fat from their products and diets, they replaced it with refined carbohydrates. People filled up on bread, pasta, low-fat chips and cookies, and low-fat sweetened yogurt. Eating lots of these highly processed carbohydrates floods your bloodstream with sugar, triggering a release of insulin to clear the sugar from your blood. But that can push your blood sugar too low, leaving you hungry again after just a few hours, which encourages overeating and weight gain. What’s more, a steady diet of these unhealthy carbs can eventually impair your body’s ability to respond to insulin, which can lead to diabetes. Both obesity and diabetes are closely linked to a heightened risk of heart disease.
But eating too many refined carbs wasn’t the only problem. Avoiding unsaturated fats — those found in nuts, seeds, olives, avocados, and fish — isn’t necessary. Not only do these foods make your meals more satisfying and tasty, unsaturated fat promotes cardiovascular health.
What about ultra-low-fat diets?
Some physicians advocate an ultra-low-fat diet, which includes just 10% of calories from fat. This diet excludes all animal-based products (such as meat, poultry, dairy, and fish), as well as refined carbohydrates (including white flour, white sugar, and even fruit juice). But it also shuns some healthier unsaturated fats, including added oils and high-fat, plant-based foods such as avocados and nuts. Small studies have shown that this eating pattern may actually reverse the buildup of cholesterol-clogged plaque in the arteries.
At least some of that benefit may stem from the abundant fiber and other nutrients in the diet’s copious amounts of vegetables, beans, and whole grains, all of which are fairly scarce in the typical American diet. The only problem with an ultra-low-fat vegan diet is that it’s very challenging for most people to stick to over the long term. “If you are among the 1% of people who can, may the Force be with you,” says Dr. Rimm.
For everyone else, a Mediterranean-style diet offers the best of both worlds — a plant-centric diet that’s not overly restrictive (see “Simple steps to a Mediterranean-style eating plan”). “The Mediterranean diet doesn’t require extreme eating habits that make it difficult to socialize with other people,” he says. What’s more, he adds, it tastes good and has the best evidence from long-term clinical studies for lowering a person’s risk of heart disease.
Simple steps to a Mediterranean-style eating planTo ease into this eating style, look over these suggestions from registered dietitian Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women’s Hospital. Choose one, try it for a week, then gradually add more changes over time, she advises. Switch from whatever fats you use now to extra-virgin olive oil. Start by using olive oil when cooking, including in salad dressings. Try swapping olive oil for butter on crusty bread. Have salad every day. Choose crisp, dark greens and whatever vegetables are in season. Go nuts. Instead of a bag of chips or cookies, have a handful of raw nuts as a healthy snack. Add more whole grains to your meals. Experiment with bulgur, barley, farro, brown rice, and whole-grain pasta. Select dense, chewy, country-style bread without added sugar or butter. Add a variety of vegetables to your menus. Add an extra serving of vegetables to both lunch and dinner, aiming for three to four servings a day. Try a new vegetable every week. Eat at least three servings of legumes a week. Options include lentils, chickpeas, pinto beans, and black beans. Eat less meat. Choose lean poultry in moderate, 3- to 4-ounce portions. Save red meat for occasional consumption or use meat as a condiment, accompanied by lots of vegetables, as in stews, stir-fries, and soups. Eat more fish, aiming for two servings a week. Both canned and fresh fish are fine. Cut out sugary beverages. Replace soda and juices with water. Eat fewer high-fat, high-sugar desserts. Fresh fruit or poached fruit is best. Aim for three servings of fresh fruit a day. Save cakes and pastries for special occasions. |
BETTER Memory... BETTER Concentration... BETTER Problem-Solving Ability... and protection from the ravages of dementia
Research has shown that the brain is continuously changing and rewiring itself in response to demands and experiences of life — and that it has a wonderful capacity to change and reinvent itself to be sharper, clearer and healthier.
With the interactive Cognitive Fitness Online Course, you’ll get a detailed look at the fascinating anatomy of your amazing brain and discover how you can be more mentally sharp and maintain your ability to learn, reason, and protect your recall into your golden years.
Develop a Clearer, Sharper, Healthier Brain in 6 Simple Steps
STEP #1: Enjoy a Brain-Healthy Diet
Discover plant-based foods that can help prevent cognitive decline. The flexible, unrestrictive diet shown to reduce Alzheimer’s risk by up to 53% in a study. The best vitamins and nutrients for brain health and their food sources. Brain-damaging foods to avoid. Downloadable diet plans and recipes. And more.
STEP #2: Brain-Healthy Exercise
People who are more physically active are at less risk of dementia and score better on attention, verbal fluency, verbal memory and other cognitive abilities. Discover the benefits of three type of exercises plus mind/body exercises for better brain health. You’ll also get a printable exercise tracker to keep you motivated!
STEP #3: Brain-Healthy Sleep
Find out why getting the right amount of sleep is essential for locking long-term memory. Plus, see what to do if you have trouble falling asleep…daytime tips to improve nighttime sleep…non-drug approaches to help you relax and fall asleep…doctor-recommended over-the-counter and prescription sleep aids…and more.
STEP #4: Brain-Healthy Stress Management
Find out how chronic stress can damage your brain and lead to memory problems. Plus, discover practical tools and strategies to manage stress and boost resilience…stress-busting foods…how improving your gut health can relieve chronic stress…how to identify and deal with stress triggers…and more. PLUS: How stressed are you, really? Find out with our interactive quiz!
STEP #5: Brain-Healthy Relationships
Find out why healthy relationships are as important as physical activity and healthy diet for brain health. Discover simple steps to widen your social network…games that improve your ability to remember specific events…specific relationships that improve your ability to think on your feet…and more. PLUS: How lonely are you, really? Find out with our interactive quiz!
STEP #6: Brain-Healthy Challenges
Evidence shows that the more you stimulate your brain, the better you can protect yourself against the detrimental effects of aging. Discover the three rules for mental stimulation… how a certain puzzle can slow the onset of memory decline by as much as 2½ years…the astounding impact of computer-based brain training…and more.
PLUS — you’ll get a printable cognitive fitness checklist and a goal-planning worksheet to help keep you on target in your brain-building efforts!