I recently met with a patient, a middle-aged woman hoping to improve her heart health and, like most of us, lose weight. She had embarked on a highly restrictive diet, eliminating all grains, beans and most fruit, while increasing her intake of fats, filling up on cream, butter and oils with meals. She did lose weight, which thrilled her, but in the process experienced a shocking increase in her LDL or “bad” cholesterol, putting her at increased risk of developing plaque in her coronary arteries. She was stunned to learn that her diet — which she began in an earnest, thoughtful effort to improve her health — could actually be harming her.
I have watched this scenario play out countless times over the years with the fad diet du jour, witnessing the bewilderment, frustration and mistrust of patients, who bemoan the perceived notion that nutritional advice seems to always be changing or just plain wrong. Not everyone experiences dramatic health consequences when adopting a fad diet, but most do undergo unnecessary dietary restrictions, potentially eliminating many protective, health-promoting nutrients.
With the constant influx of online health information — an internet search for “heart-healthy diet plan” yields an overwhelming 216 million results — it feels nearly impossible to determine which nutrition advice is science-backed and accurate. A diet eschewing all carbohydrates in favor of fat? There’s a website stating that is the only way to go. A completely plant-based diet? You bet. How about a diet that eliminates plants altogether? That’s also a possibility. Maybe an all-cookie diet? Sad but true. It’s no wonder people feel confused when the experts, many self-proclaimed, vary so widely.
So what does a well-intentioned person eat to keep their heart healthy? We actually do have a good understanding of the best way to eat, and it doesn’t necessarily involve any named diet plan. Minimally processed plant foods — vegetables, fruits, whole grains, beans, nuts and seeds — should make up the foundation of what we eat. It doesn’t need to be completely vegan, though that can certainly be a healthy eating pattern, but animal proteins should be chosen thoughtfully, with special emphasis given to heart-healthy foods such as fish and seafood.
Think of lean meats as a way to season a meal, such as using only one chicken breast in a large pot of vegetable and bean soup, or adding 2-ounces of thinly sliced flank steak to a salad packed with dark leafy greens, vegetables and garbanzo beans, rather than having an 8-ounce steak with a few lettuce leaves added as an afterthought. For more information, check out OHSU’s My Heart-Healthy Plate at ohsuheart.com/plate
The good news is that eating a plant-focused diet is not only great for your heart, but it’s also good for keeping the rest of your body healthy. The vast majority of chronic disease could be prevented by making good lifestyle choices such as following a healthy diet and getting regular physical activity.
The key is consistency – instead of starting a highly restrictive diet that you will inevitably quit (risking the psychological damage of somehow feeling like a failure), begin making small but sustainable changes to your daily routine. Do you grab a granola bar on your way out the door every morning? Try making overnight oats the night before for a quick grab-and-go breakfast. Find yourself at the drive-thru or work cafeteria every day for lunch? Pack up leftovers from the previous night’s dinner for a healthier (and more affordable) mid-day meal. Do you arrive home tired and starving, with no idea what to make for dinner night after night? Begin meal planning to streamline the process – by setting aside time early in the week to figure out what you will prepare for weeknight dinners, you can ensure you have the ingredients on hand, thawed and possibly even prepped.
For those days with a late meeting or evening soccer game, toss ingredients in a slow cooker before leaving in the morning so dinner is ready when you get home. Planning meals in advance saves money by reducing impulse buys and waste. (How many times have you thrown out wilted vegetables that you forgot to cook?) The simple act of eating more home-cooked meals will help you maintain a healthier weight and reduce your chances of developing a chronic illness such as heart disease or Type 2 diabetes.
As for my patient, she stopped her restrictive fad diet and started eating balanced, plant-focused meals. Her cholesterol is now better than ever, and she has maintained the weight she had lost. Most importantly, she is preparing healthy meals that her whole family enjoys.
And about that all-cookie diet, let’s all agree to just say no. •