Following a low-fat diet may help lower cholesterol and reduce the risk of heart disease. A Mediterranean-style eating plan, however, may help you live longer.
Foods that are high in saturated and trans fats can lead to high cholesterol levels, which may contribute to atherosclerosis (clogged arteries).
While a strict low-fat diet can help fight heart disease, a whole-diet approach — similar to a Mediterranean-style diet— may be most successful at reducing cardiovascular death and heart attack, according to a new study. A Mediterranean-style eating plan includes lots of fish, nuts, fruits and vegetables.
James Dalen, MD, with the Weil Foundation (a nonprofit dedicated to the advancement of integrative medicine) and the University of Arizona College of Medicine, coauthored the study with Stephen Devries, MD, a preventive cardiologist with Northwestern Memorial Hospital in Chicago.
The authors analyzed major research on heart disease and diet conducted from 1957 until now. They noted that almost all clinical trials in the 1960s through the 1980s compared regular diets to those that focused on lowering saturated fat and dietary cholesterol while increasing polyunsaturated fats.
Saturated fats mainly come from meat and dairy products, including fatty beef, lamb, pork, poultry with skin, butter, cheese and milk.
Foods high in polyunsaturated fats include soybean oil, corn oil, safflower oil, salmon, mackerel, herring, trout, walnuts and sunflower seeds. The American Heart Association (AHA) says that polyunsaturated fats can have a beneficial effect on health when consumed in moderation.
The AHA suggests limiting fat intake to less than 30 percent of daily calories, saturated fat to 10 percent, polyunsaturated fat to 10 percent, and cholesterol to less than 300 mg per day.
Regarding low-fat eating plans, Dr. Dalen pointed out that these diets did reduce cholesterol levels, but they did not reduce the incidence of myocardial infarction (heart attack) or coronary heart disease deaths.
Investigators discovered that a broader-based Mediterranean diet appeared to be more effective at lowering the risk of heart attack and dying. While these diets are low in saturated fats, they are high in healthy fats found in nuts, fish and olive oil, and rich in vegetables, fruits and whole grains.
"The potency of combining individual cardioprotective foods is substantial — and perhaps even stronger than many of the medications and procedures that have been the focus of modern cardiology," said Dr. Devries in a statement. "Results from trials emphasizing dietary fat reduction were a disappointment, prompting subsequent studies incorporating a whole diet approach with a more nuanced recommendation for fat intake."
A study published last year in the New England Journal of Medicine, led by Dr. Ramon Estruch, found that a Mediterranean diet may be almost as effective in reducing the risk of heart attack as taking statins.
"Nutritional interventions have proven that a 'whole diet' approach with equal attention to what is consumed as well as what is excluded is more effective in preventing cardiovascular disease than low fat, low cholesterol diets,” concluded Dr. Dalen.
The study was published in February in The American Journal of Medicine.