Cardiovascular disease refers to several types of heart conditions, with the most common type being coronary artery disease. In the United States, about 610,000 people die every year from heart disease, with coronary artery disease killing 370,000. A proper heart-healthy diet has been an essential part of prevention and treatment for decades. Research from the American College of Cardiology Nutrition & Lifestyle Workgroup of the Prevention of Cardiovascular Disease Council breaks down nutritional “hypes” and controversies around various foods and heart health.
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Recommendations from the American Heart Association on a diet include eating a variety of nutritious foods, eating less nutrient-poor foods, control of calorie intake, and avoiding smoking. The American Heart Association provides basic eating pattern guidelines such as eating a wide variety of vegetables and fruits, fiber-rich whole grains, poultry and fish prepared in healthy ways, low-fat dairy products, limiting trans and saturated fats, while also cutting back on added sugars and sodium. There are challenges in establishing scientific evidence based on nutrition, the interplay between nutrients and other healthy lifestyle behaviors can influence dietary behavior. Some foods and dietary patterns go through trends of popularity, receiving “hype” from media exposure, while others become demonized as “bad” foods.
"The current nutritional recommendations show a heart-healthy diet is high in fruits, vegetables, whole grains and nuts in moderation," said Andrew Freeman, MD, FACC, director of cardiovascular prevention and wellness at National Jewish Health and the review's lead author. "However, there are many food groups which can result in confusion for patients, including dairy, added sugar, coffee, and alcohol." So, what “trendy” foods live up to the hype and which don’t? The review looked at dairy products, added sugar, legumes, mushrooms, fermented foods, and popular beverages such as alcohol, coffee, tea, and energy drinks.
Foods to limit or avoid, that created harm, were added sugars (table sugar and high fructose corn syrup) and energy drinks. Added sugars increase cardiovascular disease risk while energy drinks increased blood pressure and arrhythmia risk. The current recommendation is to eliminate added sugar from the diet as much as possible, which includes processed foods and sugar-sweetened beverages like soda and sports drinks. Other foods, like dairy products and fermented foods, were unclear on providing harm or benefit as part of a heart-healthy diet. While low-fat dairy can lower blood pressure, other studies have linked dairy intake to increased LDL cholesterol, since the benefit and harm are unclear it is best to consume with caution. Fermented foods, such as kombucha or kimchi, are trendy now but have little data for the role they may play in cardiovascular disease risk factors or improvement.
Foods that were found to have a benefit to heart health included legumes, coffee, tea, mushrooms, alcohol, omega-3 fatty acid and vitamin B12 containing foods. While some of these are typically considered “bad” at times, coffee and alcohol in moderation provide benefits such as reduced risk for stroke and diabetes with coffee and anti-inflammatory properties in alcohol. Tea, both black and green, showed many benefits including improved artery health, lowered cholesterol, and reversal of blood vessel dysfunction. Legumes (beans, chickpeas, soybeans, etc.) were shown to have heart-healthy properties like improved blood glucose and blood pressure as well as reducing coronary heart disease.
"There is no perfect, one size fits all dietary pattern for preventing heart disease," Freeman said. "But, most of the evidence continues to reinforce that a predominantly plant-based diet lower in fat, added sugars, added salt, processed foods, and with limited if any animal products seem to be where the data is pointing us. It is important for clinicians to stay on top of rising food trends and current scientific evidence to provide meaningful and accurate nutritional advice for patients."
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