Many diets can help you shed pounds. Choose one you can stick with forever that features plenty of heart-healthy foods.
Most people who've lost weight and kept it off for years will tell you that sticking to your new eating pattern is key for long-term success. Yes, you can still have a cheat meal of your old favorites once in a while. But unless you make a permanent shift away from the habits that led to your weight gain in the first place, you'll probably end up regaining the weight you've lost. It's an all-too-common problem, as evidenced by the rising trend of overweight and obesity in this country.
But with so many weight-loss diets to choose from, how do you decide which eating strategy may work best for you, without harming your cardiovascular health? Dr. Deirdre Tobias, assistant professor of nutrition at Harvard's T.H. Chan School of Public Health, says people should be cautious about diets that restrict a specific category of food (such as carbohydrates, fats, or even animal products) without focusing on the overall quality of the foods.
Processing the problem
"In theory, any of those diets can be healthy. But you can get off track if you simply make a lateral move to a new version of a processed food, like fat-free cookies or low-carb chips," says Dr. Tobias. Food manufacturers are smart and will reformulate their products to fit the latest diet craze. But that doesn't mean their products are healthy -- especially if you end up gorging yourself on those snacks. These and other ultra-processed foods (packaged and instant soups, noodles, and desserts and the like) often contain lots of additives, such as artificial colors, flavorings, and preservatives, notes Dr. Tobias. Growing evidence suggests that people who eat lots of these foods face a higher risk of both obesity and heart disease.
For people paying attention to their heart health--which should include all older adults -- certain low-carb diets may also be worrisome, says Dr. Tobias. For example, some people who gravitate toward the Atkins or the keto diet (both of which strictly limit carbohydrates) end up eating lots of red meat and processed meat such as bacon. Processed meat in particular isn't good for heart health. However, people can lose weight on less-extreme versions of either low-carb or low-fat diets, as long as they focus mostly on eating unprocessed or minimally processed food.
Last year, a study involving 32,700 adults in JAMA Internal Medicine found that both low-carb and low-fat diets may lower the risk of premature death by 27%, but only if those diets emphasized high-quality fats and carbs. The people who did best filled their plates with whole grains, non-starchy vegetables, whole fruits, and nuts. In contrast, those who ate more refined carbs, animal protein, and saturated fat tended to die younger. (See "The tried-and-true diets that are good for your waistline and your heart" for two diets that focus on high-quality fats and carbs.)
If you're making drastic changes to your diet, consult a registered dietitian who can offer targeted advice and make sure that you're not missing out on crucial nutrients. Dr. Tobias also recommends getting an annual wellness visit so you can keep tabs on your blood pressure, blood sugar, and cholesterol, all of which can be influenced by your weight. "Remember that it's not so much about the number on the scale, but how your weight affects your health," says Dr. Tobias.
The tried-and-true diets that are good for your waistline and your heart
They're not new or trendy, but these two diets have the best evidence for promoting cardiovascular health -- and they can be just as effective as other popular diets for fostering weight loss.
Mediterranean diet. This eating pattern features an abundance of vegetables, fruits, nuts, beans, and whole or minimally processed grains, along with modest amounts of cheese, yogurt, fish, and poultry, and red meat only infrequently in small amounts. Olive oil is the main source of fat. Here are some sample meals:
Plain Greek yogurt topped with nuts and fresh berries
Whole-grain bread topped with a small amount of low-fat cheese and slices of fresh tomato, drizzled with a little extra-virgin olive oil
Vegetable omelet made with mushrooms, spinach, and onions cooked in olive oil, with crusty whole-grain bread
Vegetarian pizza topped with part-skim mozzarella cheese, roasted broccoli, onions, green peppers, and carrots
Greek salad made with chopped mixed greens, kalamata olives, tomatoes, fresh parsley, feta cheese, dressed with extra-virgin olive oil and fresh lemon juice
Chickpea and farro salad with red peppers, spring onions, and fresh oregano, dressed with extra-virgin olive oil and fresh lemon juice
Grilled vegetable kabobs with shrimp, toasted quinoa salad, and mixed green salad with pine nuts
Chicken stir-fried in olive oil with broccoli, cauliflower, asparagus, and yellow peppers, served over brown rice
Steamed mussels with spinach-orzo salad and minestrone soup
DASH diet. The Dietary Approaches to Stop Hypertension (DASH) plan was originally developed to lower blood pressure without medication, so it aims to cut back on sodium. Like the Mediterranean diet, the DASH plan includes lots of vegetables, fruits, and grains, with an emphasis on whole grains. Low-fat or nonfat dairy foods, beans, nuts, seeds, lean meats, poultry, and seafood are also allowed, along with limited amounts of added fats and sweets. Sample menus are available at www.health.harvard.edu/dashmenu.
For more information, see The Diet Review, a Special Health Report from Harvard Health Publishing, which details the science and evidence (or lack thereof) of 39 popular nutrition and weight-loss plans. To order, go to www.health.harvard.edu/tdr.