Harvard Heart Letter

Heart Beat: Your choice for dieting

If you need to lose weight, what type of pound-melting diet is best for your heart? In 2000, the stock answer would have been a low-fat diet. But the wild popularity of the low-carbohydrate Atkins and South Beach diets in the early 2000s prompted researchers to do some careful comparisons of weight-loss diets. The latest of these, from Israel, supports the idea that almost any type of diet that provides healthful nutrition can be as good for your heart as it is for your waistline.

In the Dietary Intervention Randomized Controlled Trial (DIRECT), 322 overweight men and women followed one of three diets for two years: a low-fat diet, a low-carb diet, or a Mediterranean-type diet. Those on the low-fat diet lost the least amount of weight, an average of 6 pounds, compared with those on the low-carb and Mediterranean diets, who lost about 10 pounds.

The DIRECT researchers also looked at what was happening inside the participants' carotid arteries. Changes in the thickness or volume of the walls of these easily measured arteries can indicate the buildup of harmful cholesterol-filled plaque. Carotid wall volume, and thus plaque, decreased roughly the same amount with all three diets (Circulation, March 16, 2010). The change was most pronounced in those who lost the most weight and had the greatest improvement in blood pressure.

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