The Best Post Heart Attack Diet and How it Can Also Prevent a First Heart Attack

I can say with no uncertainty that the fastest way to get into an argument with a bunch of heart attack survivors is to discuss diet. Seriously, you’re better off discussing politics or religion. I think the reason for this is quite simple — nobody really knows the best way to eat to prevent heart disease, the number one cause of death in the world.

Well, that’s not entirely true. I don’t think anyone would argue that a truly healthy diet is mostly focused on fruits (providing you are not diabetic) and vegetables. And while we can argue about the merits of measuring glycemic load vs glycemic index, or whether juicing fruit removes too many of its healthy properties, fruit is healthy for most people and it is part of a balanced diet.

But that’s where the agreement ends and zealotry begins. For every diet “expert” on the Internet that claims fat will kill you there are an equal number who tell you fat is our friend. Should we eat meat? Just white meat? Just fish? And what about carbs? Simple or complex? Gluten or gluten-free? And just what the hell is a FODMAP?

For each style of eating there’s a diet out there that helps you meet these typically strict requirements. U.S. News and World Report recently published its 2018 ranking of diets, and they looked at no less than 40 popular diets. Some you’ve likely heard about, like the Mediterranean Diet, Weight Watchers, and the Zone Diet. Others sound flat out made up, such as the Nutritarian Diet, the Volumetrics Diet, and the Flexitarian Diet. And of course there are the “hot new trend” diets like the Whole30 Diet, the Engine 2 Diet, and the suddenly everywhere Keto Diet.

But back to my fellow heart attack survivors. I run a support group for heart attack survivors on Facebook and whenever diet comes up the same thing happens — everyone chimes in that their diet is best and if you don’t eat this way you’ll die. And they usually point to legitimate studies to support their view. And that’s the real problem. Many of these diets will improve your overall health, but in some cases the diets themselves contradict each other.

For example, one popular diet among the heart attack crowd is the Esselstyn Diet, which purports to prevent and reverse heart disease. Holy crap, shouldn’t we all be on this diet? Dr. Esselstyn argues that a plant-based, oil-free diet can not only prevent and stop the progression of heart disease, but also reverse its effects. On his diet, you’ll also need to eliminate nuts/nut butters and saturated fat, but you can increase whole grains. Hot dog buns yes, hot dogs no? And beware of the vegan police!

Then there’s the Keto diet, which argues you can have all the meat you want, plenty of high fat dairy, nuts and other fats but stay away from grains, fruits and sugar. Lamb chops yes, apples no?

Which diet is right? Can they both be right? Well, that’s a tough question. Both diets will undoubtedly lead to weight loss, but I’m interested in heart disease prevention. Which is it, bread or no bread? Fat or no fat? Apples or no apples? Trying to figure this out is enough to cause a heart attack!

For what it’s worth, U.S. News and World Report ranked the Keto Diet 35th out of 40 for best heart-healthy diet and dead last in overall diets, for the most part because it’s hard to follow and the data is not in yet on this relatively new diet (although it sounds an awful lot like the old Atkins Diet to me).

U.S. News selected the DASH Diet tops overall and for heart health. This diet focuses on lowering blood pressure, emphasizes fruits, veggies, whole grains, lean protein and low-fat dairy, and suggests you avoid foods high in saturated fat such as fatty meats, full-fat dairy foods and tropical oils, and sugar-sweetened beverages and sweets. Hmmm. This sounds familiar — eat your fruits and veggies and lay off the fat and sugar. A little lean protein and dairy is okay.

Here’s my take — as long as the jury is still out scientifically on “fad” diets like Keto or ultra-specific diets like Essylstyn and its little brother the Engine 2 Diet, I’m going to stick to the basics. I try to eat a Mediterranean Diet, which has been proven to lower the risk for heart disease. It’s also easy to stick to and gives you flexibility. And it aligns nicely with the mantra espoused by writer and journalist Michael Pollan, who famously wrote about his seven word diet: eat food, not too much, mostly plants.

Am I eating in the best way possible for my heart? I don’t know and I don’t think the medical community knows. But my post heart attack health speaks for itself. I had a recent angiogram that showed very little plaque buildup in my arteries and my blood work would make a healthy person jealous. Cholesterol is under 100. Triglycerides at 85.

I eat a diet rich in fruits and veggies, lean poultry, fish, healthy fats (think avocado and olive oil) and small amounts of whole grains. I avoid added sugar as much as possible. Wonder Bread no, Ezekiel Bread yes. It seems to be working for me. Is this a Mediterranean Diet, or the DASH Diet, or the Michael Pollan Diet, or the “Pegan” Diet?

Yes.

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