Heart disease is the leading killer of men and women worldwide, but there are ways to significantly reduce your risk. Along with regular exercise and not smoking, a healthy diet is a major factor in helping to keep heart disease at bay. In the past, we’ve discussed various different diets and their effects on heart health, among other things, however, the American Heart Association (AHA) has taken it a bit further and named the best diet to ward off heart health.

Leading experts in nutrition ranked 10 popular diets on their ability to meet the AHA’s evidence-based dietary guidance for heart health. The winner? The DASH diet, which was 100% aligned with AHA goals for heart-healthy eating. DASH stands for Dietary Approaches to Stop Hypertension. We’ve talked about the DASH diet before because it is the diet that patients learn about and must adhere to when going through Cardiac Rehab after a heart procedure, being diagnosed with heart disease or having a traumatic heart event.

The DASH diet follows heart-healthy guidelines to limit saturated fat and trans fat, and includes eating fruits, vegetables, and low-fat or nonfat dairy foods. It also includes eating whole grains, fish, and poultry.

The runner-up diet was the pescatarian diet, which primarily focuses on fish and seafood but allows dairy and eggs and no meat or poultry. It aligned with the AHA goals for heart-healthy eating by 92%.

Third place, which may come as a bit of a shocker to some, was the Mediterranean diet, which has been long hailed as the heart-healthy diet and a key to longevity. The popular diet came in third mostly because it recommends a small glass of red wine each day and doesn’t limit salt, two factors that the AHA feel contributes negatively to heart health, earning it an 89% when it comes to aligning with the AHA’s goals.

The Common Denominator

While these three diets are different from one another, the AHA notes that they all share common traits that make them heart-healthy. In this case, the top tier of diets was, for the most part, plant-based.

The importance of eating more vegetables, fruits, and whole grains along with low-fat dairy, poultry, fish, beans, and nuts has been proven in multiple research trials.

“We basically were trying to say a diet doesn’t have to be 100 to be good,” says lead author Christopher Gardner, a research professor of medicine at the Stanford Prevention Research Center in California who directs its Nutrition Studies Research Group. “All of the diets in the top tier are plant-based, and if they are off-base a bit, they aren’t hard to adjust.”

This flexibility can help you pick and choose components of these diets that you really gravitate toward or that are easy for you to do, without feeling boxed in or restrained to one specific diet modality, which can make sticking to a healthy eating pattern a lot more successful.

“It’s hard to adhere to a diet in a society which allows ultra-processed comfort foods to be the norm, and asking society to change a major tenant of everyday living is going to be very challenging,” Gardner explains. “But I would also tell you the plant-based food movement is the fastest-growing food movement in the country.”

Protecting Your Heart

The AHA estimates that 80% of heart disease is preventable if we do a better job managing our risk factors.

Nina Asrani, M.D., a cardiologist on the medical staff of Texas Health Fort Worth and at Texas Health Heart and Vascular Specialists, a Texas Health Physicians Group practice, points to these traditional risk factors in assessing cardiovascular disease:

• High Blood Pressure. “You don’t necessarily feel bad when your blood pressure is high, which leads to damage to the heart over time,” she says. “That’s why it’s important to have it checked regularly.”
• Diabetes. Adults with diabetes are twice as likely to have a heart attack as people without diabetes. It also could happen at a younger age. “Knowing your fasting blood sugar can reveal diabetes, which is a big marker for heart disease,” according to Asrani.
• High Cholesterol. Blood tests can determine your good and bad cholesterol levels. Bad cholesterol (LDL) is especially important in assessing your risk for heart disease.
• Smoking. According to the Centers for Disease Control, smoking causes roughly one in every four deaths from heart disease.
• Overweight and Obesity. Too much fat, especially in the waist area, puts you at higher risk for health problems.
• Family History. Heart health can be hereditary, so Asrani recommends getting a screening test. “If you know you have inherited a higher risk of heart disease, that empowers you to take making lifestyle changes a little more seriously than if you thought you were at a lower risk.”

The good news is there is plenty you can do to protect your heart and minimize your risk of developing heart disease. The AHA’s Life’s Essential 8™ are key measures for improving and maintaining cardiovascular health. In addition to eating better, or more aligned with the AHA’s findings discussed earlier, these 8 measures also include:

1. Being more active. Aim for at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week.
2. Quitting tobacco. Get help to quit if you smoke or vape and avoid secondhand smoke.
3. Getting healthy sleep Aim for an average of 7-9 hours of sleep a day.
4. Managing your weight. Reach and maintain a healthy body weight, which can be determined by calculating your body mass index (BMI).
5. Controlling your cholesterol. Get your cholesterol checked and talk to your health care provider about your numbers and how they impact your overall risk.
6. Managing your blood sugar. Keep your fasting blood sugar less than 100 mg/dL or your A1C at less than 5.7%.
7. Managing your blood pressure. Keep your blood pressure below 120/80 mm Hg.

Trying the DASH Diet

If you’d like to try your hand at following the DASH diet, the National Heart, Lung, and Blood Institute has created a week-long eating plan to get you started. As we mentioned earlier, many of these diets crossover, and this particular DASH recipe also borrows some healthy ingredients from the Mediterranean diet.

Baked Red Snapper With Zesty Tomato Sauce
Makes 4 Servings
Prep time: 10 minutes
Cook time: 40 minutes
Serving size: 3 oz fillet, 1 cup sauce

Ingredients

For Fish:

• 12 oz fillets of red snapper or bass, cut into 4 portions (3 oz each)
• 1 tbsp olive oil
• ½ tsp salt
• ¼ tsp ground black pepper

For Tomato Sauce:

• 1 tbsp olive oil
• 1 red bell pepper, rinsed and cut into ¼-inch sticks
• 1 green bell pepper, rinsed and cut into ¼-inch sticks
• 1 cup canned no-salt-added diced tomatoes
• 2 cups canned no-salt-added tomato sauce
• 1 tbsp fresh oregano, rinsed and chopped (or 1 tsp dried)
• 1 tbsp fresh basil, rinsed and chopped (or 1 tsp dried)
• 1 tbsp fresh parsley, rinsed and chopped (or 1 tsp dried)

Directions

1. Preheat oven to 350°F. Pat fish fillets dry with paper towels. Coat each fillet with olive oil and season with salt and pepper.
2. Place fish fillets on a baking sheet, and bake for 25–30 minutes or until fish is white and flakes easily with a fork in the thickest part (to a minimum internal temperature of 145°F).
3. For sauce, heat olive oil in a medium-sized saucepan.
4. Add bell peppers, and cook gently until they are still firm, but tender, about 3–5 minutes.
5. Add tomatoes and tomato sauce, and bring to a boil over high heat. Reduce heat and simmer for 10–15 minutes or until the tomatoes are soft. Add oregano, basil, and parsley, and simmer for an additional 2–3 minutes. Remove sauce from the heat and set aside.
6. When the fish is done (see step 2), remove from the oven.
7. Serve each 3-ounce fillet with 1 cup of sauce.

Each serving provides 213 calories, 8g total fat, 1g saturated fat, 30mg cholesterol, 365mg sodium, 20g protein, 15g carbohydrates, 910mg potassium, 4g total fiber.

To learn more about the DASH eating plan, and for more recipes, visit The National Heart, Lung, and Blood Institute.