By: Steven Nissen, MD
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I often am asked what people should eat to help maintain their heart health. One reason might be that the topic of diet has become very controversial in recent years.
For example, the U.S. Department of Agriculture told Americans for years in dietary guidelines to avoid eating more than three eggs a week. It turns out that only about 10 percent to 15 percent of the cholesterol in your bloodstream comes from cholesterol in the diet. Most of it is actually made by your own body.
So getting rid of eggs and foods that contain cholesterol doesn’t have a very big impact on your cholesterol levels. Eggs are fine. They’re actually a very healthy food.
Good fats, bad fats
Even more controversial is the question of the type of fats that you eat. Again, we were told for many years not to eat butter. Many physician scientists now are beginning to question whether strict avoidance of butter is necessary.
We do know that certain kinds of fats known as polyunsaturated fats and mono unsaturated fats seem to lower cholesterol a little bit. These are the kind of fats that are in olive oil and canola oil. They’re probably a bit healthier.
There is one type of fat you don’t want to eat. It’s called trans fats or hydrogenated vegetable oil. The data is really pretty solid that trans fats are to be avoided.
People need to read the labels on food. If it says hydrogenated vegetable oil, it’s a good idea to stay away. And if any of the margarine products that some people eat say hydrogenated vegetable oil, that’s also a good reason to stay away.
Those hydrogenated oils are commonly used in some fast foods, various kinds of chips and other snack foods. Being aware of that can help significantly.
One warning on fats to everybody: The idea that a low-fat diet is healthy has been disproven over and over again.
There also is controversy about salt. There certainly are salt-sensitive people, but a debate is going on now about whether everybody needs to reduce salt in their diet.
You certainly don’t want to overdose on salt. But if your blood pressure is normal and you’re otherwise healthy, some amount of salt in the diet should not be viewed as a sin.
The overall diet that’s best
And then finally what kind of a diet is the healthiest diet? We have very good evidence from a very large study performed in Spain that shows that the Mediterranean diet is the healthiest diet.
The Mediterranean diet is a diet that’s rich in olive oil and nuts. It has relatively small amounts of meat, an increased amount of fish, lots of fruits and vegetables.
You can get cookbooks on the Mediterranean diet and it has one huge advantage over the kinds of fad diets that are circulating around the country: It’s tasty. You don’t have to eat cardboard boxes for dinner to actually have a healthy diet.