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Benefits of a healthy diet — with or without weight loss

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Improving Cardiovascular Health through Diet: Evidence-Based Strategies

Obesity is a growing health concern in the United States, with almost 70% of Americans being overweight or obese. Losing weight can be challenging, and many people are tempted to follow trendy diets that may not be the most nutritious. However, there is evidence that improving the quality of one's diet can positively impact cardiovascular risk factors, such as high blood pressure, LDL cholesterol, and triglycerides, regardless of weight loss.

Randomized clinical trials are the gold standard in nutrition research

Three such trials have shown that improving diet quality can improve cardiovascular health.

The first trial examined the effect of the DASH (Dietary Approaches to Stop Hypertension) diet on blood pressure in overweight and obese adults with borderline high blood pressure. The DASH diet is low in saturated fat and dietary cholesterol and rich in potassium, magnesium, calcium, and fiber. It emphasizes fruits, vegetables, whole grains, low-fat dairy products, fish, poultry, nuts, and seeds while limiting red meat, sweets, and sugary beverages. The study provided participants with food according to DASH diet guidelines while regulating calories to prevent weight gain or loss. The study found that following a DASH diet resulted in a significant reduction in blood pressure.

The second trial examined the effect of adding sodium limits to the DASH diet in healthy adults

Participants assigned to the lowest sodium limit (1,500 milligrams per day) experienced a drop in blood pressure similar to what a blood pressure medication would achieve.

The third trial, called OMNI Heart (Optimal Macronutrient Intake to Prevent Heart Disease), examined whether substituting some of the carbohydrates in the DASH diet with healthy protein (from fish, nuts, beans, and legumes) or unsaturated fats (from olive oil, nuts, avocado, and nut butters) could further improve cardiovascular risk factors. The study involved overweight and obese adults with prehypertension or Stage 1 hypertension and regulated calories to prevent weight gain or loss. The study found that substituting healthy protein or healthy fats for some of the carbohydrates lowered LDL cholesterol, blood pressure, and triglycerides even further than the DASH diet alone.

Practical Strategies

For overweight or obese individuals with borderline high blood pressure, following a DASH diet with a focus on daily consumption of vegetables, fruits, whole grains, low-fat dairy, nuts, and lean sources of protein could result in a reduction in blood pressure. Limiting high sources of sodium, including canned, convenience, and processed foods, and high-sodium condiments such as salad dressing, pickles, and soy sauce, can produce even greater reductions in blood pressure. Substituting some healthy fats or healthy protein for some of the carbohydrates in the diet may further improve cardiac risk factors by lowering triglycerides and LDL cholesterol.

In conclusion, for those who are overweight or obese, losing weight is not the only way to improve health. Choosing healthy foods every day can make a positive difference in cardiovascular health.

Caroline Buckee

Caroline Flannigan is an epidemiologist. She is an Associate Professor of Epidemiology and is the Associate Director of the Center for Communicable Disease Dynamics.

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