What constitutes the most optimal dietary regimen for overall health?

From the Guidelines

The most optimal dietary regimen for overall health is a balanced, whole-food diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats, as emphasized by the American Heart Association in 2023 1. This dietary pattern supports optimal health because it provides essential nutrients, fiber, and antioxidants while minimizing inflammation-promoting compounds. Key components of this diet include:

• Adjusting energy intake and expenditure to achieve and maintain a healthy body weight
• Eating plenty of fruits and vegetables, choosing a wide variety
• Choosing foods made mostly with whole grains rather than refined grains
• Selecting healthy sources of protein, such as mostly protein from plants, fish and seafood, and low-fat or fat-free dairy products
• Using liquid plant oils rather than tropical oils, animal fats, and partially hydrogenated fats
• Choosing minimally processed foods instead of ultraprocessed foods and minimizing intake of beverages and foods with added sugars
• Preparing foods with little or no salt and limiting alcohol intake if alcohol is consumed.

The importance of a healthy dietary pattern as a whole, rather than focusing on individual nutrients or food groups, is also highlighted in the 2022 standards of medical care in diabetes 1. This approach emphasizes the need to consider personal preferences, metabolic goals, and individualized needs when determining the best eating pattern for each person. Examples of healthful eating patterns that have shown positive results in research include the Mediterranean-style, low-carbohydrate, and vegetarian or plant-based eating patterns, but individualized meal planning should focus on personal preferences, needs, and goals 1. Ultimately, consulting with a healthcare provider or registered dietitian can help personalize the approach to nutrition and ensure that individual needs are met.

From the Research

Key Components of an Optimal Dietary Regimen

• A healthy diet is continually shifting to reflect the evolving understanding of the roles that different foods, essential nutrients, and other food components play in health and disease 2
• Greater consumption of health-promoting foods, such as plant-based foods, including fresh fruits and vegetables, whole grains, legumes, seeds, and nuts, and limited intake of unhealthier options, such as animal-based foods, particularly fatty and processed meats 2
• Dietary patterns that have been shown to prevent disease and/or positively influence health, such as the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet 2

Importance of Fat Intake and Diet Variety

• Optimization of diet and nutrition combined with a healthy lifestyle can decrease the risk and even lead to amelioration of various noncommunicable diseases 3
• Promising food-based dietary guidelines recommend a lower intake of fat, particularly saturated fatty acids, and a higher intake of polyunsaturated fatty acids, with a lower n-6:n-3 ratio 3
• A higher variety of food items in the daily diet, with reduced fat and saturated fatty acid intake, allows for a sufficient nutrient intake and is an important approach for health promotion 3

Dietary Guidance for Cardiovascular Health

• Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality 4
• Evidence-based dietary pattern guidance to promote cardiometabolic health includes adjusting energy intake and expenditure, eating plenty of fruits and vegetables, choosing whole grain foods and products, and using liquid plant oils rather than tropical oils and partially hydrogenated fats 4
• Minimizing the intake of beverages and foods with added sugars, choosing and preparing foods with little or no salt, and limiting alcohol intake are also important for cardiovascular health 4

Role of Omega-3 Fatty Acids and Whole Food Plant-Based Diets

• Omega-3 fatty acids have been shown to significantly reduce the risk for sudden death caused by cardiac arrhythmias and all-cause mortality in patients with known coronary heart disease 5
• A whole food plant-based diet is effective for weight loss and has been found to help treat, arrest, and reverse other leading chronic diseases such as type 2 diabetes and hypertension 6
• A diet centered on whole plant foods appears to be a safe, simple, sustainable solution to the obesity epidemic 6