Why Diet Quality Matters Most
Researchers looking at the diets of nearly 200,000 U.S. adults across three large, long-running studies have found that the foods within low-fat and low-carb diets matter more than the macronutrients these diets restrict. They have made these findings:
- Healthy low-carb and low-fat diets both reduce the risk of heart disease.
- Low-carb and low-fat diets may contain unhealthy foods — bacon in a low-carb diet, for example, or snacks with added sugars in a low-fat diet — that are not dense in nutrients and could increase the risk of heart disease. These include foods with added fats and salt.
- Although the diets look very different on paper, your body responds to good versions of them in similar, heart-friendly ways.
This may explain why the debate between the benefits of a low-fat diet versus a low-carb diet has not had a clear winner.
“In practice, I see that when individuals focus on whole, minimally processed foods, their cholesterol, blood sugar, and inflammatory levels often improve, regardless of whether they identify as following a low-carb or low-fat diet approach,” Derocha says.
The reason? High-quality ingredients.
“Low-carb and low-fat diets that are considered healthy have similar characteristics,” says Sean Heffron, MD, a preventive cardiologist and the director of cardiovascular fitness and nutrition at the Center for the Prevention of Cardiovascular Disease at NYU Langone Health in New York City.
Both diets, Dr. Heffron says, are rich in potentially beneficial antioxidants and nutrients from these sources:
- Fruits and vegetables
- Whole grains
- Seafood
- Nuts
- Seeds
These higher-quality foods support heart health by improving key biomarkers such as lowering triglycerides, raising HDL (“good”) cholesterol, and reducing inflammation, says Zhiyuan Wu, PhD, a study co-author and postdoctoral research fellow at the Harvard T.H. Chan School of Public Health in Boston. This is largely because of the healthy fats, antioxidants, and anti-inflammatory compounds found in whole, plant-based foods, he says.
“Regardless of whether someone follows a low-carb or low-fat diet, choosing higher-quality foods helps the body regulate fat and inflammation more effectively, which likely explains the healthier biomarker profile we observed,” Dr. Wu says.
Conversely, you can easily find low-quality ingredients to eat within the framework of each diet. The secret, researchers say, is finding the balance between the positives of each approach.
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