What kind of diet should I be on?

Deciding on a diet program can be a daunting task given the amount of conflicting advices given in the market. Several comments can be made from a cardiovascular standpoint.

1. High blood pressure is a major risk factor in stroke, coronary artery disease, heart failure, and kidney failure. One component of controlling blood pressure is reducing the amount of salt intake. Limiting salt intake is difficult because salt is available in every facet of our daily lives from restaurant foods to processed foods such as breads, grains, cereals, soups, sauces, cured meats, etc. The general population currently has an average sodium intake of about 3.7 gram/day. The current guideline for dietary sodium intake in all Americans is less than 1.5 gram/day, with an upper tolerable limit of 2.3 gram/day.

2. There are two diet programs that have been shown in the literature to be beneficial to your heart. One is the DASH (Dietary Approaches to Stop Hypertension) diet, and the second is the Mediterranean diet. 

DASH diet- was studied in several large trials and was shown to be effective in lowering blood pressure.  It emphasizes on fruits, vegetables, and low-fat dairy products; includes whole grains, poultry, fish and nuts; and reduces fats, red meat, sweets, and sugar-containing beverages.

Mediterranean diet-has also been shown to have multiple benefits to your health. Similar the DASH diet, it features more plant-based food (fruits, vegetables and nuts), whole grains and fish, less red and processed meats.

Special considerations:

In patients with chronic kidney disease, potassium intake should be limited, and DASH diet might not work because it is high in potassium.

In patients with congestive heart failure, it is important to avoid excessive fluid intake. Depending on the volume status and the level of congestion, it might be necessary to fluid restrict to 1.5 to 2 L/day.

Further readings