Which diet is right for you?

Published: 15 July 2020

Trends on how to eat come and go, making diet advice confusing. In this article we explore different dietary trends and the benefits they could have for your heart health.

Why do we have different diets?

People choose to eat different types of food for lots of reasons. Eating for health is just one factor behind the food decisions we make every day. 

There are cultural and religious reasons for choosing one food over another. As well as ethical and environmental reasons. Some people eat a certain way due to food allergies, or medical and health conditions too. Then finally, we have our own preferences on what foods we like and dislike. 

Some people believe if their diet works for them, then everyone else should eat that way too. This is partly fuelled by the media leading you to believe there may be one way of eating that is better than another.

There is no one-size-fits-all approach when it comes to healthy eating. However, there are some basic guidelines that are recommended.

What different diets are popular today?

1. Plant-based eating

If you follow a plant-based diet the main part of your meals will come from plant foods, like vegetables and legumes.

It’s common to think that a plant-based diet is a vegan diet. However, the term ‘plant-based’ covers a range of eating patterns. Each type of plant-based diet depends on how many animal products, like meat, dairy and eggs, are included in the diet. 

Some common variations of plant-based eating include:

• flexitarian – sometimes known as ‘semi-vegetarian’, includes eggs and dairy and may include small amounts of meat, poultry, fish and seafood
• pescatarian – includes eggs, dairy, fish and seafood, and excludes meat and poultry
• vegetarian – also known as ‘lacto-ovo vegetarian’, includes eggs and dairy, and excludes meat, poultry, fish and seafood
• vegan – excludes all meat, poultry, fish, seafood, eggs and dairy. 

It’s common to think that any plant-based diet is immediately healthier. However, there are some highly processed foods that are vegetarian or vegan, but these foods aren’t considered part of a heart healthy eating pattern. Focus on choosing less processed foods like fruits, vegetables, and wholegrains, as the main part of your diet. 

If you'd like to include more plant-based foods in your diet, try these three simple steps. If you have questions about following a plant-based diet that will give you all the nutrients you need, speak with a Registered Dietitian. 

More on plant-based, vegetarian and vegan diets and meat-free products.

2. Mediterranean diet

The Mediterranean diet is a traditional diet from the Mediterranean basin from the 50’s and 60’s. The modern diet, eaten in this area, contains more red meat and processed food. This is common in all Western countries.

A traditional Mediterranean diet, the diet that has been extensively studied for the past 20 years, is well known for including lots of extra-virgin cold-pressed olive oil every day. It also includes: 

• lots of leafy green vegetables, fruits, cereals, nuts and legumes/pulses
• moderate amounts of fish and other meat, as well as dairy and red wine
• small amounts of food coming from eggs and sugary foods.

The Mediterranean diet is full of unprocessed plant-foods and heart-healthy fats from olive oil. It's low in the less healthy saturated fat because less meat is eaten. All of which fits well within the foundations of a heart-healthy diet. 

This diet has been shown to lower the risk of heart disease in the general population. It's also been found to lower the risk of heart disease, and improve risk factors such as blood pressure, cholesterol levels and blood glucose levels in people with a high risk of heart disease.

3. Low-carbohydrate diet (+ high/healthy fat)

Low-carbohydrate diets involve restricting how many carbohydrates you eat, usually in favour of eating more fat. 

Sometimes these diets are called low-carb/high-fat or more recently low-carb/healthy fat, both described as LCHF. Low-carbohydrate diets have been around for years in some shape or form. The Atkins diet was first talked about back in the 70’s.

There can be quite a large variation between what is/isn't included in a LCHF diet. Followers generally eat a diet that includes:

• non-starchy vegetables
• meat
• poultry
• fish
• eggs
• nuts
• seeds
• full-fat dairy
• natural fats (like avocado, butter and coconut oil/cream) 
• legumes may/may not be included in some versions of this diet and fruit is usually limited.

The diet doesn't include, or heavily restricts:

• processed foods
• sugar
• refined carbohydrates and starchy foods (like bread, pasta, rice and starchy vegetables, such as potato, taro and kumara). 

How is a ketogenic diet different?

A ketogenic diet, or ‘keto diet’, is a strict form of low carbohydrate diet that involves almost not eating any carbohydrate foods, with the goal to move the body into ketosis. Ketosis is where the body uses fat as its main energy source.

The keto diet is often high in meat (including processed meats like sausages and bacon), eggs, cheese, fish, nuts, butter, oils, seeds and vegetables.

There is evidence to show that a ketogenic diet may be an appropriate therapy for people who have uncontrolled type 2 diabetes, or children with epilepsy. However, following this style of diet should only be done with the support and monitoring from a health professional.

From a heart health perspective, people following a ketogenic diet are recommended to choose good quality foods and eat plenty of plant foods, like vegetables and fruit.

This means choosing good quality heart-healthy fats (foods high in healthier polyunsaturated and monounsaturated fats instead of less-healthy saturated and trans fats) and good quality proteins, like lean meat, chicken, fish and legumes, instead of processed meats.

Looking at low carbohydrate diets overall

There are parts of a lower carb diet that many people could benefit from. For example, eating less refined carbohydrate foods like muffins, biscuits and white pasta is good. And eating more non-starchy vegetables and some healthy fats is good for your heart. However, we don’t recommend cutting out whole food groups, unless there is a medical reason to do so.

Whole grains, starchy vegetables, fruit and legumes can all be included as part of a heart-healthy diet.

4. Intermittent fasting

Intermittent fasting is a type of eating that involves not eating any food during planned times.

There are different ways that you can try intermittent fasting and a common one is the 5:2 diet. This involves eating ‘normally’ for five days then eating less food on the other two days. As with all other diets that involve some food restriction, there can be some resulting weight loss.

It’s important to know what foods you should eat on the 5-days of ‘normal’ eating. The days with no restrictions are not a free pass to eat whatever you like. It's important to eat healthily during this time by having lots of plant-based foods and good quality protein sources.

Some people experience side-effects when they follow this diet. This varies between individuals but can include:

• extreme hunger
• dizziness
• low energy levels
• headaches
• loss of concentration
• mood swings. 

This way of eating is not recommended for those with insulin-dependent diabetes.

Getting the right information

Lots of nutritional information is available to anyone at the click of a button these days, but it's always important to check:

• the source of your information
• the author’s credentials 
• whether there are any vested interests behind a message stating there is ‘one’ way to eat. 

Restrictive diets, whether followed for a short or long time, can cause harm to our bodies. They can make us feel unhappy with our bodies, cause yo-yo dieting, yo-yo weight changes and disordered eating. 

Ultimately, a healthy way of eating includes a healthy relationship with food and your body. These factors are all tightly linked and can become a complex tangle if ignored.

What should we consider when talking about different eating patterns?

Media stories about which diet to follow and whether carbohydrate or fat is the devil will no doubt continue over the years. It can be difficult to separate fact from opinion with this noise, but we need to remember that we eat food, not singular nutrients. 

The most important thing to acknowledge when talking about different eating patterns is that we’re all different. No two individuals are the same and therefore no two individuals will respond in the same way to one way of eating. 

A heart-healthy diet is based largely on:

• whole and minimally processed foods 
• plenty of vegetables and fruit
• some whole grains, in place of refined grains
• legumes, nuts, seeds, and other sources of healthy fats such as oily fish
• it may also contain small amounts of non-processed lean meats or poultry and/or dairy.

The Heart Foundation’s heart healthy eating approach is well evidenced, and we acknowledge that there is no one-size-fits all approach. If we focus on getting the base of what food we eat right, then the nutrients will look after themselves.

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Nickie Hursthouse, NZRD

National Nutrition Advisor

As a Registered Dietitian, I know that food gives us so much more than just nutrients. I am driven to simplify nutrition messages, educate on all aspects of food and support Kiwis to develop a love of food that helps them stay healthy throughout their life.