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Clean Eating: Highly Rated Diets to Support Heart Health

Eating healthy is an important goal for people looking to maintain or improve their physical health, particularly as it relates to the heart. With often conflicting information available online and via social media, it may be difficult or downright confusing to find the eating plan for you.

To help navigate the maze of information – and misinformation – experts assessed and scored the heart healthiness of several popular diets. Each diet was evaluated for a heart-healthy eating pattern, which emphasizes eating a variety of vegetables and fruits, whole grains, lean proteins (including fish, low- or non-fat dairy and plant proteins), non-tropical plant oils and minimally processed foods; avoiding added sugars, salt and alcohol; and sticking to this guidance even when you’re eating away from home.

Tier 1: Highest-Rated Eating Plans (scores higher than 85)

The four patterns with the highest ratings align best with heart-healthy guidance, are flexible, and provide an array of healthy foods to choose from.

  • DASH – With a perfect score by meeting all guidance, an eating pattern similar to the Dietary Approaches to Stop Hypertension plan emphasizes vegetables, fruits, whole grains, legumes, nuts, seeds, low-fat dairy, lean meats, poultry, fish and non-tropical oils. Nordic and Baltic diets are also examples of this eating pattern, which is low in salt, added sugar, alcohol, tropical oils, and processed foods.

  • Mediterranean – This pattern limits dairy while emphasizing fruit, vegetables, whole grains, legumes, nuts, seeds, fatty fish and extra-virgin olive oil. Because it includes moderate alcohol drinking, rather than avoiding or limiting consumption, it scored a few points lower than DASH.

  • Vegetarian/Pescatarian – A plant-based eating pattern that includes fish.

  • Vegetarian/Ovo/Lacto – Plant-based eating patterns that include eggs (ovo-vegetarian), dairy (lacto-vegetarian), or both (ovo-lacto vegetarian).

Tier 2: Vegan and Low-Fat Diets (scores 75-85)

These eating patterns mostly align with heart-healthy criteria and emphasize important food groups but fell short of reaching the top tier due to limitations.

  • Vegan – A plant-based eating pattern that includes no animal products. Restrictions in this plan may make it more difficult to follow long term or when dining out. Following a vegan eating pattern increases the risk of some nutrient deficiencies, which may be overcome by supplements or fortified foods.

  • Low Fat – A diet that limits fat intake to less than 30% of total calories, including the volumetrics eating plan and therapeutic lifestyle change plan. These types of plans often treat all fats equally while the American Heart Association’s guidance suggests replacing saturated fats with healthier fats such as monounsaturated and polyunsaturated fats. Those who follow low-fat diets may overconsume less healthy sources of carbohydrates, such as added sugars and refined grains. However, these factors may be overcome with proper counseling and education from a health professional.

To find the full results and learn more about heart-healthy eating, visit


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Image by Jessica Felicio


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