The 4 best diets for heart health, and 1 to avoid

Heart disease is the leading cause of death for men and women in the U.S., according to the Centers for Disease Control and Prevention, killing someone every 33 seconds. While some characteristics, like family history or sex, can raise your risk for heart disease, many factors can be controlled through lifestyle changes. Healthy eating is one of the best forms of preventative medicine, especially for life-threatening illnesses such as heart disease.

The American Heart Association’s (AHA) 2021 scientific statement outlined key components of a heart-healthy dietary pattern:

• Adjust your calories eaten and calories burned to maintain a healthy weight.

• Wide variety of fruits and vegetables

• Whole grains over refined

• Lean proteins, such as legumes, nuts, fish, and seafood

• Minimally processed foods over ultra-processed

• Minimal added sugars

• No alcohol

In April 2023, the AHA published their ranking of popular diets based on the association's dietary guidance for heart health. And more recently, US News & World Report ranked the best heart-healthy diets for 2025. The eating patterns below were ranked best diets for heart health by both the AHA and U.S. News & World Report.

1. Mediterranean

The Mediterranean diet focuses on overall eating patterns rather than specific foods, according to the Cleveland Clinic.  It incorporates:

• Plenty of vegetables, fruits, legumes (beans and lentils), and nuts.

• Whole grains like brown rice, bulgur, and whole-grain bread.

• Extra virgin olive oil as a main source of healthy fat.

• Fish rich in omega-3 fatty acids.

• Moderate amount of natural cheese and yogurt.

• Little or no red meat, sweets, sugary drinks, or butter.

The diet, which US News & World Report ranked as the overall best for 2025,has been linked with lower rates of heart disease, stroke, and cardiovascular disease, according to the AHA.

2. DASH

The DASH, or Dietary Approaches to Stop Hypertension, eating plan is similar to the Mediterranean diet, and focuses on incorporating or limiting the following foods, according to the National Heart, Lung, and Blood Institute:

• Vegetables, fruits, and whole grains.

• Fat-free or low-fat dairy products.

• Fish, poultry, beans, nuts, and vegetable oils.

• Limit foods high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.

• Limit sugar-sweetened beverages and sweets.

US News & World Report named the DASH diet the best diet for heart health and its second-best overall diet of 2025. It has long been supported by the National Institutes of Health for heart health. One study from the journal Nutrients found the DASH diet helped lower incidence of cardiovascular disease, coronary heart disease, stroke, diabetes, blood pressure, blood sugar, and helped reduce body weight.

3. Pescatarian

Pescatarian diets are good options for people looking to shift more plant-based, but aren’t quite ready to go full vegan or vegetarian. It’s fairly straight-forward, according to Harvard Health: You generally consume a vegetarian diet—eggs and dairy included—with the addition of fish and seafood, and no meat or poultry.

The lack of red and processed meat is one of the main benefits of this diet.

Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, praises the pescatarian diet for emphasizing seafood proteins, which are excellent sources of vitamin D, vitamin B12, iron, selenium, and zinc—and can be harder to get on a vegetarian or vegan diet. You can also get the perks of omega-3 fatty acids, which are known to support brain and heart health, and are found in fatty fish like salmon, mackerel, herring, and sardines.

4. Vegetarian

A vegetarian diet, also called lacto-ovo or ovo-lacto vegetarianism, typically excludes meat, poultry, and fish, but still incorporates eggs and dairy. Ensuring this way of eating is as heart-healthy as possible means focusing on the core qualities that make all four diets healthy: limiting saturated fats, and added sugars, while eating a variety of plants, plant-proteins, and healthy unsaturated fats.

The AHA points out that both the pescatarian and vegetarian diets are not healthy if they are made up of primarily fried fish or ultra-processed plant-sourced foods, such as refined grains, sweets, tropical oils.

You might want to avoid these diets

AHA researchers found diets that severely restrict fats or carbohydrates, such as keto and paleo, end up limiting heart-healthy foods such as nuts, plant oils, whole grains, legumes, and fruits, which is why they aren’t recommended.

Meanwhile, meats and animal-sourced foods tend to be overemphasized in these diets, causing limited fiber intake and increased saturated fat intake. The AHA is concerned that these diets could lead to nutrient deficiencies and high cholesterol as a result.

This story was originally featured on Fortune.com