You Docs: The vegan weight-loss plan; heart disease in younger women | Columns

A: Everyone is different. For some folks, a low-fat diet is the most effective way to lose weight, for others it’s low-carb, and for some the Mediterranean diet is easier to stick with, and therefore a more effective way to shed pounds.

That being said, there is an interesting randomized, crossover study in the Journal of the American College of Nutrition that found a low-fat vegan diet leads to greater weight loss, healthier cholesterol levels and increased insulin sensitivity compared with the Mediterranean diet.

For 16 weeks, researchers from the Physicians Committee for Responsible Medicine had one-half of study participants go on a low-fat vegan diet focused on fruits, vegetables, whole grains and legumes. The other half went on the Med diet, focusing on fruits, vegetables, legumes, fish, low-fat dairy and extra-virgin olive oil — while limiting red meat and saturated fats. Both groups then went back to their ordinary way of eating for four weeks before switching to the opposite diet for another 16 weeks.

The results: Participants lost an average of 13 pounds on the vegan diet (improving insulin resistance) — but nothing on the Mediterranean one. Those eating a vegan diet also lost about 7.5 pounds more fat mass than Med diet folks. Lousy LDL cholesterol went down 15.3mg/dL for the vegans; no change on the Med diet. The only benefit from the Med diet was to systolic blood pressure — it declined by 9.3 mmHg; only 3.4 on the vegan diet.

Overall, the vegan diet came out ahead, according to the researchers, because of lower calorie intake, increased fiber intake and decreased fat and saturated fat consumption. So you can give vegan a try — just remember your goal is to adopt a healthy eating style you can stick with indefinitely, so you can sustain better health.

Q: My cousin Ellen, who’s only 48, had a heart attack. What makes a younger woman vulnerable? I’d like to dodge that bullet.

—Katie, Santa Rosa, Calif.

A: We used to think women weren’t at risk for heart disease until after menopause. But these days, risk factors such as chronic stress, a sedentary lifestyle, smoking, diabetes and obesity are affecting younger and younger women and can cancel out the “estrogen advantage.”

New research published in European Heart Journal — Quality of Care and Clinical Outcomes found that since 2010, the death rate from heart disease in U.S. women under age 65 has gone up. And the 2018 Atherosclerosis Risk in Communities study found that while the risk of heart attack is going down for older folks, those ages 35 to 54 are seeing an increase, especially women. High blood pressure and Type 2 diabetes are major contributing factors.

Fortunately, most risk factors can be reduced with upgrades to nutrition, physical activity, sleep habits and stress management. Medications also can help control high blood pressure, cholesterol levels and diabetes. That’s why everyone should have a baseline heart health checkup to assess their risk:

• Get your cholesterol level checked at age 20. If it’s normal, then check it every four to six years. If HDL is low or LDL is high, check it every six months to see if medication (statins) or lifestyle changes (better nutrition, more exercise) are helping. Over 20 and never been checked? Do it now.

• At any age, if you’re overweight or obese, get a fasting blood glucose test to check for pre- or full-blown diabetes. Even if you don’t have prediabetes or diabetes, consult a nutritionist so you can keep it away.

• If you’re plagued with chronic stress, get 150-300 minutes of exercise weekly and do 10 minutes of mindful meditation morning and night.

When it comes to avoiding heart disease, remember, you have the power to eliminate your risk for this this largely preventable disease!