Pick a diet — any diet

CHICAGO — Deciding what to have for a healthful breakfast just got a little easier.

While a healthy high-carb diet has been shown to be good for you, replacing a few of the carbohydrates with a little protein like scrambled-egg substitute or beneficial fats like olive oil margarine could be even better, helping further reduce heart-disease risks, a study found.

At dinner, this might mean trying black-bean tacos and multigrain pilaf with olive oil instead of pasta, the researchers said.

They had volunteers try three variations of the same diet, all of them low in saturated fats and including plenty of fruits and vegetables.

All three improved blood pressure and cholesterol readings after just six weeks, and adopting any of them would be beneficial, said lead researcher Dr. Lawrence Appel of Johns Hopkins School of Medicine.

"Most people aren't following anything close to any of these," he said, adding that the bottom line is: "You can eat healthy in three different ways, and two of them are a bit better than the other."

Appel presented the results last month at an American Heart Association conference. The study also appeared in the Journal of the American Medical Association (JAMA).

All participants tried each of the diets, taking a few weeks' break before starting the next diet.

The volunteers' average blood pressure started out borderline high — 131 over 77. Systolic pressure — the top number in blood-pressure readings — fell by an average of about 8 points while they were on the carb diet, 9.5 points on the protein diet and 9.3 points on the healthful-fats diet.

Levels of LDL cholesterol, the bad kind, measured 129 on average at the start; 100 is considered optimal. LDL levels fell an average of almost 12 points on the carb diet, about 14 points on the protein diet and about 13 points on the healthy fats diet.

Those reductions likely would translate into less heart disease if the diets were widely adopted, the researchers said.

They estimated that for every 100 people with mild high blood pressure, there would be one less heart attack over 10 years for those on the protein or healthful-fats diet, compared with the more carb-friendly diet.

Appel said the high-protein diet also seemed to produce feelings of fullness and reduced appetite.

"These symptoms raise the intriguing possibility that if individuals were to follow these diets long-term, there may be some weight loss on the protein diet," he told conference participants.

Dr. Timothy Gardner, a Delaware cardiologist, said at the meeting that the study was "a tricky, difficult type of study to conduct, controlling all the factors, with very interesting results."

A JAMA editorial about Appel's research, which was funded by the National Institutes of Health, questioned whether people in the real world would stick to the diets since they'd have to buy and prepare their own meals.

"Longer trials examining actual cardiovascular-event outcomes will be needed to convince a skeptical public of the benefit of yet another unique and difficult-to-achieve dietary regimen," said editorial author Dr. Myron Weinberger of Indiana University.

Rachel Johnson, a University of Vermont nutrition professor, said the results refine "what we already know. It's not a huge about-face."