Dietary quality, defined by the consumption of whole, minimally processed plant-based foods, is a more powerful determinant of coronary heart disease prevention than macronutrient ratios such as fat or carbohydrate percentage.

Study: Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults.

This study found that eating more whole plants like vegetables, fruits, nuts, and whole grains lowers heart disease risk a lot — even more than just worrying about how much fat or carbs you eat.

Study: Effect of Low-Carbohydrate and Low-Fat Diets on Metabolomic Indices and Coronary Heart Disease in U.S. Individuals.

Whether you eat low-carb or low-fat, what matters most for your heart is whether your food comes from plants (like veggies, beans, whole grains) or processed/animal products — plant-based foods lower heart disease risk no matter the carb or fat percentage.

Study: Association between healthy plant-based diet-lifestyle (hPDI-Lifestyle) score and incidence of coronary heart disease, and effect modification by genetic predisposition: a prospective analysis in a population-based cohort

This study found that people who ate mostly whole plants like vegetables, fruits, and whole grains — and lived healthily — had much lower heart disease risk, even if they were genetically prone to it. This supports the idea that what you eat (whole plants) matters more than just how much fat or carbs you consume.

Study: Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review

This study says what you eat — like veggies, nuts, and whole grains instead of processed junk — matters more for heart health than whether your diet is high in fat or carbs.