Fixing heart problems that are the result of unhealthy eating habits — like regular stops at fast food outlets or ice cream shops — is not easy, so the American Heart Association is taking a different tack. Rather than labeling specific foods or nutrients as “good” or “bad,” its new scientific statement identifies 10 principles of good nutrition and stresses the value of nutrition education and eating well throughout life in reducing the risk of heart disease.
The most recent scientific evidence on the benefits of heart-healthy eating during the entire lifecycle and the relationship between poor nutrition and the risk of cardiovascular disease was used in writing the new nutrition guidance from AHA.
The new guidelines encourage people to start eating better early. One of the keys to the prevention of heart disease is reducing childhood obesity. Heart-healthy eating, along with healthy lifestyle behaviors, should begin with a mother during pregnancy and continue throughout a person’s life. This should reduce the occurrence of risk factors associated with heart disease such as elevated LDL or “bad” cholesterol, obesity, high blood pressure, type 2 diabetes and metabolic syndrome.
For older adults, the benefits of a heart-healthy diet aren’t limited to heart health, but also include slower age-related declines in cognitive ability.
“The evidence indicates that people of all ages can benefit from sticking to the principles of a heart-healthy dietary pattern,” Alice H. Lichtenstein, one of the authors, said in a statement. “[I]t is important to educate children at all ages so as they transition into adulthood, they will be able to make informed decisions about what they eat and serve as positive role models for generations to come.”
The 10 features of a heart-healthy diet as outlined by the AHA Scientific Statement are:
1. Adjust calorie intake and physical activity to achieve or maintain a healthy body weight.
2. Choose a wide variety of fruits and vegetables, and eat plenty of them in order to get the full range of nutrients they provide.
4. Include healthy sources of protein such as soy, beans, peas, nuts, legumes, fish or seafood, low or non-fat dairy foods and lean cuts of meat. Limit red meat and meats that have been smoked, cured or salted.
5. Use liquid non-tropical plant oils such as olive or sunflower oils instead of tropical oils like coconut, palm, palm kernel oil and animal fats like butter and lard.
6. As often as possible, avoid ultra-processed foods. Choose foods that are minimally processed.
7. Limit the use of foods and beverages that have added sugars.
9. Limit the consumption of alcohol, and if you don’t drink, don’t start.
10. Use these guidelines regardless of where you shop, prepare or consume food.
The guidelines address the issue of sustainability for the first time. Plant-based diets like DASH and the Mediterranean diet not only have many health benefits, but they also reduce land use, water use and greenhouse gas emissions, moderating the environmental impact of animal foods that are a large part of the typical American diet.
Of course, not all plant-based diets are healthy. Excessive consumption of refined carbohydrates and added sugars increases the risk of type 2 diabetes and heart disease.
The targeted marketing of unhealthy foods and drinks are among the societal challenges that need to be addressed to support heart-healthy eating.
The new AHA dietary guidance also addresses challenges to adopting or maintaining a heart-healthy diet. A lack of nutrition education in K-12 schools, as well as medical schools, is a barrier to heart-heathy eating. And so is dietary misinformation likely picked up from the Internet.
The guidelines also take aim at some of the systemic factors contributing to poor diets. Food insecurity; neighborhoods without grocery stores and easy access to fresh fruits and vegetables, but having an abundance of convenience stores and fast-food restaurants; and the targeted marketing of unhealthy foods and drinks are all societal challenges that need to be addressed to support heart-healthy eating.
It will take action by public health officials and policy changes to tackle these challenges and barriers, according to the statement.
The new AHA guidance reinforces a previous statement for health care professionals that encouraged routine nutrition assessments for patients, documentation in the medical record and follow-ups at future appointments.
The full scientific statement is published in Circulation.