Heart-healthy dietary guidelines updated for first time in more than a decade

For the first time in 15 years, the American Heart Association on Tuesday updated its guidelines for adopting a heart-healthy diet.

Alice H. Lichtenstein, chair of the association’s writing group that released a statement, told Everyday Health that finding a dietary pattern that is consistent with what you enjoy is key.

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“What we’ve learned is that when people try to make drastic changes in their diet because they suddenly decide they want to get healthier, they frequently don’t stick with those changes for a long period of time,” said Lichtenstein, a senior scientist and director of the cardiovascular nutrition team at the USDA Human Nutrition Research Center on Aging at Tufts University.

“If you make changes within your current dietary pattern that consider factors such as affordability, availability, convenience, and what you like to eat, it’s more likely to become more of a way of life,” she added.

According to the U.S. Centers for Disease Control and Prevention, heart disease is the leading cause of death for both men and women nationwide, resulting in an estimated 659,000 deaths annually.

Meanwhile, a study published in the peer-reviewed European Heart Journal in October 2020 indicated that more than two-thirds of global heart disease-related deaths can be linked to food choices and estimated that six million deaths could have been averted with healthier diets, Everyday Health reported.

According to Today, the updated heart-health guidelines, published in the journal Circulation, focus on the “the balance, variety and combination of foods” consumed, rather than individual foods or nutrients.

“You can absolutely adapt a heart-healthy diet to different lifestyles, including one that incorporates eating out at restaurants. It might take a little planning, however, after the first few times, it can become routine,” Lichtenstein told Today.

Specifically, the AHA issued the following recommendations:

  • Maintain a healthy weight throughout life by balancing calorie intake with physical activity. The authors advised adopting healthy portion-control habits, couples with at least 150 minutes of moderate physical activity each week. People should also eat less as they age because daily energy needs decrease by as many as 100 calories with each decade.
  • Eat lots of fruits and vegetables. With the exception of white potatoes, diets rich in fruits and vegetables are associated with a reduced risk of heart disease, the authors stated. Specifically, they recommend consuming deeply-colored produce, such as leafy greens and succulent fruits, because they are more nutrient rich. They also noted that whole fruits and veggies are superior to juicing because “whole” foods provide more dietary fiber, which contributes to feeling fuller, longer.
  • Choose whole grains when possible. Products made with at least 51% whole grains are typically classified as whole-grain, and increased consumption reduces cardiovascular risk factors, the authors stated.
  • Not all proteins are created equal.
    • The study’s authors classified the healthiest sources of protein as plant-based, such as legumes and nuts, which also happen to be another source of fiber. Legumes include soybeans (which can be in the form of edamame and tofu), lentils, chickpeas and split peas, Today reported.
    • Meanwhile, at least two servings of fish and seafood per week are recommended, as long as the choices are not fried, because of their high omega-3 fatty acid content.
    • Where possible, replace full-fat dairy with low-fat or non-fat options to reduce consumption of saturated fat.
    • Stick with lean cuts of meat and poultry, and try to limit consumption of red and processed meats such as bacon, sausage, hot dogs and salami because those options are high in salt, saturated fat and cholesterol.
  • Cook with liquid, non-tropical plant oils such as olive, canola, sunflower, soybean, corn, safflower and sunflower oils, plus fat found in walnuts and flax seeds. Meanwhile, coconut oil, butter, lard and partially hydrogenated fats should be avoided.
  • Limit consumption of processed foods, or at least work to minimize the degree to which those options are processed. For instance, avoid items that contain added salt, sugar, fats, artificial colors, flavors or preservatives. A fresh apple, a home-cooked fish filet, bagged spinach and raw, unsalted nuts are examples of unprocessed or minimally-processed foods, while store-bought cakes, cookies and frozen pizzas epitomize highly-processed foods, Today reported.
  • Minimize sugary drinks and foods because added sugars not only add extra pounds, they have been linked with a higher risk of developing Type 2 diabetes and coronary heart disease.
  • Choose or prepare foods with little or no salt because, as the guidelines authors noted, there is a “direct, positive relationship” between salt intake and blood pressure, meaning that consuming less salt lowers blood pressure.

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  • Limit alcohol consumption. Although low alcohol intake has been associated with a lower risk of coronary heart disease and ischemic stroke, the AHA does not support starting drinking at any level, “given the uncertainty about net health effects,” the authors stated. Generally speaking, though, if you don’t currently drink, don’t start. If you do drink regularly, limit your intake to one drink per day.
  • Stick with this guidance wherever you are. Choose wisely.