'It does not need to be complicated': 10 steps to heart-healthy eating

Adhering to 10 key features of a heart-healthy eating pattern can lead to a reduction in the risk of heart disease and stroke, according to a new analysis from the American Heart Association (AHA) published in Circulation.

Those 10 features are:

  1. Balance food and calorie intake with physical activity to maintain a healthy weight.
  2. Choose a wide variety and eat plenty of fruits and vegetables to get a full range of nutrients from food rather than supplements.
  3. Choose whole grains and other foods made up mostly of whole grains.
  4. Include healthy sources of lean and/or high-fiber protein such as plant proteins (nuts and legumes), fish or seafood, low fat or non-fat dairy, lean cuts of meat and limit red and processed meats.
  5. Use liquid non-tropical plant oils such as olive or sunflower oils.
  6. Choose minimally processed foods rather than ultra-processed foods as much as possible.
  7. Minimize intake of beverages and foods with added sugars.
  8. Choose or prepare foods with little or no salt.
  9. Limit alcohol consumption: if you don’t drink, do not start; and
  10. Apply this guidance no matter where food is prepared or consumed.

“We can all benefit from a heart-healthy dietary pattern regardless of stage of life, and it is possible to design one that is consistent with personal preferences, lifestyles and cultural customs,” Alice H. Lichtenstein, DSc, senior scientist and director of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, said in a prepared statement. “It does not need to be complicated, time consuming, expensive or unappealing.”

AHA's scientific statement, “2021 Dietary Guidance to Improve Cardiovascular Health,” draws from data that support the benefits of a life of heart-healthy meals and show that a bad diet is associated with an elevated risk of both cardiovascular disease and death.

The statement's authors stressed the importance of a person's overall dietary pattern instead of focusing on individual foods. It also emphasized the important role of nutrition in all stages of life and points out that these features can be adapted to accommodate individual food likes and dislikes, cultural traditions and whether most meals are consumed at home or away.

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

The guidance, for the first time, includes the issue of sustainability, pointing out that red meats have “the largest environmental impact in terms of water and land usage, and contribute significantly to greenhouse gas emissions. Hence, shifting reliance from meat to plant proteins can help to improve individual health and the environment.

“It is a win-win for individuals and our environment," Lichtenstein added. 

However, according to the AHA, not all sustainable diets are necessarily healthy for the heart. For example, if a plant-based diet includes an abundance of refined carbohydrates and added sugars, the risk of type 2 diabetes and heart disease rises.

In addition to dietary considerations, AHA contends that societal challenges are also necessary to support heart-healthy eating.

Among the challenges: widespread dietary misinformation from the internet; a lack of nutrition education in grade schools and medical schools; food and nutrition insecurity; structural racism and neighborhood segregation; and the targeted marketing of unhealthy foods and beverages to people from diverse racial and ethnic backgrounds.

“Creating an environment that promotes and supports adherence to heart-healthy dietary patterns among all individuals is a public health imperative,” the statement's authors wrote. 

The full scientific statement can be read here

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