The American Heart Association has published a “2021 Dietary Guidance to Improve Cardiovascular Health” this week in their journal Circulation.  This guidance focuses on the role that nutrition plays in all stages of life on cardiovascular health and the importance of maintaining a healthy eating pattern that takes into account the balance, variety, amounts and combinations of foods that you eat on a regular basis.  They point out that it’s not about focusing on individual foods or fad diets, but instead adopting a lifestyle that is sustainable in the long term.

Their evidence-based guidance outlines 10 features of a heart-healthy dietary pattern:

  1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight.  This means that you have to take into account your age, activity level, sex, and size and make sure that the amount of food that you take in is balanced out by the amount of exercise you do to make sure you don’t become obese.  They recommend at least 150 minutes of moderate physical activity per week to help you achieve that balance.
  2. Eat plenty of fruits and vegetables, choose a wide variety.  Deeply colored fruits and vegetables like leafy greens and berries tend to be more nutrient dense than the lighter colored ones.  Whole fruits and vegetables provide more dietary fiber and keep you fuller longer, so whenever possible eat the whole fruit or veggie instead of drinking its juice.  By eating a wide variety of fruits and vegetables, you’re more likely to get all the essential nutrients and phytochemicals that you need, and don’t be afraid to buy frozen which will last longer and offer similar nutrient content, perhaps even at a lower price.
  3. Choose foods made mostly with whole grains rather than refined grains.  Eating whole grains is associated with lower risk of heart disease, as well as benefiting gut health and helping to keep you regular.
  4. Choose healthy sources of protein.  This should include mostly protein from plants (legumes and nuts), fish and seafood, low-fat or fat-free dairy, and lean cuts if you choose meat or poultry, avoiding red and processed meats.
  5. Use liquid plant oils rather than tropical oils (coconut, palm, palm kernel), animal fats (butter and lard), and partially hydrogenated fats.
  6. Choose minimally processed foods instead of ultra-processed foods.
  7. Minimize intake of beverages and foods with added sugars.
  8. Choose and prepare foods with little or no salt.
  9. If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake.
  10. Adhere to this guidance regardless of where food is prepared or consumed.  This means that even if you’re eating out you can make choices like brown rice instead of white, or purchasing whole grain pasta instead of white.

They also point out that the dietary fiber in plant foods, including fruits, vegetables, whole grains, nuts, seeds, beans, and legumes, is associated with better heart health; a high-quality diet is associated with a lower risk of all-cause mortality, heart disease and related mortality, cancer and related mortality, diabetes, and neurogenerative diseases; healthy dietary patterns like the Mediterranean-style diet are linked to better cognitive abilities and slower decline with age.  The added bonus comes with the fact that mostly plant-based diets also benefit our environment because animal-based food production and consumption contribute substantially to greenhouse gas emissions, and water and land usage, resulting in a lower carbon footprint.

We also need to overcome societal challenges to adhering to heart-healthy dietary patterns.  These include targeted marketing of unhealthy foods and beverages, structural racism, neighborhood segregation, and food and nutrition insecurity.  From the time of fetal development and early childhood through all life stages, it’s important to educate and establish lifelong healthy eating patterns in all segments of the population.

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