The American Heart Association (AHA) released its latest dietary guidelines for improving cardiovascular health in 2021. This update marks the first revision in 15 years of one of the most influential medical guidelines in the United States.
Given the current dietary habits of people, such as the increased consumption of fast foods, takeouts, processed foods, and meal kits—exacerbated by the COVID-19 pandemic—the AHA sought to adjust its recommendations accordingly.
The new guidelines also take into account various dietary restrictions and prohibitions, as well as cultural, ethnic, and religious backgrounds, making them more practical for everyone.
The AHA advises cultivating healthy habits rather than making sudden, drastic changes based on dietary fads. “Heart-healthy diets also help protect the environment,” the AHA stated, noting that this is the first time sustainability has been included in their dietary guidelines.
Here are the AHA’s top ten dietary recommendations for heart health:
1. Maintain a Healthy Weight
According to the AHA, maintaining a healthy weight throughout life is a key factor in reducing the risk of cardiovascular diseases. Modern lifestyles often involve eating more and moving less.
The AHA report states that energy requirements vary greatly depending on factors such as age, activity level, gender, and body shape. Generally, energy needs decrease by 70-100 calories every ten years during adulthood. Therefore, it is essential to balance diet and calorie intake through exercise to maintain a healthy weight.
2. Eat More Fruits and Vegetables (Variety is Key)
The AHA report highlights that consuming more fruits and vegetables can reduce mortality risk. The wider the variety of fruits and vegetables consumed, the better, as it ensures a comprehensive intake of nutrients.
All forms of fruits and vegetables—including fresh, frozen, canned, and dried—can be part of a heart-healthy diet. They provide essential nutrients and phytochemicals. However, heart disease experts particularly recommend colorful fruits and vegetables and suggest eating them whole rather than juicing them. The report advises limiting salted and sugared fruit and vegetable products.
3. Choose Whole Grains Over Refined Foods
The AHA report confirms the benefits of whole grains over processed foods. Overall, they recommend choosing foods that contain at least 51% whole grains.
4. Opt for Healthy Proteins
Based on AHA research, protein sources should primarily be plant-based, such as legumes and nuts. Legume proteins include soy (such as edamame and tofu), beans, lentils, chickpeas, and peas.
The AHA also notes that replacing animal-based foods with plant-based options can reduce the carbon footprint of food, making it more environmentally friendly. However, they caution against “plant-based meats” due to their current status as ultra-processed foods containing added saturated fats, sugars, salts, preservatives, and stabilizers. Evidence regarding the long-term and short-term health impacts of these plant-based meats is still limited.
Therefore, the AHA recommends trying:
•Regular consumption of fish and shellfish
•Low-fat or fat-free dairy products instead of full-fat versions
•Lean cuts of red meat or poultry, avoiding processed meats
5. Use Liquid Plant Oils
The AHA emphasizes avoiding tropical oils (coconut oil, palm oil), animal fats (butter and lard), and partially hydrogenated fats. They recommend using soybean oil, corn oil, safflower oil, sunflower oil, walnut oil, and flaxseed oil. Additionally, canola oil, olive oil, peanut oil, and most nut oils are also recommended.
6. Limit Ultra-Processed Foods
The AHA report warns that excessive consumption of ultra-processed foods is concerning due to their adverse health effects, including overweight and obesity, metabolic disorders (type 2 diabetes, cardiovascular diseases), and increased mortality. Therefore, the report advises consuming minimally processed or unprocessed foods.
7. Reduce Sugary Foods and Beverages
Another AHA recommendation is to limit sugary beverages and foods, including glucose, dextrose, sucrose, and other sweeteners such as corn syrup, honey, maple syrup, or fruit concentrates. They also advise limiting low-calorie sweeteners and low-glycemic monosaccharides and disaccharides due to uncertain potential benefits.
8. Reduce Salt Intake
Unsurprisingly, this classic advice from cardiologists suggests reducing salt intake. This recommendation includes not only the salt added during cooking but also the salt in processed, canned, and packaged foods. The AHA also suggests using potassium-rich salt substitutes, especially in the food processing sector.
9. If You Don’t Drink Alcohol, Don’t Start; If You Do, Drink Less
This recommendation can be challenging for many. The AHA acknowledges that the relationship between alcohol and cardiovascular disease is “complex,” with risks varying depending on the amount and type of alcohol consumed, age, and gender differences. The Dietary Guidelines for Americans 2020-2025 continue to recommend that women limit alcohol to one drink per day and men to two drinks per day.
10. Follow These Dietary Habits Regardless of Where You Eat
The AHA advises that these recommendations apply to all foods and beverages, regardless of where they are prepared, purchased, and consumed. They also advocate for policies that encourage healthier food choices, such as producing more whole grain foods to replace refined grains and reducing salt and sugar content in foods.
Key Information
The AHA emphasizes the importance of overall dietary patterns rather than focusing on “good” or “bad” individual foods or nutrients. Heart-healthy diets should be lifelong, starting early and continuing throughout life. The statement also highlights the importance of nutritional education, noting that poor diet quality is strongly linked to an increased risk of cardiovascular diseases and death. The AHA suggests societal changes are necessary to support heart-healthy diets.
Challenges and Barriers
The AHA’s guidelines also address challenges in adopting or maintaining heart-healthy diets, including:
•Widespread misinformation about diets on the internet
•Lack of nutrition education in schools and medical schools
•Food and nutrition insecurity, with data indicating that approximately 37 million Americans faced limited or unstable access to safe and nutritious food in 2020
•Structural racism and neighborhood segregation, where communities with high proportions of racial and ethnic minorities often have many fast food outlets but lack grocery stores
•Targeted marketing of unhealthy foods and beverages to diverse and minority communities through tailored advertisements and sponsorships
Addressing these challenges requires public health actions and policy changes, according to the AHA statement.