Experts: A Right Balance Can Help Form Heart-Healthy Eating Habits
For years, the American Heart Association (AHA) has been educating the public about heart health and encouraging Americans to eat servings of individual foods like vegetables or fruits, and staying away from cholesterol-raising foods that contain trans fat.
With the recent release of its “2021 Dietary Guidance to Improve Cardiovascular Health,” the AHA has gone beyond simply focusing on “good” foods to eat and “bad” foods to avoid. The report stresses the importance of people maintaining a heart-healthy diet throughout their lifetime.
“The emphasis is on dietary patterns, not specific foods or nutrients,” said Alice H. Lichtenstein, who led the writing committee for the AHA’s scientific statement on improving cardiovascular health. “And it’s not just about what people shouldn’t be eating. The focus is really on what people should be eating so they can customize it to their personal preferences and lifestyles.”
The AHA’s report defines “dietary pattern” as the “balance, variety, amounts and combination of foods and beverages regularly eaten.” An overall dietary pattern should support cardiovascular health and general well-being, and take into account personal preferences, ethnic and religious practices, and life stages, according to the report published November 2 in the AHA’s flagship journal, Circulation.
The AHA acknowledges that the eating habits of Americans have changed since the AHA’s report was last updated in 2006. For instance, eating healthy no longer means preparing meals at home because people can now choose from meal delivery kits, prepared foods at grocery stores, as well as “fast-food, fast-casual and sit-down restaurants,” said Maya Vadiveloo, the report’s co-author.
“It’s much more of a regular part of almost every person’s dietary pattern,” said Vadiveloo, who is also an assistant professor in the department of nutrition and food sciences at the University of Rhode Island in Kingston. “So, no matter where people are, they need to think about what they are eating.”
The updated report stressed the importance of the “whole package” of what someone eats in a day or a week, according to Lichtenstein, a Gershoff Professor of Nutrition Science and Policy and director of the Cardiovascular Nutrition Laboratory at Tufts University in Boston. With the guidelines now looking at the whole picture, it “dispels the idea” that a heart-healthy diet consists of adding one vegetable or vitamin, Lichtenstein said.
The 10 Features in AHA’s 2021 Dietary Guidance
The updated AHA guidelines say a heart-healthy dietary pattern includes the following 10 features:
- Achieve and maintain healthy body weight. This can done, in part, by controlling food portions, being mindful of calorie intake, and engaging in at least 150 minutes of moderate physical exercise every week.
- Eat a variety of fruits and vegetables. Observational studies have shown that a dietary pattern rich in fruits and vegetables (except for white potatoes) is associated with a reduced risk of cardiovascular disease.
- Choose foods made mostly with whole grains rather than refined grains. Whole-grain foods, such as beans, legumes, and seafood, are good sources of lean and/or high-fiber protein. The nutrients found in refined grains, such as white rice and white bread, are stripped during processing.
- Choose healthy sources of protein, such as fish and seafood, and low-fat dairy or non-fat dairy products.
- Use liquid plant oils (soybean, corn, safflower, and sunflower oils, for instance) instead of tropical oils (coconut, palm, and palm kernel), animal fats (butter and lard), and partially hydrogenated fats, usually found in such foods as shortening, baked goods, and stick margarine.
- Choose minimally processed foods (such as fruits and vegetables, meats, and eggs) instead of ultra-processed foods which add fat, sugar, salt, artificial colors or preservatives, and other ingredients.
- Minimize intake of beverages and foods with added sugars.
- Choose and prepare foods with little or no salt. Studies have shown that too much salt (sodium chloride) in the diet can lead to high blood pressure, heart disease, and stroke.
- If you don’t drink alcohol, don’t start; if you choose to drink alcohol, limit your intake.
- Adhere to this guidance regardless of wherever food is prepared or consumed.
The guidance also advises getting essential nutrients from foods and beverages that are part of heart-healthy dietary patterns rather than nutritional supplements, such as vitamins and herbal products.
The updated report acknowledges that cultural differences, societal challenges, and targeted marketing of unhealthy foods in underserved communities limit many people from accessing safe and nutritious food. According to the report, policy changes and public health measures are needed to address these and other societal challenges.
The dietary guidance also stressed the importance of incorporating nutrition education into schools, starting at an early age, Lichtenstein said.
“This will ensure children have the basic facts and can draw on these as they develop into independent adults, making their own choices,” she said.
According to the AHA, developing and maintaining a heart-healthy dietary pattern does not need to be complicated, time-consuming, or expensive. It also does not need to be restrictive or unappealing.
You can eat what you enjoy, Lichtenstein said. But, keep in mind that “it’s not all of one thing and none of another. It’s the balance among your choices in terms of diet and, ultimately, lifestyle.”