New Guidelines on Lifestyle Choices to Reduce Cardiovascular Risk

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The American Heart Association (AHA) and the American College of Cardiology (ACC) have released updated guidelines on the important role of lifestyle choices in reducing cardiovascular risk.

According to the latest statistics from the AHA, heart disease and stroke are the leading causes of death in the United States, responsible for an estimated 840,678 deaths each year – about 1 out of every 3. The focus of the guidelines is prevention of heart attack, angina, stroke, peripheral arterial disease, heart failure, and atrial fibrillation. The report clearly states that the most important way to prevent cardiovascular disease is through a healthy lifestyle. According to Donna Arnett, co-chair of the 18-person guidelines writing committee, making lifestyle changes before adding medication is important, because our daily food choices and exercise habits have a direct influence on cardiovascular health.

The report details 5 ways to reduce cardiovascular disease:

  1. Healthy food choices
  2. Regular exercise
  3. Do not use tobacco products, including e-cigarettes
  4. Talk with your doctor about factors that affect your health, such as housing, food security, transportation, self-image, and culture
  5. Talk with your doctor about whether aspirin for prevention is right for you

The role of nutrition and healthy food choices

The scientific research clearly shows that routinely choosing foods that are high in animal fat and protein, low in fiber, and high in added sugars and processed foods are associated with increased cardiac risk. Here are some recommendations from the report, based on the resources they found...

  • Adults should eat a heart-healthy diet by:
    • Emphasizing plant-based foods such as vegetables, fruits, legumes (dried beans and peas such as lentils, chickpeas, kidney beans, black beans, and pinto beans), nuts, and whole grains.
      • These foods are high in fiber and low in saturated fat and cholesterol, and a plant-based, Mediterranean style diet lowers cardiovascular risk compared to other types of eating patterns.
      • Here are some ways to emphasize plant-based foods...
        • Fill half your plate with vegetables or fruit at meals.
        • Add legumes like chickpeas or pinto beans to salads, or choose legume-based soups like lentil, black bean, or vegetarian chili.
        • Sprinkle nuts on oatmeal, in yogurt, or on salads.
        • Choose whole grain breads, cereals and crackers; brown rice, and whole grain pasta.
    • Choosing more lean protein foods such as fish or skinless chicken and turkey while eating less red meat and processed meats such as sausage, bacon, and lunch meats that are high in harmful saturated fat and sodium.
      • Here are some ways to choose more lean protein...
        • Cook chicken or turkey with the skin on, and then remove the skin before eating to enjoy flavorful and moist meat with less harmful saturated fat.
        • Choose baked, broiled or grilled fish instead of seafood that is breaded and fried.
        • Replace lunchmeats with nut butter or slice your own roasted chicken or turkey.
    • Choosing more foods that are high in healthful monounsaturated fats such as olive oil and canola oil, and fewer foods that are high in saturated fat such as coconut and palm oil.
      • Choose fat-free or low-fat milk and yogurt to reduce the amount of saturated fat and cholesterol.
    • Enjoying more foods that are less processed to reduce sodium, trans fat, and saturated fat.
      • Be mindful of sodium content of processed and restaurant foods.
      • Here are some ways to choose less-processed options...
        • Popcorn is a fiber-rich whole grain food that makes a delicious and satisfying crunchy snack. Choose air-popped popcorn or pop your own in canola oil.
        • Bake chicken instead of using breaded and fried chicken tenders or nuggets.
        • Keep raw fruit and vegetables on hand for snacks.
        • Choose fresh fruit instead of pre-packaged crispy or sweet snacks.
      • Drinking fewer sweetened beverages such as soda, sweetened iced tea, lemonade, or fruit drinks with added sugar.
  • Overweight and obesity increase risk of cardiovascular disease.
  • Losing at least 5% of body weight is associated with improvement in blood pressure, cholesterol, triglycerides and glucose levels and also delays the development of type 2 diabetes.
  • Here's how to put this into action...
    • Decrease calorie intake and participate in regular physical activity by making lifelong changes in daily habits to lose weight and then maintain at a lower weight.
    • Use the above nutrition recommendations to plan meals and snacks that are based on plant foods and contain less saturated fat, trans fat, and sodium.
    • 150 minutes of physical activity per week, or about 20 minutes per day, greatly decreases cardiovascular risk. Here are some ways to add physical activity into your day:
      • Take the stairs instead of the elevator
      • Park further away from work and stores
      • Walk the long way around when shopping or at work
      • Stand up and march in place every 30 minutes when watching TV or using the computer.

By Lynn Grieger, RDN, CDE, CPT, CHWC


  1. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019;March 17
  2. American Heart Association News. New guidelines: healthy lifestyle, managing risks, are key to prevent heart attack, stroke. published 3-17-19. Accessed 3-20-19
  3. McRae MP. Dietary Fiber Is Beneficial for the Prevention of Cardiovascular Disease: An Umbrella Review of Meta-analyses. J Chiropr Med. 2017;16(4):289-299.
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