Update to the AHA Guidelines: Part One

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The American Heart Association recently released updated diet and lifestyle guidelines to reduce risk of cardiovascular disease such as heart attack, stroke, and arrythmia; and improve cardiovascular health. The previous guidelines were published in 2006, and these updated guidelines reflect the most recent scientific research.

The report lists 10 guidelines, and here are the first 5:

  1.  Adjust energy intake and expenditure to achieve and maintain a healthy body weight. The focus is on lifelong healthy body weight which can be achieved with food choices, portion control, and 150 minutes of exercise each week. The report notes that during adulthood, energy needs decrease by approximately 70 to 100 calories with each decade of life. If you maintained your weight consuming 1800 calories in your 20s, in your 60s you’ll only need about 1400 calories. Large portion sizes, even for healthy foods, can contribute to consuming more calories than you burn and result in gradual weight gain.
  2. Eat plenty of fruits and vegetables, choose a wide variety. The report emphasizes choosing deeply-colored fruits and vegetables such as dark green leafy greens, peaches, plums, and tomatoes, which tend to be more nutrient-dense than lighter-colored and white fruits and vegetables. The report calls out white potatoes as the only vegetable not associated with decreased risk of cardiovascular disease. Choose fresh, frozen, canned, or dried fruits or vegetables without added sugars or salt and limit fruit or vegetable juice, which tends to be lower in fiber.
  3. Choose foods made mostly with whole grains rather than refined grains. The report goes on to encourage including whole grains in daily food choices because research shows that people who eat whole grains daily instead of refined grains have reduced risk of cardiovascular disease, coronary heart disease (CHD), stroke, and metabolic syndrome (the combination of Type 2 diabetes, high blood pressure, and elevated cholesterol). Whole grains have minimal processing and contain all the parts of the grain, which means they’re higher in nutrients and fiber. Look for the word "whole" in the first ingredient in bread, crackers, and cereals and choose whole grains like brown rice and quinoa.
  4. Choose healthy sources of protein mostly from plants such as soy, nuts, seeds, and legumes such as chickpeas, lentils, and black beans because these foods are also high in fiber and essential nutrients. Fish and seafood and low-fat or fat-free dairy products are also associated with decreased risk of cardiovascular disease. Red meat and processed meats are highly associated with increased risk of cardiovascular disease. For the best health, replace red meat and processed meat such as bacon, sausage, hot dogs, deli meat, pepperoni, and salami with plant sources of protein.
  5. Use liquid plant oils rather than tropical oils (coconut, palm, and palm kernel), animal fats such as butter and lard, and partially-hydrogenated fats. Replacing fats that are high in saturated fat like animal fats, tropical oils, and partially-hydrogenated fats in processed foods with unsaturated fats decreases risk of cardiovascular disease. Choose healthier types of fats such as soybean, corn, safflower, sunflower, canola and olive oils.

By Lynn Grieger, RDN, CDCES, CPT, CHWC

You can find the rest of the guidelines in the post Update to the AHA Guidelines: Part Two.


  1. Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, Sacks FM, Thorndike AN, Van Horn L, Wylie-Rosett J; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Clinical Cardiology; and Stroke Council. 2021 Dietary guidance to improve cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2021;144:e•••–e•••. doi: 10.1161/CIR.0000000000001031
  2. American Heart Association. Whole Grains, Refined Grains, and Dietary Fiber. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/whole-grains-refined-grains-and-dietary-fiber last reviewed 11-1-21; accessed 11-24-21 
  3. Gibney MJ. Ultra-Processed Foods: Definitions and Policy Issues. Curr Dev Nutr. 2018;3(2):nzy077. Published 2018 Sep 14. doi:10.1093/cdn/nzy077
  4. American Heart Association. Added Sugars. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars last reviewed 11-2-21; accessed 11-24-21
  5. American Heart Association. How much sodium should I eat per day? https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day  last reviewed 11-1-21; accessed 11-24-21
  6. American Heart Association. Drinking red wine for heart health? Read this before you toast. https://www.heart.org/en/news/2019/05/24/drinking-red-wine-for-heart-health-read-this-before-you-toast published 5-24-19; accessed 11-24-21
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