Update to the AHA Guidelines: Part Two

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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. You can find the first 5 in the post Update to the AHA Guidelines: Part One. Here are the second 5 guidelines...

  1. Choose minimally-processed foods instead of ultra-processed foods. Ultra-processed foods contain added salt, sweeteners, fat, artificial colors and flavors, and preservatives that promote shelf stability, preserve texture, and add flavors and textures we love, but also are strongly associated with increased risk of overweight and obesity, type 2 diabetes, and cardiovascular disease. Ultra-processed foods include commercially-made cookies, cakes, pastries, candies, chips, many frozen meals, chicken nuggets, hot dogs, sausages, burgers, fish sticks; and salted, pickled, smoked or cured meat and fish.
  2. Minimize intake of beverages and foods with added sugars. It’s much easier to identify the amount of added sugars in foods now that food labels include a separate line for added sugars. Added sugars also include the sugar you might add yourself to tea, coffee, lemonade, or cooked cereal. Common types of added sugar include glucose, dextrose, sucrose (table sugar), corn syrup, honey, maple syrup, and concentrated fruit juice. Added sugars are consistently associated with elevated risk of type 2 diabetes, CHD, and obesity. The American Heart Association recommends limiting added sugars to no more than 6% of total daily calories. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar. For men, it’s 150 calories per day, or about 9 teaspoons.
  3. Choose and prepare foods with little or no salt. There is a direct relationship between the amount of salt we consume and risk of high blood pressure, which is a key risk factor for stroke. The top sources of salt are processed foods, packaged foods, and restaurant foods, together accounting for almost three-quarters of total dietary sodium. Even foods labeled 100% whole wheat or organic can be high in sodium. Read food labels for the amount of sodium in foods, aiming for no more than 2300mg of sodium per day.
  4. If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake. It’s clear that as alcohol intake increases, so does risk of stroke and atrial fibrillation. Many people believe that red wine may be good for the heart because it contains antioxidants such as resveratrol, which is primarily found in the skin of grapes but also is in peanuts and blueberries. Some studies suggest resveratrol can reduce cholesterol and lower blood pressure. However, resveratrol and other heart-healthy antioxidants are also found in fruit and vegetables which also contain other healthy nutrients such as fiber. The 2020 Dietary Guidelines Advisory Committee recently concluded that if you choose to drink alcohol, you should consume no more than 1 drink per day and should not drink alcohol in binges.
  5. Adhere to this guidance regardless of where food is prepared or consumed. Food today is available just about anywhere, and we tend to eat wherever we happen to be. Strategies for healthier food choices include preparing foods at home and bringing them with you instead of stopping at the drive-through or getting take-out; reading food labels and choosing foods lower in salt, saturated fat, and added sugar; and preparing more foods from scratch so that you use fewer processed foods.

By Lynn Grieger, RDN, CDCES, CPT, CHWC

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


  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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