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 Dr. George Jacob
Heart Infocenter


Cardiovascular Health

American Heart Association's Dietary Guidelines for Heart Diseases and Stroke

The American Heart Association's revised dietary guidelines includes specific recommendations tailored to an individual's risk of heart disease and stroke. The guidelines are based on an analysis of hundreds of studies.

Summary of American Heart Association Dietary Guidelines
To Achieve An Overall Healthy Eating Pattern

Choose an overall balanced diet with foods from all major food groups, emphasizing fruits, vegetables and grains.

Consume a variety of fruits, vegetables and grain products.

At least 5 daily servings of fruits and vegetables.

At least 6 daily servings of grain products, including whole grains.

Include fat-free and low-fat dairy products, fish, legumes, poultry and lean meats.

Eat at least two servings of fish per week. 

To Achieve A Healthy Body Weight

Avoid excess intake of calories.

Maintain a level of physical activity that achieves fitness and balances energy expenditure with caloric intake; for weight reduction, expenditure should exceed intake.

Limit foods that are high in calories and/or low in nutritional quality, including those with a high amount of added sugar. 

To Achieve A Desirable Cholesterol Level

Limit foods with a high content of saturated fat and cholesterol. Substitute with grains and unsaturated fat from vegetables, fish, legumes and nuts.

Limit cholesterol to 300 milligrams (mg) a day for the general population, and 200 mg a day for those with heart disease or its risk factors.

Limit trans fatty acids. Trans fatty acids are found in foods containing partially hydrogenated vegetable oils such as packaged cookies, crackers and other baked goods; commercially prepared fried foods and some margarines. 

To Achieve A Desirable Blood Pressure Level

Limit salt intake to less than 6 grams (2,400 mg sodium) per day, slightly more than one teaspoon a day.

If you drink, limit alcohol consumption to no more than one drink per day for women and two drinks per day for men.

Ronald M. Krauss, M.D., the principal author of the guidelines and a senior scientist at the Lawrence Berkeley National Laboratory at the University of California, stated that the four main goals of the new guidelines are to help Americans achieve an overall healthy eating pattern; achieve and maintain an appropriate body weight; achieve and maintain a desirable cholesterol profile, and achieve and maintain a desirable blood pressure level.

For the first time, the guidelines stress the importance of preventing obesity and are easier to use because they stress overall eating patterns, rather than a percentage of dietary fat or other nutrients.

It is important to understand the overall eating plan. Eat more plant-based foods. Americans also need to limit saturated fats and cholesterol. According to Dr. Krauss, "if you follow these dietary guidelines, you will be consuming a balanced diet rich in nutrients."

The Guidelines Emphasize A Varied Diet Full Of Fruits, Vegetables, Grains And Fish

A diet rich in fruits, vegetables, legumes (beans), whole grains, low-fat dairy products, fish, lean meats and poultry is still the basis of the recommendations. AHA recommends eating five servings of fruits and vegetables and six servings of grains daily. Two weekly servings of fatty fish, such as tuna or salmon, are also recommended.

Fruits and vegetables are high in nutrients and fiber, and are relatively low in calories. People whose diet includes a high intake of fruits and vegetables are found to be associated with a lower risk of developing heart disease, stroke, and hypertension. Consuming a variety of fruits and vegetables (especially those that are dark green, deep orange, or yellow) helps ensure adequate intakes of micronutrients normally present in this food group.

According to AHA, grain products provide complex carbohydrates, vitamins, minerals, and fiber. Dietary patterns high in grain products and fiber have been associated with decreased risk of cardiovascular disease. Eat foods high in starches (eg, bread, pasta, cereal, potatoes). Your major sources of calories in the diet should come from foods that are sources of whole grains as well as nutrient-fortified and enriched starches (such as cereals).

Healthy adults must minimize the intake of foods containing high levels of saturated fats (found in animal products and tropical oils) and substantially reduce the intake of trans fatty acids (the hydrogenated oil found in commercially prepared foods and some hard margarines). For individuals with risk factors for heart disease or existent heart disease, a further reduction in saturated fat intake is recommended.

The recommended intakes of salt (less than 6 grams per day, or 2,400 mg of sodium) and dietary cholesterol (300 mg/day for healthy individuals, and 200 mg per day in high-risk individuals) remain unchanged. If an individual chooses to consume alcohol, the limit should be one drink a day for women and two drinks a day for men. People who do not normally drink alcohol should not begin drinking. AHA recommends that individuals get their nutrients from foods, not from supplements.

Diet helps prevent weight gain, obesity

Adherence to the AHA guidelines will also help you keep fit and trim. According to Dr. Krauss, "although the guidelines were developed to reduce or delay heart disease and stroke, Americans who follow them could reap many other benefits. Research indicates these nutritional steps could also decrease the risk of developing cancer or osteoporosis."

For obese individuals, the guidelines recommend a gradual weight loss of no more than one to two pounds per week. To lose weight, you must eat fewer calories than you burn and increase physical activity, such as brisk walking, to at least 30 minutes daily.

Avoid foods that are not "nutrient dense" which often have a lot of added sugars in them - for example sugary soft drinks and commercially baked goods.

The best way to lose weight is to reduce the caloric intake by following the guidelines for healthy adults - a diet rich in fruits, vegetables, low-fat dairy products, and leaner cuts of meat eaten in smaller portions. The first priority is to prevent weight gain. Once you accomplish this, you can look into strategies to lose weight if you are overweight.

Targeting high risk populations

AHA guidelines offer a framework in tailoring specific medical nutrition therapy to meet the needs of individuals with high blood pressure, cholesterol disorders, diabetes, insulin resistance, high triglycerides, congestive heart failure, kidney disease, and/or obesity.

For individuals with high blood pressure, try to lose 5 percent to 10 percent of body weight if you are obese. Modest amount of weight loss can significantly improve blood pressure. "Consuming a diet rich in fruits, vegetables, low-fat dairy products and limiting salt and alcohol has been shown in a large study to have major benefits in controlling blood pressure levels," according to Dr. Krauss.

In recent years, scientists have been studying individuals who have a cluster of metabolic risk factors for heart disease and/or stroke -- excessive fat tissue in the abdominal region, glucose intolerance or diabetes, high blood pressure, and high levels of triglycerides (more than 200 mg/dL). This cluster of risk factors is sometimes called "Syndrome X."

For individuals diagnosed with the syndrome, it may be desirable to avoid very low-fat, high carbohydrate diets, and to emphasize unsaturated fats, such as vegetable oils and seed oils (excluding tropical oils), rather than carbohydrates. Very low-fat diets (less than 15-20 percent of total calories from fat) with correspondingly high carbohydrate content can lower "good" cholesterol.

Source: American Heart Association

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