10 steps to a heart-healthy diet can lower heart disease and stroke risk

DALLAS, Texas — Most weight loss plans include a list of acceptable foods as well as a number of foods to avoid. However, when it comes to heart health, scientists have identified 10 key steps to healthy eating that can help individuals lose weight and, more importantly, maintain a healthier heart. By sticking to this plan, they add people can not only keep their heart happy, but help save the environment too.

A team with the American Heart Association named the 10 key steps, which experts say are crucial to maintaining healthy eating patterns and promoting sustainability. The guidelines encourage people to look through a wider lens at their dietary patterns, rather than focusing on individual foods or sources of nutrients.

Researchers designed the steps to adapt to accommodate individual food preferences, cultural traditions, and whether eat their meals at home or on the go. The scientific statement reflects the latest evidence on the benefits of heart-healthy eating throughout life. It also shows the strong link between poor diet and an increased risk of cardiovascular disease and death.

It’s possible to eat out and still eat healthy

According to the researchers, a dietary pattern refers to the balance, variety, amounts, and combination of foods and drinks regularly consumed. The statement goes on to highlight the critical role of nutrition education, starting healthy eating at an early age, and maintaining a healthy diet throughout life, as well as societal and other challenges that may make it harder to start or maintain healthy eating.

“We can all benefit from a heart-healthy dietary pattern regardless of the stage of life, and it is possible to design one that is consistent with personal preferences, lifestyles, and cultural customs. It does not need to be complicated, time-consuming, expensive, or unappealing,” says Professor Alice Lichtenstein, the director of the Cardiovascular Nutrition team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, in a media release.

Because people often go out to eat, the statement emphasizes that it is still possible to follow a heart-healthy lifestyle regardless of whether food is prepared at home, ordered in a restaurant or online, or as a microwaved meal.

“You can absolutely adapt a heart-healthy diet to different lifestyles, including one that incorporates eating out at restaurants. It might take a little planning, however, after the first few times it can become routine,” adds Prof. Lichtenstein, who also teaches at the Friedman School of Nutrition Science and Policy.

The researchers’ 2021 Dietary Guidance to Improve Cardiovascular Health:

  1. Balance food and calorie intake with physical activity to maintain a healthy weight.
  2. Choose a wide variety of foods and eat plenty of fruits and vegetables to get a full range of nutrients from food rather than supplements.
  3. Choose whole grains and other foods made up mostly of whole grains.
  4. Include healthy sources of lean and/or high-fiber protein such as plant proteins (nuts and legumes), fish or seafood, low fat or nonfat dairy, lean cuts of meat, and limit red and processed meats.
  5. Use liquid non-tropical plant oils such as olive or sunflower oils.
  6. Choose minimally processed foods rather than ultra-processed foods as much as possible.
  7. Minimize intake of beverages and foods with added sugars.
  8. Choose or prepare foods with little or no salt.
  9. Limit alcohol consumption; if you don’t drink, do not start.
  10. Apply this guidance no matter where food is prepared or consumed.

The team explained that processed foods include meats that are preserved by smoking, curing, or adding chemical preservatives. Processed plant-based foods have added salt, sugar, or fats. Food scientists some foods “ultra-processed” — which means they go beyond adding sugar and salt, to include artificial flavors, colors, and preservatives for longer shelf life.

Because many of these foods are high in salt, saturated fats, and cholesterol, research shows that the best way to avoid the nasty consequences of eating them is to replace processed foods with other protein sources with a connection to lower death rates.

Key benefits for pregnant women and older adults

Nutrition plays a critical role in maintaining a happy heart regardless of how old you are. The statement outlines that a heart-healthy diet paired with healthy lifestyle behaviors, such as not smoking and taking regular exercise, is key to lowering the risk of developing high cholesterol levels, high blood pressure, obesity, type 2 diabetes, and metabolic syndrome, each of which can increase the risk of developing potentially fatal heart disease.

According to the research team, moms-to-be who eat a healthy diet before and during pregnancy can reduce their heart disease risk factors, which also may help to prevent unhealthy weight gain in their children. Evidence has shown that the prevention of childhood obesity is key to preserving and prolonging heart health throughout life. Additionally, older people who stick to a healthy diet enjoy slower rates of age-related declines in thinking abilities and memory.

“The evidence indicates that people of all ages can benefit from sticking to the principles of a heart-healthy dietary pattern. Likewise, it is important to educate children at all ages so as they transition into adulthood, they will be able to make informed decisions about what they eat and serve as positive role models for generations to come,” says Prof. Lichtenstein.

Healthy eating can be eco-friendly

The statement also shows how a healthy diet can help the environment as well. For the first time, researchers included the issue of sustainability in the Association’s dietary guidelines.

Commonly eaten animal products, particularly red meat, have a devastating effect on the environment. The red meat industry not only uses vast amounts of water and land but also contributes significantly to greenhouse gas emissions. Therefore, by shifting reliance from meat to plant proteins, you can simultaneously help your health and the environment.

“It is important to recognize that the guidance is consistent not only with heart health but also sustainability — it is a win-win for individuals and our environment,” the study author continues.

However, the statement notes, not all sustainable diets are heart-healthy. For example, if a plant-based diet includes lots of refined carbohydrates and added sugars, evidence shows that the risk of type 2 diabetes and heart disease increases.

Heart-healthy diet may also improve social conditions

The Association’s 2021 dietary guidance discussed the social challenges that can make it harder for people to start and maintain a healthy eating plan. These challenges include misinformation shared online and a lack of nutrition education in schools.

According to references cited in the statement, an estimated 37 million Americans had limited or unstable access to safe and nutritious foods in 2020. Alongside food insecurity, structural racism and neighborhood segregation are factors too, where communities with a higher proportion of racial and ethnic diversity have fewer grocery stores than fast-food outlets. This disparity is driven by the targeted marketing of unhealthy foods and drinks to people from diverse racial and ethnic backgrounds, through tailored advertising efforts and the sponsorship of events and organizations in those communities.

According to the statement, public health action and policy changes are required to address these challenges and barriers.

“Creating an environment that promotes and supports adherence to heart-healthy dietary patterns among all individuals is a public health imperative,” Prof. Lichtenstein concludes.

The research appears in the journal Circulation.

South West News Service writer Georgia Lambert contributed to this report.