The American Heart Association's updated guidelines on cardiovascular health for Americans are moving beyond diet to lifestyle.
The guidelines, last issued in 2000, were revised after a panel of nutrition and cardiovascular disease experts reviewed the scientific literature published in the intervening 6 years. “The key message of the [updated] recommendations is to focus on long-term, permanent changes in how we eat and live. The best way to lower cardiovascular risk is to combine physical activity with heart-healthy eating habits, coupled with weight control and avoiding tobacco products,” said Dr. Alice H. Lichtenstein, chair of the association's nutrition committee, in a statement accompanying release of the new guidelines.
Thirty minutes or more of physical activity per day is recommended, even if it is broken up into small increments.
“Achieving a physically active lifestyle requires effective time management, with a particular focus on reducing sedentary activities such as screen time (e.g., watching television, surfing the Web, playing computer games) and making daily choices to move rather than be moved (e.g., taking the stairs instead of the elevator),” the recommendations state (Circulation 2006;doi:10.1161/CIRCULATIONAHA. 106.176158).
The current recommendations advise consuming lower amounts of saturated fat, from less than 10% to less than 7% of the diet, and—for the first time—advise limiting trans fats to less than 1% of the diet. The guidelines also call for increasing consumption of vegetables, fruits, and whole grain foods; eating fish at least twice a week; and minimizing intake of high-sugar drinks and foods.
The point is not to meticulously calculate the amount and types of fats and other potentially harmful dietary components, but to more generally avoid foods made with hydrogenated fats or added salt and sugar, as well as to choose foods that minimize these components, such as leaner meats and lower-fat dairy products.
The recommendations specifically address adhering to a heart-healthy diet and restricting portion size when consuming food prepared at restaurants, grocery stores, schools, and fast-food outlets, because food eaten outside the home constitutes an estimated one-third of the calories that Americans consume, said Dr. Lichtenstein, who is also Gershoff professor of nutrition science and policy at Tufts University, Boston, and her associates.
The guidelines now include sections with practical tips for clinicians to recommend and for patients to follow. And for the first time, restaurants, the food industry, schools, and local governments are called on to take practical steps to encourage physical activity and discourage unhealthy eating. These measures include reformulating processed foods, packaging foods in smaller portions, providing more vegetable options, and providing safe venues for walking and biking.