Top Things to Know: Recommended Dietary Pattern to Achieve Adherence to the AHA/ACC Guidelines

1. In 2011-2012, 1.5% of U.S. adults and 0.6% of U.S. children met the American Heart Association’s Ideal Diet Score which includes meeting 4 or more targets for fruits and vegetables, fish and shellfish, sodium, sugar sweetened beverages, and whole grains. However, 54.6% of U.S. children and 41% of U.S. adults in 2011- 2012 were categorized as having poor diets as meeting fewer than two of these targets.i
2. The 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk provided recommendations for a heart-healthy dietary pattern which emphasizes vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, non-tropical vegetable oils, and nuts; and has and limits intake of sweets, sugar-sweetened beverages, and red meats.ii
3. This Scientific Statement provides guidance for achieving adherence to a heart-healthy dietary pattern that accommodates cultural, ethnic or economic influences that shape personal food preferences. Implementation strategies target nutrient dense foods that contain cardiopreventive types of fats while avoiding caloricallydense, nutrient-poor foods that can contribute to excessive energy intake.
4. Regular physical activity is an essential and complementary component of a heart-healthy lifestyle. Most adults should engage in at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity (or an equal combination of both) each week. For adults who would benefit from lowering LDL cholesterol or blood pressure, the 2013 Lifestyle Guidelines recommend 3-4 sessions of 40 minutes of moderate-to-vigorous physical activity each week.iii
5. More than two-thirds of U.S. adults and 31.8% of U.S. children are overweight or obese. iv Most Americans overconsume “empty calories” – those foods which often contribute excess calories from solid fats and added sugars but few or no nutrients.v Increased availability of foods prepared with refined grains, caloric sweeteners, solid fats, and sodium laden-foods have contributed to the public health challenge of excess energy consumption and increased risk of overweight, obesity, hypertension, dyslipidemia, and insulin resistance.
6. Several dietary patterns can reduce energy intake, which can improve cardiometabolic risk factors. The dietary pattern described in this statement has several features in common with established dietary patterns such as DASH (Dietary Approaches to Stop Hypertension), Mediterranean, and U.S. Department of Agriculture (USDA) dietary patterns that emphasize fruits, vegetables, whole grains, and other healthful foods.
7. Fad diets should be avoided because they do not achieve long term weight loss or benefit cardiovascular health.
8. While a heart-healthy dietary pattern is well-defined, additional research is needed to develop evidence based translational strategies that achieve sustained dietary changes and eating behaviors that reduce risk of CVD across all population groups.
9. This statement helps health care providers to develop healthy lifestyle recommendations for their patients and clients with nutrient dense choices to meet individual calorie needs while promoting energy balance. It also outlines implementation strategies to assess adherence, address limitations, and encourage behavior change.
10. Developing an intervention approach that is tailored to the individual and encourages self-monitoring of diet and physical activity levels is an effective strategy for promoting greater acceptance and sustained adherence to adoption of the recommended heart-healthy lifestyle.

ⁱ Mozaffarian (2015) Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association. Circulation 2015;132:000-000. DOI: 10.1161/CIR.0000000000000350.

ⁱⁱ Eckel (2013) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S76-99. doi: 10.1161/01.cir.0000437740.48606.d1.

ⁱⁱⁱ Eckel (2013) 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24;129(25 Suppl 2):S76-99. doi: 10.1161/01.cir.0000437740.48606.d1.

^iv Mozaffarian (2015) Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association. Circulation 2015;132:000-000. DOI: 10.1161/CIR.0000000000000350.

^v Scientific Report of the 2015 Dietary Guidelines Advisory Committee (PDF) . Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture.