The Margin: No more ‘good’ vs. ‘bad’ foods: 10 healthy eating ‘patterns’ to prevent heart disease and death

The full “2021 Dietary Guidance to Improve Cardiovascular Health” was published in the Association’s flagship journal Circulation on Tuesday. And this more modern approach to nutrition is intended to adapt more easily to different cultural traditions, individual likes and dislikes, as well as societal issues such as whether most meals are made and eaten at home, or picked up on-the-go while people are at work or school.

“We can all benefit from a heart-healthy dietary pattern regardless of stage of life, and it is possible to design one that is consistent with personal preferences, lifestyles and cultural customs,” said Alice H. Lichtenstein, the chair of the scientific statement writing group, in a statement.

“It does not need to be complicated, time consuming, expensive or unappealing,” added Lichtenstein, who is the director of the Cardiovascular Nutrition Team at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. 

She concedes that adopting heart-healthy eating habits such as choosing the fish entrée over the steak at a restaurant, or opting for brown rice instead of fried white rice from your favorite Chinese takeout joint, may feel strange at first. “It might take a little planning, however, after the first few times it can become routine,” she said.

Here’s the American Heart Association’s 10 steps for a dietary pattern to promote heart health:

1. Balance food and calorie intake with physical activity to maintain a healthy weight.

2. Choose a wide variety of fruits and vegetables, and eat plenty of produce, to get a full range of nutrients from food — rather than from supplements.

3. Choose whole grains and other foods made up mostly of whole grains, such as whole wheat, oatmeal, brown rice and popcorn.

4. Include healthy sources of lean and/or high-fiber protein such as plant proteins (nuts and legumes); fish or seafood; low fat or non-fat 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 (such as a bag of salad or  roasted, unsalted nuts) rather than ultra-processed foods (such as sugary cereal, potato chips or smoked sausage) as much as possible.

7. Minimize eating and drinking food and beverages with added sugars.

8. Choose or prepare foods with little or no salt.

9. Limit alcohol consumption. And if you don’t drink, do not start. 

10. Apply this guidance no matter where food is prepared or consumed, such as whether you’re at home, dining out or ordering takeout.

These tips should sound familiar; much of this advice has been supported by scientific research for years. 

Read more: These 4 diet and lifestyle changes can lower your cancer risk by almost 20%

And that’s the point. The AHA’s new statement reflects the latest scientific evidence on the benefits of heart-healthy eating throughout life, and how poor diet quality is strongly associated with an increased risk of cardiovascular disease and death.

Weight Watchers took a similar step a few years ago. The company was founded to help people lose weight, and watching the scale was literally in its name. But in 2018, Weight Watchers International Inc. announced it was shifting its focus from weight loss to a wellness journey, and it changed its legal name to WW International Inc
WW,
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in September 2019. More people were joining Weight Watchers for “something more than getting into a size 8,” Chief Executive Mindy Grossman said in 2018. “Today, healthy is the new skinny.” And the brand has been customizing its lifestyle guides for individual users, and moving away from the old school “one size fits all” approach.

Related: ‘The Covid 15?’ If only — this is how much weight the average person actually gained during the pandemic

And now for the first time, the AHA is highlighting challenges such as societal factors that can make it tougher for people to learn or maintain healthy eating patterns. For example, about 2.3 million Americans live in food deserts more than one mile away from a supermarket and do not own a car, according to federal data, making it difficult to shop for more nutritious and less processed foods. The COVID-19 pandemic also saw more people ordering takeout from home — and, conversely, dining out spiked as bars and restaurants have reopened in some areas.

The AHA highlighted the following societal challenges that can make it harder to start or maintain a heart-healthy eating pattern:  

• Widespread dietary misinformation from the internet.

• A lack of nutrition education in grade schools and medical schools.

• Food and nutrition insecurity — according to references cited in the statement, an estimated 37 million Americans had limited or unstable access to safe and nutritious foods in 2020.

• Structural racism and neighborhood segregation, whereby many communities with a higher proportion of racial and ethnic diversity have few grocery stores but many fast-food outlets.

• Targeted marketing of unhealthy foods and beverages to people from diverse racial and ethnic backgrounds through tailored advertising efforts and sponsorship of events and organizations in those communities.

The guidance recommends public health action and policy changes to address these barriers, calling it “a public imperative.” 

The AHA statement also notes that this heart-healthy eating pattern is good for the environment. Popular animal products, particularly red meat (beef, lamb, pork, veal, venison or goat), have the largest environmental impact in terms of water and land usage, and contribute significantly to greenhouse gas emissions, compared with plant-based foods. “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,” said Lichtenstein.