By Jeremy Appleton, ND, CNS

Healthnotes Newswire (August 3, 2006)—Prevention is the highest form of cure—and cardiovascular disease, our nation’s number one killer, is to a large extent preventable. Organizations like the American Heart Association (AHA) have been refining their prevention strategies over the years. That group has now released their first new diet and lifestyle recommendations in six years in an effort to stem the tide of obesity and heart disease.

Dr. Alice H. Lichtenstein, D.Sc., chair of the AHA’s Nutrition Committee and Gershoff professor of nutrition science and policy at the Friedman School of Nutrition Science and Policy at Tufts University, was the lead author of the recommendations. Dr. Lichtenstein and colleagues indicated several overarching goals to achieve the recommendations: consume an overall healthy diet; aim for a healthy body weight; aim for recommended levels of LDL (“bad”) and HDL (“good”) cholesterol and triglycerides; aim for normal blood pressure; aim for a normal blood glucose level; be physically active; and avoid use of and exposure to tobacco products.

The AHA recognized that diet is a critical part of an overall healthy lifestyle. The 2006 recommendations incorporate new scientific evidence that has emerged after publication of their last set of guidelines in 2000. The guidelines are reformatted to be more easily understood and to include a section raising awareness about environmental influences.

Guidelines for healthy eating

The AHA’s dietary recommendations are straightforward, sensible, and backed by an immense body of scientific research. They advise people to balance caloric intake and physical activity to achieve and maintain a healthy body weight; to consume a diet rich in vegetables and fruits; to choose whole-grain, high-fiber foods; to eat fish, especially oily fish, at least twice a week; to limit intake of saturated fat to less than 7% of calories, trans fat to less than 1% of calories, and cholesterol to less than 300 mg per day by choosing vegetables, lean meats, and fat-free (skim) or low-fat (1% fat) dairy products; to minimize intake of partially hydrogenated fats; to minimize intake of beverages and foods with added sugars; and to choose and prepare foods with little or no salt. For those who drink alcohol, AHA recommends doing so in moderation. They also point out that these recommendations need to be followed whether you are eating at home or in restaurants.

Practical tips to help you succeed

Knowing how you should eat and actually eating that way are two separate matters. Considering this, the AHA provided practical guidance on how to achieve their recommended diet and lifestyle changes. Lifestyle tips include: know your caloric needs to achieve and maintain a healthy weight; know the calorie content of the foods and beverages you consume; keep track of your weight, activity level, and calorie intake; cook and eat smaller portions; decrease screen time (watching television, surfing the Internet, playing computer games, and so on); include more physical movement in routine activities; don’t smoke; and if you drink alcohol, do so in moderation (no more than one drink for women or two drinks for men per day).

The new guidelines offer practical tips on food choices and preparation as well: pay attention to the nutrition facts panel and ingredients list when buying food; eat fresh, frozen, and canned vegetables and fruits without high-calorie sauces and added salt and sugars; replace high-calorie foods with fruits and vegetables; increase fiber intake by eating beans (legumes), whole-grain products, fruits, and vegetables; use liquid vegetable oils in place of solid fats; limit beverages and foods high in added sugars (for example, high fructose corn syrup); choose foods made with whole grains (for example, whole wheat, oats, bulgur, and brown rice); cut back on pastries and high-calorie baked goods; choose fat-free or low-fat milk and dairy products; reduce salt intake by comparing the sodium content of similar products and choosing products with less salt; limit the use of salty condiments (for example, soy sauce and ketchup); use lean cuts of meat and remove skin from poultry before eating; limit processed meats that are high in saturated fat and sodium; grill, bake, or broil fish, meat, and poultry; use vegetable-based meat substitutes (such as tofu) in favorite recipes; and eat whole vegetables and fruits in place of juices.

“The key message of the recommendations is to focus on long-term, permanent changes in how we eat and live,” Dr. Lichtenstein said in an AHA statement. “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.”

The AHA has many resources available to help people educate themselves to make more healthful diet and lifestyle choices. Many of these are listed in the published recommendations and can also be found on the AHA’s Web site: www.americanheart.org.

(Circulation 2006;114:82–96)

Jeremy Appleton, ND, CNS, is a licensed naturopathic physician, certified nutrition specialist, and published author. Dr. Appleton was the Nutrition Department Chair at the National College of Naturopathic Medicine, has served on the faculty at Bastyr University of Natural Health Sciences, and is a former Healthnotes Senior Science Editor and a founding contributor to Healthnotes Newswire. He has worked extensively in scientific and regulatory affairs in the supplement industry and is now a consultant through his company Praxis Natural Products Consulting and Wellness Services.

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