New Guidelines From American Heart Association Focus on Dietary Patterns

Dietary patterns are more important for heart health than any one specific food item or nutrient, according to new guidance from the American Heart Association (AHA).

Heart-healthy diets include a variety of fruits, vegetables, and whole grains, according to the AHA. The association also recommends using plant oils rather than tropical oils like coconut or animal fats like butter and lard.

Instead of listing specific food items, the AHA kept recommendations broad to be more inclusive in its latest guidelines, leaving room for personal preferences. The last update to the guideline was in 2006.

"The guidance is routinely reevaluated to ensure it is consistent with new information," Alice H. Lichtenstein, DSc, co-author of the AHA guidelines and director of the Cardiovascular Nutrition Laboratory at the Human Nutrition Research Center on Aging at Tufts University, told Verywell.

Another big change in the new guidelines aimed to "highlight structural challenges that impede the adoption of heart-healthy dietary patterns," according to Lichtenstein.

The 2021 guidelines acknowledged that factors like “targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism" have made it challenging for some people to adhere to a heart-healthy dietary pattern.

Barriers to Heart-Healthy Diets

People living in food deserts or places that have inadequate access to fresh food often don't have a choice in their dietary habits.

"The environment is stacked up against making healthy choices," Lawrence J. Appel, MD, MPH, a professor of medicine at The Johns Hopkins University and co-author of the new guidelines, told Verywell.

Neighborhood segregation has created environments that don't promote healthy options. A 2019 study showed that 5.6% of the U.S. population live in neighborhoods that are far from grocery stores or supermarkets.

Appel added that food offerings, especially the healthier options, are limited in marginalized neighborhoods.

Some policy changes have been made to address environmental disparities. Supplemental Nutrition Assistance Program (SNAP), a federal program that offers food assistance to low-income families, launched a pilot program in May to allow recipients to use their benefits for online grocery stores.

While this may remove some barriers, it isn't a perfect solution.

The AHA guidelines explained that online grocery shopping "might have the opposite effect by using artificial intelligence to promote unhealthy foods and beverages."

"There is no easy answer." Appel said. "This is a societal problem that requires a societal solution."

Prevention Is Key

Focusing on prevention is another important component of the updated AHA guidelines. Starting a heart-healthy diet early can help reduce the risk of cardiovascular disease later in life.

"The prevention of pediatric obesity is key to preserving and prolonging ideal cardiovascular health," the guidelines stated.

However, it's also challenging to promote a nutritious diet to children. Similar to the tobacco industry, the food industry has also used targeted marketing to sell high-fat and sugary snacks to people of color, according to the AHA. Research shows Black and Hispanic children are more likely than White children to be exposed to ads for processed foods.

Lichtenstein suggested that teaching children how to differentiate credible sources of information from less reputable ones may help in the long-run. Schools could enrich its existing classes by incorporating nutrition topics and making these discussions more approachable for children, she added.

"Start by introducing different types of foods and where they come from at the elementary level," Lichtenstein said. "At the next level introduce simple cooking skills into science class. Then move on to basic budgeting skills as economic lessons."

A Dietitian’s Perspective on the New Guidelines

Grace Derocha, MBA, RD, a spokesperson for the Academy of Nutrition and Dietetics, told Verywell that she's glad to see the new AHA guidelines left room for individual differences and choices.

Derocha said that there are many factors that influence what goes on someone's plate. Cultural traditions, access to grocery stores, and a lack of understanding of healthy eating practices can all come into play.

The new AHA guidelines are moving in the right direction, Derocha suggested, but some phrases might still be confusing to people.

For instance, the recommendation said to choose minimally processed foods instead of ultra-processed foods. Understanding the difference between "minimal" and "ultra" can be tricky. This kind of phrasing might lead people to think they can only eat fresh foods, which could be inaccessible for some people. Foods like frozen broccoli are processed but they're not necessarily unhealthy, Derocha explained.

Since adopting the new guidelines can be overwhelming, she encouraged people to take in the nutritional advice at their own pace. It can start with small changes like drinking more water or adding a few more fruits and vegetables each day.

"Take the information and figure out ways to apply it," Derocha said. "But allow yourself the grace and patience to figure it out slowly and surely."