Clinical Scorecard: AHA Updates Heart-Healthy Dietary Guidance

At a Glance

Key Highlights

• Nine actionable features define heart-healthy dietary patterns focusing on food choices rather than nutrient targets
• Emphasis on maintaining healthy body weight through energy balance and physical activity (≥60 min/day for youth, ≥150 min/week for adults)
• Strong evidence supports replacing saturated fats with unsaturated fats and minimizing ultraprocessed foods and added sugars

Guideline-Based Recommendations

Diagnosis

• Identify poor diet quality as a significant contributor to increased CVD risk across all risk levels

Management

• Adjust energy intake and expenditure to maintain healthy body weight
• Consume a wide variety of vegetables and fruits, preferably whole or minimally processed
• Choose whole grains over refined grains
• Select healthy protein sources emphasizing legumes, nuts, fish/seafood, and low-fat dairy
• Replace saturated fats with unsaturated fats, favoring plant oils and spreads
• Limit intake of ultraprocessed foods and added sugars
• Reduce sodium intake
• If alcohol is consumed, limit intake; do not start if abstinent

Monitoring & Follow-up

• Monitor body weight and physical activity levels
• Assess dietary patterns for adherence to heart-healthy features
• Evaluate cardiovascular risk factors including blood lipids, blood pressure, and glycemic control

Risks

• Popular weight loss diets may have uncertain long-term cardiovascular impact and can worsen CVD risk factors
• Fish oil supplementation alone has not demonstrated CVD risk reduction and may increase atrial fibrillation risk in some patients
• Ultraprocessed foods and high added sugar intake are linked to increased risk of obesity, CVD, type 2 diabetes, and mortality

Patient & Prescribing Data

General US population including pediatric, adolescent, and adult patients

Dietary patterns emphasizing whole/minimally processed plant foods, healthy protein sources, and unsaturated fats improve cardiovascular risk profiles; physical activity is integral

Clinical Best Practices

• Encourage consumption of a variety of whole fruits and vegetables, including frozen and canned without added sugars or sodium
• Promote whole grains containing all kernel components to reduce CVD and metabolic risks
• Advise protein intake focusing on legumes, nuts, fish, and low-fat dairy while limiting red and processed meats
• Recommend replacing saturated fats with polyunsaturated and monounsaturated fats from plant sources
• Discourage consumption of ultraprocessed foods and minimize added sugars throughout the life course
• Advocate for regular moderate to vigorous physical activity tailored to age groups
• Counsel patients on limiting alcohol intake or abstaining if not currently consuming

References

• American Heart Association 2026 Dietary Guidance Statement