Guidelines for a Heart-Healthy Lifestyle

Sponsoring Organizations: American College of Cardiology, American Heart Association

Target Population: Primary care providers

Background and Objective

The ACC/AHA Task Force based these recommendations on an evidence review of the relationship between dietary patterns, nutrient intake, and physical activity and cardiovascular disease (CVD) in adults conducted by an Expert Work Group convened by the National Heart, Lung, and Blood Institute. The Work Group developed three critical questions to define the scope of the review:

1. What is the effect of dietary patterns, macronutrients, or both on CVD risk factors?

2. What is the effect of dietary intake of sodium and potassium on CVD risk factors and outcomes?

3. What is the effect of physical activity on blood pressure (BP) and lipids compared with no treatment or with other types of interventions?

Key Points

• The authors recommend consumption of a diet rich in vegetables, fruits, and whole grains and incorporating low-fat dairy products. Recommended protein sources include fish, legumes, and poultry; recommended sources of fats include vegetable oils and nuts.

• They identify three plans that exemplify this dietary pattern: DASH, the USDA Food Pattern, and the AHA Diet.

• Additional recommendations for lowering LDL include a dietary pattern that derives 5% to 6% of calories from saturated fat and a reduction in the percentage of calories from trans fats.

• Additional recommendations for lowering BP include restriction of sodium intake to no more than 2400 mg per day — and, if possible, to 1500 mg per day. Evidence exists that reduction in sodium intake of approximately 1000 mg per day reduces CVD events by approximately 30%.

• The DASH dietary pattern has been shown to be beneficial for reducing BP in a wide range of subgroups, including women and men; African-American and non–African-American adults; older and younger adults; and hypertensive and nonhypertensive individuals.

• Recommendations for physical activity to reduce LDL, non-HDL cholesterol, and BP include three to four sessions of moderate-to-vigorous–intensity aerobic activity per week, lasting an average of 40 minutes per session.