A heart-healthy way to eat

By Jane E. Brody

There are no “good” and “bad” foods. Instead, your overall diet pattern is most important when it comes to healthy eating.

This is the main message of the American Heart Association in its latest Dietary Guidelines to improve the hearts and health of Americans of all ages and life circumstances.

The experts who wrote the guidelines understand that people don’t eat individual nutrients or ingredients. They eat foods, and most people want to enjoy the foods they eat while staying within their budgets, the association hopes, without harming their bodies.

This doesn’t mean you need to avoid Big Mac, Cola, and French fries entirely, but it does mean that you shouldn’t regularly indulge in such fare if you want to stay healthy.

Dr. Robert H. Eckel, former president of the American Heart Association, an endocrinologist and lipid specialist at the University of Colorado Denver, tells me that “once in a while” I indulge in foods outside of a healthy diet. However, the operative word here is “occasional”.

“There is no one-size-fits-all diet, but there are principles to form the basis of one-size-fits-all diets,” said Dr. Neil J. Stone, a preventive cardiologist at Northwestern University School of Medicine, who praised the guideline committee’s interest and expertise, in an interview.

He added: “The goal is to make good nutrition possible for everyone. The longer we can keep everyone in this country healthy, the lower our health costs will be.”

In the 15 years since the Heart Association released their latest dietary guidelines to reduce the risk of cardiovascular disease, almost nothing has changed for the better. The typical American diet has remained highly processed. Americans consume too many added sugars, artery-clogging fats, refined starches, red meat, and salt, and don’t eat enough vegetables, fruits, nuts, beans, and whole grains, which can help prevent heart disease, diabetes, and cancer.

But instead of getting discouraged, the association decided to try a different approach. For too long, nutrition advice has focused too much on individual nutrients and ingredients, Alice H. Liechtenstein, senior author of the guidelines tells me, and not enough focus on the holistic nutritional patterns that can best fit people’s lives and budgets.

Instead of a “shouldn’t eat” laundry list, the Association’s Committee on Nutrition and Cardiovascular Diseases chose to promote heart-healthy dietary patterns that can suit a wide range of tastes and eating habits, Liechtenstein said. In avoiding the “nos” and dietary revolutions, the new guidelines could promote incremental evolutionary changes that are meant to last a lifetime.

The Commission recognized that for people to adopt and stick to a healthy eating pattern, it must accommodate their likes and dislikes, ethnic and cultural practices, and conditions of life, and must consider whether most meals are eaten at home or on the go.

For example, rather than urging people to skip pasta because it is a refined carb, a more effective message might be telling people to eat it the traditional Italian way, as a small part of their first course. Or, if pasta is the main dish, choose a product made with unrefined carbohydrates such as whole wheat, brown rice, or lentils.

“We’re talking about lifelong changes that involve personal preferences, culinary traditions, and what’s available where people shop and eat,” said Lichtenstein, professor of nutrition science and policy at Tufts University’s Friedman College. “The advice is evidence-based and applies to everything people eat regardless of where the food is purchased, prepared and consumed.”

The guidelines’ first principle is to modify “energy intake and expenditure” in order to “achieve and maintain a healthy body weight,” a recommendation that may be easier to follow with the following two principles: eat plenty of fruits and vegetables, and choose foods made mostly with whole grains rather than grains duplicate. If cost or availability is an issue, as in many of the country’s food deserts where fresh produce is scarce, Liechtenstein suggested keeping bags of frozen fruits and vegetables on hand to reduce waste, increase convenience and save money.

Some of the healthy protein options recommended by the committee included fish and seafood (although not fried and baked), legumes, nuts, and low-fat or fat-free dairy products. If you want to eat meat, choose lean cuts and refrain from processed meats such as sausages, sausages, and deli meats that are high in salt and saturated fat.

The panel’s advice on protein foods, published during the climate talks in Glasgow, Scotland, was well-timed. Choosing plant proteins rather than animal sources of protein not only has health value for consumers, but can also help promote a healthier planet.

Experts have long known that animal products such as beef, lamb, pork and veal have a disproportionate negative impact on the environment. Raising animals requires more water and land and produces more greenhouse gases than it does to grow protein-rich plants.

“This is a win-win for everyone and for our environment,” Liechtenstein said. However, she cautioned, if a plant-based diet is loaded with refined carbohydrates and sugars, it will increase the risk of type 2 diabetes and heart disease. It also discouraged a reliance on alternatives to plant-based meats that are popular, over-processed and often high in sodium, fat and unhealthy calories, the production of which “may not be environmentally sound”.

To protect the environment and human health, the committee advised shifting one’s diet away from tropical oils – coconut, palm and palm kernel – as well as animal fats (butter and lard) and partially hydrogenated fats (read the nutrition label). Instead, use liquid vegetable oils such as corn, soybean, safflower, sunflower, canola, walnut, and olive. It has been shown to reduce the risk of cardiovascular disease by about 30%, an effect comparable to taking a statin.

Finally, the dietary patterns established by the committee can go beyond reducing the risk of cardiovascular diseases such as heart attacks and strokes. They can also protect against type 2 diabetes and worsening kidney function, and may also help promote better cognitive abilities and a slower rate of age-related cognitive decline.

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