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New guideline advises lowering heart disease risk through nutrition
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2013 AHA/ACC Guideline provide insight into how lifestyle management can reduce cardiovascular risk

by Penny M. Kris-Etherton, PhD, RD and Jennifer Fleming MS, RD

In November 2013, the American Heart Association and American College of Cardiology issued a lifestyle guideline to decrease cardiovascular disease  risk. The new guideline targets two important risk factors for heart disease: an elevated LDL-cholesterol (LDL-C) and high blood pressure. By emphasizing good nutrition practices, the guideline advises adults who would benefit from lowering their LDL-C and/or blood pressure to consume a dietary pattern that focuses on eating more vegetables, fruits, and whole grains; includes low-fat dairy products, poultry, fish, legumes, nontropical vegetable oils, and nuts; and limits intake of sweets, sugar-sweetened beverages and red meats. Beyond this, the guideline specifically targets reducing saturated fat to lower LDL-C and sodium for lowering blood pressure.

To lower LDL-C, the guideline specifically recommends that only 5-6% of daily calories come from saturated fat. This amount is about half the current consumption in the United States. Major sources of saturated fat in the U.S. diet are full-fat dairy products, fatty meats and grain-based desserts. To lower saturated fat intake to meet the new guideline, skim milk and low-fat dairy products and lean meats are recommended. Solid fats like butter should be replaced with soft margarine (which you should still use sparingly) and liquid vegetable oils. While a paper published in the Annals of Internal Medicine recently suggested that there may not be a specific link between saturated fat and heart disease, the available scientific evidence clearly shows heart disease risk is reduced when saturated fats are replaced with olive oil, especially when in conjunction with a heart-healthy diet.

To lower blood pressure, the guideline recommends reducing sodium, noting that a reduction by at least 1000 mg/day will reduce blood pressure, even if the desired target (2400 mg/day) is not achieved. Current sodium intake in the United States is about 3500 mg/day. Major sources of sodium in the diet are processed foods and foods eaten away from home, which account for about 70% of our daily sodium intake. It's important to pay attention to the Nutrition Facts Panel on processed food products that are purchased in the grocery store and try to order lower sodium items from menus at restaurants.

Following a heart-healthy diet is central to lowering your risk of cardiovascular disease, so be sure to monitor your intake of saturated fat and sodium in order to have the most success -- and be sure to eat your fruit, vegetables, and whole grains!

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AHA/ACC 2013 Lifestyle Guideline

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