scholarly journals 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association

Circulation ◽  
2021 ◽  
Author(s):  
Alice H. Lichtenstein ◽  
Lawrence J. Appel ◽  
Maya Vadiveloo ◽  
Frank B. Hu ◽  
Penny M. Kris-Etherton ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Cardiovascular Health ◽  
Critical Role ◽  
Heart Association ◽  
Cardiometabolic Health ◽  
Processed Foods ◽  
Structural Racism ◽  
Scientific Statement ◽  
Targeted Marketing

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the intake of beverages and foods with added sugars; (8) choose and prepare foods with little or no salt; (9) if you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.

scholarly journals Assessing nutritional quality as a ‘vital sign’ of cardiometabolic health

2019 ◽  
Vol 122 (2) ◽  
pp. 195-205
Author(s):  
Dorothée Buteau-Poulin ◽  
Paul Poirier ◽  
Jean-Pierre Després ◽  
Natalie Alméras
Keyword(s):  
Vital Sign ◽  
Nutritional Quality ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Hdl Cholesterol ◽  
Activity Level ◽  
Cardiometabolic Health ◽  
Lifestyle Habits ◽  
Ideal Cardiovascular Health ◽  
Cholesterol Ratio

AbstractHigh overall nutritional quality (NQ) is an important component of ideal cardiovascular health, a concept introduced in 2010 by the American Heart Association. However, data on the independent contribution of overall NQ to the variation in the cardiometabolic risk (CMR) profile are limited. This observational study aimed to investigate the association between overall NQ and the CMR profile in 4785 participants (65⋅4 % of men, age 43⋅3 (sd 10⋅8) years) who underwent a cardiometabolic health evaluation, including lifestyle habits, anthropometric measurements, blood pressure, lipid profile and HbA1c concentrations. In addition, a submaximal exercise test was conducted to assess cardiorespiratory fitness (CRF). Using a standardised NQ questionnaire (twenty-five items food-based questionnaire), participants were classified into three subgroups: (1) low, (2) moderate or (3) high NQ and variance and multiple linear regression analyses were performed. Results showed that less than 15 % of participants presented a high NQ. A high NQ was associated with a healthier lifestyle habits and a more favourable CMR profile (lower values of waist circumference and cholesterol:HDL-cholesterol ratio, lower concentrations of non-HDL-cholesterol, TAG and HbA1c). Some of these associations were independent of age, physical activity level (PAL) and CRF. A better NQ was also associated with a lower proportion of participants presenting the hypertriacylglycerolaemic waist phenotype independently of both PAL and CRF. The present study suggests that overall NQ can be assessed with a short food-based questionnaire and should be considered in clinical practice as a new ‘vital sign’ associated with other health behaviours and cardiometabolic health.

scholarly journals Dietary Patterns Trend in Mexican Adolescent Population from 2006 to 2018, by Area of Residence

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 566-566
Author(s):  
Teresa Shamah-Levy ◽  
Sonia Rodríguez-Ramírez ◽  
Elsa Gaona-Pineda ◽  
Edith Kim-Herrera ◽  
Andrys Valdez-Sánchez
Keyword(s):  
Urban Area ◽  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Red Meat ◽  
Leafy Vegetables ◽  
Categorical Variables ◽  
Processed Foods ◽  
Food Groups ◽  
Animal Products ◽  
Adolescent Population

Abstract Objectives To analyze the dietary patterns trend in Mexican adolescent population from 2006 to 2018 by area of residence. Methods We analyzed information from four National Health and Nutrition Surveys in Mexico from 2006 to 2018. Dietary information was collected using a validated seven-day, semi-quantitative Food frequency questionnaire. We analyzed the consumption of different food groups: 1) Fruits and vegetables (g), 2) Red meat (consumption yes or not), 3) animal products (kcal), 4) sugar-sweetened beverages (SSB) (kcal), and ultra-processed foods (kcal), according to NOVA classification. We estimated the Dietary Diversity Score (DDS), which was constructed based on 10 food groups consumed: 1) grains, roots, and tubers; 2) pulses; 3) nuts and seeds; 4) dairy; 5) meat, poultry and fish; 6) eggs; 7) dark green leafy vegetables; 8) other vitamin A-rich fruits and vegetables; 9) other vegetables; 10) other fruits. Food groups were assigned to 1 if any food item within the group was consumed, otherwise 0. We estimated the proportion of population with consumption of ≥ 400 g of fruits and vegetables/d, with ≥ 5 food groups (Minimum DDS) and percentage of consumers of red meat, and the contribution to the total energy of SSB, ultra-processed food and animal products (energy percentage). Demographic and socio-economic characteristics of sampled individuals such as sex, age, area and socio-economic status (SES) were obtained. The country was divided into urban and rural areas (≥2500 or < 2500 inhabitants, respectively). We used linear and logistic regression models to continuous and categorical variables, respectively. We analyzed difference by area. Results The percentage of population of Minimum DDS was lower in rural when compared with urban area by every year of survey (P < 0.05). The contribution of energy percentage from ultra-processed foods and animal products was lower in rural area than urban area (P < 0.05). The SSB contribution was similar in both areas. Conclusions Current findings show that the area of residence was associated with variations in the consumption of fruits, vegetables and red meat in Mexican adolescents. Consequently, interventions should focus on increasing healthy eating habits in this population, taking into account when designing preventive strategies the area of residence. Funding Sources Mexican Ministry of Health.

scholarly journals Habitual Nightly Fasting Duration, Eating Timing, and Eating Frequency are Associated with Cardiometabolic Risk in Women

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3043
Author(s):  
Nour Makarem ◽  
Dorothy D. Sears ◽  
Marie-Pierre St-Onge ◽  
Faris M. Zuraikat ◽  
Linda C. Gallo ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Cardiometabolic Risk ◽  
Heart Association ◽  
Cardiometabolic Health ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Eating Frequency ◽  
Nighttime Eating ◽  
Fasting Duration ◽  
Prospective Analyses

Nightly fasting duration (NFD) and eating timing and frequency may influence cardiometabolic health via their impact on circadian rhythms, which are entrained by food intake, but observational studies are limited. This 1-year prospective study of 116 US women (33 ± 12y, 45% Hispanic) investigated associations of habitual NFD and eating timing and frequency with cardiovascular health (CVH; American Heart Association Life’s Simple 7 score) and cardiometabolic risk factors. NFD, eating timing and frequency, and nighttime eating levels were evaluated from 1-week electronic food records completed at baseline and 1 y. In multivariable-adjusted linear regression models, longer NFD was associated with poorer CVH (β = −0.22, p = 0.016 and β = −0.22, p = 0.050) and higher diastolic blood pressure (DBP) (β = 1.08, p < 0.01 and β = 1.74, p < 0.01) in cross-sectional and prospective analyses, respectively. Later timing of the first eating occasion at baseline was associated with poorer CVH (β = −0.20, p = 0.013) and higher DBP (β = 1.18, p < 0.01) and fasting glucose (β = 1.43, p = 0.045) at 1 y. After adjustment for baseline outcomes, longer NFD and later eating times were also associated with higher waist circumference (β = 0.35, p = 0.021 and β = 0.27, p < 0.01, respectively). Eating frequency was inversely related to DBP in cross-sectional (β = −1.94, p = 0.033) and prospective analyses (β = −3.37, p < 0.01). In cross-sectional analyses of baseline data and prospective analyses, a higher percentage of daily calories consumed at the largest evening meal was associated with higher DBP (β = 1.69, p = 0.046 and β = 2.32, p = 0.029, respectively). Findings suggest that frequent and earlier eating may lower cardiometabolic risk, while longer NFD may have adverse effects. Results warrant confirmation in larger multi-ethnic cohort studies with longer follow-up periods.

scholarly journals Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (3) ◽  
Author(s):  
Jo Ann S. Carson ◽  
Alice H. Lichtenstein ◽  
Cheryl A.M. Anderson ◽  
Lawrence J. Appel ◽  
Penny M. Kris-Etherton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dietary Patterns ◽  
Cardiovascular Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Low Density Lipoprotein ◽  
Dietary Cholesterol ◽  
Density Lipoprotein ◽  
Heart Association ◽  
Meta Analyses

The elimination of specific dietary cholesterol target recommendations in recent guidelines has raised questions about its role with respect to cardiovascular disease. This advisory was developed after a review of human studies on the relationship of dietary cholesterol with blood lipids, lipoproteins, and cardiovascular disease risk to address questions about the relevance of dietary cholesterol guidance for heart health. Evidence from observational studies conducted in several countries generally does not indicate a significant association with cardiovascular disease risk. Although meta-analyses of intervention studies differ in their findings, most associate intakes of cholesterol that exceed current average levels with elevated total or low-density lipoprotein cholesterol concentrations. Dietary guidance should focus on healthy dietary patterns (eg, Mediterranean-style and DASH [Dietary Approaches to Stop Hypertension]–style diets) that are inherently relatively low in cholesterol with typical levels similar to the current US intake. These patterns emphasize fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils. A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement; hence, guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health.

scholarly journals Achieving Optimal Population Cardiovascular Health Requires an Interdisciplinary Team and a Learning Healthcare System: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Author(s):  
Randi E. Foraker ◽  
Catherine P. Benziger ◽  
Bailey M. DeBarmore ◽  
Crystal W. Cené ◽  
Fleetwood Loustalot ◽  
...  
Keyword(s):  
Healthcare System ◽  
Cardiovascular Health ◽  
Interdisciplinary Team ◽  
Heart Association ◽  
Evidence Base ◽  
Current Evidence ◽  
Team Approach ◽  
Learning Healthcare System ◽  
Scientific Statement ◽  
The Impact

Population cardiovascular health, or improving cardiovascular health among patients and the population at large, requires a redoubling of primordial and primary prevention efforts as declines in cardiovascular disease mortality have decelerated over the past decade. Great potential exists for healthcare systems–based approaches to aid in reversing these trends. A learning healthcare system, in which population cardiovascular health metrics are measured, evaluated, intervened on, and re-evaluated, can serve as a model for developing the evidence base for developing, deploying, and disseminating interventions. This scientific statement on optimizing population cardiovascular health summarizes the current evidence for such an approach; reviews contemporary sources for relevant performance and clinical metrics; highlights the role of implementation science strategies; and advocates for an interdisciplinary team approach to enhance the impact of this work.

scholarly journals Associations between Food Consumption Patterns and Chronic Diseases and Self-Reported Morbidities in 6 American Indian Communities

2019 ◽  
Vol 3 (Supplement_2) ◽  
pp. 69-80
Author(s):  
Felicia J Setiono ◽  
Brittany Jock ◽  
Angela Trude ◽  
Caroline R Wensel ◽  
Lisa Poirier ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
American Indian ◽  
Chronic Diseases ◽  
Food Consumption ◽  
Dietary Patterns ◽  
Fruits And Vegetables ◽  
Processed Foods ◽  
Waist To Hip Ratio ◽  
Fried Foods

ABSTRACT Background American Indian (AI) have the highest rates of diet-related chronic diseases in the country. Yet, the relation between dietary patterns and chronic diseases in this population has not been well explored. Objective We aimed to characterize common dietary patterns among adults from 6 AI communities (N = 580) and assess their relation with BMI, percentage body fat, waist-to-hip ratio, hypertension, and self-reported type 2 diabetes and cardiovascular disease. Methods We conducted a baseline assessment of an obesity prevention study (N = 580). Dietary intake data were collected using a modified Block FFQ. Exploratory factor analysis was used to characterize dietary patterns. We used multivariate linear and logistic regression analyses to assess associations between dietary patterns and health outcomes, controlling for age, sex, employment status, smoking status, geographic region, and energy intake. Results Five dietary patterns, explaining 81.8% of variance in reported food consumption, were identified: “meat and fried foods,” “processed foods,” “fruits and vegetables,” “sugary snacks,” and “meat alternatives and high-protein foods.” “Those with higher consumption of “meat and fried foods” were associated with higher mean waist-to-hip ratio (0.03; 95% CI: 0.01, 0.04), higher mean BMI (2.45 kg/m2; 95% CI: 0.83, 4.07), and increased odds of being overweight or obese (OR: 2.63; 95% CI: 1.10, 6.31) compared to those with lower consumption of “meat and fried foods.” Higher consumption of “processed foods” was associated with increased odds of self-reported type 2 diabetes (OR: 3.41; 95% CI: 1.31, 8.90). No protective effect of consumption of “fruits and vegetables” was observed, although average consumption was below national recommendation levels. Conclusions AI dietary patterns corroborate nutritional concerns previously reported among AI populations. Future interventions should discourage overconsumption of meat, fried foods, and processed foods, and promote consumption of fruits and vegetables to reduce chronic disease burden in this population.

scholarly journals Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association

Circulation ◽  
2017 ◽  
Vol 136 (21) ◽  
Author(s):  
Mercedes R. Carnethon ◽  
Jia Pu ◽  
George Howard ◽  
Michelle A. Albert ◽  
Cheryl A.M. Anderson ◽  
...  
Keyword(s):  
African Americans ◽  
American Heart Association ◽  
Cardiovascular Health ◽  
American Heart ◽  
Heart Association ◽  
Scientific Statement
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