Perspective from Nanette K. Wenger, MD
November 12, 2013
2 min read

New lifestyle guideline emphasizes heart-healthy diet, physical activity

Perspective from Nanette K. Wenger, MD
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A new clinical practice guideline on lifestyle modification outlines an optimal heart-healthy diet and makes recommendations for physical activity.

The 2013 Guideline on the Assessment of Cardiovascular Risk, issued by the American College of Cardiology and the American Heart Association, stresses that lifestyle modification be part of a CVD prevention strategy for all people, even those taking medications to manage BP and cholesterol.

The guideline writing group examined evidence that “dietary patterns, nutrient intake and levels and types of physical activity can play a major role in CVD prevention and treatment through effects on modifiable CVD risk factors, specifically related to lipids and BP,” Robert Eckel, MD, co-chair of the writing committee, said at a press conference. “The concept here is that diet and physical activity are both important in CVD risk reduction.”

Heart-healthy diet recommendations

The work group’s outline for a heart-healthy eating pattern based on a 2,000 calorie per day diet is as follows:

  • Four or five servings of fruits per day.
  • Four or five servings of vegetables per day.
  • Six to eight servings of whole grains, preferably high fiber, per day.
  • Two or three servings of fat-free or low-fat milk and milk products per day.
  • Six or fewer ounces of lean meats, poultry and fish per day.
  • Four or five servings of nuts, legumes and seeds per week.
  • Two or three servings of healthy oils per day, with limitations on trans fat and saturated fat.
  • Limitations on sweets and added sugars.

“These guidelines are increasingly emphasizing the importance of dietary patterns,” Eckel said. “We’re talking about diets that are enriched in fruits and vegetables, whole grains, fish and lean poultry, and limited in saturated fat intake and trans fat intake. In addition, [we recommend] diets that have nuts and are otherwise consistent with that of the Mediterranean diet or the DASH [Dietary Approaches to Stop Hypertension] dietary pattern. These were the two diets that got the most attention, because they were most represented in the more recent literature which we surveyed.”

“There is strong evidence to support that reductions in saturated fats lower LDL,” Eckel said, noting that reducing intake of trans fats and sodium is also important. The guideline recommends sodium intake of no more than 2,400 mg/day, with a preference for 1,500 mg/day. The current average in US adults is 3,600 mg/day.

Physical activity recommendations

The guideline’s recommendations for physical activity are largely based on a 2008 report from the Department of Health and Human Services indicating that 30 to 40 minutes of moderate to vigorous physical activity at least three or four days per week is beneficial for reducing LDL, non-HDL and BP, Eckel said.

The guideline does not address weight loss issues, which are covered in a separate guideline.

For more information:

Eckel R. Circulation. 2013;doi:10.1161/01.cir.0000437740.48606.d1.

Eckel R. J Am Coll Cardiol. 2013;doi:10.1016/j.jacc.2013.11.003.

Disclosure: See the full guideline for a list of the work group members’ relevant financial disclosures.