NewYork-Presbyterian. The University Hospital of Columbia and Cornell.

-- New guidelines concerning diet and lifestyle are intended to help prevent cardiovascular disease, the number one cause of death in the US.

The new guidelines from the American Heart Association (AHA) are intended for healthy Americans age 2 and older. The new recommendations replace guidelines issued by the AHA in 2000.

The 2006 guidelines were published this week in Circulation: Journal of the American Heart Association.

Emphasis Broadened to Include Lifestyle

“The key message of the recommendations is to focus on long-term, permanent changes in how we eat and live. The best way to lower cardiovascular risk is to combine physical activity with heart-healthy eating habits, coupled with weight control and avoiding tobacco products,” says Alice Lichtenstein, D.Sc.

Dr. Lichtenstein is chair of the AHA’s Nutrition Committee and Gershoff Professor of Nutrition Science and Policy at the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

“The previous recommendations stressed a healthy dietary pattern; the new ones broaden that concept to include the importance of a healthy lifestyle pattern. The two go together - they should be inseparable,” says Dr. Lichtenstein,

The AHA continues to emphasize achieving and maintaining a healthy body weight, but is putting more emphasis on balancing the number of calories consumed with the number of calories burned.

A stronger focus is now placed on food preparation methods that avoid adding saturated fat, sugar, or salt. Portion size control is also stressed.

Besides the goals and recommendations, the statement has new sections with practical information for consumers such as knowing your caloric needs, food preparation tips, and some examples of dietary patterns consistent with the new recommendations.

Recommendations now include:

• further reducing saturated and trans fatty acids in the diet
• minimizing the intake of food and beverages with added sugars
• emphasizing physical activity and weight control
• eating a diet rich in vegetables, fruits, and whole-grain foods
• avoiding use of and exposure to tobacco products
• achieving and maintaining healthy cholesterol, blood pressure and blood glucose levels

More than 90 scientific publications were reviewed by a panel of nutrition and cardiovascular disease experts for the new AHA recommendations.

Environmental Factors Considered

Because environmental factors strongly influence how Americans eat and exercise, a new feature of the 2006 recommendations is a list of ways that healthcare providers, restaurants, the food industry, schools, and local governments can help the general public adopt these recommendations.

Examples include displaying caloric content prominently on menus, reducing portion size, limiting trans fatty acids, and using low-saturated-fatty-acid oils in food preparation.

Another major change in the dietary recommendations is a lower goal for saturated fat - from less than 10 percent to less than 7 percent - and establishing a goal for trans fatty acids of less than 1 percent of total calories.

Trans-fatty acids - which are now required to be shown on the Nutrition Facts panel of packaged foods - are commonly found in commercially baked and fried foods, such as crackers, French fries, cakes, pies, bread, and cookies.

The AHA urges industry to gradually reduce the salt and sugar content of processed foods and to increase the proportion of whole grains compared to white flour in baked goods, among other recommendations.

Small Changes Can Help

“Almost anyone can make changes in how they eat and move their bodies to bring themselves closer to the recommended goals. The changes can be small but need to be maintained. In no way are we saying people will have to give up all the things they enjoy; they just may have to make a few modifications in their current habits,” Dr. Lichtenstein says.

“A good first step to improve your diet and lifestyle - start paying attention to portion size and liquid calories, such as those in soft drinks, fruit drinks, fruit juices and alcoholic beverages. The next step is to try to get at least 30 minutes of physical activity every day,” Dr. Lichtenstein says.

“It does not have to be done all at once - accumulating 30 minutes throughout the day is fine - and, of course, more is better. No one is too old or too out of shape to make small changes to increase physical activity,” she adds

Always consult your physician for more information.