Matters of the heart: New American Heart Association guidelines focus on balanced eating patterns vs. strict diet

While most Americans will indulge for Thanksgiving, what really counts are daily eating habits to reduce heart disease and stroke.

Strict diets don’t tend to work. Experts today urge people to seek balance and follow healthier eating strategies. That’s found in the American Heart Association’s newly released dietary guidance, last updated in 2006, which offers 10 heart-healthy eating patterns to use daily.

The tools are more adaptable to individual tastes, cultural traditions and on-the-go consumption, the AHA says.

“It’s not like a one-size-fits-all because we all have different preferences, different cultural and ethnic traditions, but it’s how can we still choose healthier options that fit into those?” said Delaney Wakefield, Spokane exercise physiologist and registered dietitian for Providence St. Luke’s Cardiopulmonary Rehabilitation.

“A rigid diet is not sustainable. We have to live. It’s about what can we do that fits in with everything else?”

AHA’s 10 heart-healthy dietary focuses are to:

• Balance food and calorie intake with physical activity to maintain a healthy weight.

• Choose a wide variety as well as plenty of fruits and vegetables to get a full range of nutrients from food rather than supplements.

• Select whole grains and other foods made up mostly of whole grains.

• Choose healthy sources of proteins: plant sources such as legumes and nuts, fish and seafood, low-fat or nonfat dairy and lean cuts of meat, while limiting red meats and processed meats.

• Use liquid plant oils that are nontropical (think olive oil).

• Choose minimally processed foods overall rather than ultraprocessed foods as much as possible.

• Minimize intake of added sugars in foods and beverages.

• Choose or prepare foods with little or no salt.

• Limit alcohol consumption; if you don’t drink, don’t start.

• Apply the guidance wherever your food is prepared or consumed.

Wakefield said it’s key to think of overall healthier choices that are combined with regular physical activity. Loading up on a variety of fruits and vegetables is better for our bodies, she added, “because they’re full of nutrients and antioxidants.”

But Wakefield also gets the challenge of how to pack in more fresh produce throughout the day.

“If we can kickstart our morning and sneak some veggies in, that’s just going to kickstart the day,” she said. “It’s thinking, if we’re having eggs or an omelette, can you load that up with spinach, asparagus, peppers, and what other colors can we add?”

“Even a fruit smoothie, you can think of adding spinach or kale. Coming into winter, if you’re making different chilies or soups in the crockpot, loading it up again with diced-up vegetables is an easy way to sneak it in to increase and boost the veggies we’re eating.”

People also should think of whole grains that contain more fiber and nutrients than do processed grains, so “choosing whole-grain bread versus white bread and whole-grain pasta versus white pasta,” or brown instead of white rice.

One of the AHA goals would go to the top of advice given by Lisa Randall, Spokane Providence Health Services dietician and diabetes educator.

“I’d put (it) as No. 1, to choose minimally processed foods instead of ultraprocessed foods,” Randall said.

“To me, if we eat less processed food, we have more success with weight loss. If we eat less processed food, we’re eating healthier choices. If we eat less processed food, we’re eating more fruits and vegetables.”

To understand better what those processed foods are, dietitians might refer to it as cooking with whole foods that are as close as possible to its natural state – such as more fresh produce, beans, whole grains and nuts.

Randall has a definition for minimally processed. “It’s not in a box.” She urges patients to look for what comes off a tree or out of the ground.

“If it comes from a factory or if it’s in a box, that’s a processed food. This guidance doesn’t even say no processed food, it just says minimally processed. Cheetos are pretty highly processed.

“The second thing I’d say is don’t drink your calories – no sugary beverages.”

Randall also thinks dietary guidelines need to have simpler messages that drive home the connection between diet and heart disease, but that’s tough to do, she said.

“I don’t disagree with any of what they’re saying at all. It’s irrefutable. It’s just the message you’ve got to get to people who need it.

“Changing your lifestyle doesn’t change the outcomes right away. You need to do it consistently for a long period of time to see the benefits.”

Wakefield hopes people think of ways to work toward the AHA guidelines, such as including more fish and plant sources a few times each week and the goals toward eating minimally processed foods.

“I always say to people, if you’re someone right now who is eating red meat five times a week, it might not be realistic to cut that down to zero, but how can you substitute and pick other options slowly over time to get to those goals?”

She has another tip for using cooking oils.

“A good rule is our oils that are at liquid at room temperature are technically going to be more of our heart-healthy oils,” Wakefield said. While coconut oil is a popular shelf item today, she cautions to use it in moderation.

Meanwhile, sugar can sneak in at high levels if people don’t consider food choices. Use similar strategies at a restaurant, or Wakefield suggests eating heart-healthier selections earlier in a day if later going to a steakhouse.

“This is more of a lifestyle. What changes can we make that are sustainable for our lifestyle, so it’s not a diet we’re following, but more a way of life and a way of eating.”

Social media, culture, habits and quick-fix products can all influence unhealthy eating patterns, Randall said. “It’s how everybody around you eats, it’s what you do for entertainment, it’s what you do for your meal, and people don’t realize how harmful that is.”

Randall agrees with balanced eating because no one food is the healthiest, but that it’s also important to understand the connection between heart disease and diet.

“Patients come in here all the time and can tell me they understand they should eat more fruits and vegetables, but they don’t understand how not eating more fruits and vegetables contributes to heart disease,” Randall said.

“A healthy eating pattern makes a healthy body. Conversely, people don’t eat healthy not because they don’t want to eat healthy, but because it is just fast and convenient and tasty. But I don’t think they understand how much that pattern contributes to heart disease.”