The AHA’s latest guidance shows how consistent, real food choices, rather than fad diets and ad-hoc diets, from childhood to adulthood can meaningfully reduce lifelong risk of heart disease.
Study: 2026 Dietary Guidance to Improve Cardiovascular Health: American Heart Association Scientific Statement. Image credit: Chinnapong/Shutterstock.com
recent american heart association The scientific statement summarized current evidence on food-based dietary patterns and provided practical, context-sensitive guidance to reduce the risk of cardiovascular disease and improve overall cardiovascular health.
Heart-healthy diet: Why it’s important to start early
American Heart Association (AHA) dietary guidance focuses on overall dietary patterns rather than individual foods or nutrients. A heart-healthy pattern includes a diet rich in vegetables, fruits, whole grains, lean proteins, non-tropical vegetable oils, and low in added sugar, saturated fat, and sodium. Overall, diets high in plant-based foods and low in animal foods are associated with a lower risk of coronary heart disease and a more favorable coronary heart disease risk factor and metabolic profile.
Eating habits are shaped and shared within the family and learned early in life, but can change during important transitions such as adolescence and young adulthood. Dietary quality is important even before birth, as the risk of cardiovascular disease (CVD) begins to accumulate early in life. Inappropriate dietary patterns in childhood contribute to obesity, metabolic syndrome, hypertension, dyslipidemia, and type 2 diabetes (T2D), and these conditions can progress into adulthood.
A heart-healthy diet applies to any eating environment
Consistent attention to dietary choices in all settings is essential to achieving and maintaining heart-healthy patterns and supports widespread policy efforts to improve dietary environments. Therefore, the AHA guidance applies universally, including meals at home, restaurants, workplaces, schools, and other establishments.
The current statement highlights important features of a heart-healthy dietary pattern.
Feature 1: Balance energy intake and physical activity to maintain a healthy weight
Maintaining a healthy weight is important for cardiovascular health. Obesity affects approximately 21% of children and adolescents and 40% of adults in the United States and increases CVD risk. Energy intake should be tailored to individual needs, taking into account age, gender, body composition, and activity level.
Physical activity goals include daily exercise for young children, at least 60 minutes of moderate-to-vigorous exercise for older children and adolescents, and at least 150 minutes per week along with regular strength-strengthening activities for adults.
Eating patterns such as Mediterranean style, pescetarian, and ovo-lacto-vegetarian support cardiovascular health and a healthy weight. However, while some popular weight loss diets may provide short-term benefits, long-term cardiovascular effects are uncertain and may exacerbate cardiovascular risk factors.. Individualized instruction that considers cultural, socio-economic, and personal factors is key to promoting continued adherence.
Feature 2: Consume plenty of vegetables and fruits every day
Whole, minimally processed vegetables and fruits are the foundation of a heart-healthy diet. These foods are consistently associated with improved blood lipids, blood pressure, and glycemic control. Whole fruits are preferred over juices in terms of fiber content. Fresh, frozen, and canned varieties are all beneficial and ideally have no added sugar or sodium.
Feature 3: Whole grains rather than refined grains
Whole grains, such as whole wheat, oats, brown rice, quinoa, barley, and rye, retain all three grain components (endosperm, germ, and bran) and provide fiber, vitamins, minerals, and bioactive compounds. Regular consumption of whole grains not only reduces the risk of CVD, stroke, T2D, and metabolic syndrome, but also improves blood pressure, lipid levels, and blood sugar control. Replacing refined grains with whole grains also supports gut microbiome health and reduces inflammatory markers.
Feature 4: Heart-healthy protein source
Quality of protein is more important than quantity for cardiovascular health. Recommendations focus on protein sources with favorable fatty acid profiles and fiber content and are categorized into the following subgroups:
- Plant sources: Legumes and nuts are rich in protein, unsaturated fats and fiber, linked to a lower risk of CVD and all-cause mortality. Plant-based meat alternatives can diversify your intake, but should be used with caution as they are often ultra-processed and may contain added sugar, sodium and preservatives.
- Seafood: Seafood that is not fried has a lower risk of CVD events and myocardial infarction, primarily due to its content of omega-3 fatty acids and the replacement of saturated fat with high protein sources. Fish oil supplementation alone has not been shown to reduce the risk of atrial fibrillation in healthy adults and may increase the risk of atrial fibrillation in some people.
- Dairy products: Low-fat and non-dairy unsaturated fat sources are preferred over full-fat dairy products for cardiovascular health, but the evidence comparing low-fat and full-fat dairy products is controversial and context-specific. Fermented dairy products may provide additional benefits through modulation of the gut microbiome, but evidence is still limited.
- Red and processed meat: Replacing red or processed meat with plant protein, poultry, dairy products, or eggs reduces the risk of coronary heart disease, but the effect varies by food substitute, with a stronger inverse association observed for processed meat than for unprocessed red meat. When consuming red meat, limited portions of lean, unprocessed cuts are preferred and processed meats should be kept to a minimum.
Feature 5: Replace saturated fat with unsaturated fat sources
Replacing saturated fat with polyunsaturated fat reduces LDL cholesterol and lowers the risk of coronary heart disease. Non-tropical vegetable oils (e.g. soybean, canola, olive) are preferred over animal fats and tropical oils (e.g. coconut, palm) in food preparation.
Feature 6: Minimize consumption of ultra-processed foods
Food processing can improve safety, shelf life, and nutritional fortification, but ultra-processed foods are often high in sodium, sugar, and additives, while lacking fiber and important nutrients. Intakes are increasing worldwide, and there is strong evidence linking ultra-processed diets to obesity, CVD, T2D, and all-cause mortality. However, definitions and classification systems for ultra-processed foods vary, and not all products are nutritionally equivalent. Minimally processed alternatives should be prioritized in all food environments.
Feature 7: Limit added sugars
Added sugars, often found in processed foods, sugary drinks, syrups, and concentrates, are strongly associated with obesity, T2D, coronary heart disease, and cardiovascular mortality. Adults who consume more than 25% of their energy from added sugars face an almost three times higher risk of CVD mortality than those who consume less than 10%, independent of obesity. Minimizing added sugar intake is recommended across all life stages.
Feature 8: Reduce sodium intake
Sodium and potassium have opposing effects on blood pressure. These are the main modifiable risk factors for preventable mortality. Reducing salt intake lowers blood pressure in both hypertensive and normotensive people, but it has the greatest effect on black people, older people, and people with hypertension or diabetes. Increasing your potassium intake through vegetables and fruits also lowers blood pressure, which is linked to lower CVD risk.
A combined approach of reducing sodium and increasing potassium is recommended. However, potassium-rich salt substitutes should be used with caution in people at risk of hyperkalemia and may have less impact if most of their sodium intake comes from commercial foods.
Feature 9: Avoid alcohol or severely limit your intake
Previous observational data suggested that low-to-moderate alcohol intake has a protective effect against coronary heart disease, but Mendelian randomized studies have not confirmed this association.
The relationship between alcohol and blood pressure is linear from the lowest intake, and there is no safe threshold for hypertension risk. The 2025 AHA/ACC guidelines recommend avoiding alcohol to prevent or treat high blood pressure, and both the World Health Organization (WHO) and the U.S. Department of Health and Human Services (HHS) recommend avoiding alcohol to reduce the risk of certain cancers, rather than suggesting any preventive effect.
Binge drinking and binge drinking should be strongly discouraged, and even if you do not consume alcohol, you should not start drinking to obtain cardiovascular benefits. If ingested, the amount should be limited.
conclusion
The latest AHA guidelines identify nine characteristics of a heart-healthy dietary pattern. Eat a variety of vegetables and fruits every day. Prefer whole grains over refined grains. Choose heart-healthy protein sources. Replace saturated fats with unsaturated fats. Minimize ultra-processed foods. Limit added sugars. Reduce sodium. Avoid or severely limit alcohol.
These patterns are nutritious, support fiber intake, generally limit high-cholesterol foods, keep saturated fat below 10% of total energy, and are consistent with dietary guidance for T2D, certain cancers, kidney disease, and cognitive health, while recognizing that dietary cholesterol is not the primary goal for most people.
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