URI professor helps create new AHA dietary guidelines

Following heart-healthy nutritional guidance -; despite the well-known benefits of doing so and the even better known detriments of not -; often proves to be a difficult commitment. But the American Heart Association is making it simpler to follow in its new guidelines, and a University of Rhode Island professor is helping.

Nutrition and Food Sciences Assistant Professor Maya Vadiveloo serves on the national Nutrition Committee for the heart association's Lifestyle and Epidemiology Council, a division of the association made up of 10 health experts who study emerging science and advise the group and the public. Part of that advice is crafting the association's official health guidance, and Vadiveloo served as co-author of the new guidelines.

Last year, I led one of the AHA dietary statements on the importance of assessing diet in clinical settings. When we were talking about the need to update dietary guidance, I was nominated to vice-chair the statement based on that work, In terms of the standards the AHA uses to determine what is a healthy diet, this is the guidance for that. It should replace U.S. dietary guidelines."

Maya Vadiveloo, Nutrition and Food Sciences Assistant Professor, University of Rhode Island

The statement offers the common advice of focusing a diet on more fruits and vegetables, low-fat dairy and whole grains; depending more on plant proteins like beans and legumes; mostly limiting animal proteins to low-fat options like chicken and fish; and avoiding processed foods. Where the guidance deviates from past recommendations is in its structure. Acknowledging the difficulty some can have following specific guidelines, the new statement focuses more on a dietary pattern -; combining elements of the above instead of stringently narrowing the options.

"The big takeaway is that it was very consistent and simple and easily implementable," Vadiveloo said. "We care about the overall dietary pattern, not just an individual food. You can really have flexibility in that pattern to fit your preferences, rather than have a one-size-fits-all, this is the only way to eat. It's about adopting these principles and implementing them wherever you eat."

Another change in the guidelines is the stronger focus on a mostly plant-based diet, not only for health reasons but also for environmental sustainability. The guidance also takes a stronger stand on the need to eliminate "ultra-processed foods."

"The discussion on the shift to increasing the proportion of plant-based foods broadly is a shift in tone, including the discussion on increasing minimally processed foods," said Vadiveloo, noting the guidance is strictly based on the science and is not influenced by outside entities. "More research is needed on 'ultra-processed,' but we know there is risk of processed foods having a negative effect on heart health, diabetes, etc. So the influence on minimally processed foods is a bit of a change."

The association's guidance also addresses the obstacles people face maintaining a healthy diet, especially demographic realities. Some communities facing structural racism simply don't have access to good, healthy options, and if they do, residents often can't afford the higher prices. Time constraints in lower-income, working families can make preparing healthy meals difficult. And deceptive food marketing practices often conflict with heart-healthy guidance, causing confusion among consumers.

"I think the call to action on addressing some of these factors as really huge contributors of diet-related health disparities and the challenges of adhering to a heart-healthy diet are also a big piece of this statement," Vadiveloo said. "There is an urgent need. We're seeing ongoing disparities between different groups. In some, there is stabilization; in others, cardiovascular disease is increasing quite a bit."

The committee's next step is to try to tear down some of those obstacles. The health experts are discussing recommending better nutrition and cooking education in schools, and addressing local zoning laws to help avoid food deserts. This kind of official intervention is effective when such campaigns win public buy-in, such as the anti-smoking campaign that saw higher taxes on cigarettes and fewer places where smoking is welcome.

"That strong package of public interventions has reduced smoking quite a bit, to the point it is no longer the number one risk factor for heart disease," Vadiveloo said. "The number one risk factor is now diet. But we treat it, societally, as an option. We don't have the same urgency to improve diet as we did in reducing smoking. Despite the decades of progress on cardiovascular health, it is still the leading cause of death. More is absolutely needed."