Aim for an overall healthful dietary pattern, the American
Heart Association advises, rather than focusing on "good" or
"bad" foods.
There are no "good" foods and "bad"
foods. Instead, your overall dietary pattern matters most when it comes to
healthful eating.
That's the main message from the American Heart Association
in its latest nutrition guidance to improve the hearts and health of Americans
of all ages and life circumstances.
The experts who wrote the recommendations recognize that
people don't eat nutrients or individual ingredients. They eat foods, and most
people want to enjoy the foods they eat while staying within their budgets and,
the association hopes, without injuring their bodies.
This doesn't mean you need to avoid Big Macs, Cokes and
French fries totally, but it does mean you should not regularly indulge in such
fare if you want to stay healthy.
ADVERTISEMENT Dr Robert H. Eckel, a former president of the
American Heart Association and an endocrinologist and lipid specialist at the
University of Colorado Denver, told me he "occasionally" indulges in
foods outside a wholesome dietary pattern. The operative word here, though, is
"occasionally."
dr Neil J. Stone, a preventive cardiologist at the Feinberg
School of Medicine at Northwestern University, who praised the thoughtfulness
and expertise of the guidance committee, said in an interview, "There's no
such thing as one diet that fits all, but there are principles to form the
basis of diets that fit everyone." He added: "The goal is to make
good nutrition possible for all. The healthier we can keep everybody in this
country, the lower our health costs will be."
In the 15 years since the heart association last issued
dietary guidelines to reduce the risk of cardiovascular disease, almost nothing
has changed for the better. The typical American diet has remained highly
processed. Americans consume too much-added sugars, artery-clogging fats,
refined starches, red meat and salt and don't eat enough nutrient-rich
vegetables, fruits, nuts, beans and whole grains that can help prevent heart disease, diabetes and cancer.
But rather than become discouraged, the association decided
to try a different approach. For too long, nutrition advice has been overly
focused on individual nutrients and ingredients, Alice H. Lichtenstein, the
guidelines' chief author, told me, and it hasn't been focused enough on overall
dietary patterns that can best fit people's lives and budgets.
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So instead of a laundry list of "thou shalt not
eat," Dr Lichtenstein said, the association's committee on nutrition and
cardiovascular disease chose to promote heart-healthy dietary patterns that
could suit a wide range of tastes and eating habits. In avoiding "no
noes" and dietary revolutions, the new guidance can foster gradual
evolutionary changes meant to last a lifetime.
The committee recognized that for people to adopt and stick
to a wholesome dietary pattern, it should accommodate personal likes and
dislikes, ethnic and cultural practices and life circumstances, and it should
consider whether most meals are consumed at home or on the go.
For example, rather than urging people to skip pasta because
it's a refined carbohydrate, a more effective message might be to tell people
to eat it the traditional Italian way, as a small first-course portion. Or, if
pasta is your main course, choose a product made from an unrefined carbohydrate
like whole wheat, brown rice or lentils.
"We're talking about lifelong changes that incorporate
personal preferences, culinary traditions and what's available where people
shop and eat," said Dr Lichtenstein, a professor of nutrition science and
policy at the Friedman School at Tufts University. "The advice is evidence-based
and applies to everything people eat regardless of where the food is procured,
prepared and consumed."
The guidelines' first principle is to adjust one's
"energy intake and expenditure" to "achieve and maintain a
healthy body weight," a recommendation that may be easier to follow with
the next two principles: Eat plenty of fruits and vegetables, and choose foods
made mostly with whole grains rather than refined grains. If cost or
availability is an issue, as is the case in many of the country's food deserts
where fresh produce is scarce, Dr Lichtenstein suggested keeping bags of frozen
fruits and vegetables on hand to reduce waste, add convenience and save money.
Some wholesome protein choices that the committee
recommended included fish and seafood (although not breaded and fried), legumes
and nuts, and low-fat or fat-free dairy products. If meat is desired, choose
lean cuts and refrain from processed meats like sausages, hot dogs and deli
meats that are high in salt and saturated fat.
