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Diet and Lifestyle Recommendations
A Scientific Statement from the American Heart
Association Nutrition Committee.
Improving diet and lifestyle is a critical
component of clinical practice and of the American Heart
Association's plan to prevent cardiovascular disease.
This most recent summary of their latest
strategy emphasizes the following elements of prevention:
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Consume a healthy diet: focus on overall
diet rather than a single component.
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Maintain a healthy body weight with BMI
18.5-24.9kg/m2.
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Aim for optimal lipid profile with LDL
less than 100mg/dl. The AHA discussion also includes trans
fats and emphasizes that they increase LDL less than saturated
fats, but unlike saturated fat, trans fat does not increase
HDL.
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Aim for a normal blood pressure, 120/80.
Dietary factors that impact blood pressure include salt,
moderate alcohol intake, and maintaining optimal weight.
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Aim for normal blood glucose, less than or
equal to 100mg/dL.
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Be physically active: exercise at least 30
minutes most days of the week. Balance exercise with caloric
intake.
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Specific dietary recommendations include:
Eat a variety of fruits and vegetables. Choose whole grain,
high fiber products. Consume fish at least twice a week. Limit
saturated fat to less than 7% of energy, trans fat to less
than 1% energy; and cholesterol to less than 300mg/day. Total
fat should equal 25-35% of calories. Limit salt to
1.5-2.3g/day. Drink alcohol in moderation: 2 drinks/day for
men; 1 drink/day for women. Follow AHA recommendations when
eating away from home.
The AHA 2006 recommendations are old news,
but it is helpful to see them summarized so clearly. Although
the scientific committee does recognize socioeconomic groups at
high risk for adopting these suggestions (also at high risk for
CVD), they do not explore specific suggestions to address the
impact of environment on eating or suggest ways to help a
struggling practitioner implement these guidelines.
Michael Pollan, author of The Omnivore's
Dilemma, addresses the complex determinants of what we eat. He
says: "So we find ourselves as a species almost back where we
started: anxious omnivores struggling once again to figure out
what it is wise to eat. Instead of relying on the accumulated
wisdom of a cuisine, or even on the wisdom of our senses, we
rely on expert opinion, advertising, government food pyramids,
and diet books, and we place our faith in science to sort out
for us what culture once did with rather more success. Such has
been the genius of capitalism, to re-create something akin to a
state of nature in the modern supermarket or fast-food outlet,
throwing us back on a perplexing, nutritionally perilous
landscape deeply shadowed by the omnivore's dilemma."
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