The American Heart Association has issued updated dietary guidance outlining nine key features of a heart-healthy eating pattern that can significantly reduce cardiovascular disease risk when followed throughout life. This scientific statement, published in Circulation, comes at a critical time as more than half of U.S. adults currently have some type of cardiovascular disease, driven in part by high rates of health factors including high blood pressure, diabetes and obesity that are often linked to poor dietary habits.
The 2026 Dietary Guidance to Improve Cardiovascular Health updates the Association's 2021 recommendations with strengthened scientific evidence and emphasizes swapping unhealthy choices for healthier alternatives. The guidance recommends adjusting energy intake and expenditure to maintain a healthy body weight, eating plenty of vegetables and fruits in variety, choosing whole grains over refined grains, and selecting healthy protein sources with a shift toward plant-based options like legumes, nuts and seeds. It also advises choosing unsaturated fats over saturated fats, selecting minimally processed foods instead of ultraprocessed foods, minimizing added sugars, choosing low-sodium foods, and limiting alcohol intake.
"As a trusted source, the American Heart Association issues evidence-based dietary guidance about every five years, undertaking a complex review that evolves alongside emerging research," said Alice H. Lichtenstein, D.Sc., FAHA, volunteer chair of the scientific statement writing committee. "We did find that the science supporting this guidance has strengthened. The stronger body of evidence is driving a few nuanced, yet important, updates that ensure the guidance remains aligned with the most current and strongest science on diet and cardiovascular health."
The updated guidance provides specific emphasis on protein sources, recognizing that most people currently consume more protein from meat than plants and encouraging the exchange of red meat for multiple alternate protein-rich foods. It also offers broader guidance on choosing food sources of unsaturated fat over food sources of saturated fat, with dietary patterns adhering to the nine features unlikely to exceed 10% of energy from saturated fat. The statement acknowledges ongoing debate about full-fat versus low-fat dairy products while still recommending low-fat and fat-free options as preferred choices.
Current research linking ultraprocessed foods to poor health outcomes has prompted the guidance to focus on encouraging minimally processed food choices as an approach to shifting the marketplace. The updated statement also places more emphasis on choosing foods low in sodium and preparing foods with minimal or no salt, recognizing that many ultraprocessed foods are high in sodium. Regarding alcohol, the guidance presents current evidence as it relates to cardiovascular disease and supports the recommendation of not starting to drink or limiting intake if consumed.
According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, the Association projects cardiovascular disease will climb to affect 1 in 6 U.S. adults by 2050, driven by increased rates of health factors like high blood pressure, obesity and diabetes. More than 40% of adults and more than 1 in 5 children have obesity, with those numbers projected to increase according to American Heart Association forecasts.
"These rates are alarming and reinforce that a lifetime of healthy eating is critical because high blood pressure and obesity are leading drivers of chronic disease and death," said Amit Khera, M.D., FAHA, volunteer vice-chair of the dietary guidance writing committee. "Intentional choices at all stages of life can make a big difference. Parents and other adults can support and model overall healthy behaviors for their children for a healthy start."
The guidance emphasizes that cardiovascular disease begins early in life, with even prenatal factors contributing to increased risk, making it important that healthy eating patterns are adopted in childhood and continue throughout the entire lifespan. The 2026 updated guidance recommends children can and should begin following a heart-healthy dietary pattern starting at 1 year of age, with families playing a crucial role in modeling and providing access to healthy foods.
Beyond cardiovascular benefits, a heart-healthy dietary pattern also provides essential nutrients for most people without requiring dietary supplements, offers healthy fiber from vegetables, fruits, whole grains and legumes, limits foods high in dietary cholesterol, and helps keep saturated fat to 10% or less of total daily calories. While specifically designed to improve cardiovascular health, the guidance is generally consistent with dietary recommendations for other conditions like type 2 diabetes, kidney disease, some cancers and brain health due to shared risk factors.
The American Heart Association continues to address root causes of poor diets through initiatives including informing the definition of ultraprocessed foods as applied in public policy, supporting development of a front-of-pack nutrition labeling system, advocating for increased funding for nutrition science research at the National Institutes of Health, and expanding community-level impact through investments like the American Heart Association's Social Impact Funds to increase access to affordable, healthy foods in under-resourced communities.
