The American Heart Association has released updated dietary guidance outlining nine key features of a heart-healthy eating pattern designed to reduce cardiovascular disease risk throughout the lifespan. 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, with projections indicating this will climb to one in six adults by 2050.
The 2026 Dietary Guidance to Improve Cardiovascular Health updates the Association's 2021 recommendations with strengthened scientific evidence. The guidance emphasizes a dietary pattern rich in vegetables, fruits, and whole grains while minimizing sugar, salt, and ultraprocessed foods. It prioritizes protein from plant-based sources such as legumes, nuts, and seeds, while still allowing for fish, seafood, and lean animal proteins.
Alice H. Lichtenstein, D.Sc., FAHA, volunteer chair of the scientific statement writing committee, noted that while the guidance hasn't shifted greatly from 2021 recommendations, the science supporting it 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," she said.
The nine key features include adjusting energy intake and expenditure to maintain healthy body weight, eating plenty of vegetables and fruits, choosing whole grains over refined grains, selecting healthy protein sources, using unsaturated fats instead of saturated fats, choosing minimally processed foods over ultraprocessed options, minimizing added sugars, reducing sodium intake, and limiting alcohol consumption. The guidance specifically notes that if alcohol is not consumed, individuals should not start, and if consumed, intake should be limited.
Several important updates distinguish the 2026 guidance. Regarding protein, while evidence on the relationship between protein amount and heart disease risk remains uncertain, the guidance now supports multiple healthy protein choices and encourages exchanging red meat for alternate protein-rich foods. For saturated fat, the update provides broader guidance on choosing food sources of unsaturated fat over saturated fat sources. The statement underscores that dietary patterns following the nine features are unlikely to exceed 10% of energy from saturated fat, aligning with federal dietary guidelines.
The guidance takes a stronger stance on ultraprocessed foods, noting current research links their consumption to poor health outcomes. It emphasizes choosing minimally processed foods as an approach to shifting the marketplace away from ultraprocessed products. Regarding sodium, the 2026 guidance puts more emphasis on choosing foods low in sodium and preparing foods with minimal or no salt, while including more current information on potassium-rich foods' role in blood pressure control.
Perhaps most significantly, the guidance emphasizes starting heart-healthy eating patterns early, recommending children can and should begin following such patterns starting at age one. "Cardiovascular disease begins early in life; even prenatal factors can contribute to increased risk in children as they grow," Lichtenstein explained. "So, it's important that healthy eating patterns are adopted in childhood and continue throughout the entire lifespan."
The guidance comes amid alarming statistics about American health. According to the American Heart Association's 2026 Heart Disease and Stroke Statistics, more than half of U.S. adults and about 60% of children have unhealthy diets. Only one in four U.S. adults and one in five youths meet national recommendations for physical activity. More than 40% of adults and more than one in five children have obesity, with those numbers projected to increase.
Amit Khera, M.D., FAHA, volunteer vice-chair of the dietary guidance writing committee, emphasized the preventive potential of these dietary changes. "As much as 80% of heart disease and stroke is preventable," he noted, adding that following the American Heart Association's Life's Essential 8 healthy lifestyle guidance can support prevention efforts. Integrating the 2026 dietary guidance into everyday life represents an excellent first step toward reducing and preventing heart disease and stroke risk.
Beyond cardiovascular benefits, the heart-healthy dietary pattern provides essential nutrients for most people, is rich in healthy fiber, limits foods high in dietary cholesterol, and helps keep saturated fat to 10% or less of total daily calories. 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 impacted by dietary intake.
The American Heart Association continues to address root causes of poor diets through initiatives including informing the definition of ultraprocessed foods in public policy, supporting front-of-pack nutrition labeling systems, advocating for increased nutrition science research funding, and expanding community-level impact through programs like the American Heart Association's Social Impact Funds. These efforts complement the new dietary guidance by helping ensure more people can consistently access heart-healthy foods.
