American Heart Association updates dietary guidance with focus on plant-based protein and whole foods

The American Heart Association has updated its dietary guidance, outlining nine key features of a heart-healthy eating pattern designed to reduce the risk of cardiovascular disease and support long-term health.

The American Heart Association has released updated dietary guidance emphasizing lifelong healthy eating patterns to reduce cardiovascular disease risk
The guidance prioritizes plant-based protein sources, whole foods and reduced intake of sugar, sodium and ultra-processed foods
More than half of US adults currently live with some form of cardiovascular disease, with rates projected to rise further by 2050

Published in the journal Circulation, the 2026 scientific statement builds on the Association’s 2021 recommendations, incorporating the latest evidence on diet and cardiovascular health. The updated guidance arrives as rates of diet-related health conditions remain high, with more than half of US adults and around 60% of children reported to have unhealthy diets.

The new framework emphasizes a shift toward overall dietary patterns rather than focusing on individual nutrients or foods. It encourages a consistent approach to eating that can be maintained across different life stages, environments and personal preferences.

Alice H. Lichtenstein, volunteer chair of the scientific statement writing committee and senior scientist at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, said: “Our 2026 guidance may look familiar, as it hasn’t shifted greatly from the 2021 recommendations. We did find that the science supporting this guidance has strengthened.”

The guidance outlines nine core principles, including increasing intake of vegetables, fruits and whole grains, prioritizing plant-based protein sources such as legumes, nuts and seeds, and reducing consumption of added sugars, sodium and ultra-processed foods. It also highlights the importance of choosing unsaturated fats over saturated fats and maintaining a balance between energy intake and physical activity.

Protein sources are a key focus of the update. While the relationship between total protein intake and cardiovascular disease remains unclear, the Association noted that most people consume more protein from meat than plant sources. The updated guidance therefore supports a broader range of protein choices and encourages replacing red and processed meat with plant-based alternatives and other sources such as fish and low-fat dairy.

The statement also expands its recommendations on fat intake, shifting from specific guidance on oils toward a broader emphasis on choosing food sources of unsaturated fats over those high in saturated fat. According to the Association, dietary patterns aligned with the nine key features are unlikely to exceed recommended limits for saturated fat intake.

Ultra-processed foods are another area of increased focus. The guidance links high consumption of these products to poor health outcomes and recommends prioritizing minimally processed foods. It also suggests that greater demand for such foods could influence the wider food system by increasing availability of healthier options.

Sodium reduction remains a central recommendation, with the updated guidance highlighting the role of potassium-rich foods in managing blood pressure. The statement also acknowledges evolving evidence around alcohol consumption, noting that there is no safe level of alcohol intake in relation to certain cancer risks while maintaining existing cardiovascular guidance to limit or avoid consumption.

The Association emphasized that the guidance is intended to be flexible rather than prescriptive. Lichtenstein said: “For healthy eating to be more attainable and sustainable, we recommend people focus on their overall eating pattern rather than specific nutrients or foods.”

She added: “You want to strive for progress rather than perfection. Every time you choose to make a swap for a healthier alternative, you’re making a step toward a healthier life.”

The guidance also highlights the importance of early adoption and long-term adherence. According to the statement, heart-healthy eating patterns can begin from the age of one and should be maintained throughout life, with families playing a central role in shaping dietary habits.

Amit Khera, volunteer vice-chair of the writing committee and director of preventive cardiology at the University of Texas Southwestern Medical Center, said: “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.”

He added that up to 80% of heart disease and stroke may be preventable through lifestyle changes, including diet and physical activity.

The updated guidance aligns with broader public health efforts to address rising rates of cardiovascular disease, obesity and diabetes. According to the American Heart Association’s latest statistics, more than half of US adults currently live with some form of cardiovascular disease, with that figure projected to reach 60% by 2050.

Alongside dietary changes, the Association highlighted the need for improved access to healthy foods and increased physical activity. It noted that only one in four US adults and one in five young people meet recommended activity levels, while obesity rates remain high across both groups.

Beyond cardiovascular health, the guidance also supports broader health outcomes, including reduced risk of type 2 diabetes, kidney disease and certain cancers. This reflects shared underlying risk factors such as high blood pressure, cholesterol and body weight, all of which are influenced by dietary patterns.

Lichtenstein said: “A healthy dietary pattern can support lifelong health and well-being beyond cardiovascular health.”

The American Heart Association said it will continue to support the adoption of healthier eating patterns through policy advocacy, research funding and community initiatives aimed at improving access to nutritious foods.