Dietary Guidance to Improve Cardiovascular Health

Publication Date: November 2, 2021

Summary of Key Recommendations

Evidence-Based Dietary Guidance to Promote Cardiovascular Health

1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight

2. Eat plenty of fruits and vegetables, choose a wide variety

3. Choose foods made mostly with whole grains rather than refined grains

4. Choose healthy sources of protein
 a. mostly protein from plants (legumes and nuts)
 b. fish and seafood
 c. low-fat or fat-free dairy products instead of full-fat dairy products
 d. if meat or poultry are desired, choose lean cuts and avoid processed forms

5. Use liquid plant oils rather than tropical oils (coconut, palm, and palm kernel), animal fats (eg, butter and lard), and partially hydrogenated fats

6. Choose minimally processed foods instead of ultra-processed foods*

7. Minimize intake of beverages and foods with added sugars

8. Choose and prepare foods with little or no salt

9. If you do not drink alcohol, do not start; if you choose to drink alcohol, limit intake

10. Adhere to this guidance regardless of where food is prepared or consumed
* There is no commonly accepted definition for ultra-processed foods, and some healthy foods may exist within the ultra-processed food category.

Figure: Dietary patterns to promote cardiovascular health

Recommendation Grading




2021 Dietary Guidance to Improve Cardiovascular Health

Authoring Organization

Publication Month/Year

November 2, 2021

Supplemental Implementation Tools

Document Type


Country of Publication


Document Objectives

This scientific statement emphasizes the importance of dietary patterns beyond individual foods or nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns, and highlights structural challenges that impede adherence to heart-healthy dietary patterns. 

Target Patient Population

All patients

Target Provider Population

All providers

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Long term care, School

Intended Users

Diabetes educator, dietician nutritionist, nurse, nurse practitioner, physician, physician assistant


Counseling, Management, Prevention

Diseases/Conditions (MeSH)

D000066888 - Diet, Food, and Nutrition, D004032 - Diet, D000073601 - Dietary Approaches To Stop Hypertension


nutrition, diet, heart health

Source Citation

Lichtenstein AH, Appel LJ, Vadiveloo M, Hu FB, Kris-Etherton PM, Rebholz CM, Sacks FM, Thorndike AN, Van Horn L, Wylie-Rosett J. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021 Dec 7;144(23):e472-e487. doi: 10.1161/CIR.0000000000001031. Epub 2021 Nov 2. PMID: 34724806.

Supplemental Methodology Resources

Methodology Supplement