How swapping unhealthy foods can significantly reduce your heart risk

More than half of adults and about 60% of children in the U.S. have unhealthy diets, which can contribute to higher rates of health factors such as high blood pressure and obesity, and lead directly to poor health outcomes including deaths from cardiovascular disease and other chronic conditions, according to the American Heart Association. Following a lifelong healthy eating pattern may significantly reduce risk and is the basis for an updated scientific statement reflecting the latest nutrition guidance published today in Circulation, the peer-reviewed, flagship journal of the American Heart Association, a global force changing the future of health for all.

The 2026 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association updates the Association’s 2021 guidance with the latest in evidence-based science aligned with reducing cardiovascular disease risk, improving quality of life and saving lives. The statement outlines nine key features of a heart-healthy dietary pattern:

1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight: Try to balance how much you eat with how active you are, to reach and maintain a healthy body weight.
2. Eat plenty of vegetables and fruits and choose a wide variety: Include different colors, textures and types of produce, and remember, even canned and frozen can be nutritious and affordable.
3. Choose foods made mostly with whole grains rather than refined grains: Foods such as whole‑wheat bread, brown rice and oatmeal are better choices than refined grains including white bread or white rice.
4. Choose healthy sources of protein: Shift from meat to plant-based sources such as legumes, including beans, peas and lentils, along with nuts and seeds; regularly consume fish and seafood; select low-fat or fat-free dairy products; and if red meat is desired, choose lean cuts, avoid processed forms and limit portion size.
5. Choose sources of unsaturated fats in place of sources of saturated fat: Replace saturated fats with healthy unsaturated fats, including those from nuts, seeds, avocados and nontropical plant oils.
6. Choose minimally processed foods instead of ultraprocessed foods: Go with foods close to their natural state, with minimal added commercial ingredients, rather than those that are highly processed with additives.
7. Minimize intake of added sugars in beverages and foods: Limit the sugar-sweetened beverages you drink and the foods with added sugar you eat.
8. Choose foods low in sodium and prepare foods with minimal or no salt: Be aware of hidden sources of sodium in commercially prepared and packaged foods and season your food with healthier options such as herbs, spices or lemon instead of salt.
9. If alcohol is not consumed, do not start; if alcohol is consumed, limit intake: Alcohol can increase your risk for high blood pressure and other health conditions, so if you don’t drink, don’t start.

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. 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 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.”

Alice H. Lichtenstein, D.Sc., FAHA, volunteer chair of the scientific statement writing committee and senior scientist and leader of the Diet & Chronic Disease Prevention Directive at the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston

The 2026 dietary guidance is a more concise statement focused specifically on what to eat for heart health. The most recent evidence affirms the key features and shifts emphasis to swapping out unhealthy choices for healthier ones. It highlights sources of healthy protein and unsaturated fat and reinforces the importance of adhering to a heart healthy dietary pattern throughout the life course.

Specifics include:

• Protein: While the evidence on the relationship between protein amount and heart disease risk is still uncertain, the 2026 updated guidance recognizes that most people currently consume more protein from meat than plants, so guidance now supports multiple healthy protein choices including plant-rich sources and encourages the exchange of red meat for multiple alternate protein-rich foods, both plant and animal.
• Saturated Fat: Previous guidance focused specifically on using liquid plant oils instead of animal fat, tropical oils or partially hydrogenated fats (trans fats). The 2026 update, instead, provides broader guidance on choosing food sources of unsaturated fat over food sources of saturated fat. The statement also underscores that “dietary patterns that adhere to the 9 features outlined in this document are unlikely to exceed 10% of energy from saturated fat” – aligning with the 2025-2030 Dietary Guidelines for Americans issued by the federal government.
• Dairy: While still recommending low-fat and fat-free dairy products as a preferred choice to control calories and fat intake, the updated guidance recognizes that the potential health benefits of these compared with full-fat dairy products continue to be debated.
• Ultraprocessed Foods: Current research links the consumption of ultraprocessed foods to poor health outcomes. The updated guidance notes that efforts should focus on encouraging the choice of minimally processed foods as an approach to shifting the marketplace away from ultraprocessed products. The result could be increased availability of minimally processed options wherever people buy or eat food.
• Sodium: Recognizing that many foods, particularly those that are ultraprocessed, are high in sodium, the 2026 guidance puts more emphasis on choosing foods low in sodium and preparing foods with minimal or no salt. It also includes more current information on the role of potassium-rich foods in controlling blood-pressure compared to what was known in 2021.
• Alcohol: The new guidance acknowledges that the U.S. Department of Health and Human Services and the World Health Organization recognize that there is no safe level of alcohol consumption when it comes to the risk of developing certain cancers; the Association’s updated guidance presents the current evidence as it relates to cardiovascular disease and supports the recommendation of not starting to drink or limiting the intake of alcohol if it is consumed.

Progress over perfection

The 2026 dietary guidance focuses on the specific relationship between your health and what you eat. However, Lichtenstein said it’s important to recognize this is neither prescriptive nor restrictive. It is intentionally designed to provide flexibility in customizing a healthy dietary pattern to accommodate personal preferences, ethnic and religious practices, personal needs and budgets and varying life stages. She adds that this is the best approach to encourage lifelong adherence.

“For healthy eating to be more attainable and sustainable, we recommend people focus on their overall eating pattern rather than specific nutrients or foods. This approach is actionable, something that can be modified as people pass through different life-stages, while still adhering to the 9 key features,” she said. “The guidance applies to wherever you eat: at home, school, work, restaurants or in your community. 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.”

A lifetime of healthy eating: why it matters

Lichtenstein notes that what’s most critical is making healthier choices that can be sustained for a lifetime.

“Cardiovascular disease begins early in life; even prenatal factors can contribute to increased risk in children as they grow. So, it’s important that healthy eating patterns are adopted in childhood and continue throughout the entire lifespan,” she said. “The best way to do that is for adults to role model heart healthy eating patterns inside and outside the home.”

The 2026 updated guidance recommends:

• Children can and should begin following a heart‑healthy dietary pattern starting at 1 year of age.
• Families play a huge role – when adults stock the house with and choose heart-healthy foods, kids are more likely to do the same.
• Dietary needs vary throughout the life course and may change; work with your doctor and health care team to tailor these recommendations to your individual health needs and medical history.
• Heart-healthy dietary patterns are adaptable to cultural and personal food preferences.

According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, more than half of all U.S. adults currently have some type of cardiovascular disease. The Association projects that number will climb to 1 in 6 U.S. adults by 2050, driven by increased rates of health factors like high blood pressure, obesity and diabetes.

Along with poor dietary habits, most people in the U.S. are not getting an adequate amount of physical activity.

• Also noted in the Association’s 2026 statistics update, only 1 in 4 U.S. adults and 1 in 5 youths 6 to 17 years of age meet national recommendations for being physically active.

This combination of unhealthy eating and physical inactivity is also likely to drive high rates of overweight and obesity among adults and kids.

• More than 40% of adults and more than 1 in 5 children (age 2-19 years of age) have obesity and those numbers are 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. As we look at our work to improve the health of all people, it’s critical to understand the need for earlier prevention efforts,” said Amit Khera, M.D., FAHA, volunteer vice-chair of the dietary guidance writing committee and the director of preventive cardiology and clinical chief of cardiology at the University of Texas Southwestern Medical Center in Dallas. “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.”

Khera noted that as much as 80% of heart disease and stroke is preventable and that following the American Heart Association’s Life’s Essential 8™ healthy lifestyle guidance can support those prevention efforts. Life’s Essential 8 is a set of four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (manage weight, control cholesterol, manage blood sugar and manage blood pressure) that are key measures for improving and maintaining cardiovascular health.

“Integrating the elements of the 2026 dietary guidance into your everyday life is an excellent first step toward reducing – and importantly preventing – the risk of heart disease and stroke for you and your family for years to come,” he said.

Beyond heart health

The 2026 dietary guidance provides additional benefits beyond support for cardiovascular health.

A heart-healthy dietary pattern also provides a combination of foods and beverages that:

• Meet the essential nutrient requirements for most people in terms of vitamins, essential minerals and other health-promoting components. This means most people would not need to calculate how much of each nutrient is in their diet or take dietary supplements, with possible exceptions for pregnant women, some older adults and those following restricted diets.
• Are rich in healthy fiber from vegetables, fruits, whole grains, nuts, seeds and legumes including beans, peas and lentils.
• Limit foods high in dietary cholesterol by replacing fatty and processed meats with plant-based and lean sources and replacing full fat dairy with non-fat and low-fat dairy, while allowing for moderate egg consumption.
• Help keep saturated fat to 10% or less of total daily calories.

While the updated guidance is specifically designed to improve cardiovascular health, it is generally consistent with dietary recommendations for other conditions like type 2 diabetes, kidney disease, some cancers and brain health. This is largely due to shared risk factors that impact both physical and cognitive health, including high blood pressure, high cholesterol, high blood sugar, excess weight and reduced kidney function – all impacted by dietary intake.

“What you put in your body is going to significantly impact how it performs and changes as you age,” Lichtenstein said. “A healthy dietary pattern can support lifelong health and well-being beyond cardiovascular health.”

Addressing the issue

The American Heart Association continues to aggressively address the root causes of poor diets, including food insecurity, through evidence‑based policy advocacy, community investment and health care innovation. Specific initiatives include:

• Informing the definition of ultraprocessed foods as applied in public policy.
• Supporting the development of a front-of-pack nutrition labeling system and a “healthy” icon for food packaging.
• Federal, state and local advocacy efforts support making healthy food more accessible and discouraging consumption of sugary drinks to improve diet quality.
• Advocating to increase funding for nutrition science research, including food is medicine research, at the National Institutes of Health.
• Through the Health Care by Food™ initiative and The Periodic Table of Food Initiative (PTFI)^®, the Association is improving the understanding of the critical role healthy food can play in preventing and managing chronic disease.
• The Association is expanding its community-level impact by investing in local organizations through American Heart Association’s Social Impact Funds, including the Bernard J. Tyson Impact Fund, to increase access to affordable, healthy foods in under‑resourced communities.

“Together, these efforts complement the Association’s new dietary guidance by helping ensure more people can consistently access and benefit from heart‑healthy foods,” Khera said.

To learn more about eating for your heart and brain health, visit heart.org/healthydiet and talk to your health care provider about what will work best for you.

This scientific statement was prepared by a volunteer writing group on behalf of the American Heart Association. American Heart Association scientific statements promote greater awareness about cardiovascular diseases and stroke issues and help facilitate informed health care decisions. Scientific statements outline what is currently known about a topic and what areas need additional research. While scientific statements inform the development of guidelines, they do not make treatment recommendations. American Heart Association guidelines provide the Association’s official clinical practice recommendations.