Implementing American Heart Association Pediatric and Adult Nutrition Guidelines

Abstract

Cardiovascular disease mortality rates have fallen by ≈50% over the past 50 to 60 years. However, cardiovascular disease prevalence remains high, and cardiovascular disease is still the leading cause of death and disability in the United States.1,2 It has been estimated that preventive efforts have contributed to at least half of this decline, with the primary contribution coming from declines in mean blood cholesterol concentrations, mean blood pressure levels, and tobacco use rates. Regrettably, during this past decade, the increased prevalence of obesity and diabetes mellitus has dramatically slowed the secular decline in cardiovascular mortality rates.1,3,4 In fact, in the United States, the contribution of prevention to the decline of cardiovascular mortality is now much lower than in other industrialized countries and the United States historically.1,5 The continuing challenge is preventing the development of cardiovascular disease, especially early in life. Nutrition remains a cornerstone of that effort. Modernization and industrialization of the food supply and distribution patterns, as with our lifestyles, have produced many benefits but also unanticipated consequences.6 Decline in saturated fat and cholesterol intake, influenced by public awareness of adverse health consequences, coupled with increased availability of foods lower in cholesterol and saturated fat, has been associated with reductions in cardiovascular disease. However, recent studies of trends in the dietary patterns of the United States suggest a significant drift toward less healthful eating patterns and overconsumption of energy, which have been associated with increases in prevalence of obesity, metabolic syndrome, and type 2 diabetes mellitus.1–4 These data strongly suggest that additional emphasis is needed on ways to implement current guidelines in contemporary society. A great benefit can be achieved from adopting a heart-healthy nutrition pattern at a young age, thereby preventing the rise in cholesterol and blood pressure levels associated with excess saturated …