Healthcare providers should consider personal, ethnic and cultural preferences and use easy-to-understand language and food examples when counseling people about eating healthy, a new American Heart Association statement recommends.

“It’s one thing for professionals to summarize the data and develop guidelines, but an entirely different strategy is required to translate those guidelines into daily behaviors embraced in real life, by real people,” said Linda V. Van Horn, Ph.D., R.D., chair of the writing group of the statement published in the AHA journal Circulation.

“To consumers, it’s an apple, an orange, a pizza. It’s not saturated fat, refined carbohydrates and potassium. That’s nutrition jargon familiar among professionals, but not normal conversation for the average American.”

The statement reflects 2013 guidelines from the AHA and American College of Cardiology that emphasize a healthy eating pattern:

  • Eat a variety of fruits and vegetables, whole grains, non- and low-fat dairy products, skinless poultry, fish, nuts, beans and non-tropical vegetable oils.
  • Limit red and processed meat, sweets and sugary drinks.

The dietary recommendations can be adapted to fit different cultural and personal health preferences and economic realities, said Van Horn, professor of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.

“Identifying optimal nutrition for preserving good health is an ongoing, dynamic science,” she said. “But there are fundamental principles we know now about how some foods decrease risk of heart disease, while other foods increase risk. For example, I’ve yet to see a study reporting that fruits and vegetables are bad for you.”

Some ethnic groups experience a disproportionately greater burden of heart disease and stroke, so recognizing dietary elements common to each culture may help reduce risk. For example:

  • Non-Hispanic black adults report lower intake of fruits, vegetables and whole grains and higher amounts of sugar-sweetened beverages than non-Hispanic white adults.
  • The typical diet of people of Chinese, Korean or Japanese heritage is lower in saturated fat, but higher in sodium than typical U.S. diets.
  • The typical dietary pattern for people of Asian Indian heritage is high in saturated and hydrogenated fats and refined carbohydrates.
  • American Indians and Pacific Islanders eat fewer fruits and vegetables than non-Hispanic whites.
  • Mexican-Americans eat more fiber-rich foods than other ethnic groups, but struggle with obesity.

Reasons for the differences include culture, tradition, neighborhood availability of healthier foods and price.

The statement makes practical, food-based suggestions to help people make healthier choices and achieve a heart-healthy eating pattern. Portion sizes are listed for commonly purchased items, such as different types of vegetables, whole grains, meat, poultry and eggs.

The statement also includes evidence-based approaches for motivating patients to choose well, plan for relapses, track what they eat and gradually adopt a more physically active lifestyle to complement their healthy diet.

“We translate the recommendations into real-life, buy-it-at-the-grocery store, order-it-on-the-menu type choices,” Van Horn said. “Counseling people about healthy eating is a process, but when someone becomes motivated to actually make dietary changes such as eating more fruits and vegetables, amazing things happen. In as little as three weeks, they develop a preference for those foods and even begin to miss them if they’re not on the plate.”

More than 80 percent of the U.S. population eat less than the recommended amount of vegetables and about 70 percent eat more saturated fat, sodium and added sugar than is recommended, according to the National Health and Nutrition Examination Survey. The top three sources of calories in the United States are burgers, sandwiches and tacos, followed by desserts, sweet snacks and sugar-sweetened beverages.