Health care providers should consider personal, ethnic and cultural preferences when counseling patients on the selection of healthier eating patterns, according to a scientific statement released Oct. 27 from the American Heart Association (AHA) and published in Circulation.

The statement spells out recommendations from the 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk in the form of a toolkit for providers, fully equipped with practical, food-based suggestions to improve cardiovascular health and help people make healthier choices.

By employing the use of easy-to-understand language and relatable food examples, the toolkit aims to translate guidelines into digestible messages that will positively impact the daily behaviors of the average consumer.

According to the most recent data from the National Health and Nutrition Examination Survey, more than 80 percent of the U.S. population eats less than the recommended amount of vegetables, while about 70 percent of the population eats more than the recommended amount of saturated fat, sodium and added sugar. These numbers are representative across all ages.

Due to a variety of reasons, including culture, tradition and availability of healthy foods, some ethnic groups experience a disproportionately higher risk of cardiovascular disease and stroke. Therefore, targeted dietary counseling with consideration to each culture may help reduce that 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; and
• Mexican-Americans eat more fiber-rich foods than other ethnic groups, but also struggle with obesity.

The authors conclude that health care providers should keep culture and socioeconomic circumstances in mind when counseling patients about dietary changes in order to more effectively help patients find a healthier way to eat that fits within their cultural and personal taste preferences.

“The Statement builds on the work of the 2013 guideline by offering some practical examples of better eating in the U.S., and highlights many of the deficiencies in our knowledge and in the application of such advice in areas of our country with significant logistical and culture challenges to adopting healthy eating advice,” commented Andrew M. Freeman, MD, FACC, member of ACC’s Prevention of Cardiovascular Disease Section and co-chair of the Nutrition and Lifestyle Work Group. “Although it also offers advice for those trying to adopt a more healthful diet, it could go further in providing clearer advice for those seeking a fully plant-based diet, and highlights the need for more research into which approach would provide optimal cardiovascular outcomes,” he adds.

“The Statement will ultimately help patients/consumers make long-term, healthy food choices that are familiar and enjoyed with appropriate consideration of cultural, economic and social influences,” says Penny Kris-Etherton, PhD, RN, member of ACC’s Prevention of Cardiovascular Disease Section and co-chair of the Nutrition and Lifestyle Work Group. “By individualizing dietary guidance for different individuals/groups, the Statement is intended to increase adoption rates of current heart-healthy dietary recommendations.”

Keywords: Adult, American Heart Association, Beverages, Carbohydrates, Cardiovascular Diseases, Counseling, Diet, Ethnic Groups, European Continental Ancestry Group, Food Habits, Fruit, Health Personnel, Humans, Hydrogen, Indians, North American, Language, Life Style, Nutrition Policy, Nutrition Surveys, Obesity, Risk Factors, Sodium, Stroke, Sweetening Agents, Taste, United States, Vegetables, Edible Grain

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