Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. 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. Evidence-based dietary pattern guidance to promote cardiometabolic health includes the following: (1) adjust energy intake and expenditure to achieve and maintain a healthy body weight; (2) eat plenty and a variety of fruits and vegetables; (3) choose whole grain foods and products; (4) choose healthy sources of protein (mostly plants; regular intake of fish and seafood; low-fat or fat-free dairy products; and if meat or poultry is desired, choose lean cuts and unprocessed forms); (5) use liquid plant oils rather than tropical oils and partially hydrogenated fats; (6) choose minimally processed foods instead of ultra-processed foods; (7) minimize the 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; and (10) adhere to this guidance regardless of where food is prepared or consumed. Challenges that impede adherence to heart-healthy dietary patterns include targeted marketing of unhealthy foods, neighborhood segregation, food and nutrition insecurity, and structural racism. Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.

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2021 年改善心血管健康的膳食指南：美国心脏协会的科学声明

饮食质量差与心血管疾病发病率和死亡率的升高密切相关。这一科学声明强调了饮食模式在个体食物或营养素之外的重要性，强调了营养在生命早期的关键作用，介绍了心脏健康饮食模式的要素，并强调了阻碍坚持心脏健康饮食模式的结构性挑战。促进心脏代谢健康的循证饮食模式指导包括以下内容：（1）调整能量摄入和消耗，以实现和保持健康的体重；（2）多吃各种水果和蔬菜；(3) 选择全谷物食品和产品；(4) 选择健康的蛋白质来源（主要是植物；定期摄入鱼和海鲜；低脂或无脂乳制品；如果需要肉类或家禽，请选择瘦肉和未加工的形式）；(5) 使用液态植物油而不是热带油和部分氢化脂肪；（6）选择微加工食品而不是超加工食品；(7) 尽量减少饮料和添加糖的食物的摄入；(8) 选择和准备少盐或无盐的食物；（9）如果不喝酒，不要开始；如果您选择饮酒，请限制摄入量；(10) 无论在哪里准备或食用食物，都必须遵守本指南。阻碍坚持心脏健康饮食模式的挑战包括不健康食品的定向营销、社区隔离、食品和营养不安全以及结构性种族主义。创造一个促进而不是阻碍的环境，