American Institute for Cancer Research (AICR) Foods That Fight Cancer
AICR’s New American Plate: A Plant-Based Diet Transition to the New American Plate
Plant-Based Diets
10 Cancer Prevention Recommendations EAT-Lancet
EAT-Lancet Commission Summary Report Harvard School of Public Health
Healthy Eating Plate
Dietary Guidelines for Americans (DGA)
Understanding the Dietary Guidelines for Americans
Dietary Guidelines for Americans, 2020-2025 Executive Summary Linus Pauling Institute (LPI)
Rx for Health
World Cancer Research Fund (WCRF) Cancer Prevention Recommendations World Health Organization (WHO)
Healthy diet
Nutrition advice for adults during the COVID-19 outbreak
American Heart Association/American College of Cardiology (AHA/ACC)
Notes on
Organizational
Guidelines
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
American Institute for
Cancer Research (AICR)
American Institute for Cancer Research (AICR)
No single food can protect you against cancer by itself.
But research shows that a diet filled with a variety of vegetables, fruits, whole grains, beans and other plant foods helps lower risk for many cancers. In laboratory studies, many individual minerals, vitamins and phytochemicals demonstrate anti-cancer effects.
Apples Blueberries Cherries Cranberries Grapefruit Grapes Oranges Raspberries Strawberries
Asparagus
Broccoli and Cruciferous Vegetables Brussels Sprouts
Carrots Cauliflower Garlic Kale Spinach
Squash (Winter) Tomatoes
Foods That Fight Cancer
Foods That Fight Cancer
Fruits
Vegetables
Beverages
Coffee Tea
Flaxseed Walnuts
Also, all Pulses/Legumes (Dry Beans, Peas, and Lentils) and Whole Grains.
A lot of us grow up eating foods that might be okay to eat, but aren’t necessarily the best thing to eat. As you build your meal plans, make sure you’re not overdoing it with foods that are best to have in small portions.
Alcohol
Processed meat (sausages, ham, bacon, hot dogs, salami) Red meat (beef, pork, lamb)
Sugar-sweetened drinks
Nuts & Seeds
Foods to limit
American Institute for Cancer Research (AICR)
AICR’s New American Plate is a plant-based diet created to reflect research on reducing cancer risk. It emphasizes:
Choosing foods with plenty of fiber, nutrients and plant compounds that may help protect against cancer
Limiting foods that increase the risk of cancer
Reaching and maintaining a healthy weight, which research shows can play a major role in reducing cancer risk.
The goal is to have (non-starchy) vegetables, fruits, whole grains and beans make up 2/3 (or more) of each meal, and animal protein to make up 1/3 (or less).
All plant foods are not the same. High-fiber diets rich in whole grains, non-starchy vegetables, and fruits reduce risk of a wide range of cancers.
Aim to include several servings of whole grains daily, and eat a variety of vegetables and fruits for the widest array of nutrients and protective phytochemicals.
The average American diet is much lower in fiber than amounts recommended for lower risk of colorectal cancer, and all these plant foods, as well as legumes, nuts and seeds, can help you reach recommended levels.
Including relatively unprocessed plant foods — whole grains, vegetables, fruits, beans and nuts — as at least 2/3 of each meal may offer cancer protection beyond the fiber these foods provide. In laboratory studies, nutrients and compounds in these plant foods can change the expression of tumor suppressor and other genes, and influence cell signaling pathways, inflammation, and self-destruction of abnormal cells.
Dairy products, poultry, fish or red meat – if included – are kept to no more than 1/3 of each meal.
Red meat (beef, lamb and pork) is limited to no more than 12-18 ounces (cooked) per week because excess amounts increase risk of colorectal cancer.
AICR’s New American Plate:
A Plant-Based Diet
AICR’s New American Plate: A Plant-
Based Diet
If you include red meat occasionally, be sure that it’s mostly unprocessed red meat. Processed meats (like bacon, sausage, salami and hot dogs) pose greater cancer risk, so it’s best to save them for much more occasional use.
Even though they’re technically plant-based foods, choices that are highly
processed and contain a lot of fat and added sugar make it harder to maintain the healthy weight that plays a strong role in reducing the risk of at least 12 forms of cancer.
The overall context of AICR’s New American Plate as part of a healthy lifestyle also matters. Be physically active in some way every day, limit the time you spend sitting, aim to reach and maintain a healthy weight, limit alcohol, and of course, avoid tobacco in any form.
American Institute for Cancer Research (AICR)
The typical American meal is heavy on red meat, fish and poultry. Take a look at this plate. Fully half is loaded with a huge (8–12 oz.) steak. The remainder is filled with a hearty helping of buttery mashed potatoes and peas.
Although this meal is a home-style favorite, it is high in calories and low in phytochemicals and fiber. A few changes, however, will bring it closer to the New American Plate.
Transition to the New American Plate
Transition to the New American Plate
The Old American Plate
The modest 3-ounce serving of meat (fish, poultry, or red meat) pictured here fits AICR guidelines for cancer prevention. This plate also features a wider variety of foods, resulting in a diverse assortment of cancer-fighting nutrients. Two kinds of vegetables increase the proportion of plant- based foods, and a healthy serving of a tasty whole grain (brown rice, barley, kasha, bulgur, millet, and quinoa) completes the meal.
The New American Plate
American Institute for Cancer Research (AICR)
Healthy dietary patterns linked with lower cancer risk limit consumption of alcohol and of red and processed meats.
Evidence from long-term observational population studies shows that vegetarian diets as a whole are consistently linked to lower risk of cancer compared to diets that include meat and fish more than once a week.
These vegetarian diets include pesco-vegetarian diets as well as vegan and lacto-ovo vegetarian diets and diets that include meat or fish up to once a week.
People who follow a vegetarian diet but include frequent use of sweets, refined grains, sugar-sweetened beverages and unhealthy choices of added fats do not show as much health benefit. People following a vegetarian diet who limit these foods and include abundant vegetables, legumes (dry beans, peas, lentils, and soy foods), nuts and seeds tend to show lowest risk of cancer and heart disease.
People in studies who follow vegetarian diets tend to also consume little or no alcohol, avoid tobacco, get regular physical activity, and maintain a healthy weight . Although researchers try to adjust for these factors in their statistical analysis, the overall lifestyle of people who follow vegetarian diets may be reflected in the health benefits seen.
People following a vegetarian diet are less likely to have overweight or obesity, which is another way that these eating habits help reduce risk of cancer. But simply eliminating all animal foods does not necessarily lead to a healthy weight for people who eat more calories than they need, especially if they frequently include large portions of foods or drinks high in added sugars or fats.
Plant-Based Diets
General guidelines
Limit alcohol and red and processed meat
Vegetarian diets
Confounding variables
Individual diets
Beyond meeting the recommendation for a plant-based diet, evidence is too limited to allow any conclusions about a pesco-vegetarian diet as a specific choice for reducing cancer risk.
Pescatarian diets specifically show a similar association with lower overall cancer risk.
In a major study of U.S. vegetarians, pesco-vegetarians showed particularly low risk of colorectal cancer, even compared to people following other types of vegetarian diets.
Limited evidence suggests a potential association between fish and lower colorectal cancer (as well as liver cancer) risk.
Beyond meeting the recommendation for a plant-based diet, evidence is too limited to allow any conclusions about a lacto-ovo vegetarian diet as a specific choice for reducing cancer risk
Lacto-ovo vegetarian diets have been linked with lower risk of overall gastrointestinal tract cancers. Such a link makes sense, since strong evidence links greater consumption of dairy products and of dietary calcium with lower risk of colorectal cancer.
Conducting and interpreting research on the Mediterranean diet is challenging, because
Specific food choices and typical menus vary in different areas of the Mediterranean Average eating habits in countries around the Mediterranean today do not represent the
“Mediterranean diet” identified in the 1960s that has been associated with good health in research studies.
Beyond meeting the recommendation for a plant-based diet, evidence is too limited to allow any conclusions about a Mediterranean diet specifically and cancer risk.
Healthy fat, more than high-fat. Mediterranean cuisine is traditionally relatively high in fat, due to liberal use of olive oil. But research on this diet and health is based largely on scoring systems that include awarding points for more healthy types of fat, not for using more fat.
Meats and sweets in very limited amounts. Despite the popularity of processed meats in Mediterranean-flavored dishes as seen in restaurants and homes today, the original, healthy Mediterranean diet included meats occasionally and as “condiment”-sized portions.
Likewise, popular desserts in Mediterranean-type restaurants were traditionally for special celebrations. Fruits and nuts are the traditional – and more healthful – choice for daily desserts and snacks.
Pescovegetarian/Pescatarian Diet
Lacto-Ovo Vegetarian Diet
Mediterranean Diet
Wine in moderation is optional, not essential. Human research does not support red wine as different from other alcoholic beverages as it increases cancer risk.
Flexitarian Diet
American Institute for Cancer Research (AICR)
1. Be a Healthy Weight. Keep your weight within the healthy range and avoid weight gain in adult life. The evidence linking body fatness to cancer is overwhelming and has grown stronger over the past decade.
2. Be Physically Active. Be physically active as part of everyday life. Walking more and sitting less is a great way to reduce cancer risk. The more active you are, the greater the benefit.
3. Eat a Diet Rich in Whole Grains, Vegetables, Fruits, and Beans. Make whole grains, vegetables, fruits and pulses (legumes) such as beans and lentils a major part of your normal diet. A healthy pattern of eating and drinking is associated with a lower risk of cancer. Independent studies show that the more closely you follow our
recommendations, the more you reduce risk of developing cancer.
4. Limit Consumption of “Fast Foods” and Other Processed Foods That are High In Fat, Starches, or Sugars. Limiting these products helps you control your calorie intake and makes it easier to maintain a healthy weight. There is strong evidence that diets containing greater amounts of "fast foods" and other processed foods high in fat, starches or sugars are a cause of weight gain, overweight and obesity. Greater body fatness is a cause of 12 cancers.
5. Limit Consumption of Red and Processed Meat. Eat no more than moderate
amounts (12-18 ounces per week) of red meat, such as beef, pork, and lamb. Eat little, if any, processed meat. There is strong evidence that eating red or processed meat are both causes of colorectal cancer.
6. Limit Consumption of Sugar-Sweetened Drinks. Drink mostly water and
unsweetened drinks. There is strong evidence that regularly drinking sugar sweetened drinks is a cause of weight gain, overweight and obesity. Greater body fatness is a cause of at least 12 cancers.
7. Limit Alcohol Consumption. For cancer prevention, it is best not to drink alcohol. There is strong evidence that drinking alcohol is a cause of six cancers, and even one small glass of alcohol a day can increase the risk of some cancers.
8. Do Not Use Supplements for Cancer Prevention. Aim to meet your nutritional needs through diet alone. We advise against the use of supplements as protection against specific cancers.
9. For Mothers: Breastfeed Your Baby, If You Can. Breastfeeding is good for both mother and baby. It carries many health benefits, including the ability to reduce your
10 Cancer Prevention Recommendations
10 Cancer Prevention Recommendations
chances of developing breast cancer.
10. After a Cancer Diagnosis: Follow Our Recommendations, If You Can.
Unless otherwise advised, and if you can, all cancer survivors are advised to follow the recommendations as far as possible. Always, check with your health professional about what is right for you.
EAT-Lancet
EAT-Lancet
Food is the single strongest lever to optimize human health and environmental sustainability on Earth.
However, food is currently threatening both people and planet. An immense challenge facing humanity is to provide a growing world population with healthy diets from sustainable food systems.
While global food production of calories has generally kept pace with population growth, more than 820 million people still lack sufficient food, and many more consume either low- quality diets or too much food.
Unhealthy diets now pose a greater risk to morbidity and mortality than unsafe sex, alcohol, drug and tobacco use combined.
Global food production threatens climate stability and ecosystem resilience and constitutes the single largest driver of environmental degradation and transgression of planetary boundaries.
Without action, the world risks failing to meet the UN Sustainable Development Goals (SDGs) and the Paris Agreement, and today’s children will inherit a planet that has been
severely degraded and where much of the population will increasingly suffer from malnutrition and preventable disease.
The EAT-Lancet Commission convened 37 leading scientists from 16 countries in various
disciplines including human health, agriculture, political sciences and environmental sustainability to develop global scientific targets for healthy diets and sustainable food production . This is the first attempt to set universal scientific targets for the food system that apply to all people and the planet.
Our definition of sustainable food production stays within safe planetary boundaries for six environmental processes that together regulate the state of the Earth system, and include:
EAT-Lancet Commission Summary Report
EAT-Lancet Commission Summary Report
Introduction
1. Climate change 2. Land-system change 3. Freshwater use 4. Biodiversity loss
5. Interference with the global nitrogen and phosphorus cycles
We show that it is possible to feed a global population of nearly 10 billion people a healthy diet within food production boundaries by 2050.
Healthy diets:
1. Have an appropriate caloric intake 2. Consist of:
A diversity of plant-based foods Low amounts of animal source foods Unsaturated rather than saturated fats
Small amounts of refined grains, highly processed foods, and added sugars.
Our universal healthy reference diet largely consists of vegetables, fruits, whole grains, legumes, nuts, and unsaturated oils, includes a low to moderate amount of seafood and poultry, and includes no or a low quantity of red meat, processed meat, added sugar, refined grains, and starchy vegetables.
Fish
Vegetables Dark green Red and orange Other
Fruit Legumes Whole grains Nuts
Unsaturated oils
Eggs Poultry
Healthy diets
Emphasized Foods
Optional foods
Dairy
Red meat
Starchy vegetables Added sugars Saturated oils
Limited intake
Harvard School of Public
Health
Harvard School of Public Health
Aim for color and variety, and remember that potatoes don’t count as vegetables on the Healthy Eating Plate because of their negative impact on blood sugar.
Whole and intact grains—whole wheat, barley, wheat berries, quinoa, oats, brown rice, and foods made with them, such as whole wheat pasta—have a milder effect on blood sugar and insulin than white bread, white rice, and other refined grains.
Fish, poultry, beans, and nuts are all healthy, versatile protein sources—they can be mixed into salads, and pair well with vegetables on a plate.
Limit red meat, and avoid processed meats such as bacon and sausage.
Choose healthy vegetable oils like olive, canola, soy, corn, sunflower, peanut, and others, and avoid partially hydrogenated oils, which contain unhealthy trans fats.
Remember that low-fat does not mean “healthy.”
Skip sugary drinks.
Limit milk and dairy products to one to two servings per day Limit juice to a small glass per day.
The type of carbohydrate in the diet is more important than the amount of carbohydrate in the diet, because some sources of carbohydrate—like vegetables (other than potatoes),
Healthy Eating Plate
Healthy Eating Plate
½ plate: Vegetables and fruits
¼ plate: Whole grains
¼ plate: Protein
In moderation: Healthy plant oils.
Drink water, coffee, or tea.
Focus on diet quality
fruits, whole grains, and beans—are healthier than others.
Avoid sugary beverages, a major source of calories—usually with little nutritional value—in the American diet.
This includes soda, pop, cola, tonic, fruit punch, lemonade (and other “ades”), sweetened powdered drinks, as well as sports and energy drinks.
Use healthy oils. The Healthy Eating Plate does not set a maximum on the percentage of calories from fat.
The Healthy Eating Plate does not define a certain number of calories or servings per day from each food group.
The relative section sizes suggest approximate relative proportions of each of the food groups to include on a healthy plate.
They are not based on specific calorie amounts, and they are not meant to prescribe a certain number of calories or servings per day, since individuals’ calorie and nutrient needs vary based on age, gender, body size, and level of activity.
You can apply this approach to non-plate meals by using the same proportions.
For example, while you wouldn’t consume soup on a plate—you can consider the relative sizes of each section when choosing what to add to the pot before serving in a bowl: make about half of your ingredients a variety of colorful vegetables (carrots, celery, spinach, tomatoes, sautéed in olive oil), and the other half a mix of whole grains (such as farro) and a healthy protein (such as beans).
Your questions answered
Dietary Guidelines for
Americans (DGA)
Dietary Guidelines for Americans (DGA)
MyPlate is a nutrition education program based on the guidelines.
Fruits Vegetables Proteins Grains Dairy
½ plate should be fruits and veggies
¼ plate should be grains
At least ½ of grains should be whole grains (not multigrain, seven-grain, etc.) Brown rice and whole-wheat pasta count.
Avoid grain-based desserts and snacks, such as baked goods.
¼ plate should be proteins Vary sources
Includes fish, shellfish, eggs, beans, peas, unsalted nuts, seeds, and soy products, in addition to lean meat.
Limit alcohol intake to 2 drinks or less a day for men and 1 drink a day or less for women.
Limit added sugars, sodium, and saturated fat.
At least 85% of calories should come from nutrient-dense foods.
Calculate your serving size recommendations based on age, sex, and physical activity using
Understanding the Dietary Guidelines for Americans
Understanding the Dietary Guidelines for Americans
There are five food groups
Recommendations
Additional resources
the MyPlate Plan.
See Customizing the Dietary Guidelines Frameworkfor customizing the guidelines to your individual personal preferences.
Any fruit or 100% fruit juice.
Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, pureed, or cooked.
At least half of the recommended amount of fruit should come from whole fruit, rather than 100% fruit juice.
1 cup raw, frozen, or cooked/canned fruit; or
½ cup dried fruit 1 cup 100% fruit juice Specific fruits:
1 small (or ½ large) apple (150g) 1 large banana (136g)
22 grapes (120g) 1 large orange (184g) 1 large peach
1 medium pear
8 large strawberries (160g)
Any vegetable or 100% vegetable juice.
Vegetables may be raw or cooked; fresh, frozen, canned, or dried/dehydrated; and may be whole, cut-up, or mashed.
1 cup raw or cooked/canned vegetables; or
2 cups leafy salad greens (60g) or 1 cup cooked (180g) 1 cup 100% vegetable juice
Food Groups
Fruits
What counts?
Serving size (1 cup equivalents):
Vegetables
What counts?
Serving size (1 cup equivalents):
Specific vegetables:
1 cup broccoli florets (156g) 2 medium carrots
1 cup baby carrots 1 large bell pepper
1 large sweet potato (in “Red and Orange Vegetables” group) 1 large tomato
1 cup cooked beans, peas, and lentils 1 large ear of corn
1 medium white potato
Dark-Green Cruciferous, Leafy greens Red and Orange
Carrots Pumpkin
Red and orange bell peppers Sweet potato
Tomatoes Winter squash
Beans, Peas, and Lentils Starchy Vegetables
Corn Hominy Plantains White potatoes Other
Avocado Cabbage Cauliflower Celery Cucumber
Green bell peppers Lettuce
Mushrooms Onions
Summer squash
Categories
Grains
What counts?
1. Whole Grains: Contain the entire grain kernel ― the bran, germ, and endosperm.
Examples: whole-wheat flour, bulgur (cracked wheat), oatmeal, whole grain cornmeal, and brown rice.
2. Refined Grains: Have been milled, a process that removes the bran and germ. This is done to give grains a finer texture and improve their shelf life, but it also removes dietary fiber, iron, and many B vitamins.
Examples: white flour, corn grits, white bread, and white rice.
Refined grain choices should be enriched. This means certain B vitamins (thiamin, riboflavin, niacin, folic acid) and iron are added back after processing.
Fiber is not added back to enriched grains.
Check the ingredient list on refined grain products to make sure that the word
"enriched" is included in the grain name.
Only foods that are made with 100% whole grains are considered a whole grain food.
Some food products are made from mixtures of whole grains and refined grains.
1 slice bread (43g)
1 ounce ready-to-eat cereal (28g)
1 ounce dry oatmeal, rice, pasta (28g)
½ cup cooked rice, pasta, or cereal (100g)
All foods made from seafood; meat, poultry, and eggs; beans, peas, and lentils; and nuts, seeds, and soy products.
Beans, peas, and lentils are also part of the Vegetable Group.
1 ounce seafood, lean meat, or poultry 1 egg
1 Tbsp peanut butter
¼ cup cooked beans, peas, or lentils
Meat and poultry choices should be lean or low-fat, like 93% lean ground beef, pork loin, and skinless chicken breasts.
Serving size
Protein
What counts?
Serving size (1 oz equivalents):
Recommendations
Choose seafood options that are higher in beneficial fatty acids (omega-3s) and lower in methylmercury, such as salmon, anchovies, and trout.
Vegetarian options in the Protein Foods Group include beans, peas, and lentils, nuts, seeds, and soy products.
Meats Poultry Seafood Eggs
Nuts and seeds
Beans, peas, and lentils
The Dairy Group includes milk, yogurt, cheese, lactose-free milk and fortified soy milk and yogurt.
It does not include foods made from milk that have little calcium and a high fat content, such as cream cheese, sour cream, cream, and butter.
Milk
1 cup milk
½ cup evaporated milk
1 cup calcium-fortified soy milk 1 cup yogurt (dairy or fortified soy) Cheese
1 ½ oz hard cheese (cheddar, mozzarella, Swiss, Parmesan)
⅓ cup shredded cheese
1 oz processed cheese (American)
½ cup ricotta cheese 2 cups cottage cheese
For individuals who choose dairy alternatives, fortified soy milk and yogurt - which have calcium, vitamin A, and vitamin D added - are included as part of the Dairy Group because their nutrition content is similar to dairy milk and yogurt.
There are other calcium choices, but they are not part of the Dairy Group because the amount of calcium that can be absorbed varies:
Calcium-fortified juices and plant-based milks
Categories
Dairy
What counts?
Serving size (1 cup equivalents):
Recommendations
Canned fish
Tofu made with calcium sulfate
Some leafy greens (collard and turnip greens, spinach, kale, bok choy)
Dietary Guidelines for Americans (DGA)
For most individuals, no matter their age or health status, achieving a healthy dietary pattern will require changes in food and beverage choices. Some of these changes can be accomplished by making simple substitutions, while others will require greater effort to accomplish.
Although individuals ultimately decide what and how much to consume, their personal relationships; the settings in which they live, learn, work, play, and gather; and other
contextual factors - including their ability to consistently access healthy and affordable food - strongly influence their choices.
At every life stage - infancy, toddlerhood, childhood, adolescence, adulthood, pregnancy, lactation, and older adulthood - it is never too early or too late to eat healthfully
For about the first 6 months of life, exclusively feed infants human milk.
Continue to feed infants human milk through at least the first year of life, and longer if desired.
Feed infants iron-fortified infant formula during the first year of life when human milk is unavailable.
Provide infants with supplemental vitamin D beginning soon after birth.
At about 6 months, introduce infants to nutrient-dense complementary foods.
Introduce infants to potentially allergenic foods along with other complementary foods.
Encourage infants and toddlers to consume a variety of foods from all food groups.
Include foods rich in iron and zinc, particularly for infants fed human milk.
From 12 months through older adulthood, follow a healthy dietary pattern across the
Dietary Guidelines for Americans, 2020-2025 Executive Summary
DGA 2020-2025 Executive Summary
The Guidelines
1. Follow a healthy dietary pattern at every life stage.
lifespan to meet nutrient needs, help achieve a healthy body weight, and reduce the risk of chronic disease.
A healthy dietary pattern can benefit all individuals regardless of age, race, or ethnicity, or current health status.
Nutritional needs should be met primarily from foods and beverages - specifically, nutrient-dense foods and beverages.
A healthy dietary pattern consists of:
1. Nutrient-dense forms of foods and beverages across all food groups, 2. In recommended amounts
3. Within calorie limits
The core elements that make up a healthy dietary pattern include:
Vegetables of all types: dark green; red and orange; beans, peas, and lentils; starchy;
and other vegetables
Fruits, especially whole fruit
Grains, at least half of which are whole grain
Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified soy beverages and yogurt as alternatives
Protein foods, including lean meats, poultry, and eggs; seafood; beans, peas, and lentils;
and nuts, seeds, and soy products
Oils, including vegetable oils and oils in food, such as seafood and nuts
Meeting food group recommendations - even with nutrient-dense choices - requires most of a person’s daily calorie needs and sodium limits.
A healthy dietary pattern doesn’t have much room for extra added sugars, saturated fat, or sodium - or for alcoholic beverages.
2. Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations.
3. Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits.
4. Limit foods and beverages higher in added sugars,
saturated fat, and sodium, and limit alcoholic beverages.
Limits are:
Added sugars: Less than 10 percent of calories per day.
Avoid foods and beverages with added sugars for those younger than age 2.
Saturated fat: Less than 10 percent of calories per day.
Sodium: Less than 2,300 milligrams per day.
Alcoholic beverages: Adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed.
Drinking less is better for health than drinking more.
There are some adults who should not drink alcohol, such as women who are pregnant.
The combination of foods and beverages that constitutes an individual’s complete dietary intake over time. This may be a description of a customary way of eating or a description of a
combination of foods recommended for consumption.
Provides vitamins, minerals, and other health-promoting components and have little added sugars, saturated fat, and sodium.
The following are nutrient dense foods, when prepared with no or little added sugars, saturated fat, and sodium:
Vegetables Fruits
Whole grains Seafood Eggs
Beans, peas, and lentils Unsalted nuts and seeds
Fat-free and low-fat dairy products Lean meats and poultry
Terminology
Dietary pattern
Nutrient dense
Linus Pauling Institute (LPI)
Linus Pauling Institute (LPI)
Balance your energy intake with physical activity: calorie-rich food should be consumed in moderation. Don't drink your calories: avoid calorie-rich beverages.
Eat four servings (2 cups) of fruit and five servings (2½ cups) of vegetables daily
Rx for Health
Rx for Health
Healthy Eating
Don't include potatoes in your tally
Eat a variety of fruit and vegetables daily.
Frozen vegetables are just as nutritious as fresh vegetables.
Drink water throughout the day to stay hydrated.
Unsweetened coffee and tea are also good beverage choices, keeping in mind that both contain caffeine (More on coffee and tea).
Choose low-fat dairy or soy milk
Avoid sugary soft drinks and energy drinks
Limit your intake of 100% fruit or vegetable juice to 1 cup daily Increase your intake of omega-3 fats by:
Eating fish twice weekly
Consuming food rich in α-linolenic acid, such as walnuts, flaxseeds, and flaxseed or canola oil.
Reduce your intake of food high in saturated fat, such as red meat, whole milk, and full-fat yogurt or cheese; substitute soft margarine spreads for butter.
Increase your intake of choline by eating food like eggs, seafood, meat, poultry, beans, mushrooms, cauliflower, broccoli, and nuts.
Choose sources of unsaturated fats, such as nuts, olives, or avocados, and use soy, corn, safflower, or olive oil for cooking and salad dressings.
Reduce your intake of white potatoes, white flour, and white rice by substituting whole-grain products, such as whole-wheat flour and pasta, whole-grain bread and cereal, and brown rice.
Choose a variety of lean and low-fat protein sources, such as seafood, eggs, meat, poultry, dairy products, legumes (beans and peas), nuts, seeds, and soy products.
Reduce your exposure to food-borne carcinogens, avoid smoked or cured foods and charred or seared fish, meat, and poultry.
Avoid highly processed, nutrient-poor food, such as cookies, candies, chips, crackers, processed meats and sugar-coated breakfast cereal, which are typically high in sugar, saturated fat, trans fat, or sodium.
Although the "Nutrition Facts" label may state that a food is "Not a significant source of trans fat," if "partially hydrogenated" vegetable oil is listed under ingredients, the food may contain up to 0.5 grams of trans fat per serving.
Aim for a healthy weight and waist circumference (40 inches or less for men and 35 inches or less for women).
Being overweight or obese increases your risk for many chronic diseases, such as cardiovascular disease; colorectal, breast and other cancers; and type 2 diabetes.
If you are overweight or obese, even a 10% weight loss can help lower your chronic disease risk.
Limit sedentary behavior, such as prolonged sitting or TV viewing.
Get at least 150 minutes or moderate or 75 minutes or vigorous aerobic activity each week.
Healthy Lifestyle
Aerobic activity for at least 10 minutes at a time will count toward your goal.
Add muscle-strengthening activities, such as weight lifting or push-ups, at least twice weekly.
Make every effort to quit if you smoke. Even if you have smoked for many years, quitting dramatically decreases risk for chronic diseases.
Moderate alcohol consumption is associated with reduced risk for cardiovascular disease but increased risk for some cancers. If you drink alcohol, limit your
consumption to one alcoholic drink per day for women and two for men. Avoid alcohol if you have a personal or family history of breast or colon cancer or alcoholism.
Take a daily multivitamin/mineral supplement and consider taking additional dietary supplements.
Take a multivitamin/mineral supplement (MVM) with 100% of the Daily Value (DV) for most vitamins and essential minerals, keeping the following recommendations in mind:
Vitamin A: Look for an MVM containing no more than 2,500 IU (750 μg) of vitamin A, unless any extra amount is in the form of β-carotene.
Smokers should not take supplemental β-carotene.
Vitamin B12: Adults older than 50 years should take 100 to 400 μg of supplemental vitamin B12 daily.
Poor absorption of vitamin B12 is common among older adults.
Vitamin C: Aim for a daily intake of at 400 mg.
Five servings of fruit and vegetables generally provide about 150 to 200 mg, especially if vitamin C-rich fruits (e.g., citrus fruit, kiwifruit) are consumed.
Vitamin D: Take 2,000 IU (50 μg) of supplemental vitamin D daily.
Sun exposure, which varies with latitude and season, is the primary source of vitamin D, but sunscreen blocks skin synthesis of the vitamin. People with dark-colored skin, older adults, and obese individuals are especially at risk for low vitamin D levels.
Vitamin K: Aim for a daily intake of 120 μg for men and 90 μg for women.
Some MVMs do not contain 100% of the DV for vitamin K.
The best sources for vitamin K are green leafy vegetables, naturally fermented food, and vegetable oils.
Calcium: Aim for a daily intake of 1,000 mg.
No MVM contains 100% of the DV for calcium.
Dairy products, fortified beverages, and legumes are good sources of calcium.
If your total calcium intake from your MVM and diet is inadequate, take a calcium supplement with a meal to make up the difference. To maximize the absorption, take no more than 500 mg at a time.
Iron: In general, men and postmenopausal women should avoid taking an MVM containing iron. If you are anemic, consult your physician.
Magnesium: Aim for a daily intake of about 400 mg for men and 300 mg for women.
No MVM contains 100% of the DV for magnesium.
Green leafy vegetables, whole grains, and nuts are good sources of magnesium.
Vitamin and Mineral Supplements
If your total magnesium intake from your MVM and diet is inadequate, take a
magnesium supplement to make up the difference. Avoid taking more than 350 mg per day of supplemental magnesium.
Potassium: Aim for a daily intake of 4,700 mg.
No MVM contains 100% of the DV for potassium.
Potassium is abundant in fruit and vegetables. Low-sodium and no-sodium salt substitutes also contain potassium.
Fish Oil: If you don't regularly consume fish, consider taking a two-gram fish oil supplement several times a week. If you are prone to bleeding or take anticoagulant drugs, consult your physician.
Lipoic Acid and L-Carnitine: Adults over the age of 50 may consider a daily supplement of 200-400 mg of α-lipoic acid and 500-1,000 mg of acetyl-L-carnitine.
Information about the quality and composition of dietary supplements can be found at consumerlab.com.
To ensure quality, purity, and potency, buy US Pharmacopeia (USP) grade supplements . Look for a "USP Verified" mark on the label.
Don't store your supplements in the refrigerator, bathroom, or other humid environment; store them in a cool, dark place.
For best absorption of fat-soluble vitamins, an MVM should be taken with a meal containing fat.
Except for vitamin E and folic acid, there is no difference between natural and synthetic vitamins.
Synthetic vitamin E is about 50% natural vitamin E (d-α-tocopherol).
Folic acid, the form of the B vitamin used in supplements and food fortification, is more bioavailable than folate, which is found in food.
Although vitamin E is a family of four tocopherols and four tocotrienols, d-α-tocopherol is the only form retained by the body.
If you take large amounts of vitamin C daily, take them in divided doses to maintain consistently high plasma concentrations.
Micronutrients and dietary factors may affect the action of drugs, and drugs may affect micronutrient status. For example, people using proton-pump inhibitor drugs or antacids for heartburn may be at increased risk for vitamin B12 deficiency.
The Linus Pauling Institute does not make recommendations for herbal supplements, which have no nutritional value.
Other Supplements
Supplement Tips
World Cancer Research
Fund (WCRF)
World Cancer Research Fund (WCRF)
Interactive Cancer Risk Matrix
The Recommendations help people to reduce their risk of developing cancer.
They are based on the latest science available, and derive from the extensive evidence that was analysed for Diet, Nutrition, Physical Activity and Cancer: a Global Perspective – the Third Expert Report from World Cancer Research Fund and the American Institute of Cancer Research.
Only evidence that strongly links a risk factor to cancer is used to make a recommendation.
The Cancer Prevention Recommendations work together as an overall way of living healthily to prevent cancer. They provide a blueprint to beat cancer that people can trust, because they are based on evidence that has now proved consistent for decades.
To prevent cancer, people should aim to follow as many as possible of the Cancer
Prevention Recommendations. However, any change that works towards meeting the goals set out in the Recommendations will go some way to reducing cancer risk.
Recommendations are made only when our panel of experts judges the evidence to be sufficiently strong. Our experts have also taken into account relevant dietary advice from authoritative
international and national organisations.
There is strong evidence that greater body fatness causes many cancers, and this evidence has strengthened over the last decade.
Cancer Prevention Recommendations
Cancer Prevention Recommendations
About our Cancer Prevention Recommendations
Be a healthy weight
Ensure that body weight during childhood and adolescence projects towards the lower end of the healthy adult BMI range
Keep your weight as low as you can within the healthy range throughout life (BMI of 18.5–24.9)
Avoid weight gain throughout adulthood
This Recommendation can best be achieved by maintaining energy balance throughout life by:
being physically active
eating a diet rich in wholegrains, vegetables, fruit and pulses such as beans limiting ‘fast foods’ and other processed foods high in fat, starches or sugars limiting sugar sweetened drinks
There is strong evidence that physical activity protects against cancers of the colon, breast and endometrium, and that it helps prevent excess weight gain.
Be at least moderately physically active and follow or exceed national guidelines Limit sedentary habits
walking cycling
household chores gardening
swimming dancing
running
fast swimming fast cycling aerobics team sports
Our goals for being a healthy weight
How can I be a healthy weight?
Be physically active
Our goals for being physically active
Moderate-intensity activities include:
Vigorous-intensity activities include:
Watching television or screens, including at work, and using electronic devices, such as playing games consoles, are forms of sedentary behaviour.
Both adults and children should minimise the amount of time they are sedentary. Although evidence for sitting time as a risk for cancer (for example, endometrial cancer), and as a determinant of weight is still emerging, it is likely that extended periods of sitting may promote weight gain and so indirectly increase cancer risk.
There is evidence that eating wholegrains, fibre, vegetables and fruit can help protect against certain cancers, as well as against weight gain, overweight and obesity.
Consume a diet that provides at least 30g per day of fibre from food
Include foods containing wholegrains, non-starchy vegetables, fruit and pulses (legumes) such as beans and lentils in most meals
Eat a diet high in all types of plant foods including at least five portions or servings (at least 400g or 15oz in total) of a variety of non-starchy vegetables and fruit every day
If you eat starchy roots and tubers as staple foods, eat non-starchy vegetables, fruit and pulses (legumes) regularly too if possible
non-starchy vegetables and fruit of different colours
non-starchy roots and tubers (eg carrots, artichokes, celeriac (celery root), swede (rutabaga), turnips)
wholegrains (eg brown rice, wheats, oats, barley and rye)
Relatively unprocessed foods of plant origin are rich in nutrients and dietary fibre. Higher consumption of these foods, instead of processed foods high in fat, refined starches (eg white bread or pasta, biscuits, cakes and pastries) and sugars, would mean a diet is higher in essential nutrients and more effective for regulating energy intake relative to energy expenditure. This could protect against weight gain, overweight and obesity and therefore protect against obesity- related cancers.
Limit sedentary behavior
Eat wholegrains, vegetables, fruit and beans
Dietary goals
What should we be eating?
Limit ‘fast foods’
There is strong evidence that diets containing greater amounts of ‘fast foods’ and other processed foods high in fat, starches or sugars – and consuming a ‘Western type’ diet (characterised by a high amount of free sugars, meat and fat) – are causes of weight gain, overweight and obesity by increasing the risk of excess energy intake relative to expenditure. Greater body fatness is a cause of many cancers.
potato products such as chips and crisps
products made from white flour such as bread, pasta and pizza cakes, pastries, biscuits and cookies
confectionery
Limit consumption of processed foods high in fat, starches or sugars – including ‘fast foods’;
many pre-prepared dishes, snacks, bakery foods and desserts; and confectionery (candy)
This Recommendation does not imply that all foods high in fat need to be avoided. Some, such as certain oils of plant origin, nuts and seeds, are important sources of nutrients. Their consumption has not been linked with weight gain, and by their nature they tend to be consumed in smaller portions.
There is strong evidence that consumption of either red or processed meat are both causes of colorectal cancer.
All types of muscle meat from a mammal, including beef, veal, pork, lamb, mutton, horse and goat.
If you eat red meat, limit consumption to no more than about three portions per week. Three portions is equivalent to about 350–500g (about 12–18oz) cooked weight. Consume very little, if any, processed meat.
Meat can be a valuable source of nutrients, in particular protein, iron, zinc and vitamin B12.
However, eating meat is not an essential part of a healthy diet. People who choose to eat meat-free diets can obtain adequate amounts of these nutrients through careful
These foods include:
Dietary goal
Limit red and processed meat
What is red meat?
Dietary goal
Should I give up red meat?
food selection.
For those who consume it, lean rather than fatty cuts are preferred.
Poultry and fish are valuable substitutes for red meat.
Eggs and dairy are also valuable sources of protein and micronutrients.
People can obtain adequate protein from a mixture of pulses (legumes) and cereals (grains).
Iron is present in many plant foods, though it is less bioavailable than that in meat.
There is convincing evidence that consumption of sugar sweetened drinks is a cause of weight gain, overweight and obesity in both children and adults, especially when consumed frequently or in large portions. Sugar sweetened drinks do this by promoting excess energy intake relative to energy expenditure.
Do not consume sugar sweetened drinks
There is evidence that coffee probably protects against liver and endometrial cancers.
Fruit juices should not be consumed in large quantities, as even with no added sugar they are likely to promote weight gain in a similar way to sugar sweetened drinks.
There is no strong evidence in humans to suggest that artificially sweetened drinks with minimal energy content, such as diet sodas, are a cause of cancer . The evidence that artificially sweetened drinks help prevent weight gain, overweight and obesity is not consistent. The available evidence is insufficient to make a recommendation regarding artificially sweetened drinks.
There is strong evidence that drinking alcohol is a cause of many cancers.
For cancer prevention, it’s best not to drink alcohol
For most people consumption of the right food and drink is more likely to protect against cancer than dietary supplements
There is strong evidence from randomised controlled trials that high-dose beta-carotene supplements may increase the risk of lung cancer in some people. There is no strong evidence that dietary supplements,
Limit sugar sweetened drinks
Dietary goal
What about tea, coffee and fruit juice?
Limit alcohol consumption
Our goal
Do not use supplements for cancer prevention
apart from calcium for colorectal cancer, can reduce cancer risk.
High-dose dietary supplements are not recommended for cancer prevention – aim to meet nutritional needs through diet alone
The Panel recognises that dietary supplements, in addition to varied diets, may at times be beneficial for specific population groups:
Vitamin B12 for people over the age of 50 who have difficulty absorbing naturally occurring vitamin B12
Iron and folic acid supplements for women who may become or are pregnant
Vitamin D supplements for infants and young children and for pregnant and breastfeeding women, although specific recommendations for iron and vitamin D supplementation vary between countries
There is strong evidence that breastfeeding protects against breast cancer in the mother and promotes healthy growth in the infant.
The Expert Panel endorses the advice of the World Health Organization, which recommends infants are exclusively breastfed for six months, and then for up to two years or beyond alongside appropriate complementary foods.
Check with your health professional what is right for you.
All cancer survivors should receive nutritional care and physical activity guidance from trained professionals
Unless otherwise advised, and if they can, all cancer survivors are advised to follow the Cancer Prevention Recommendations as far as possible after the acute stage of treatment
Our goal
When supplements are advisable
For mothers: breastfeed your baby, if you can
A global goal
After a cancer diagnosis follow our Recommendations, if you can
Goals
World Health Organization
(WHO)
World Health Organization (WHO)
A healthy diet helps to protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including such as diabetes, heart disease, stroke and cancer. Unhealthy diet and lack of physical activity are leading global risks to health.
Healthy dietary practices start early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life.
Energy intake (calories) should be in balance with energy expenditure.
To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake.
Intake of saturated fats should be less than 10% of total energy intake intake of trans-fats less than 1% of total energy intake,
Shift fat consumption away from saturated fats and trans-fats to unsaturated fats, and towards the goal of eliminating industrially-produced trans-fats.
Limiting intake of free sugars to less than 10% of total energy intake is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits.
Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2,000 mg per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population.
Fruit, vegetables, legumes (e.g. lentils and beans), nuts and whole grains (e.g.
unprocessed maize, millet, oats, wheat and brown rice).
At least 400 g (i.e. five portions) of fruit and vegetables per day, excluding potatoes, sweet potatoes, cassava and other starchy roots.
Less than 10% of total energy intake from free sugars, but ideally is less than 5%
of total energy intake for additional health benefits.
10% is equivalent to 50 g (or about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories per day,
Healthy diet
Healthy diet
Key facts
Healthy Diet
Free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
Less than 30% of total energy intake from fats.
Unsaturated fats (found in fish, avocado and nuts, and in sunflower, soybean, canola and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats and
camels).
It is suggested that the intake of saturated fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake.
In particular, industrially-produced trans-fats are not part of a healthy diet and should be avoided.
Less than 5g of salt (~1 tsp, 2,000 mg sodium) per day. Salt should be iodized.
Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs and helps to ensure an adequate daily intake of dietary fibre.
Fruit and vegetable intake can be improved by:
always including vegetables in meals;
eating fresh fruit and raw vegetables as snacks;
eating fresh fruit and vegetables that are in season; and eating a variety of fruit and vegetables.
Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population. Also, the risk of developing NCDs is lowered by:
reducing saturated fats to less than 10% of total energy intake;
reducing trans-fats to less than 1% of total energy intake; and
replacing both saturated fats and trans-fats with unsaturated fats - in particular, with polyunsaturated fats.
Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:
steaming or boiling instead of frying when cooking;
Practical Advice
Fruit and vegetables
Fats
replacing butter, lard and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oils;
eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat
; and
limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits and wafers) that contain industrially- produced trans-fats.
Most people consume too much sodium through salt (corresponding to consuming an average of 9- 12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and
insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke.
Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year.
People are often unaware of the amount of salt they consume. In many countries, most salt comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami;
cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).
Salt intake can be reduced by:
limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce and bouillon) when cooking and preparing foods
not having salt or high-sodium sauces on the table limiting the consumption of salty snacks
choosing products with lower sodium content
Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.
In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake. A reduction to less than 5% of total energy intake would provide additional health benefits.
Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to
overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for
cardiovascular diseases.
Salt, sodium and potassium
Sugars
Sugars intake can be reduced by:
limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies and sugar-sweetened beverages (i.e. all types of beverages containing free sugars - these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee and flavoured milk drinks); and eating fresh fruit and raw vegetables as snacks instead of sugary snacks.
World Health Organization (WHO)
People who eat a well-balanced diet tend to be healthier with stronger immune systems and lower risk of chronic illnesses and infectious diseases.
So you should:
Eat a variety of fresh and unprocessed foods every day to get the vitamins, minerals, dietary fibre, protein and antioxidants your body needs.
Drink enough water.
Avoid sugar, fat and salt to significantly lower your risk of overweight, obesity, heart disease, stroke, diabetes and certain types of cancer.
Eat fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice or starchy tubers or roots such as potato, yam, taro or cassava), and foods from animal sources (e.g. meat, fish, eggs and milk).
Daily, eat:
2 cups of fruit (4 servings)
2.5 cups of vegetables (5 servings) 180 g of grains
160 g of meat and beans (red meat can be eaten 1−2 times per week, and poultry 2−3 times per week)
For snacks, choose raw vegetables and fresh fruit rather than foods that are high in sugar, fat or salt.
Do not overcook vegetables and fruit as this can lead to the loss of important vitamins.
Nutrition advice for adults during the COVID-19
outbreak
Nutrition advice for adults during the COVID-19 outbreak
Eat fresh and unprocessed foods every day
When using canned or dried vegetables and fruit, choose varieties without added salt or sugar.
Water is essential for life. It transports nutrients and compounds in blood, regulates your body temperature, gets rid of waste, and lubricates and cushions joints.
Drink 8-10 cups of water every day.
Water is the best choice, but you can also consume other drinks, fruits and vegetables that contain water, for example lemon juice (diluted in water and unsweetened), tea and coffee.
Be careful not to consume too much caffeine
Avoid sweetened fruit juices, syrups, fruit juice concentrates, fizzy and still drinks as they all contain sugar.
Consume unsaturated fats (e.g. found in fish, avocado, nuts, olive oil, soy, canola, sunflower and corn oils) rather than saturated fats (e.g. found in fatty meat, butter, coconut oil, cream, cheese, ghee and lard).
Choose white meat (e.g. poultry) and fish, which are generally low in fat, rather than red meat.
Avoid processed meats because they are high in fat and salt.
Where possible, opt for low-fat or reduced-fat versions of milk and dairy products.
Avoid industrially produced trans fats. These are often found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads.
When cooking and preparing food, limit the amount of salt and high-sodium condiments (e.g.
soy sauce and fish sauce).
Limit your daily salt intake to less than 5 g (approximately 1 teaspoon), and use iodized salt.
Avoid foods (e.g. snacks) that are high in salt and sugar.
Limit your intake of soft drinks or sodas and other drinks that are high in sugar (e.g. fruit juices, fruit juice concentrates and syrups, flavoured milks and yogurt drinks).
Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate.
Drink enough water every day
Eat moderate amounts of fat and oil
Eat less salt and sugar
American Heart
Association/American
College of Cardiology
(AHA/ACC)
American Heart Association/American College of Cardiology (AHA/ACC)
Most ASCVD events are avoidable through primordial prevention (i.e., the prevention of risk factor development) and control of traditional cardiovascular risk factors.
1. Tobacco avoidance is critically important for ASCVD prevention.
2. All adults should strive to engage in regular brisk physical activity most days of the week 3. All adults should adhere to a healthy dietary pattern to help lower future ASCVD risk.
A diet high in fruits, vegetables, and whole grains is best.
Fish, legumes, and poultry are the preferred sources of protein.
4. Minimizing the consumption of:
Trans fats
Added sugars (including sugar-sweetened beverages) Red meats
Sodium
Saturated fats.
5. Clinicians should work in partnership with patients to assess their readiness for sustained lifestyle improvements, identify potential barriers to change, and encourage them to try to achieve measurable goals and continue to monitor their progress
The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life
2019 ACC/AHA Guideline on the Primary Prevention of
Cardiovascular Disease
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
Summary
Top Take-Home Messages
.
All adults should consume a healthy diet that:
Emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish
Minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages.
For adults with overweight and obesity, counseling and caloric restriction are recommended for achieving and maintaining weight loss.
Adults should engage in exercise of at least:
150 minutes per week of accumulated moderate-intensity physical activity, or 75 minutes per week of vigorous-intensity physical activity
All adults should be assessed at every healthcare visit for tobacco use, and those who use tobacco should be assisted and strongly advised to quit.
Aspirin should be used infrequently in the routine primary prevention of ASCVD because of lack of net benefit.
Statin therapy is first-line treatment for primary prevention of ASCVD in patients:
With elevated low-density lipoprotein cholesterol levels (≥190 mg/dL) With diabetes mellitus
Who are 40 to 75 years of age
Those determined to be at sufficient ASCVD risk after a clinician–patient risk discussion
Nonpharmacological interventions are recommended for all adults with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should generally be <130/80 mm Hg.
Abbreviation Meaning/Phrase
ASCVD atherosclerotic cardiovascular disease
BMI body mass index
BP blood pressure
CHD coronary heart disease
CKD chronic kidney disease
CVD cardiovascular disease
DASH Dietary Approaches to Stop Hypertension
Abbreviations
DBP diastolic blood pressure
FDA U.S. Food and Drug Administration
HbA1c hemoglobin A1c
HDL-C high-density lipoprotein cholesterol
LDL-C low-density lipoprotein cholesterol
MI myocardial infarction
RCT randomized controlled trial
SBP systolic blood pressure
SGLT-2 sodium-glucose cotransporter 2
T2D type 2 diabetes
Family history of premature ASCVD (males, age <55 y; females, age <65 y) Primary hypercholesterolemia
LDL-C, 160–189 mg/dL [4.1–4.8 mmol/L]
non–HDL-C 190–219 mg/dL [4.9–5.6 mmol/L]) Metabolic syndrome
Increased waist circumference [by ethnically appropriate cutpoints]
Elevated triglycerides [>150 mg/dL, nonfasting]
Elevated blood pressure Elevated glucose
Low HDL-C [<40 mg/dL in men; <50 mg/dL in women] are factors; a tally of 3 makes the diagnosis
Chronic kidney disease (eGFR 15–59 mL/min/1.73 m2 with or without albuminuria; not treated with dialysis or kidney transplantation)
Chronic inflammatory conditions, such as psoriasis, RA, lupus, or HIV/AIDS
History of premature menopause (before age 40 y) and history of pregnancy- associated conditions that increase later ASCVD risk, such as preeclampsia High-risk race/ethnicity (e.g., South Asian ancestry)
Lipids/biomarkers: associated with increased ASCVD risk
Persistently elevated∗ primary hypertriglyceridemia (≥175 mg/dL, nonfasting) Elevated high-sensitivity C-reactive protein (≥2.0 mg/L)
Elevated Lp(a): A relative indication for its measurement is family history of premature ASCVD. An Lp(a) ≥50 mg/dL or ≥125 nmol/L constitutes a risk-enhancing factor,
especially at higher levels of Lp(a).
Elevated apoB (≥130 mg/dL): A relative indication for its measurement would be triglyceride ≥200 mg/dL. A level ≥130 mg/dL corresponds to an LDL-C >160 mg/dL and constitutes a risk-enhancing factor
ABI (<0.9)