Formulating Foods for Heart Health

Cardiovascular disease is the leading cause of death globally. According to the World Health Organization (WHO), an estimated 17.9 million people died from cardiovascular diseases in 2016, representing 31% of all global deaths. Of these, 85% were due to heart attack and stroke.

In the U.S., more than 600,000 Americans die of heart disease each year, accounting for one in every four deaths, according to the Centers for Disease Control and Prevention (CDC). Heart disease doesn’t discriminate either. It is the number one killer for men, women, and people of most racial and ethnic groups in the U.S.

In the Unites States and globally, non-communicable disease, such as obesity and overweight, are on the rise.  Obesity has tripled worldwide since 1975. In 2016, more than 1.9 billion adults, 18 years and older, were overweight and of these, over 650 million were obese. In the U.S., the prevalence of obesity in adults was 42% in 2017-2018.  Obesity and overweight are risk factors for heart disease.

The CDC says high blood pressure, high blood cholesterol, and smoking are key risk factors for heart disease, and 47% of Americans have at least one of these three risk factors. Among other medical conditions and lifestyle choices that can increase the risk for heart disease are diabetes and consuming an unhealthy diet.

Developing Heart-Healthy Foods
With several of these health conditions linked to diet and nutrition, many countries, including the U.S., provide food-based dietary guidance to encourage healthy eating habits and lifestyles. The dietary guidance provides advice on foods, food groups, and dietary patterns to obtain the required nutrients to promote overall health and prevent the risk of diet-related chronic diseases. According to the 2015-2020 Dietary Guidelines for Americans, “all foods consumed as part of a healthy eating pattern fit together like a puzzle to meet nutritional needs without exceeding limits, such as those for saturated fats, added sugars, sodium, and total calories.”

The science of food community can and does play a role in helping consumers reduce the risk of this life-threatening disease. For many decades, product developers have used the dietary guidelines as a roadmap to evaluate and determine the nutrients and ingredients included in their current product portfolio and new products in development to contribute to healthy dietary patterns. While there are many factors to consider including safety, texture, palatability, affordability, and nutrition density, there is still more work to be done.

The dietary guidelines recommend limiting saturated fat intake to less than 10% of total calories, however, the current average intake of saturated fats is higher (11% of calories).  Evaluating the amount of saturated fat in products and considering heart healthy alternatives is one area food scientists have focused on to help put healthier options on store shelves for consumers. By designing or reformulating foods using healthier oils containing more monounsaturated fatty acids and/or polyunsaturated fatty acids or reducing the content of saturated fats, food scientists can help consumers decrease their intake of saturated fatty acids.

Sodium intake is far above the recommended levels for many Americans. The dietary guidelines recommend consuming less than 2,300 milligrams (mg) of sodium per day for adults and children 14 years of age and older.  The WHO limits it even further, recommending less than 2,000 mg of sodium per day for adults. According to WHO, there is evidence showing a reduction in sodium intake significantly reduces blood pressure in adults, one of the major risk factors for heart disease. Sodium is not only found in table salt, but also naturally in a variety of foods, including milk, cream, eggs, meat, and shellfish, as well as many processed foods and condiments. Food scientists continue to pursue a variety of approaches to reduce sodium in foods including using herb and spice blends, mineral salts, taste enhancers, and aroma compounds. These formulation adjustments can make a substantial difference in contributing to the heart healthy diets of people around the world.

Whole grains are a source of nutrients, such as dietary fiber and some vitamins and minerals. Dietary fiber from whole grains or other foods may help reduce blood cholesterol levels and may lower risk of heart disease.  The dietary guidelines recommend that at least half of grain intake be whole grains. However, consumption of whole grains among children and adults is well below the recommended levels. For example, for adults, whole grains account for less than 20% of their total grain intake. Food scientists continue to reformulate and design palatable new products to help consumers increase their intake of whole grains.

The USDA says a diet rich in vegetables and fruits may reduce the risk for heart disease, including heart attack and stroke. However, fewer than 24% of American adults meet recommendations for fruits and 13% for vegetables. Fruits and vegetables are important sources of many nutrients, including potassium, which may help maintain healthy blood pressure, and dietary fiber. According to the dietary guidelines, “all forms of fruits and vegetables, including fresh, canned, dried, and frozen, can be included in healthy eating patterns.” Formulating or reformulating products with fruits and vegetables is yet another opportunity food scientists are using to optimize the nutritional profile of existing products and provide more heart healthy options to consumers.

Helping Consumers Make Smart Choices
One tool to assist consumers in making informed choices about the foods they purchase and consume is the Nutrition Facts label on packaged foods.  The Nutrition Facts label is an excellent resource to help people identify the amount of calories, saturated fats, dietary fiber, sodium, and other nutrients and food components in each serving of food. Information on serving size and number of servings per container can help people monitor portion size. For more information on how to use the Nutrition Facts label, check out our toolkit.

References

Albertson, A. M., Reicks, M., Joshi, N., & Gugger, C. K. (2016). Whole grain consumption trends and associations with body weight measures in the United States: results from the cross sectional National Health and Nutrition Examination Survey 2001-2012. Nutrition Journal, 15, 8. https://doi.org/10.1186/s12937-016-0126-4

Centers for Disease Control and Prevention. “About Heart Disease.” December 9, 2019. https://www.cdc.gov/heartdisease/about.htm

Centers for Disease Control and Prevention. “Contribution of Whole Grains to Total Grains Intake Among Adults Aged 20 and Over: United States, 2013–2016.” July 9, 2019. https://www.cdc.gov/nchs/products/databriefs/db341.htm

Centers for Disease Control and Prevention. “Heart Disease Facts.” December 2, 2019. https://www.cdc.gov/heartdisease/facts.htm

Centers for Disease Control and Prevention. “Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017–2018.” February 27, 2020. https://www.cdc.gov/nchs/products/databriefs/db360.htm

U.S. Department of Agriculture. “Nutrients and Health Benefits of Grains.” https://www.choosemyplate.gov/eathealthy/grains/grains-nutrients-health

U.S. Department of Agriculture. “Nutrients and Health Benefits of Vegetables.”

https://www.choosemyplate.gov/eathealthy/vegetables/vegetables-nutrients-health

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/executive-summary/

World Health Organization. “Cardiovascular diseases (CVDs).” May 17, 2017. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)

World Health Organization. “Reducing sodium intake to reduce blood pressure and risk of cardiovascular diseases in adults.” August 7, 2019. https://www.who.int/elena/titles/sodium_cvd_adults/en/