Table 5-1.

AHA Dietary Targets and Healthy Diet Score for Defining Cardiovascular Health

AHA TargetConsumption Range for Alternative Healthy Diet Score*Alternative Scoring Range*
Primary dietary metrics
  Fruits and vegetables≥4.5 cups/d0 to ≥4.5 cups/d0–10
  Fish and shellfish2 or more 3.5-oz servings/wk (≥200 g/wk)0 to ≥7 oz/wk0–10
  Sodium≤1500 mg/d≤1500 to >4500 mg/d10–0
  SSBs≤36 fl oz per week≤36 to >210 fl oz/wk10–0
  Whole grains3 or more 1-oz-equivalent servings/d0 to ≥3 oz/d0–10
Secondary dietary metrics
  Nuts, seeds, and legumes≥4 servings/wk (nuts/seeds: 1 oz; legumes: ½ cup)0 to ≥4 servings/d0–10
  Processed meats2 or fewer 1.75-oz servings/wk (≤100 g/wk)≤3.5 to >17.5 oz/wk10–0
  Saturated fat≤7% energy≤7 to >15 (% energy)10–0
AHA Diet Score (primary)Ideal: 4 or 5 dietary targets (≥80%)
Intermediate: 2 or 3 dietary targets (40%–79%)
Poor: <2 dietary targets (<40%)
Sum of scores for primary metrics0 (worst) to 100 (best)§
Ideal: 80–100 Intermediate: 40–79 Poor:<40
AHA Diet Score (secondary)Ideal: 4 or 5 dietary targets (≥80%)
Intermediate: 2 or 3 dietary targets (40%–79%)
Poor: <2 dietary targets (<40%)
Sum of scores for primary and secondary metrics0 (worst) to 100 (best)§ Ideal: 80–100
Intermediate: 40–79
Poor:<40
  • AHA indicates American Heart Association; and SSBs, sugar-sweetened beverages.

  • * Consistent with other dietary pattern scores, the highest score (10) was given for meeting or exceeding the AHA target (eg, at least 4.5 cups of fruits and vegetables per day; no more than 1500 mg/d of sodium), and the lowest score (0) was given for zero intake (protective factors) or for very high intake (harmful factors). The score for each metric was scaled continuously within this range. For harmful factors, the level of high intake that corresponded to a zero score was identified as approximately the 90th percentile distribution of US population intake.

  • Selected by the AHA based on evidence for likely causal effects on cardiovascular events, diabetes mellitus, or obesity; a general prioritization of food rather than nutrient metrics; consistency with US and AHA dietary guidelines; ability to measure and track these metrics in the US population; and parsimony, that is, the inclusion of as few components as possible that had minimal overlap with each other while at the same time having some overlap with the many other relevant dietary factors that were not included.2 The AHA dietary metrics should be targeted in the context of a healthy diet pattern that is appropriate in energy balance and consistent with a DASH (Dietary Approaches to Stop Hypertension)-type eating plan, including but not limited to these metrics.

  • Including up to one 8-oz serving per day of 100% fruit juice and up to 0.42 cups/d (3 cups/wk) of starchy vegetables such as potatoes or corn.

  • § The natural range of the primary AHA Diet Score is 0 to 50 (5 components), and the natural range of the secondary AHA Diet Score is 0 to 80 (8 components). Both scores are then rescaled to a range of 0 to 100 for comparison purposes. The ideal range of the primary AHA Diet Score corresponds to the AHA scoring system of meeting at least 4 of 5 binary dietary targets (≥80%), the intermediate range corresponds to meeting 2 or 3 dietary targets (40%–79%), and the poor range corresponds to meeting <2 dietary targets (<40%). The same ranges are used for the secondary AHA Diet Score for consistency and comparison.