Food and Health: Nutrition for Prevention and Management of Cardiovascular Disease: 2026 ACC Scientific Statement

Nutrition is a foundational determinant of cardiovascular health and a central component of the prevention and management of cardiovascular disease, type 2 diabetes, obesity, chronic kidney disease, and cardiovascular-kidney-metabolic syndrome. Suboptimal dietary patterns remain among the leading modifiable causes of morbidity and mortality worldwide. Contemporary evidence supports a shift in nutrition guidance from isolated nutrients toward whole foods and dietary patterns that emphasize overall dietary quality, food choice, and degree of processing. This American College of Cardiology Scientific Statement reviews current evidence regarding nutrition and cardiovascular health, including macronutrients, micronutrients, dietary patterns, ultra-processed foods, and emerging nutrition-based interventions. Evidence from randomized controlled trials, prospective cohort studies, and mechanistic investigations consistently supports replacing saturated fats with unsaturated fats, increasing consumption of dietary fiber and whole grains, reducing consumption of sodium and ultra-processed foods (particularly sugar-sweetened beverages and processed meats), and greater adherence to healthy dietary patterns to lower cardiovascular risk. Mediterranean, DASH (Dietary Approaches to Stop Hypertension), vegetarian, and other plant-rich dietary patterns demonstrate favorable effects on blood pressure, lipids, glycemic control, and body weight, and are consistently associated with lower rates of cardiovascular disease and mortality. Translation of nutrition science into clinical practice requires integration of dietary counseling, medical nutrition therapy, Food Is Medicine programs, public policy initiatives, and clinician education. Collectively, current evidence supports dietary patterns centered on minimally processed plant foods while limiting ultra-processed foods, particularly those high in refined starches, added sugars, sodium, or unhealthy fats, and emphasizing healthy sources of fats and proteins to reduce cardiovascular risk and improve population health.