Functional Foods: Healthful Foods for the Heart
By Toby Amidor, MS, RD, CDN, FAND
Vol. 25 No. 1 P. 12
A wider variety of packaged functional food products are hitting grocery store shelves than ever before. These foods are fortified with added nutrients and are formulated to help prevent and manage chronic disease risk factors and chronic diseases themselves, such as type 2 diabetes and heart disease.
Many of these functional foods boast the American Heart Association (AHA) health claim due to continued concerns about preventing and better managing heart health and CVD. According to the AHA, nearly one-half of American adults have high blood pressure, and many are unaware they have it.1 According to the CDC, between 2015 and 2018, nearly 12% of adults aged 20 and older had total cholesterol above 240 mg/dL, and about 17% had HDL cholesterol levels below 40 mg/dL.2 The National Diabetes Statistic Report shows that 37.3 million people have diabetes (11.3% of the US population), and 96 million people aged 18 and older have prediabetes (38% of the adult US population).3 These risk factors for heart disease and diabetes and even diabetes itself help contribute to the increasing interest in functional foods.
AHA’s Health Claim
In 1995, the AHA launched the Heart-Check food and recipe certification program, which specifies foods and recipes that meet the FDA regulatory requirements for heart health claims. At the grocery store, these foods boast the AHA name on the front of the package along with the red heart and white check shield. The foods that showcase the Heart-Check Mark are designed to help consumers make informed choices about the foods they purchase. The Heart-Check Mark serves as an emblem of the program and states: “American Heart Association Certified, Meets Criteria for Heart-Healthy Food,” and features a red heart with a white check mark placed in the middle of it. In addition, “the Heart-Check Mark program helps simplify the overwhelming number of choices consumers see in the grocery aisle, but it’s important to eat a variety of nutritious foods to reduce the risk of heart disease and stroke,” says Shelley Johnson, MJ, RD, operations manager of Heart-Check Programs, at the AHA. “The American Heart Association recommends eating a variety of fruits and vegetables, whole grains, healthful sources of protein like nuts, legumes, fish and seafood, lean meats, and low-fat dairy in addition to adjusting energy intake to achieve or maintain a healthy body weight. It’s important to focus on the overall pattern and stay consistent throughout your life vs looking for quick solutions.”
These functional foods must meet strict criteria set forth by the AHA. The standard certification for FDA-regulated products must contain less than 6.5 g total fat, 1 g or less saturated fat and 15% or fewer calories from saturated fat, and less than 0.5 g trans fat per label serving and standard serving size; products containing partially hydrogenated oils aren’t eligible for certification. Products also must contain 20 mg or less of cholesterol. One of four sodium limits is acceptable depending on the specific food category (up to 140 mg, 240 mg, or 360 mg per label serving, or 480 mg per label serving and per standard serving size. Finally, foods must have 10% or more of the DV of one of the following six nutrients: vitamin A, vitamin C, iron, calcium, protein, and dietary fiber.4 There are requirements for many additional food categories, including canned fruit and vegetables, fruit and vegetable juice, grain-based products, grain-based and snack bars, milk and dairy alternatives, smoothies, snacks, and yogurt. A full list of the specific food category guidelines can be found at https://tinyurl.com/2s4zxzjk.4
Due to these nutrition requirements and the inclusion of the Heart Check mark on product packaging, sales of these heart-healthy foods are booming. According to the Institute of Food Technologists, sales of foods and beverages with an AHA heart health claim reached $3.4 billion, up 11% for the year ended October 3, 2021.5 For a product to receive the Heart-Check certificate, the “process begins with a product application and an initial business agreement,” Johnson says. “Products are then submitted for a nutritional screening by a registered dietitian. Once final nutrition approval is achieved, a product-specific license is issued, and the final license agreement is signed and the product may display the Heart-Check mark on packaging and promotional materials for one year according to specific guidelines.”
Heart Healthy Packaged and Fresh Foods
On September 1, 2022, the AHA released an updated list of AHA Heart-Check certified products that meet its nutrition criteria. The document lists the items by food category, product, company, serving size, calories, total fat, saturated fat, sodium, and sugar content per serving.6 Some of the products are packaged, and others are fresh.
Below is a sample of foods by category on the AHA list.
• S&W Low Sodium Pinto Beans. Food category: beans and legumes; Serving size: 130 g; Calories: 110; Total fat: 0 g; Saturated fat: 0 g; Sodium: 140 mg; Sugars: 1 g
• WestSoy Organic Unsweetened Soymilk. Food category: beverages; Serving size: 8 oz; Calories; 100; Total fat: 5 g; Saturated fat: 1 g; Sodium: 35 mg; Sugars: 3 g
• Cheerios. Food category: cereal; Serving size: 39 g; Calories; 140; Total fat: 2.5 g; Saturated fat: 0.5 g; Sodium: 190 mg; Sugars: 2 g
• StarKist Chunk Light Tuna in Water. Food category: fish & game: canned or processed; Serving size: 74 g; Calories; 70; Total fat: 0.5 g; Saturated Fat: 0 g; Sodium: 150 mg; Sugars: 0 g
• Fresh Seedless Watermelon. Food category: fruit: fresh, frozen, or canned; Serving size: 280 g; Calories: 80; Total fat: 0 g; Saturated fat: 0 g; Sodium: 0 mg; Sugars: 17 g
• Lean Cuisine Garlic Sesame Noodles With Beef. Food category: main dish/meals; Serving size: 226 g; Calories: 240; Total fat: 4.5 g; Saturated fat: 2 g; Sodium: 510 mg; Sugars: 9 g
• Boar’s Head Honey Smoked Turkey Breast. Food category: meat & poultry: canned or processed; Serving size: 56 g; Calories: 60; Total fat: 1 g; Saturated fat: 0 g; Sodium: 420 mg; Sugars: 0 g
• Blue Diamond Almonds Lightly Salted. Food category: nuts or seeds; Serving size: 17 g; Calories: 100; Total fat: 9 g; Saturated fat: 0.5 g; Sodium: 25 mg; Sugars: 1 g
• Wesson Canola Oil. Food category: oils; Serving size: 1 T; Calories: 120; Total fat: 14 g; Saturated fat: 1 g; Sodium: 0 mg; Sugars: 0 g
• Seapoint Farms Organic Edamame Fettuccine. Food category: pasta; Serving size: 56 g; Calories: 200; Total fat: 3 g; Saturated fat: 0.5 g; Sodium: 0 mg; Sugars: 3 g
• Idaho Potato – Russets. Food category: potatoes; Serving size: 148 g; Calories: 110; Total fat: 0 g; Saturated Fat: 0 g; Sodium: 0 mg; Sugars: 1 g
• Health Valley Organic No Salt Added Tomato Soup. Food category: soup; Serving size: 240 g; Calories: 110; Total fat: 2 g; Saturated fat: 1 g; Sodium: 25 mg; Sugars: 15 g
• Bolthouse Farms 100% Carrot Juice. Food category: vegetable juice; Serving size: 8 oz; Calories: 70; Total fat: 0 g; Saturated Fat: 0 g; Sodium: 150 mg; Sugars: 13 g
Recommendations for RDs
For clients who have been diagnosed with CVD or want to prevent or manage CVD, Johnson recommends using the list of AHA-certified products to help them create a more healthful grocery list and better understand what to look for on nutrition labels when shopping.6 In addition, the AHA has Heart-Check certified recipes that will enable clients to make nutritious meals with the Heart-Check certified products they purchase.7 Dietitians can visit the AHA website links to these recipes and help clients select those that are appropriate for their individual needs and food preferences. In addition to choosing AHA-certified foods, dietitians should educate clients on eating balanced meals and snacks that include fruits, vegetables, whole grains, healthful sources of protein such as nuts, legumes, fish and seafood, lean meats, and low-fat dairy as part of a heart healthy diet.
— Toby Amidor, MS, RD, CDN, FAND, is founder of Toby Amidor Nutrition (tobyamidornutrition.com) and a Wall Street Journal bestselling author. She’s written nine cookbooks, including Diabetes Create Your Plate Meal Prep Cookbook: 100 Delicious Plate Method Recipes, and The Family Immunity Cookbook: 101 Easy Recipes to Boost Health. She’s also a nutrition expert for FoodNetwork.com and a contributor to U.S. News Eat + Run and other national outlets.
1. The facts about high blood pressure. American Heart Association website. https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
2. Cholesterol facts. Centers for Disease Control and Prevention website. https://www.cdc.gov/cholesterol/facts.htm
3. National diabetes statistics report. Centers for Disease Control and Prevention website. https://www.cdc.gov/diabetes/data/statistics-report/index.html
4. Heart-Check Food Certification Program nutrition requirements. American Heart Association website. https://www.heart.org/en/healthy-living/company-collaboration/heart-check-certification/heart-check-in-the-grocery-store/heart-check-food-certification-program-nutrition-requirements
5. Sloan AE. Top 10 functional food trends. Food Technology. April 1, 2022. https://www.ift.org/news-and-publications/food-technology-magazine/issues/2022/april/features/top-10-functional-food-trends
6. American Heart Association. Heart-Check Food Certification Program: certified product list by food category. https://www.heart.org/-/media/Healthy-Living-Files/Heart-Check-files/Monthly-Grocery-List-2022/Heart_Check_Certified_Products_090122.pdf. Published September 1, 2022.
7. Heart-Check certified recipes. American Heart Association website. https://www.heart.org/en/healthy-living/company-collaboration/heart-check-certification/heart-check-certified-recipes