Implementing American Heart Association Pediatric and Adult Nutrition Guidelines A Scientific Statement From the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular Diseas

Cardiovascular disease mortality rates have fallen by50 % over the past 50 to 60 years. However, cardio-vascular disease prevalence remains high, and cardiovascular disease is still the leading cause of death and disability in the United States.1,2 It has been estimated that preventive efforts have contributed to at least half of this decline, with the primary contribution coming from declines in mean blood cholesterol concentrations, mean blood pressure levels, and tobacco use rates. Regrettably, during this past decade, the increased prevalence of obesity and diabetes mellitus has dramatically slowed the secular decline in cardiovascular mortality rates.1,3,4 In fact, in the United States, the contribu-tion of prevention to the decline of cardiovascular mortality is now much lower than in other industrialized countries and the United States historically.1,5 The continuing challenge is preventing the development o