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PEN® eNews 16(2) February 2026 - Heart Health

PEN® eNews 16(2) February 2026 - Heart Health

PEN eNews is a monthly e-newsletter shared with the global PEN Community and created to help dietitians position themselves as leaders in evidence-based nutrition practice. In addition, users of the PEN System will find articles on the new evidence, resources and features available and how to maximize one's use of PEN.

February 2026 · Volume 16, Issue 2

Articles in this issue

Can Chocolate Help Prevent Cardiovascular Disease? What are the Best Nutrition Strategies to Prevent Cardiovascular Disease? Should Dietary Restrictions be Recommended to Reduce Cholesterol Levels for Older Adults in Long-Ter Eating Guidelines for Pediatric Dyslipidemia

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Can Chocolate Help Prevent Cardiovascular Disease?

The age-old quest to justify the health benefits of Valentine's Day chocolate is here again. Can chocolate be good for your heart?

The Question

Should commercially available chocolate or cocoa products be recommended to healthy adults to reduce the risk of cardiovascular disease (CVD)?

Recommendation

Consuming small amounts of commercially available chocolate (e.g. 5 g/day) may be associated with a slight reduction in CVD events and mortality.

Dark chocolate intake (no dose specified), in particular, has been associated with lower risk of essential hypertension but not other CVD conditions.

Consuming chocolate in a variety of forms (e.g. bars, beverages, snacks, cocoa extract) probably has no effect on CVD risk factors (e.g. blood pressure, blood lipids, blood glucose, BMI or waist circumference).

Grade of Evidence: B & C & D

Remarks

Some research that examined specialist proprietary or patented cocoa and chocolate formulations or raw cacao has not been included in this evidence.

For studies that used commercially available products, the nature of the cocoa product varied considerably, and this impacts the interpretation of the literature.

To see the full practice question, click here.

What are the Best Nutrition Strategies to Prevent Cardiovascular Disease?

The Question

What nutrition strategies can prevent cardiovascular disease (CVD) in the healthy population (primary prevention)?

Recommendation

Decreasing abdominal obesity may be associated with reducing risk of CVD.

Cut-off values for abdominal obesity associated with increased risk of developing CVD have been established for waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR).

Grade of Evidence: B & C

Remarks

WHR is estimated by WC (cm) divided by hip circumference (cm) and WHtR is WC (cm) divided by height (cm).

Proposed cut-offs for WHR by the World Health Organization are >0.90 for men and >0.85 for women. The included study suggested a proposed cut-off for WHtR as >0.5 for men and women.

This Practice Question includes additional recommendations for Saturated Fat, Dietary Fibre, Free Sugars, Dietary Cholesterol and Omega-3 Fatty Acids. To see the full practice question, click here.

Should Dietary Restrictions be Recommended to Reduce Cholesterol Levels for Older Adults in Long-Term Care Facilities?

The Question

What dietary strategies are recommended to reduce the risk of cardiovascular disease (CVD) in frail older adults? Are dietary restrictions recommended to reduce cholesterol levels for older adults in long-term care facilities?

Recommendation

Compared with younger adults, for adults >70 years of age, a weaker association has been identified between LDL-C and mortality due to other age-related co-morbidities.

For adults >80 years of age, clinical practice guidelines do not typically recommend dyslipidemia screening and no studies have examined the effects of specific dietary treatments on CVD outcomes in this population.

For frail and/ or dependent adults, treatment goals should prioritize quality of life, including more liberalized diets.

Grade of Evidence: C & D

Remarks

The SCORE2-OP tool has been suggested as a more reliable tool to classify CV risk in otherwise healthy people over 70 years.

For decision making in individuals >75 years, an initial assessment of frailty has been suggested using a simplified FRAIL scale (see Table 2 at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084863/ )

More liberal diets means that dietary restrictions should not be applied that could negatively affect the variety and flavour of the food offered.

To see the full practice question, click here.

Eating Guidelines for Pediatric Dyslipidemia

Heart Month isn't only for adults - some children have high blood lipids, too. We've created a client handout for heart-healthy eating in the pediatric population. Below is a sneak peek of some of the tips that we recommend.

✔ Fill ½ of their plate with a variety of vegetables. Choose dark green, red and orange colours more often. Include a piece of fruit as a snack or for dessert.

✔ Fill ¼ of their plate with whole grain products such as barley, quinoa, brown and wild rice, pasta or breads.

✔ Fill ¼ of their plate with legumes (peas, beans, lentils), tofu, lower fat meat, skinless poultry, fish, and eggs.

✔ Add a glass of lower-fat milk, unsweetened fortified soy beverage or a small bowl of lower-fat yogurt to complete their meal.

Talk to your health care provider or dietitian before giving a child fish oil supplements (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to help improve their triglyceride levels.

For more information, view our handout here.

PEN eNews

February 2026 · Volume 16 (2)

A Publication of the PEN System Global Partners,

a collaborative partnership between International Dietetic Associations.

Learn more about PEN.