American Heart Association Announces Life’s Essential 8

Blog Post

Stephen W. Farrell, PhD, FACSM
The Cooper Team
August 29, 2022

Unhealthy behaviors are a leading cause of cardiovascular disease (CVD), which is defined as all diseases that affect the heart and blood vessels. CVD has been the leading cause of death in the United States for both men and women for well over a century. In 2010, the American Heart Association (AHA) developed seven easy-to-understand recommendations that aimed to improve cardiovascular health and decrease unnecessary and premature cardiovascular morbidity (illness) and mortality (death) in the U.S. These recommendations were known as Life’s Simple 7. Recently, the AHA updated these guidelines based on 12 additional years of research findings. These new guidelines are known as Life’s Essential 8, and are summarized below.

Life's essential 8

Diet: Aim for an overall healthy eating pattern that includes whole foods, lots of fruits and vegetables, lean protein, nuts, seeds, and cooking in non-tropical oils such as olive and canola.

Physical Activity: Adults should get 2 ½ hours of moderate or 75 minutes of vigorous physical activity per week. Kids should have 60 minutes every day, including play and structured activities.

Nicotine Exposure: Use of inhaled nicotine delivery products, which includes traditional cigarettes, e-cigarettes and vaping, is the leading cause of preventable death in the U.S., including about a third of all deaths from heart disease. About a third of U.S. children ages 3-11 are exposed to secondhand smoke or vaping.

Sleep Duration: Most adults need 7-9 hours of sleep each night. Children require more: 10-16 hours for ages 5 and younger, including naps; 9-12 hours for ages 6-12; and 8-10 hours for ages 13-18. Adequate sleep promotes healing, improves brain function and reduces the risk for chronic diseases.  

Body Weight: Achieving and maintaining a healthy weight has many benefits. Body mass index (BMI), a numerical value of your weight in relation to your height, is a useful gauge. Optimal BMI for adults is 25 kg/m2. You can calculate BMI online or consult a health care professional.

Blood Cholesterol: High levels of non-HDL, or “bad,” cholesterol can lead to heart disease. Your health care professional can consider non-HDL cholesterol as the preferred number to monitor, rather than total cholesterol, because it can be measured without fasting beforehand and is reliably calculated among all people. An optimal level of non-HDL cholesterol in adults is less than 130 milligrams per deciliter (mg/dL).

Blood Sugar: Most of the food we eat is turned into glucose (or blood sugar) that our bodies use as energy. Over time, high levels of blood sugar can damage your heart, kidneys, eyes and nerves. As part of testing, monitoring hemoglobin A1c can better reflect long-term control in people with diabetes or prediabetes. A normal A1c level is less than 5.7%. A normal fasting blood sugar level is between 60 and 99 mg/dL.

Blood Pressure: Keeping your blood pressure within acceptable ranges can keep you healthier longer. Levels less than 120/80 mm Hg are optimal. High blood pressure is defined as 130-139 mm Hg systolic pressure (the top number in a reading) or 80-89 mm Hg diastolic pressure (bottom number).

American Heart Association Life's Essential 8

So what is the Status of Heart Health in Americans with Regard to These New Guidelines?

A recent paper in Circulation reported on a random sample of 23,409 Americans who participated in the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2018. A heart-health scoring system called My Life Check was used to summarize an overall total score, as well as a score for each of the Essential 8 items above, on a scale from 0 to 100. Here is a brief breakdown in scoring, comparing adult men and women.

Overall Total Score Men (63.6) Women (68.1)
Diet 38.1 51.9
Physical Activity 54.0 49.2
Nicotine Exposure 63.1 75.1
Sleep Duration 84.0 85.3
Body Weight 57.8 57.1
Body Cholesterol 64.8 69.9
Blood Sugar 76.8 80.0
Blood Pressure 67.6 73.8

As seen in the Table above, both men and women scored the most poorly on the Diet, Physical Activity, and Body Weight components.

The researchers also examined overall total score for various ethnic groups. This summary is found below:

Ethnic Group Overall Total Score
Asian 68.5
Non-Hispanic Black 59.7
Non-Hispanic White 65.7
Mexican 62.8
Other Hispanic 65.1

With estimated annual direct costs of CVD exceeding $300 billion, not to mention the emotional toll caused by CVD, the public would be wise to heed the Life’s Essential 8 guidelines. Now that you know about Life’s Essential 8, we suggest that you take the related online questionnaire and receive your heart health score as well as some valuable health tips, by going to My Life Check.


Lloyd-Jones, D.M., et al. (2022). Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health: A Presidential Advisory from the American Heart Association. Circulation 146:e18-e43.

Lloyd-Jones, D.M., et al. (2022). Status of Cardiovascular Health in US Adults and Children Using the American Heart Association's New "Life's Essential 8" Metrics: Prevalence Estimates from the National Health and Nutrition Examination Survey (NHANES), 2013-2018. Circulation.


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