Cardiovascular disease: 6 foods linked to lower risk, mortality

Evan Walker
Evan Walker TheMediTary.Com |
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Certain food groups may be associated with a lower risk of cardiovascular disease. Alessandra Desole/Stocksy
  • Researchers investigated the impact of different food groups on cardiovascular health.
  • They found that diets rich in fruits, vegetables, legumes, nuts, whole-fat dairy, and fish were linked to lower cardiovascular risk.
  • Further studies are needed to understand how much each component contributes to overall risk reduction.

Unhealthy diets are a major risk factor for cardiovascular disease (CVD). In particular, higher amounts of processed meats, refined grains, and sugar-sweetened beverages are known to increase cardiovascular risk.

Concurrently, diets such as the Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean and Healthy Eating Index (HEI) are linked to lower CVD risk. These diets all include increased consumption of:

  • Fruit
  • Vegetables
  • Legumes
  • Nuts
  • Fish

However, recent studies, have shown that some foods—such as whole-fat dairy—previously thought to increase CVD risk may have neutral or beneficial effects. However, many of these new findings have yet to be incorporated into dietary guidelines.

Moreover, as most dietary studies have been conducted in North America, Europe, and East Asia, whether previous findings apply to other parts of the world remains to be seen.

Recently, researchers examined diets and health records from 80 countries across five continents.

They found that diets high in fruit, vegetables, nuts, legumes, fish, and whole-fat dairy are linked to a lower risk of CVD and mortality in all world regions. The findings were particularly strong for lower-income countries.

The study was published in theEuropean Heart Journal.

First, the researchers analyzed data from 166,762 individuals ages 35–70 years in 21 low, middle, and high-income countries across five continents. They followed the participants for an average of 9.3 years.

The researchers created a healthy diet score based on six food categories linked with lower mortality rates:

They called the diet score the ‘PURE’ diet score after the study it was based upon.

Altogether, the researchers noted that the average diet score was 2.95 and that healthier diet scores were more common in countries with higher per-capita gross national income.

They also recorded a total of 8,201 major CVD events and 10,076 deaths during the follow-up period.

Ultimately, participants with diet scores of 5 or 6 were significantly less likely than those with a diet score of 0 or 1 to experience cardiovascular complications. Altogether, they had a:

The researchers found similar results after applying the PURE diet score to data from five other studies involving 96,955 participants in 70 countries.

They added that the PURE diet score had a slightly stronger association with death or CVD than other common diet scores, including HEI, Mediterranean, and DASH diet scores.

However, the PURE diet score was significantly more predictive of mortality and major CVD events than the Planetary diet score.

The Planetary diet was developed as a way to balance a sustainable food system with a healthy diet. It is the most restrictive of the diets studied as it emphasizes plant-based food sources and limits red meat, poultry, and fish to 98 grams, 203 grams, and 196 grams per week.

MNT asked Dana Hunnes Ph.D., a senior clinical dietitian at the UCLA Medical Center in Los Angeles, who was not involved in the study, about its limitations. She noted that the study only reported associations and did not explain causation.

“The best we can do with this type of study is to say these six foods are associated with lower risk for cardiovascular disease, but it doesn’t really look at how powerful each of those six foods is in potentially ‘causing’ cardiovascular disease,” Dr. Hunnes explained.

She noted that this is important as it could be that most benefits occurred from eating more fruits, vegetables, nuts, and legumes and that those who ate these fruits just happened to eat fish and dairy, from which benefits may be smaller.

Dr. Greene added that the findings are easy to misconstrue. She noted that while a pint of decadent ice cream is technically a full-fat dairy product, it is also a highly processed and fattening food, meaning it is best avoided.

“However, a splash of heavy cream in your coffee in the morning would be a better alternative than a low fat/sugar-free flavored creamer—which is a highly processed food that contains chemicals linked to diabetes, obesity, and heart disease. Making the distinction when talking about these individual food groups is very important,” she added.

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