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Diet, Cardiovascular Disease, and Mortality in 80 Countries Publisher Pubmed

Summary: A global study found eating more fruit, veggies, nuts, legumes, fish, and whole-fat dairy lowers mortality and heart disease risk. #HealthyDiet #HeartHealth

Mente A1, 2 ; Dehghan M1 ; Rangarajan S1 ; Odonnell M3, 4 ; Hu W1 ; Dagenais G5 ; Wielgosz A6 ; Lear SA7 ; Wei L8 ; Diaz R9 ; Avezum A10 ; Lopezjaramillo P11 ; Lanas F12 ; Swaminathan S13 Show All Authors
Authors
  1. Mente A1, 2
  2. Dehghan M1
  3. Rangarajan S1
  4. Odonnell M3, 4
  5. Hu W1
  6. Dagenais G5
  7. Wielgosz A6
  8. Lear SA7
  9. Wei L8
  10. Diaz R9
  11. Avezum A10
  12. Lopezjaramillo P11
  13. Lanas F12
  14. Swaminathan S13
  15. Kaur M14
  16. Vijayakumar K15
  17. Mohan V16
  18. Gupta R17
  19. Szuba A18
  20. Iqbal R19
  21. Yusuf R20
  22. Mohammadifard N21
  23. Khatib R22
  24. Nasir NM23
  25. Karsidag K24
  26. Rosengren A25
  27. Yusufali A26
  28. Wentzelviljoen E27
  29. Chifamba J28
  30. Dans A29
  31. Alhabib KF30
  32. Yeates K31
  33. Teo K1, 2, 3
  34. Gerstein HC1, 2, 3
  35. Yusuf S1, 2, 3

Source: European Heart Journal Published:2023


Abstract

Aims: To develop a healthy diet score that is associated with health outcomes and is globally applicable using data from the Prospective Urban Rural Epidemiology (PURE) study and replicate it in five independent studies on a total of 245 000 people from 80 countries. Methods and results: A healthy diet score was developed in 147 642 people from the general population, from 21 countries in the PURE study, and the consistency of the associations of the score with events was examined in five large independent studies from 70 countries. The healthy diet score was developed based on six foods each of which has been associated with a significantly lower risk of mortality [i.e. fruit, vegetables, nuts, legumes, fish, and dairy (mainly whole-fat); range of scores, 0-6]. The main outcome measures were all-cause mortality and major cardiovascular events [cardiovascular disease (CVD)]. During a median follow-up of 9.3 years in PURE, compared with a diet score of ≤1 points, a diet score of ≥5 points was associated with a lower risk of mortality [hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.63-0.77)], CVD (HR 0.82; 0.75-0.91), myocardial infarction (HR 0.86; 0.75-0.99), and stroke (HR 0.81; 0.71-0.93). In three independent studies in vascular patients, similar results were found, with a higher diet score being associated with lower mortality (HR 0.73; 0.66-0.81), CVD (HR 0.79; 0.72-0.87), myocardial infarction (HR 0.85; 0.71-0.99), and a non-statistically significant lower risk of stroke (HR 0.87; 0.73-1.03). Additionally, in two case-control studies, a higher diet score was associated with lower first myocardial infarction [odds ratio (OR) 0.72; 0.65-0.80] and stroke (OR 0.57; 0.50-0.65). A higher diet score was associated with a significantly lower risk of death or CVD in regions with lower than with higher gross national incomes (P for heterogeneity <0.0001). The PURE score showed slightly stronger associations with death or CVD than several other common diet scores (P < 0.001 for each comparison). Conclusion: A diet comprised of higher amounts of fruit, vegetables, nuts, legumes, fish, and whole-fat dairy is associated with lower CVD and mortality in all world regions, especially in countries with lower income where consumption of these foods is low. © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
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