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Dietary Patterns Systematic Reviews

Dietary Patterns and Risk of Cardiovascular Disease

Dietary patterns associated with decreased risk of cardiovascular disease were characterized by regular consumption of fruits, vegetables, whole grains, low-fat dairy, and fish and were low in red and processed meat and sugar sweetened foods and drinks. Regular consumption of nuts and legumes and moderate consumption of alcohol were also shown to be beneficial in most studies. Additionally, research that included specific nutrients in their description of dietary patterns indicated that patterns that were low in saturated fat, cholesterol, and sodium and rich in fiber and potassium may be beneficial for reducing cardiovascular disease risk.

Conclusion Statements: Dietary Patterns and Risk of Cardiovascular Disease

Strong or Moderate Evidence:

There is strong and consistent evidence that in healthy adults increased adherence to dietary patterns scoring high in fruits, vegetables, whole grains, nuts, legumes, unsaturated oils, low-fat dairy, poultry, and fish; low in red and processed meat, high-fat dairy, and sugar-sweetened foods and drinks; and moderate in alcohol is associated with decreased risk of fatal and non-fatal cardiovascular diseases, including coronary heart disease and stroke.

(Grade: I - Strong) (Index Analysis)

There is strong and consistent evidence that consumption of a DASH diet results in reduced blood pressure in adults with above optimal blood pressure, up to and including stage 1 hypertension. A dietary pattern consistent with the DASH diet is rich in fruits, vegetables, low-fat dairy, fish, whole grains, fiber, potassium, and other minerals at recommended levels, and low in red and processed meat, sugar-sweetened foods and drinks, saturated fat, cholesterol, and sodium. There is limited evidence that adherence to vegetarian diets is associated with decreased death from ischemic heart disease, with the association being stronger in men than in women.

(Grade: I - Strong - DASH and Blood Pressure; Grade: III - Limited - Vegetarian and Ischemic Heart Disease) (Other Methods)

Limited or Insufficient Evidence:

Limited evidence from epidemiological studies indicates that dietary patterns, assessed using cluster or factor analysis, characterized by vegetables, fruits, whole grains, fish, and low-fat dairy products are associated with decreased risk of cardiovascular disease in adults. Evidence of a relationship between dietary patterns characterized by red and processed meat, sugar-sweetened foods and drinks, and fried foods and an increased risk of cardiovascular disease is limited and less consistent.

(Grade: III - Limited) (Cluster or Factor Analysis)

Insufficient evidence, due to a small number of studies, was available to examine the relationship between dietary patterns derived using reduced rank regression and risk of cardiovascular disease. The disparate nature of the methods used made it difficult to compare results, and therefore, no conclusions were drawn.

(Grade: IV - Not Assignable) (Reduced Rank Regression)

Systematic Review Questions

Dietary Patterns and Risk of Cardiovascular Disease

What is the relationship between adherence to dietary guidelines/recommendations or specific dietary patterns, assessed using an index or score, and risk of cardiovascular disease?

Are prevailing patterns of diet behavior in a population, assessed using factor or cluster analysis, related to risk of cardiovascular disease?

What is the relationship between adherence to dietary guidelines/recommendations or specific dietary patterns, assessed using reduced rank regression analysis, and cardiovascular disease?

What is the relationship between adherence to dietary guidelines/recommendations or specific dietary patterns (assessed using methods other than index/score, cluster or factor, or reduced rank regression analyses) and risk of cardiovascular disease?