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Impact of healthy eating was especially evident in countries where consumption of these foods is low, which elevates the risk for cardiovascular disease, including heart attacks and strokes.
Individuals who do not eat enough of the 6 key foods have a higher risk for cardiovascular disease (CVD), according to the results of a study by McMaster University and Hamilton Health Sciences.1 The 6 foods, which are fruits, vegetables, legumes, nuts, fish, and whole-fat dairy products, may also lower the risk of heart attacks and strokes, according to the investigators.1
“There is a recent increased focus on higher consumption of protective foods for disease prevention. Outside of larger amounts of fruits, vegetables, nuts, and legumes, the [investigators] showed that moderation is key in the consumption of natural foods,” Andrew Mente, PhD, Population Health Research Institute (PHRI) scientist and assistant professor at McMaster University’s Department of Health Research Methods, Evidence, and Impact, said in a statement.1 “Moderate amounts of fish and whole-fat dairy are associated with a lower risk of CVD and mortality. The same health outcomes can be achieved with moderate consumption of grains and meats, as long as they are unrefined whole grains and unprocessed meats.”
Furthermore, the investigators found that although this association was seen in all world regions, it was especially evident in countries that have lower incomes and where consumption of these foods is low.2 Previous studies have focused on Western countries and diets that combine ultra-processed food with nutrient-dense foods, therefore, the study authors aimed to focus on foods considered to be healthy in a more global scope.1
The investigators used a diet score from the PHRI’s large-scale global PURE (NCT03225586) study, which is currently ongoing. They replicated 5 independent studies to measure the health outcomes in different regions of the world, in both those with and without prior CVD.1
In the PURE study, there was a median follow-up of 9.3 years, with a diet score of 5 or greater for lower risk of mortality, CVD, myocardial infarction, and stroke, compared with a diet score of 1 or less, according to the results of the study. In 3 additional independent studies, investigators found similar results for lower mortality, CVD, and myocardial infarction; however, there was a non-statistically significant lower risk of stroke.2
In 2 other studies, a higher diet score was associated with lower first myocardial infarction and stroke. Additionally, investigators found that a higher score was associated with a significantly lower risk of death or CVD in regions with lower gross national income.2
The study, which was published in the European Heart Journal, included data from 245,000 individuals in 80 countries from multiple prior studies. Investigators said they also included a good representation of high-, middle-, and low-income countries.1
Additionally, the study was exclusively focused on protective or natural foods instead of foods considered “unhealthy,” or over-processed foods.1
“We were unique in that focus. The other diet scores combined foods considered to be harmful, such as processed and ultra-processed foods, with foods and nutrients believed to be protective of one’s health,” Mente said in the statement.1
References
1. Not eating enough of these six healthy foods is associated with higher cardiovascular disease and deaths globally. News release. EurekAlert. July 6, 2023. Accessed July 12, 2023. https://www.eurekalert.org/news-releases/994659
2. Mente A, Dehghan M, Rangarajan S, O’Donnell M, et al. Diet, cardiovascular disease, and mortality in 80 countries. Eur Heart J. 2023;ehad269. doi:10.1093/eurheartj/ehad269