Find the most important recent research around the types of dietary patterns that support cardiovascular health
General
Individuals with discordantly high apoB to LDL-cholesterol levels carry a higher risk of atherosclerotic CVD compared with those with average or discordantly low apoB to LDL-cholesterol. This study aimed to determine associations between apoB and LDL-cholesterol discordance in relation to nutrient patterns (NP) using National Health and Nutrition Examination Survey data. Three NP explained 63·2 % of variance in nutrient consumption. These consisted of NP1 rich in saturated fat, carbohydrate and vitamins, NP2 high in fibre, minerals, vitamins and PUFA and NP3 rich in dietary cholesterol, protein and sodium. The discordantly high apoB to LDL-cholesterol group had the highest consumption of the NP1 and the lowest consumption of the NP2.
Mediterranean diet
Miguel A Martínez-González, Cesar I Fernandez-Lazaro, Estefanía Toledo, et al (2020), Carbohydrate quality changes and concurrent changes in cardiovascular risk factors: a longitudinal analysis in the PREDIMED-Plus randomized trial, The American Journal of Clinical Nutrition, nqz298, https://doi.org/10.1093/ajcn/nqz298
This study examined 6 and 12 month changes in carbohydrate quality index (CQI) and concurrent changes in several CVD risk factors in a multicenter, randomized, primary-prevention trial (PREDIMED-Plus) based on an intensive weight-loss lifestyle intervention program. During the 12 month follow-up, the majority of participants improved their CQI by increasing their consumption of fruits, vegetables, legumes, fish, and nuts and decreasing their consumption of refined cereals, added sugars, and sugar-sweetened beverages. After 6 months, body weight, waist circumference (WC), systolic and diastolic blood pressure (BP), fasting blood glucose, glycated hemoglobin (HbA1c), triglyceride levels, triglycerides and glucose (TyG) index, and TyG-WC decreased across successive quintiles of improvement in the CQI. After 12 months, improvements were additionally observed for HDL cholesterol and for the ratio of total to HDL cholesterol.
This randomised controlled trial found that among people at high cardiovascular risk, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the incidence of major cardiovascular events.
Vegetarian diets
This meta-analyses of 20 observational or interventional studies assessed at least one health outcome in association with vegetarian diets. In comparison to omnivorous diets, vegetarian diets are associated with clinically relevant positive outcomes on both total and LDL cholesterol and body weight. Subjects adhering to vegetarian diets had a significantly lower risk of diabetes, ischaemic heart disease, and cancer, in comparison to omnivores
Diets higher in plant foods and lower in animal foods were associated with a lower risk of cardiovascular morbidity and mortality in a general population.
This review summarises the current evidence base examining the associations of plant-based diets with cardiovascular endpoints, and discusses the potential biological mechanisms underlying their health effects, practical recommendations and applications of this research, and directions for future research. The authors conclude that healthy plant-based diets should be recommended as an environmentally sustainable dietary option for improved cardiovascular health.
Current evidence demonstrates that the Portfolio dietary pattern leads to clinically meaningful improvements in LDL-C as well as other established cardiometabolic risk factors and estimated 10-year CHD risk.
Dietary Approaches to Stop Hypertension (DASH)
Findings from this study suggest that higher quality diet is associated with improved adiposity measures and a less insulin resistant, pro-inflammatory, pro-thrombotic and pro-atherogenic cardiometabolic profile which may impact on central obesity and metabolic syndrome risk.