A ‘heart’ healthy diet should include more vegetables, fruits, whole grains, legumes, nuts and fish and less red meat, processed meat and sugar-sweetened beverages

In October 2017 researchers from Germany, Austria and Belgium published their review of the medical scientific literature to assess the relationship between the consumption of 12 major food groups and risk of coronary heart disease, stroke and heart failure.  A total of 123 studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages and the risk of coronary heart disease, stroke and heart failure were included in the analysis.

Results showed that a higher consumption of whole grains, vegetables, fruits, nuts, legumes and fish reduced the risk of coronary heart disease, whereas refined grains, red meat, processed meat and sugar-sweetened beverages increased the risk. A further analysis revealed that the risk of coronary heart disease decreased by 17% with an intake of whole grains up to 100g/day, by 12% for vegetables up to 400g/day (although additional benefit could be demonstrated above this amount), by 15% for fruits up to 200g/day, by 21% for nuts up to 10-15g/day, by approximately 10% for legumes up to 100 g/day, and by approximately 15% for fish up to 250g/day. The risk of coronary heart disease increased by 10–20% with an intake of red meat up to 100g/day and by 35% for sugar-sweetened beverages up to 500ml/day.

With respect to stroke, vegetables, fruits, dairy and fish reduced the risk, whilst red meat, processed meat and sugar sweetened beverages increased the risk. A further analysis revealed that the risk of stroke decreased by 12% with an intake of vegetables up to 400g/day, by 20% for fruits up to 200g/day, by 5% for dairy up to 500g/day (no difference was detected when low-fat and high-fat dairy products were compared), and by 10% for fish up to 80-100g/day.  The risk of stroke increased by 10–20% with an intake of red meat up to 100g/d, by 15% for processed meat up to 70g/day and by 16% with sugar-sweetened beverages up to 500ml/day.

For heart failure, whole grains and fish were seen to reduce the risk, whilst red meat, processed meat and eggs appeared to increase the risk. A further analysis revealed that the risk of heart failure decreased with each additional 30g/day of whole grains, and by 20% for fish up to 80-100g/day. The risk of heart failure increased by 10–20% with an intake of red meat up to 100g/day, by 25% for processed meat up to 70g/day, and by 50% for eggs up to 100g/day.

Bechthold A et al. Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2017 Oct 17:1-20

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