Public Health, Epidemiology & Biostatistics, University of Birmingham, UK.
Background: Lifestyle modification, including diet, is a key strategy for prevention and regression of cardiovascular disease (CVD), a leading cause of death worldwide. Traditionally, the study of the relationship between diet and CVD has focused on the analysis of single nutrients, or foods, in relation to CVD risk.
Objective: In part one of this review, we present current epidemiologic and clinical evidence on nutrition and cardiovascular health with regards to specific foods and nutrients aimed at preventing CVD.
Methods: The Cochrane Library database between 2006 and 2012 was searched for studies on effects of dietary factors on cardiovascular health.
Discussion: Evidence is presented on soy protein, fats, fish, nuts, fruit, vegetables, electrolytes, vitamins, and carbohydrate including fibre, glycaemic index, and wholegrains. Evidence from specific foods underpins current dietary CVD prevention guidelines, that advise on replacing saturated with unsaturated fat, consuming carbohydrate foods that are wholegrain or of low glycaemic index, increased consumption of fruit, vegetables (particularly cruciferous), nuts, and oily fish. Other nutrients (such as soya protein, or reducing sodium intake) reduce CVD risk via favourable effects on disease contributors (such as LDL-cholesterol or blood pressure), but also infer/promote dietary change that impacts other nutrients (using less animal or processed foods, resulting in saturated fat reduction). The complexity and limitations of interpreting dietary epidemiologic studies is reviewed.
With the general ineffectiveness of nutrient-based intervention, recently the shift has been towards the examination of associations between dietary patterns and cardiovascular health, which will be examined in the second part of this review.