Hygiena 2020, 65(4):140-151 | DOI: 10.21101/hygiena.a1764
Nutritional recommendations for the prevention of cardiovascular diseases - evidence, formulation, controversies and ambiguities
- Masarykova univerzita, Lékařská fakulta, Ústav ochrany a podpory zdraví, Brno, Česká republika
The aim of the article is to summarise the currently valid nutritional recommendations for the prevention of cardiovascular diseases. The basis is an overview of the main points of two recent clinical recommendations of medical societies, namely the European Recommendations 2016 and the American AHA Recommendations 2019, and their commentary. It turns out that many of the former recommendations have had to be reconsidered and are no longer valid. At the same time much remains unclear and some new findings are still contradictory and controversial. It seems that in the near future it will be necessary to further revise the nutritional recommendations for cardiovascular prevention and re-evaluate some of the existing views and approaches.
Keywords: cardiovascular diseases, atherosclerosis, disease prevention, dietary guidelines
Received: July 2020; Accepted: November 27, 2020; Published: December 17, 2020 Show citation
References
- Lincoff AM, Nicholls SJ, Riesmeyer JS, Barter PJ, Brewer HB, Fox KAA, et al; ACCELERATE Investigators. Evacetrapib and cardiovascular outcomes in high-risk vascular disease. N Engl J Med. 2017 May 18;376(20):1933-42.
Go to original source...
Go to PubMed...
- Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, et al; American Heart Association. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation. 2017 Jul 18;136(3):e1-e23. doi: 10.1161/CIR.0000000000000510.
Go to original source...
Go to PubMed...
- Dehghan M, Mente A, Zhang X, Swaminathan S, Li W, Mohan V, et al; Prospective Urban Rural Epidemiology (PURE) study investigators. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet. 2017 Nov 4;390(10107):2050-62.
Go to original source...
Go to PubMed...
- Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al; ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016 Aug 1;37(29):2315-81.
Go to original source...
Go to PubMed...
- Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Sep 10;140(11):e596-e646. doi: 10.1161/CIR.0000000000000678.
Go to original source...
Go to PubMed...
- Česká společnost pro aterosklerózu [online]. Praha: ČSAT; 2020 [cit. 2020-11-15]. Dostupné z: https://athero.cz/.
- EU Science HUB [Internet]. Brussels: European Commission; 2020 [cited 2020 Nov 15]. The European Commission's science and knowledge service: Dietary fats - Health promotion and disease prevention knowledge gateway. Available from: https://ec.europa.eu/jrc/en/health-knowledge-gateway/promotion-prevention/nutrition.
- Astrup A, Dyerberg J, Elwood P, Hermansen K, Hu FB, Jakobsen MU, et al. The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010? Am J Clin Nutr. 2011 Apr;93(4):684-8.
Go to original source...
Go to PubMed...
- Mensink RP, Katan MB. Effect of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. Arterioscler Thromb. 1992 Aug;12(8):911-9.
Go to original source...
Go to PubMed...
- Wu JHY, Micha R, Mozaffarian D. Dietary fats and cardiometabolic disease: mechanisms and effects on risk factors and outcomes. Nat Rev Cardiol. 2019 Oct;16(10):581-601.
Go to original source...
Go to PubMed...
- Brát J. Tučná fakta o tucích - aneb máme se bát tuků? Praha: Potravinářská komora ČR; 2018.
- Wen YT, Dai JH, Gao Q. Effects of Omega-3 fatty acid on major cardiovascular events and mortality in patients with coronary heart disease: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2014 May;24(5):470-5.
Go to original source...
Go to PubMed...
- Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 2012 Sep 12;308(10):1024-33.
Go to original source...
Go to PubMed...
- Wang DD, Li Y, Chiuve SE, Stampfer MJ, Manson JE, Rimm EB, et al. Association of specific dietary fats with total and cause-specific mortality. JAMA Intern Med. 2016 Aug 1;176(8):1134-45.
Go to original source...
Go to PubMed...
- Kiage JN, Merrill PD, Robinson CJ, Cao Y, Malik TA, Hundley BC, et al. Intake of trans fat and all-cause mortality in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) cohort. Am J Clin Nutr. 2013 May;97(5):1121-8.
Go to original source...
Go to PubMed...
- Brandt EJ, Myerson R, Perraillon MC, Polonsky TS. Hospital admissions for myocardial infarction and stroke before and after the trans-fatty acid restrictions in New York. JAMA Cardiol. 2017 Jun 1;2(6):627-34.
Go to original source...
Go to PubMed...
- Micha R, Mozaffarian D. Trans fatty acids: effects on metabolic syndrome, heart disease and diabetes. Nat Rev Endocrinol. 2009 Jun;5(6):335-44.
Go to original source...
Go to PubMed...
- Mozaffarian D, Katan MB, Ascherio A, Stampfer MJ, Willett WC. Trans fatty acids and cardiovascular disease. N Engl J Med. 2006 Apr 13;354(15):1601-13.
Go to original source...
Go to PubMed...
- He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens. 2002 Nov;16(11):761-70.
Go to original source...
Go to PubMed...
- Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al; DASH-Sodium Collaborative Research Group. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001 Jan 4;344(1):3-10.
Go to original source...
Go to PubMed...
- Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007 Apr 28;334(7599):885-8.
Go to original source...
Go to PubMed...
- Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. 2013 Apr 3;346:f1378. doi: 10.1136/bmj.f1378.
Go to original source...
Go to PubMed...
- Threapleton DE, Greenwood DC, Evans CE, Cleghorn CL, Nykjaer C, Woodhead C, et al. Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. BMJ. 2013 Dec 19;347:f6879. doi: 10.1136/bmj.f6879.
Go to original source...
Go to PubMed...
- Chowdhury R, Stevens S, Gorman D, Pan A, Warnakula S, Chowdhury S, et al. Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis. BMJ. 2012 Oct 30;345:e6698. doi: 10.1136/bmj.e6698.
Go to original source...
Go to PubMed...
- Schöttker B, Jorde R, Peasey A, Thorand B, Jansen EH, Groot Ld, et al; Consortium on Health and Ageing: Network of Cohorts in Europe and the United States. Vitamin D and mortality: meta-analysis of individual participant data from a large consortium of cohort studies from Europe and the United States. BMJ. 2014 Jun 17;348:g3656. doi: 10.1136/bmj.g3656.
Go to original source...
Go to PubMed...
- Wang X, Ouyang Y, Liu J, Zhu M, Zhao G, Bao W, et al. Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies. BMJ. 2014 Jul 29;349:g4490. doi: 10.1136/bmj.g4490. Erratum in: BMJ. 2014;349:5472.
Go to original source...
Go to PubMed...
- Dauchet L, Amouyel P, Hercberg S, Dallongeville J. Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. J Nutr. 2006 Oct;136(10):2588-93.
Go to original source...
Go to PubMed...
- He FJ, Nowson CA, MacGregor GA. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet. 2006 Jan 28;367(9507):320-6.
Go to original source...
Go to PubMed...
- Luo C, Zhang Y, Ding Y, Shan Z, Chen S, Yu M, et al. Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis. Am J Clin Nutr. 2014 Jul;100(1):256-69.
Go to original source...
Go to PubMed...
- Ros E, Mataix J. Fatty acid composition of nuts - implications for cardiovascular health. Br J Nutr. 2006 Nov;96 Suppl 2:S29-35. Erratum in: Br J Nutr. 2008 Feb;99(2):447-8.
Go to original source...
Go to PubMed...
- Zheng J, Huang T, Yu Y, Hu X, Yang B, Li D. Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. Public Health Nutr. 2012 Apr;15(4):725-37.
Go to original source...
Go to PubMed...
- Chowdhury R, Kunutsor S, Vitezova A, Oliver-Williams C, Chowdhury S, Kiefte-de-Jong JC, et al. Vitamin D and risk of cause specific death: systematic review and meta-analysis of observational cohort and randomised intervention studies. BMJ. 2014 Apr 1;348:g1903. doi: 10.1136/bmj.g1903.
Go to original source...
Go to PubMed...
- Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009 Apr;89(4):1037-42.
Go to original source...
Go to PubMed...
- Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med. 2014 Apr;174(4):516-24.
Go to original source...
Go to PubMed...
- Satija A, Bhupathiraju SN, Spiegelman D, Chiuve SE, Manson JE, Willett W, et al. Healthful and unhealthful plant-based diets and the risk of coronary heart disease in U.S. adults. J Am Coll Cardiol. 2017 Jul 25;70(4):411-22.
Go to original source...
Go to PubMed...
- Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011 Feb 22;342:d671. doi: 10.1136/bmj.d671.
Go to original source...
Go to PubMed...
- Dehghan M, Mente A, Rangarajan S, Sheridan P, Mohan V, Iqbal R, et al; Prospective Urban Rural Epidemiology (PURE) study investigators. Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. Lancet. 2018 Nov 24;392(10161):2288-97.
Go to original source...
Go to PubMed...
- Song M, Fung TT, Hu FB, Willett WC, Longo VD, Chan AT, et al. Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA Intern Med. 2016 Oct 1;176(10):1453-63.
Go to original source...
Go to PubMed...
- Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Guo Y, Ye Z, et al; InterAct Consortium. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ. 2014 Jul 10;349:g4164. doi: 10.1136/bmj.g4164.
Go to original source...
Go to PubMed...
- Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al; PREDIMED Study Investigators. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med. 2018 Jun 21;378(25):e34. doi: 10.1056/NEJMoa1800389.
Go to original source...
Go to PubMed...
- Kim H, Caulfield LE, Rebholz CM. Healthy plant-based diets are associated with lower risk of all-cause mortality in US adults. J Nutr. 2018 Apr 1;148(4):624-31.
Go to original source...
Go to PubMed...
- Reedy J, Krebs-Smith SM, Miller PE, Liese AD, Kahle LL, Park Y, et al. Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults. J Nutr. 2014 Jun;144(6):881-9.
Go to original source...
Go to PubMed...
- Sotos-Prieto M, Bhupathiraju SN, Mattei J, Fung TT, Li Y, Pan A, et al. Association of changes in diet quality with total and cause-specific mortality. N Engl J Med. 2017 Jul 13;377(2):143-53.
Go to original source...
Go to PubMed...
- Whalen KA, Judd S, McCullough ML, Flanders WD, Hartman TJ, Bostick RM. Paleolithic and Mediterranean diet pattern scores are inversely associated with all-cause and cause-specific mortality in adults. J Nutr. 2017 Apr;147(4):612-20.
Go to original source...
Go to PubMed...
- Bao Y, Han J, Hu FB, Giovannucci EL, Stampfer MJ, Willett WC, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med. 2013 Nov 21;369(21):2001-11.
Go to original source...
Go to PubMed...
- Bernstein AM, Sun Q, Hu FB, Stampfer MJ, Manson JE, Willett WC. Major dietary protein sources and risk of coronary heart disease in women. Circulation. 2010 Aug 31;122(9):876-83.
Go to original source...
Go to PubMed...
- Tharrey M, Mariotti F, Mashchak A, Barbillon P, Delattre M, Fraser GE. Patterns of plant and animal protein intake are strongly associated with cardiovascular mortality: the Adventist Health Study-2 cohort. Int J Epidemiol. 2018 Oct 1;47(5):1603-12.
Go to original source...
Go to PubMed...
- Martínez-González MA, Sánchez-Tainta A, Corella D, Salas-Salvadó J, Ros E, Arós F, et al; PREDIMED Group. A provegetarian food pattern and reduction in total mortality in the Prevención con Dieta Mediterránea (PREDIMED) study. Am J Clin Nutr. 2014 Jul;100 Suppl 1:320S-8S.
Go to original source...
Go to PubMed...
- Seidelmann SB, Claggett B, Cheng S, Henglin M, Shah A, Steffen LM, et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health. 2018 Sep;3(9):e419-e428. doi: 10.1016/S2468-2667(18)30135-X.
Go to original source...
Go to PubMed...
- Trichopoulou A, Psaltopoulou T, Orfanos P, Hsieh CC, Trichopoulos D. Low-carbohydrate-high-protein diet and long-term survival in a general population cohort. Eur J Clin Nutr. 2007 May;61(5):575-81.
Go to original source...
Go to PubMed...
- Noto H, Goto A, Tsujimoto T, Noda M. Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies. PLoS One. 2013;8(1):e55030. doi: 10.1371/journal.pone.0055030.
Go to original source...
Go to PubMed...
- Sofi F, Abbate R, Gensini GF, Casini A. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr. 2010 Nov;92(5):1189-96.
Go to original source...
Go to PubMed...
- Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013 Apr 4;368(14):1279-90. doi: 10.1056/NEJMoa1200303.
Go to original source...
Go to PubMed...
- Rees K, Takeda A, Martin N, Ellis L, Wijesekara D, Vepa A, et al. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2019 Mar 13;3(3):CD009825. doi: 10.1002/14651858.CD009825.pub3.
Go to original source...
Go to PubMed...
- Forouhi NG, Krauss RM, Taubes G, Willett W. Dietary fat and cardiometabolic health: evidence, controversies, and consensus for guidance. BMJ. 2018 Jun 13;361:k2139. doi: 10.1136/bmj.k2139.
Go to original source...
Go to PubMed...