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Dietary components and risk of cardiovascular disease and all-cause mortality: A review of evidence from meta-analyses

Watson, L; Loke, Y; Mallen, C; Mamas, M; Gulati, M; Kwok, CS; Michos, E; Potts, J; Wu, P


L Watson

Y Loke

M Gulati

CS Kwok

E Michos


The optimal diet for cardiovascular health is controversial. The aim of this review is to summarize the highest level of evidence and rank the risk associated with each individual component of diet within its food group.

Methods and results
A systematic search of PudMed was performed to identify the highest level of evidence available from systematic reviews or meta-analyses that evaluated different dietary components and their associated risk of all-cause mortality and cardiovascular disease (CVD). A total of 16 reviews were included for dietary food item and all-cause mortality and 17 reviews for CVD. Carbohydrates were associated with reduced risk of all-cause mortality (whole grain bread RR 0.85(95% CI 0.82-0.89), breakfast cereal RR 0.88(0.83-0.92), oats/oatmeal RR 0.88(0.83-0.92)). Fish consumption was associated with a small benefit (RR 0.98 (0.97-1.00)) and processed meat appeared to be harmful (RR 1.25(1.07-1.45)). Root vegetables (RR 0.76(0.66-0.88)), green leafy vegetables/salad (RR 0.78(0.71-0.86)), cooked vegetables (RR 0.89(0.80-0.99)) and cruciferous vegetables (RR 0.90(0.85-0.95)) were associated with reductions in all-cause mortality. Increased mortality was associated with consumption of tinned fruit (RR 1.14(1.07-1.21)). Nuts were associated with a reduced risk of mortality in a dose response relationship (all nuts RR 0.78(0.72-0.84), tree nuts RR 0.82(0.75-0.90), and peanuts RR 0.77(0.69-0.86)). For CVD, similar associations for benefit were observed for carbohydrates, nuts and fish, but red meat and processed meat were associated with harm.

Many dietary components appear to be beneficial for CVD and mortality, including grains, fish, nuts and vegetables, but processed meat and tinned fruit appear to be harmful.

Journal Article Type Article
Acceptance Date Mar 24, 2019
Online Publication Date Aug 29, 2020
Publication Date Sep 1, 2019
Journal European Journal of Preventive Cardiology
Print ISSN 2047-4873
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 26
Issue 13
Pages 1415-1429
Keywords diet, epidemiology, systematic review
Publisher URL