Consuming fruits, vegetables, legumes, nuts, fish and whole-fat dairy products is key to lowering the risk of Cardiovascular Disease (CVD), including heart attacks and strokes, according to a recent study.
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The study led by researchers from McMaster University and Hamilton Health Sciences researchers at the Population Research Health Institute (PHRI) was published in the European Heart Journal on July 6.
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The World Health Organization estimates nearly 18 million people died from CVD in 2019, representing 32% of all global deaths. Of these deaths, 85% were due to heart attacks and strokes. PHRI researchers and their global collaborators analysed dietary data from 2,45,000 people in 80 countries across the world from multiple studies. The researchers found that a healthy diet can be achieved in various ways, such as including moderate amounts of whole grains or unprocessed meats.
Diet scores
“Previous diet scores — including the EAT-Lancet Planetary Diet and the Mediterranean Diet — tested the relationship of diet to CVD and death mainly in Western countries. The Prospective Urban Rural Epidemiology (PURE) Healthy Diet Score included a good representation of high, middle, and low-income countries,” said Salim Yusuf, senior author and principal investigator of PURE.
As well as being truly global, the PURE Healthy Diet Score focused on exclusively protective, or natural, foods. “We were unique in that focus. The other diet scores combined foods considered to be harmful – such as processed and ultra-processed foods – with foods and nutrients believed to be protective of one’s health,” said PHRI scientist Andrew Mente, who is the lead author of the paper.
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“There is a recent increased focus on higher consumption of protective foods for disease prevention. Outside of larger amounts of fruits, vegetables, nuts and legumes, the researchers found that moderation is key in the consumption of natural foods,” he said.
“Moderate amounts of fish and whole-fat dairy are associated with a lower risk of CVD and mortality. The same health outcomes can be achieved with moderate consumption of grains and meats – as long as they are unrefined whole grains and unprocessed meats,” according to the study.
The PURE study
The PURE study was conducted in five sites in India — St John’s Research Institute, Bengaluru, Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Health Action by People, Trivandrum, Postgraduate Institute of Medical Education and Research, School of Public Health, Chandigarh and Rajasthan University of Health Sciences, Jaipur. A total of 26,082 subjects from these sites were used for this study.
Sumathi Swaminathan, Associate Professor at St. John’s Research Institute, who is also one of the authors, said the PURE Healthy Diet Score recommends an average daily intake of fruits at two to three servings; vegetables at two to three servings; nuts at one serving; and dairy at two servings. “The score also includes three to four weekly servings of legumes and two to three weekly servings of fish. Possible substitutes included whole grains at one serving daily, and unprocessed red meat or poultry at one serving daily,” she said.
The servings are as per the United States Department of Agriculture’s dietary guidelines, she added.