diet and heart disease

A review recently published in Cell Metabolism provides an overview of the relationship between diet and heart disease, as well as insight into recent advances in the field.

Cardiovascular disease remains the leading cause of death worldwide and contributes substantially to the global burden of disease. Better prevention and treatment strategies are rigorously being investigated to improve health outcomes. Despite some conflicting studies, researchers believe that diet is a modifiable risk factor for cardiovascular disease. A recently published mini-review in Cell Metabolism provides a commentary on the recent advances made in elucidating the relationship between diet and heart disease.

Differing study designs have advantages and disadvantages

Randomized clinical trials are the gold standard for determining causality between any two variables. They can be used to investigate the effects of diet on cardiovascular disease, however, they are particularly difficult to conduct given they require stringent control over an individual’s diet for long durations of time. Alternatively, prospective, or observational, studies can be used to examine the relationship between diet and cardiovascular disease. These studies involve the periodic collection of relevant information from participants as they are followed over time; this information can be analyzed at the end of the study period. Each study design has its own set of advantages and disadvantages, and it is, therefore, important to assess the results collectively from different investigations.

This mini-review provides a summary of the studies investigating the effects of carbohydrates, fat, and dietary patterns on cardiovascular health. Specifically, studies have shown that dietary fiber is associated with lower risk of type 2 diabetes and cardiovascular disease, while sugar and sugar-sweetened beverages have a well-documented effect on body weight, obesity, diabetes, and cardiovascular disease. Fats, however, have varying effects on health depending on the type.

Researchers identify specific dietary patterns associated with a lower risk of cardiovascular disease

Currently, the 2015-2020 Dietary Guidelines for Americans recommends a reduction of saturated fat consumption to less than 10% of an individual’s total daily caloric intake. Studies have found that replacing 5% of energy intake from saturated fats with polyunsaturated or monounsaturated fats was associated with a 25% to 15% lower risk of chronic heart disease.

Researchers have also identified specific dietary patterns that are considered healthy and which are associated with a lower risk of cardiovascular disease. These healthy diets tend to include high amounts of vegetables, fruits, whole grains, legumes, and seafood, with moderate amounts of low-fat and non-fat dairy products, as well as low amounts of red and processed meat.

There is plenty of literature that examines the association between diet and heart disease. Meta-analyses are a common and useful way of summarizing these studies, allowing healthcare professionals and policymakers to make appropriate recommendations.

Requirements for future studies

Future studies need to consider methods of improving individualized patient assessments by collecting comprehensive dietary, biochemical, and anthropometric measures more regularly. For instance, research is being done to investigate whether metabolic and genetic profiles of a patient can be used to develop nutritional recommendations tailored to that individual specifically.

Technological advancements will provide a better understanding

Further, advancements in mobile applications, big data analytics, and innovative educational and behavioural interventions will collectively provide a better understanding of the relationship between diet and cardiovascular disease.

Written by Haisam Shah, BSc

Reference: Pan, A., Lin, X., Hemler, E., & Hu, F. B. (2018). Diet and Cardiovascular Disease: Advances and Challenges in Population-Based Studies. Cell Metabolism27(3), 489-496.

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