Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies

Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore...

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Published in:Critical reviews in food science and nutrition Vol. 59; no. 7; pp. 1071 - 1090
Main Authors: Bechthold, Angela, Boeing, Heiner, Schwedhelm, Carolina, Hoffmann, Georg, Knüppel, Sven, Iqbal, Khalid, De Henauw, Stefaan, Michels, Nathalie, Devleesschauwer, Brecht, Schlesinger, Sabrina, Schwingshackl, Lukas
Format: Journal Article
Language:English
Published: United States Taylor & Francis 12.04.2019
Subjects:
Cardiovascular
confidence interval
coronary disease
coronary heart disease
diet
dose response
eating habits
eggs
fish
fish consumption
food
food groups
fruits
heart failure
legumes
meta-analysis
nuts
processed meat
prospective studies
red meat
refined grains
stroke
sugar sweetened beverages
systematic review
vegetables
whole grain foods
heart failure
Cardiovascular
dose-response
meta-analysis
coronary heart disease
diet
stroke
food
ISSN:1040-8398, 1549-7852, 1549-7852
Online Access:Get full text
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Summary:Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF). Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships. Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RR CHD : 0.95 (95% CI: 0.92-0.98), RR HF : 0.96 (0.95-0.97)), vegetables and fruits (RR CHD : 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RR stroke : 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RR CHD : 0.67 (0.43-1.05)), and fish consumption (RR CHD : 0.88 (0.79-0.99), RR stroke : 0.86 (0.75-0.99), and RR HF : 0.80 (0.67-0.95)), while a positive association was present for egg (RR HF : 1.16 (1.03-1.31)), red meat (RR CHD : 1.15 (1.08-1.23), RR stroke : 1.12 (1.06-1.17), RR HF : 1.08 (1.02-1.14)), processed meat (RR CHD : 1.27 (1.09-1.49), RR stroke : 1.17 (1.02-1.34), RR HF : 1.12 (1.05-1.19)), and SSB consumption (RR CHD : 1.17 (1.11-1.23), RR stroke : 1.07 (1.02-1.12), RR HF : 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD. Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
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ISSN:1040-8398
1549-7852
1549-7852
DOI:10.1080/10408398.2017.1392288