Dietary patterns, dietary nutrients and cardiovascular disease

The authors of a paper published in the journal ‘Reviews in Cardiovascular Medicine’ examine how a healthy dietary pattern can benefit multiple cardiovascular disease (CVD) risk factors and how, in conjunction with current standard-of-care pharmaceutical interventions, it can provide an effective strategy for the prevention of CVD.
According to the paper, previous dietary recommendations have focused on targeting macronutrients. However, most of the recent international dietary guidelines now recommend a whole food, dietary pattern approach, whilst avoiding quantitative nutrient advice.
The guidelines recommend: (1) increased intake of plant-based foods including complex, fibre-rich carbohydrates such as wholegrains, fruits and vegetables, but restricting the intake of refined starches; (2) substituting saturated fats with polyunsaturated and monounsaturated oils; (3) reducing salt intake; (4) increased fish consumption (or fish oils where applicable); (5) reducing sugar-sweetened drinks and added sugars; (6) avoiding butter and cream particularly in individuals at increased risk of CVD, but encouraging fermented products such as yoghurt; there is no specific advice on cheese and milk; (7) allowing consumption of lean meat in moderation but restricting processed meats; and (8) reducing cholesterol intake and foods rich in cholesterol (e.g., eggs and crustaceans) for those with diabetes and at increased CVD risk.
In their conclusion, the authors state that current evidence highlights the benefits of a healthy dietary pattern in lowering the risk of future CVD. A diet consisting of fruits, vegetables, and whole grains is recommended. Plant-based proteins are the preferred sources of protein followed by fish and poultry. A healthy dietary pattern should minimize consumption of refined starches, added sugars (including sugar-sweetened drinks), trans-fats, red meats (particularly processed meats) and sodium (salt intake). Saturated fats should be replaced with polyunsaturated and monounsaturated oils. Consumption of dairy is supported (without strong evidence to favour reduced-fat products), in particular fermented dairy such as yoghurt and cheese, but avoiding butter and cream principally in individuals with diabetes or at increased risk of CVD. Cholesterol and foods high in cholesterol, including eggs and crustaceans, should be limited for individuals with diabetes or those at increased risk of CVD. A healthy dietary pattern in conjunction with low-to-moderate alcohol consumption, regular physical activity, and avoidance of adiposity and tobacco, will attenuate future risk of CVD with likely similar benefits for other chronic disease conditions, the authors say.
Source: Paul J. Nestel, Trevor A. Mori. Dietary patterns, dietary nutrients and cardiovascular disease. Rev. Cardiovasc. Med. 2022, 23(1), 17.