A new dietary approach for reducing the risk of CVD

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Focusing on healthy eating patterns is more effective in reducing the risk of CVD, compared to an approach based on individual ingredients and nutrients.

We read in many prestigious publications that a healthy diet is associated with a lower risk of cardiovascular disease (CVD). But which of these two is more beneficial: to have food patterns or to focus on individual ingredients and nutrients? This was the question a research team wanted to answer in a new study conducted at Harvard T.H. Chan School of Public Health. The results of this latest research, published online in the Journal of the American Medical Association on June 15, 2020, support dietary guidelines for 2015-2020, which focus on healthy eating patterns, rather than individual ingredients and nutrients. In this way, personal traditions and cultural preferences regarding food can be better integrated.

“Although each type of healthy eating is a different combination of dietary constituents, our study indicates that greater adherence to any of the four healthy eating patterns we looked at is associated with a lower risk of cardiovascular disease and health benefits persist among racial and ethnic groups, “said Zhilei Shan, lead author and research associate in the Department of Nutrition.

Not many studies have examined how adherence to recommended healthy eating patterns influences long-term risk of CVD. For this study, researchers focused on the dietary scores of four healthy eating models: Healthy Eating Index-2015 (HEI-2015), Alternative Mediterranean Diet Score (AMDS), Healthy Plant-Based Diet Index (HPDI), Healthy Eating Index (HEI) and Alternative Healthy Eating (AHE). Even though they are called differently, each of these models emphasizes a higher intake of whole grains, vegetables, fruits, legumes and nuts and a lower intake of red and processed meat and sugary drinks.

The group of participants in the study was large, and the researchers analyzed data provided by 74,930 women enrolled in the Health Study of Nurses, 90,864 women in the Health Study of Nurses II and 43,339 men in the Follow-up Study of Professionals in Health.


Participants in each study were asked every two to four years about their dietary habits, including how often, on average, they ate a portion of different foods.

Using data collected over several decades through validated food questionnaires, the researchers created four scores for each participant. Higher dietary scores accounted for greater adherence to healthy eating patterns. After adjusting for many factors, including age, BMI, and smoking status, the analysis found that greater adherence to any of the healthy eating patterns was consistently associated with a lower risk of CVD. The study found that participants who adhered most to healthy eating patterns had a 14%, up to 21% lower risk of CVD, compared to those who adhered the least.

The findings also showed that these different healthy eating patterns were equally effective in reducing the risk of CVD in the ethnic and racial groups and other subgroups studied and were associated with a lower risk of coronary heart disease and cerebrovascular accident.

“This data provides additional evidence to support current dietary guidelines and show that following healthy eating patterns provides long-term health benefits in preventing cardiovascular disease,” said author Frank Hu, professor of nutrition and epidemiology and chair of the Department of Nutrition.

So, we have another valuable study that tells us that there is no fit-for-all diet. Instead, we learned that food can be combined, respecting healthy eating principles and according to people’s health needs, food preferences and cultural traditions. The same principles were applied in compiling the daily Dahna menus.

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