A study by researchers from McMaster University and Hamilton Health Sciences at the Population Research Health Institute (PHRI) found that not eating enough of six key foods in combination is associated with a higher risk cardiovascular disease (CVD) in adults.
Consuming fruits, vegetables, legumes, nuts, fish, and whole dairy products is key to reducing the risk of cardiovascular disease, including heart attack and stroke. The study also revealed that a healthy diet can be achieved in different ways, such as including moderate amounts of whole grains or unprocessed meats.
Previous and similar research has focused on Western countries and diets that combined harmful, ultra-processed foods with nutrient-dense foods. This research was global in scope and focused on foods generally considered healthy.
The World Health Organization estimates that almost 18 million people died from CVD in 2019, representing 32% of all deaths worldwide. Of these deaths, 85% were due to heart attacks and strokes. PHRI researchers and their global collaborators analyzed data from 245,000 people in 80 countries from multiple studies. The results were published in the European journal of the heart.
Researchers derived a diet score from PHRI’s ongoing large-scale global Prospective Urban-Rural Epidemiological Study (PURE) and then replicated it in five independent studies to measure health outcomes in different regions world and in people with and without a history of cardiovascular disease.
“Previous diet scores, including the EAT-Lancet Planetary Diet and the Mediterranean Diet, have tested the relationship between diet, cardiovascular disease, and death, primarily in Western countries. The PURE Healthy Diet Score included a good representation of high, middle and low income countries,” said Salim Yusuf, lead author and principal investigator of PURE.
In addition to being truly global, the PURE Healthy Diet Score focused on exclusively protective or natural foods.
“We were unique in this area. The other diet scores combined foods considered harmful, such as processed and ultra-processed foods, with foods and nutrients believed to protect health,” said first author Andrew Mente, PHRI Scientist and Assistant Professor in the Department of Health Research Methods, Evidence and Impact at McMaster.
“There has recently been increased attention to increased consumption of protective foods for disease prevention. Apart from higher amounts of fruits, vegetables, nuts and legumes, researchers have shown that moderation is the key to eating natural foods,” he said.
“Moderate amounts of fish and whole dairy products are associated with a lower risk of cardiovascular disease and mortality. The same health results can be achieved with a moderate intake of grains and meats, as long as they are unrefined whole grains and unprocessed meats.
The PURE Healthy Diet Score recommends an average daily intake of: Fruit at two or three servings; two to three serving vegetables; one-serving nuts; and two-serving dairy products. 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 per day and red meat or unprocessed poultry at one serving per day.