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Review

Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review

1
Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Praram VI Road, Rachathevee, Bangkok 10400, Thailand
2
Department of Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Praram VI Road, Rachathevee, Bangkok 10400, Thailand
3
Division of Endocrinology, Diabetes and Metabolism, University of Illinois College of Medicine at Chicago, 835 S Wolcott, Ste E625, Chicago, IL 60612, USA
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(4), 1088; https://doi.org/10.3390/nu12041088
Received: 20 March 2020 / Revised: 7 April 2020 / Accepted: 9 April 2020 / Published: 15 April 2020
Unhealthy diet is a significant risk factor for cardiovascular diseases (CVD). Therefore, this umbrella review aims to comprehensively review the effects of dietary factors, including dietary patterns, food groups, and nutrients on CVD risks. Medline and Scopus databases were searched through March 2020. Systematic reviews with meta-analyses (SRMA) of randomized controlled trials (RCTs) or observational studies measuring the effects of dietary factors on CVD risks were eligible. Fifty-four SRMAs, including 35 SRMAs of observational studies, 10 SRMAs of RCTs, and 9 SRMAs of combined RCT and observational studies, were included for review. Findings from the SRMAs of RCTs suggest the significant benefit of Mediterranean and high-quality diets for lowering CVD risk, with pooled risk ratios (RRs) ranging from 0.55 (95%CI: 0.39–0.76) to 0.64 (95%CI: 0.53–0.79) and 0.70 (95%CI: 0.57–0.87), respectively. For food nutrients, two SRMAs of RCTs found that high intake of n-3 polyunsaturated fatty acid (PUFA) significantly reduced CVD risks, with pooled RRs ranging from 0.89 (95%CI: 0.82, 0.98) to 0.90 (95%CI: 0.85–0.96), while evidence of efficacy of n-6 PUFA and combined n-3 and n-6 PUFA were inconsistent. Moreover, results from the SRMAs of RCTs did not find a significant benefit of a low-salt diet and low total fat intake for CVD prevention. For food groups, results from the SRMAs of cohort studies suggest that high intakes of legumes, nuts, and chocolate, as well as a vegetarian diet significantly reduced the risk of coronary heart disease, with pooled RRs of 0.90 (95%CI: 0.84–0.97), 0.68 (95%CI: 0.59–0.78), 0.90 (95%CI: 0.82–0.97), and 0.71 (95%CI: 0.57–0.87), respectively. Healthy dietary patterns had a significant benefit for CVD prevention. With the substitutional and synergistic interactions between different food groups and nutrients, dietary recommendations for CVD prevention should be focused more on healthy dietary patterns than single food groups or nutrients. View Full-Text
Keywords: dietary factor; cardiovascular disease; umbrella review dietary factor; cardiovascular disease; umbrella review
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MDPI and ACS Style

Chareonrungrueangchai, K.; Wongkawinwoot, K.; Anothaisintawee, T.; Reutrakul, S. Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review. Nutrients 2020, 12, 1088. https://doi.org/10.3390/nu12041088

AMA Style

Chareonrungrueangchai K, Wongkawinwoot K, Anothaisintawee T, Reutrakul S. Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review. Nutrients. 2020; 12(4):1088. https://doi.org/10.3390/nu12041088

Chicago/Turabian Style

Chareonrungrueangchai, Kridsada, Keerati Wongkawinwoot, Thunyarat Anothaisintawee, and Sirimon Reutrakul. 2020. "Dietary Factors and Risks of Cardiovascular Diseases: An Umbrella Review" Nutrients 12, no. 4: 1088. https://doi.org/10.3390/nu12041088

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