Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Feb;81(1):35-50.
doi: 10.1111/1747-0080.12860. Epub 2023 Dec 21.

Diet quality and cardiovascular outcomes: A systematic review and meta-analysis of cohort studies

Rachael M Taylor  1   2 , Rebecca L Haslam  1   2 , Jaimee Herbert  1   2 , Megan C Whatnall  1   2 , Laura Trijsburg  3 , Jeanne H M de Vries  3 , Malin Skinnars Josefsson  4 , Afsaneh Koochek  4 , Paulina Nowicka  4 , Nicklas Neuman  4 , Erin D Clarke  1   2 , Tracy L Burrows  1   2 , Clare E Collins  1   2
Affiliations
Meta-Analysis

Diet quality and cardiovascular outcomes: A systematic review and meta-analysis of cohort studies

Rachael M Taylor et al. Nutr Diet. 2024 Feb.

Abstract

Aims: To evaluate relationships between diet quality and cardiovascular outcomes.

Methods: Six databases were searched for studies published between January 2007 and October 2021. Eligible studies included cohort studies that assessed the relationship between a priori diet quality and cardiovascular disease mortality and morbidity in adults. The Academy of Nutrition and Dietetics Checklist was used to assess the risk of bias. Study characteristics and outcomes were extracted from eligible studies using standardised processes. Data were summarised using risk ratios for cardiovascular disease incidence and mortality with difference compared for highest versus lowest diet quality synthesised in meta-analyses using a random effects model.

Results: Of the 4780 studies identified, 159 studies (n = 6 272 676 adults) were included. Meta-analyses identified a significantly lower cardiovascular disease incidence (n = 42 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) and mortality risk (n = 49 studies, relative risk 0.83, 95% CI 0.82-0.84, p < 0.001) among those with highest versus lowest diet quality. In sensitivity analyses of a high number of pooled studies (≥13 studies) the Mediterranean style diet patterns and adherence to the heart healthy diet guidelines were significantly associated with a risk reduction of 15% and 14% for cardiovascular disease incidence and 17% and 20% for cardiovascular disease mortality respectively (p < 0.05).

Conclusions: Higher diet quality is associated with lower incidence and risk of mortality for cardiovascular disease however, significant study heterogeneity was identified for these relationships.

Keywords: cardiovascular disease; diet quality; dietary patterns; meta-analysis; systematic review.

PubMed Disclaimer

References

REFERENCES

    1. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol. 2020;76(25):2982-3021.
    1. Menotti A, Kromhout D, Blackburn H, Fidanza F, Buzina R, Nissinen A. Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the seven countries study. The seven countries study research group. Eur J Epidemiol. 1999;15(6):507-515.
    1. Keys A. Coronary heart disease in seven countries. 1970. Nutrition. 1997;13(3):250-252. discussion 49, 3.
    1. Keys A, Menotti A, Karvonen MJ, et al. The diet and 15-year death rate in the seven countries study. Am J Epidemiol. 1986;124(6):903-915.
    1. Fung TT, Rimm EB, Spiegelman D, et al. Association between dietary patterns and plasma biomarkers of obesity and cardiovascular disease risk. Am J Clin Nutr. 2001;73(1):61-67.

LinkOut - more resources