Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies
Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, De Henauw S, Michels N, Devleesschauwer B, Schlesinger S, Schwingshackl L
Critical reviews in food science and nutrition · 472 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2017-10-17 · Crit Rev Food Sci Nutr · vol. 59 · issue 7 · pp. 1071–1090
- Publisher
- Taylor & Francis
- Cited
- 717 citations · more than 99% of similar papers · 7.9× the field average
- Impact
- Top 10% most cited in its field
- References
- 212 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Nutritional Studies and Diet · Nuts composition and effects · Antioxidant Activity and Oxidative Stress
- Keywords
- Medicine, Meta-analysis, Refined grains, Relative risk, Confidence interval, Prospective cohort study, Heart failure, Stroke (engine), Red meat, Internal medicine, Food science, Whole grains, Biology, Pathology
- MeSH
- humans, fruit, nuts, vegetables, coronary disease, diet, risk factors, prospective studies, feeding behavior, risk reduction behavior, beverages, eggs, seafood, databases, factual, heart failure, stroke, whole grains, red meat
11 authors
From DE, AT, BE
- Angela Bechthold · corresponding
- Heiner Boeing · correspondingGerman Institute of Human Nutrition
- Carolina Schwedhelm · correspondingGerman Institute of Human Nutrition
- Georg E. HOFFMANN · correspondingUniversity of Vienna
- Sven Knüppel · correspondingGerman Institute of Human Nutrition
- Khalid Javed Iqbal · correspondingGerman Institute of Human Nutrition
Abstract
Background
Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).
Methods
We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.
Results
Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RRCHD: 0.95 (95% CI: 0.92-0.98), RRHF: 0.96 (0.95-0.97)), vegetables and fruits (RRCHD: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RRstroke: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RRCHD: 0.67 (0.43-1.05)), and fish consumption (RRCHD: 0.88 (0.79-0.99), RRstroke: 0.86 (0.75-0.99), and RRHF: 0.80 (0.67-0.95)), while a positive association was present for egg (RRHF: 1.16 (1.03-1.31)), red meat (RRCHD: 1.15 (1.08-1.23), RRstroke: 1.12 (1.06-1.17), RRHF: 1.08 (1.02-1.14)), processed meat (RRCHD: 1.27 (1.09-1.49), RRstroke: 1.17 (1.02-1.34), RRHF: 1.12 (1.05-1.19)), and SSB consumption (RRCHD: 1.17 (1.11-1.23), RRstroke: 1.07 (1.02-1.12), RRHF: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.
Conclusion
An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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