According to a study undertaken in 80 nations on all inhabited continents and published today in European Heart Journal, a journal of the European Society of Cardiology (ESC), whole grains and unprocessed red meat can be added or excluded from a nutritious diet. In all world areas, diets that place a strong emphasis on fruit, vegetables, dairy (mostly whole-fat), nuts, legumes, and seafood were associated with a lower risk of cardiovascular disease (CVD) and early death. Whole grains or red meat that hasn’t been processed had minimal effect on the results.
The study analyzed the connections between a new diet score and health results in a global population. A healthy diet score was made in view of six food sources that have each been connected with life span. The PURE diet included 2-3 servings of fruit each day, 2-3 servings of vegetables each day, 3-4 servings of vegetables each week, 7 servings of nuts each week, 2-3 servings of fish each week, and 14 servings of dairy products (fundamentally entire fat however excluding margarine or whipped cream) each week. A score of 1 (healthy) was given to intake higher than the group’s median, while a score of 0 (unhealthy) was given to intake lower than the median, for a range of 0 to 6. Dr. Mente explained: “Participants in the top 50% of the population – an achievable level – on each of the six food components attained the maximum diet score of six.”
In the PURE study, which included 147,642 people from the general population in 21 countries, associations of the score with mortality, myocardial infarction, stroke, and total CVD (including fatal CVD and non-fatal myocardial infarction, stroke, and heart failure) were examined. The investigations were adapted to factors that could impact the connections, for example, age, gender, waist-to-hip ratio, education level, pay, metropolitan or rural area, physical activity, smoking status, diabetes, use of statins or hypertension drugs, and total energy intake.
The diet score was on average 2.95. During a median follow-up of 9.3 years, there were 15,707 passings and 40,764 cardiovascular events. The healthiest diet (score of 5 or higher) was associated with a 30% lower risk of death, 18% lower likelihood of cardiovascular disease (CVD), 14% lower risk of myocardial infarction, and 19% lower risk of stroke compared to the least healthy diet (score of 1 or less). Relationship between the healthy diet score and results were affirmed in five free studies including a total of 96,955 patients with CVD for 70 countries.
Dr. Mente said: “This was by far the most diverse study of nutrition and health outcomes in the world and the only one with sufficient representation from high-, middle- and low-income countries. The connection between the PURE diet and health outcomes was found in generally healthy people, patients with CVD, patients with diabetes, and across economies.”
“The associations were strongest in areas with the poorest quality diet, including South Asia, China and Africa, where calorie intake was low and dominated by refined carbohydrates. This suggests that a large proportion of deaths and CVD in adults around the world may be due to undernutrition, that is, low intakes of energy and protective foods, rather than overnutrition. This challenges current beliefs,” said Professor Salim Yusuf, senior author and principal investigator of PURE.
In an accompanying editorial, Dr. Dariush Mozaffarian of the Friedman School of Nutrition Science and Policy, Tufts University, Boston, US stated: “The new results in PURE, in combination with prior reports, call for a re-evaluation of unrelenting guidelines to avoid whole-fat dairy products. Investigations such as the one by Mente and colleagues remind us of the continuing and devastating rise in diet-related chronic diseases globally, and of the power of protective foods to help address these burdens. It is time for national nutrition guidelines, private sector innovations, government tax policy and agricultural incentives, food procurement policies, labelling and other regulatory priorities, and food-based healthcare interventions to catch up to the science. Millions of lives depend on it.”
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