Dietary choices and the risk of heart disease

Researchers from the Population Health Research Institute, in Ontario, Canada evaluated the effects of dietary options on the risk of heart disease.

It’s a good article for those of us who like neat lists.

First, the details.

• 189 studies were reviewed.
• The relationship between each dietary factor and heart disease was evaluated using Bradford-Hill guidelines for the following criteria.
  • Strength of association (statistical testing)
  • Consistency of relationship (based on more than 1 study)
  • Temporal association (outcome followed exposure)
  • Coherence of evidence (doesn’t conflict with current evidence)

Their findings, with links added for further reading.

• Strong evidence of a reduced risk of heart disease
  • Vegetables
  • Nuts
  • Monounsaturated fatty acids
  • Mediterranean diet
• Modest evidence of a reduced risk of heart disease
  • Fish
  • Omega-3 fatty acids from marine sources
  • Folate
  • Whole grains
  • Alcohol
  • Fruits
  • Fiber
  • Dietary vitamins E and C and beta-carotene
• Weak evidence of a reduced risk of heart disease
  • Supplemental vitamin E and vitamin C
  • Saturated and polyunsaturated fatty acids
  • Total fats
  • Alpha-linoleic acid (ALA) (found in many vegetable oils)
  • Meat, eggs, and milk
• Harmful factors
  • Trans-fatty acids
  • Foods with a high glycemic index or load
  • Western dietary pattern

The bottom line?
“Taken together, these findings support a causal relationship between only a few dietary exposures and coronary heart disease, whereas the evidence for most individual nutrients or foods is too modest to be conclusive,” concluded the authors.

Among the dietary factors with strong evidence for a cause and effect relationship, only the Mediterranean diet is related to coronary heart disease based on a the results of a randomized clinical study.

4/17/09 14:54 JR