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Am J Public Health. 2016 Sep;106(9):1616-23. doi: 10.2105/AJPH.2016.303316. Epub 2016 Jul 26.

Diet, Lifestyle, Biomarkers, Genetic Factors, and Risk of Cardiovascular Disease in the Nurses' Health Studies.

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Edward Yu, Eric Rimm, Qi Sun, Walter C. Willett, and Frank B. Hu are with the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA. Lu Qi is with the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Kathryn Rexrode, Christine M. Albert, and JoAnn E. Manson are with the Brigham and Women's Hospital and Harvard Medical School, Boston.



To review the contributions of the Nurses' Health Studies (NHSs) to the understanding of cardiovascular disease etiology in women.


We performed a narrative review of the publications of the NHS and NHS II between 1976 and 2016.


Diets low in trans fat, saturated fat, refined carbohydrates, and sugar-sweetened beverages and rich in fruits and vegetables, whole grains, and sources of unsaturated fats are associated with reduced risk of cardiovascular disease. Healthy lifestyle choices include smoking avoidance, regular physical activity, maintaining a normal body mass index, and moderate alcohol consumption. Adherence to a combination of these healthy diet and lifestyle behaviors may prevent most vascular events. Studies also covered oral contraceptive use, postmenopausal hormone therapy, shift work, sleep duration, psychosocial factors, and various biomarkers and genetic factors. Findings, such as the association of trans fat with cardiovascular disease, have helped shaped medical guidelines and government policies.


The NHS has provided compelling evidence that the majority of vascular events may be prevented by avoiding smoking, participating in regular physical activity, maintaining normal body mass index, and eating a healthy diet.

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