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Eur J Prev Cardiol. 2019 Sep;26(13):1415-1429. doi: 10.1177/2047487319843667. Epub 2019 Apr 11.

Dietary components and risk of cardiovascular disease and all-cause mortality: a review of evidence from meta-analyses.

Author information

1 Keele Cardiovascular Research Group, Keele University, UK.
2 Department of Cardiology, Royal Stoke University Hospital, UK.
3 College of Medicine Phoenix, University of Arizona, USA.
4 Department of Medicine/Cardiology, The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, USA.
5 Research Institute for Primary Care and Health Sciences, Keele University, UK.
6 Norwich Medical School, University of East Anglia, UK.



The optimal diet for cardiovascular health is controversial. The aim of this review is to summarize the highest level of evidence and rank the risk associated with each individual component of diet within its food group.


A systematic search of PudMed was performed to identify the highest level of evidence available from systematic reviews or meta-analyses that evaluated different dietary components and their associated risk of all-cause mortality and cardiovascular disease. A total of 16 reviews were included for dietary food item and all-cause mortality and 17 reviews for cardiovascular disease. Carbohydrates were associated with a reduced risk of all-cause mortality (whole grain bread: relative risk (RR) 0.85, 95% confidence interval (CI) 0.82-0.89; breakfast cereal: RR 0.88, 95% CI 0.83-0.92; oats/oatmeal: RR 0.88, 95% CI 0.83-0.92). Fish consumption was associated with a small benefit (RR 0.98, 95% CI 0.97-1.00) and processed meat appeared to be harmful (RR 1.25, 95% CI 1.07-1.45). Root vegetables (RR 0.76, 95% CI 0.66-0.88), green leafy vegetables/salad (RR 0.78, 95% CI 0.71-0.86), cooked vegetables (RR 0.89, 95% CI 0.80-0.99) and cruciferous vegetables (RR 0.90, 95% CI 0.85-0.95) were associated with reductions in all-cause mortality. Increased mortality was associated with the consumption of tinned fruit (RR 1.14, 95% CI 1.07-1.21). Nuts were associated with a reduced risk of mortality in a dose-response relationship (all nuts: RR 0.78, 95% CI 0.72-0.84; tree nuts: RR 0.82, 95% CI 0.75-0.90; and peanuts: RR 0.77, 95% CI 0.69-0.86). For cardiovascular disease, similar associations for benefit were observed for carbohydrates, nuts and fish, but red meat and processed meat were associated with harm.


Many dietary components appear to be beneficial for cardiovascular disease and mortality, including grains, fish, nuts and vegetables, but processed meat and tinned fruit appear to be harmful.


Diet; epidemiology; systematic review


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