Newswise — Sophia Antipolis, 7 July 2023:According to a recent study published in the European Heart Journal, a journal of the European Society of Cardiology, it has been found that including or excluding unprocessed red meat and whole grains in a healthy diet may not significantly impact the overall outcomes. The study was conducted across 80 countries on all inhabited continents.
The research revealed that diets emphasizing the consumption of fruits, vegetables, dairy (especially whole-fat), nuts, legumes, and fish were associated with a reduced risk of cardiovascular disease (CVD) and premature death across all regions of the world. Surprisingly, the addition or omission of unprocessed red meat or whole grains had minimal effects on these outcomes.
Dr. Andrew Mente, the study's author from McMaster University's Population Health Research Institute in Hamilton, Canada, highlighted that low-fat foods have often received significant attention from the public, food industry, and policymakers, with a focus on reducing fat and saturated fat. However, the findings of this study suggest that it might be more beneficial to prioritize the inclusion of protective foods like nuts (which are sometimes avoided due to their high energy content), fish, and dairy, rather than severely restricting dairy intake, especially whole-fat dairy.
The study results indicate that up to two servings of dairy per day, particularly whole-fat dairy, can be part of a healthy diet. This aligns with modern nutritional science, which suggests that dairy, especially whole-fat dairy, may have protective effects against high blood pressure and metabolic syndrome.
In a global population study, researchers examined the correlations between a newly developed diet score and various health outcomes. The diet score was based on six specific foods that have previously been associated with increased longevity. The PURE diet, which was considered healthy, consisted of 2-3 servings of fruit and vegetables per day, 3-4 servings of legumes per week, 7 servings of nuts per week, 2-3 servings of fish per week, and 14 servings of dairy products (primarily whole-fat, excluding butter or whipped cream) per week. Each food component was assigned a score of 1 for intake above the median in the group, indicating a healthy intake, and a score of 0 for intake at or below the median, indicating an unhealthy intake. This resulted in a total score ranging from 0 to 6, with a higher score indicating a healthier diet. Dr. Mente, one of the study authors, explained that participants who ranked in the top 50% of the population for each of the six food components achieved the maximum diet score of six, which was an attainable level.
The study, known as PURE, involved 147,642 individuals from the general population across 21 countries. The researchers assessed the associations between the diet score and various health outcomes, including mortality, myocardial infarction (heart attack), stroke, and overall cardiovascular disease (which encompassed fatal cardiovascular events, non-fatal heart attacks, strokes, and heart failure). The analyses were adjusted to account for factors that could influence these relationships, such as age, sex, waist-to-hip ratio, education level, income, urban or rural location, physical activity, smoking status, diabetes, use of statins or high blood pressure medications, and total energy intake.
The average diet score in the study was 2.95. Over a median follow-up period of 9.3 years, there were 15,707 deaths and 40,764 cardiovascular events recorded. When comparing the least healthy diet (score of 1 or less) with the healthiest diet (score of 5 or more), it was found that the latter was associated with a 30% lower risk of death, an 18% lower likelihood of cardiovascular disease (CVD), a 14% lower risk of myocardial infarction (heart attack), and a 19% lower risk of stroke. These associations between the healthy diet score and outcomes were confirmed in five independent studies, involving a total of 96,955 patients with CVD across 70 countries.
Dr. Mente, one of the study authors, highlighted that this research was the most diverse and comprehensive study of its kind, with representation from high-, middle-, and low-income countries. The connection between the PURE diet and health outcomes was observed in various groups, including generally healthy individuals, patients with CVD, patients with diabetes, and across different economies.
The study also revealed that the associations between the healthy diet score and outcomes were particularly robust in regions with lower-quality diets, such as South Asia, China, and Africa, where calorie intake was low and predominantly consisted of refined carbohydrates. This suggests that a significant proportion of deaths and CVD cases worldwide may be attributable to undernutrition, characterized by inadequate energy intake and a lack of consumption of protective foods, rather than overnutrition. These findings challenge existing beliefs.
In an accompanying editorial, Dr. Dariush Mozaffarian of Tufts University emphasized the need to re-evaluate guidelines that advocate for the avoidance of whole-fat dairy products. The results of the study, along with previous reports, underscore the urgent need to address the escalating burden of diet-related chronic diseases globally. Protective foods have the potential to play a vital role in mitigating these health challenges. Dr. Mozaffarian called for alignment of national nutrition guidelines, private sector initiatives, government policies related to taxation and agricultural incentives, food procurement practices, labeling regulations, and food-based healthcare interventions with the latest scientific evidence. Numerous lives depend on these collective efforts.
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