A Review of Dietary Influences on Cardiovascular Health: Part 2: Dietary Patterns
Clare Stradling, Mash Hamid, Shahrad Taheri and G. Neil Thomas
Affiliation: University of Birmingham, Heart of England NHS Foundation Trust HIV Service, Birmingham, UK.
Keywords: Cardiovascular disease, diet therapy, dietary approach to stop hypertension, dietary patterns, heart disease, low
carbohydrate diet, mediterranean diet, plant based diet.
Dietary recommendations are key to cardiovascular disease (CVD) management. The underpinning evidence is
generally based on data generated from single nutrient or food types. However, food is not consumed in such a manner,
and components may interact synergistically or antagonistically depending on the dietary composition. Analyses of
dietary patterns have attempted to address these important issues. The aim of this review is to present the current evidence
on three major dietary patterns and their relationship with CVD.
The most widely reported is the Mediterranean diet, which is characterised by abundant use of olive oil, and plant-based
foods, moderate consumption of fish, dairy products, alcohol with meals, and a relatively low intake of red meat. The
strongest evidence of causality has been established for the Mediterranean diet and unlike other dietary patterns has been
shown to significantly reduce major CVD events.
The Dietary Approach to Stop Hypertension (DASH), emphasising fruit, vegetables and low fat dairy products, has
successfully been shown to lower blood pressure and cholesterol levels. However, its true effects on CVD under freeliving
conditions have yet to be fully explored. The available evidence is encouraging for CVD prevention, but long-term
effectiveness is unclear.
Very low-carbohydrate diets appear to exert their favourable effect on CVD risk factors via weight loss. However, longterm
effectiveness and safety remains unclear.
The available evidence supports the role of the DASH and Mediterranean diets in the prevention of CVD.
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