Kwok et al., 2019

Kwok, C. S., Gulati, M., Michos, E. D., Potts, J., Wu, P., Watson, L., ... & Mamas, M. A. (2019). Dietary components and risk of cardiovascular disease and all-cause mortality: a review of evidence from meta-analyses. European journal of preventive cardiology, 26(13), 1415-1429

https://academic.oup.com/eurjpc/article/26/13/1415/5925961

Abstract

Methods

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.

Results

• 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)
• processed meat appeared to be harmful (RR 1.25, 95% CI 1.07–1.45).
• reductions in all-cause mortality from:
  • 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)
  • cruciferous vegetables (RR 0.90, 95% CI 0.85–0.95).
• 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
  • 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.

Conclusions

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.

red and processed meat

Combined the results of 17 reviews (!) on the link between various food groups and all cause mortality and CVD mortality. They found that Red meat showed a RR for CVD of 1.15 (.1.05,1.26, 6 studies) per 100g eaten a day and processed meats (RR 1.24, 1.09-1.4, 6 studies) per 50g eaten a day.

Soy products

Soy products as compared by highest and lowest consumers showed lower risk of cardiovascular disease (RR 0.83 (0.75-0.93)), which was comparable to the numbers for olive oil 25g per day (0.82)

RR's were inconclusive for eggs (high vs low consumption), RR = 0.97 0.9 - 1.05, and white meat 100g per day RR 1, 0.87-1.15