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. 2011 Jun 21;123(24):2870-91.
doi: 10.1161/CIRCULATIONAHA.110.968735.

Components of a cardioprotective diet: new insights

Dariush Mozaffarian  1 , Lawrence J Appel, Linda Van Horn
Affiliations

Components of a cardioprotective diet: new insights

Dariush Mozaffarian et al. Circulation. .
No abstract available

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Figures

Figure 1.
Figure 1.
Relationships of consumption of different foods with incidence of coronary heart disease (CHD), stroke, and diabetes in meta-analyses of prospective cohort studies (PCs). Adapted with permission from Mozaffarian. Dashes indicate not reported; CVD, cardio-vascular disease; and RR (95% CI), relative risk (95% confidence interval).
Figure 2.
Figure 2.
Types of processing and structure of grains, sugars, and starches. A major research and policy gap is the absence of one accepted taxonomy to define whole grains or carbohydrate quality that incorporates their various characteristics that can influence car-diometabolic health, including extent of processing, food structure, dietary fiber content, content of bran and germ, and glycemic response to ingestion. This Figure presents a proposed taxonomy to integrate these various characteristics. Types of foods with evidence for cardiometabolic benefits are shaded green, and those with evidence for adverse cardiometabolic effects are shaded red. Intact and minimally processed whole grains (darker green; ie, greater benefits) may plausibly have greater benefits than milled whole grains (lighter green; ie, lesser benefits) because of intact food structure and lower glycemic response; refined sugars in liquid form (darkest red, ie, greatest harms) may have greater adverse effects than refined grains, starches, and sugars (lighter red; ie, lesser harms) because of particularly unfavorable effects on satiety and weight gain. † Both simple and complex refined carbohydrates induce similarly high glycemic responses following ingestion and, in amounts typically consumed in Western diets, induce de novo lipogenesis in the liver, ie, the conversion of carbohydrates to fat. Compared to glucose, fructose produces smaller blood glycemic responses but more strongly stimulates de novo lipogenesis, Animal-experimental and limited human studies suggest that fructose, which represents about half of all sugars in refined sugars such as either high frucose corn syrup or sucrose (eg, cane sugar, beet sugar), may have additional adverse effects on hepatic steatosis and insulin resistance. Corn provides reasonable fiber and modestly lower glycemic responses than many types of potatoes. Yams and sweet potatoes are not included herein because of higher nutrient contents and lower glycemic responses to ingestion.
Figure 3.
Figure 3.
Effects of dietary patterns on cardiovascular risk factors in randomized controlled trials. Effects of the DASH (Dietary Approaches to Stop Hypertension) low-fat, high-protein, and high-monounsaturated-fat (MUFA) diets compared with baseline among 162 participants in a 6-week feeding trial; and of the Mediterranean diet compared with a low-fat diet among 180 participants in a 2-year dietary advice trial.,, All differences were statistically significant at P<0.05, except for changes in high-density lipoprotein cholesterol (HDL-C) with the DASH high-MUFA diet and in triglycerides with the DASH low-fat diet. Where no results are shown (eg, DASH diets and glucose-insulin measures), findings were not reported. Across diets, blood pressure and low-density lipoprotein cholesterol (LDL-C) were generally improved to a greater extent with DASH dietary patterns, whereas atherogenic dyslipidemia and glucose-insulin measures were generally improved to a greater extent with Mediterranean dietary patterns. Overall risk factor changes with any of these dietary patterns would predict substantial reductions in cardiovascular risk. SBP indicates systolic blood pressure; DBP, diastolic blood pressure; CRP, C-reactive protein.
Figure 4.
Figure 4.
Dietary sources of sodium in the United States, 2005 to 2006. Data source: Applied Research Program, National Cancer Institute. Reprinted with permission from the Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010.
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