Dietary patterns and CVD: a systematic review and meta-analysis of observational studies.Br J Nutr 2015; 114(9):1341-59BJ
Epidemiological studies show that diet is linked to the risk of developing CVD. The objective of this meta-analysis was to estimate the association between empirically derived dietary patterns and CVD. PubMed was searched for observational studies of data-driven dietary patterns that reported outcomes of cardiovascular events. The association between dietary patterns and CVD was estimated using a random-effects meta-analysis with 95 % CI. Totally, twenty-two observational studies met the inclusion criteria. The pooled relative risk (RR) for CVD, CHD and stroke in a comparison of the highest to the lowest category of prudent/healthy dietary patterns in cohort studies was 0·69 (95% CI 0·60, 0·78; I 2=0%), 0·83 (95% CI 0·75, 0·92; I 2=44·6%) and 0·86 (95% CI 0·74, 1·01; I 2=59·5%), respectively. The pooled RR of CHD in a case-control comparison of the highest to the lowest category of prudent/healthy dietary patterns was 0·71 (95% CI 0·63, 0·80; I 2=0%). The pooled RR for CVD, CHD and stroke in a comparison of the highest to the lowest category of western dietary patterns in cohort studies was 1·14 (95% CI 0·92, 1·42; I 2=56·9%), 1·03 (95% CI 0·90, 1·17; I 2=59·4%) and 1·05 (95% CI 0·91, 1·22; I 2=27·6%), respectively; in case-control studies, there was evidence of increased CHD risk. Our results support the evidence of the prudent/healthy pattern as a protective factor for CVD.