Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System

In the paper

“Non-communicable diseases (NCDs) are forecasted to increase substantially in LMIC because of lifestyle transitions associated with increasing urbanization, economic development and globalization.”

In the paper

“These unhealthy diets are facilitated by modern food environments, a problem that is likely to become more widespread as food environments in LMIC shift to resemble those of HIC (5,7,8).”

What the sources say

• Not checked yetcites [5] 2007
• Not checked yetcites [7] 2010
• Not checked yetcites [8] Popkin, 2012, Global nutrition transition and the pandemic of obesity in developing countries, Nutr Rev source

In the paper

“Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however major gaps exist both in dietary pattern research and ways to change diets and food systems.”

In the paper

“These unhealthy diets are facilitated by modern food environments, a problem that is likely to become more widespread as food environments in LMIC shift to resemble those of HIC (5,7,8).”

What the sources say

• Not checked yetcites [5] 2007
• Not checked yetcites [7] 2010
• Not checked yetcites [8] Popkin, 2012, Global nutrition transition and the pandemic of obesity in developing countries, Nutr Rev source

In the paper

“Data relating diet to cardiovascular diseases (CVDs) has predominantly been generated from high-income countries (HIC), but over 80% of CVD deaths occur in low- and middle-income countries (LMIC).”

In the paper

“There are large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries (LMIC), particularly linked with dietary patterns are reviewed.”

In the paper

“Based on the current evidence, the traditional Mediterranean-type diet, including plant foods/emphasizing plant protein sources, provides a well-tested healthy dietary pattern to reduce CVD.”

In the paper

“State intervention in most LMICs, took a different form, such as policies to subsidize food, taxes on agricultural producers; and systems to control the supply and marketing of key commodities (19–22).”

What the sources say

• Not checked yetcites [19] Rashid, 2008
• Not checked yetcites [20] Anderson, 2010
• Not checked yetcites [21] 2007
• Not checked yetcites [22] Pinstrup-Andersen, 1988

In the paper

“These investments and changes in production systems were designed to make calories from staples (e.g., wheat, corn, rice) cheaply available, in order to simultaneously address hunger in LMIC and national food insecurity in HICs (23).”

What the sources say

• Not checked yetcites [23] Lang, 2003

In the paper

“Food systems were once dominated by local production for local markets, with relatively little processing before foods reached the household (see Supplementary Box 1) (12).”

What the sources say

• Not checked yetcites [12] Weis, 2007

In the paper

“Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however major gaps exist both in dietary pattern research and ways to change diets and food systems.”

In the paper

“The major actors who control this system have changed dramatically in HIC and LMIC, as described below (13).”

What the sources say

• Not checked yetcites [13] Reardon, 2014, The quiet revolution in Asia's rice value chains, Ann N Y Acad Sci source

In the paper

“and the overall proportion of highly processed food in diets has grown (50,51).”

What the sources say

• Not checked yetcites [50] Monteiro, 2013, Ultra-processed products are becoming dominant in the global food system, Obes Rev source
• Not checked yetcites [51] Poti, 2015, Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households?, Am J Clin Nutr source

In the paper

“First is the shift to refined carbohydrates – refined grains and added sugars.”

In the paper

“As a result of these changes, the transformation of raw commodities into food and the distribution of consumable food items beyond the farm gate has become far more important (31).”

What the sources say

• Not checked yetcites [31] Hawkes, 2012, Linking agricultural policies with obesity and noncommunicable diseases: A new perspective for a globalising world, Food Policy source

In the paper

“Today integration and control of our farm to fork food supply by major agribusinesses, food manufacturers, retailers, food service companies is more the rule that the exception (13).”

What the sources say

• Not checked yetcites [13] Reardon, 2014, The quiet revolution in Asia's rice value chains, Ann N Y Acad Sci source

In the paper

“Snacking and snack foods have grown in frequency and number (43–48); eating frequency has increased;”

In the paper

“away-from-home-eating in restaurants, in fast food outlets, and from take-out meals is increasing dramatically in LMIC;”

In the paper

“Today in the US packaged and processed food supply over 75% of foods have some form of added sugar (60).”

What the sources say

• Not checked yetcites [60] Ng, 2012, Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005–2009, J Acad Nutr Diet source

In the paper

“Retailing has been transformed in LMIC through the growth of supermarkets (18,38–41).”

What the sources say

• Not checked yetcites [18] Popkin, 2008
• Not checked yetcites [38] Khandelwal, 2013, Eliciting a policy response for the rising epidemic of overweight-obesity in India, Obes Rev source
• Not checked yetcites [39] Wilde, 2013
• Not checked yetcites [40] 2006
• Not checked yetcites [41] Hawkes, 2010, An overview of global food trade

In the paper

“This model has spread unevenly to most LMIC (35–37).”

What the sources say

• Not checked yetcites [35] Neven, 2009, Kenyan supermarkets, emerging middle-class horticultural farmers, and employment impacts on the rural poor, World Dev source
• Not checked yetcites [36] Reardon, 2012, Supermarket revolution in Asia and emerging development strategies to include small farmers, Proceedings of the National Academy of Sciences source
• Not checked yetcites [37] Reardon, 2012, The economics of the food system revolution, Ann Rev Res Econ source

In the paper

“Rapidly increasing production of starchy staples combined with processing technologies mean that refined flour is increasingly dominant in diets.”

In the paper

“Vegetable oil consumption remains two times higher in HIC than in LMIC.”

In the paper

“and plant n-3 ranged from <≈100 to 5,542 mg (global mean: 1,371 mg) per day (65).”

What the sources say

• Not checked yetcites [65] Micha, 2014, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, Br Med J source

In the paper

“Country-specific omega 6 consumption ranged from ≈1 to 13% (global mean: 6%) of energy;”

What the sources say

• Not checked yetcites [65] Micha, 2014, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, Br Med J source

In the paper

“dietary cholesterol consumption ranged from ≈97 to 440 mg (global mean: 228 mg) per day;”

What the sources say

• Not checked yetcites [65] Micha, 2014, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, Br Med J source

In the paper

“This process is accelerating across all LMIC markets (13,82,83).”

What the sources say

• Not checked yetcites [13] Reardon, 2014, The quiet revolution in Asia's rice value chains, Ann N Y Acad Sci source
• Not checked yetcites [82] Zhou, 2015, The food retail revolution in China and its association with diet and health, Food Policy source
• Not checked yetcites [83] Popkin, 2014, Nutrition, agriculture and the global food system in low and middle income countries, Food Policy source

In the paper

“trans-fat consumption ranged from ≈0.2 to 6.5% (global mean: 1%) of energy;”

What the sources say

• Not checked yetcites [65] Micha, 2014, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, Br Med J source

In the paper

“A fourth key change is the marked growth of purchases of all packaged foods and beverages (all categories of processing).”

In the paper

“seafood n-3 ranged from ≈35 to 3,886 mg (global mean: 163 mg) per day;”

What the sources say

• Not checked yetcites [65] Micha, 2014, Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys, Br Med J source

In the paper

“Between 1958 and 1996, a major global shift occurred in the amount and types of available fats, with soybean, palm, and rapeseed/canola oils replacing butter, tallow, and lard.”

In the paper

“A meta-analysis of 10 prospective cohort studies (n=296,849) (107) found increased GL associated with a 27% increased coronary heart disease (CHD) and MI risk (108).”

What the sources say

• Not checked yetcites [107] Mirrahimi, 2012, Associations of glycemic index and load with coronary heart disease events: a systematic review and meta-analysis of prospective cohorts, J Am Heart Assoc source
• Not checked yetcites [108] Mattei, 2011, A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults, Am J Clin Nutr source

In the paper

“A fifth trend noted above in relation to the added sugar change is the shift in the way LMIC are experiencing a marked increase in added sugar in beverages.”

In the paper

“Data from the international Prospective Urban and Rural Epidemiological Study (PURE; 138,926 individuals in 628 communities 17 countries) suggest a need to consider the context and availability of specific foods before making food choice recommendations (114).”

What the sources say

• Not checked yetcites [114] Yusuf, 2014, Cardiovascular risk and events in 17 low-, middle-, and high-income countries, N Engl J Med source

In the paper

“In addition, fruit and vegetable intake has remained inadequate.”

In the paper

“Fruit and vegetable consumption is substantially higher in HIC compared to LMIC (88).”

What the sources say

• Not checked yetcites [88] Blisard, 2004

In the paper

“Hall’s estimate to home food waste of about 1400 kcal/capita for the US adds up to 25–45% waste of total food for some HIC (101).”

What the sources say

• Not checked yetcites [101] Hall, 2009, The progressive increase of food waste in America and its environmental impact, PLoS One source

In the paper

“The shift to ultra-processed foods has not just affected the food available for consumption but also the way food is consumed (87).”

What the sources say

• Not checked yetcites [87] Ng, 2014, The Healthy Weight Commitment Foundation Marketplace Commitment and Consumer Packaged Goods purchased by US households with children, Am J Prev Med source

In the paper

“A large Danish prospective cohort study of the impact of replacing saturated fats with high-GI carbohydrates found that when high-GI carbohydrates replace saturated fat, myocardial infarction (MI) risk increases 33% (106).”

What the sources say

• Not checked yetcites [106] Jakobsen, 2010, Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index, Am J Clin Nutr source

In the paper

“Robust data from systematic reviews and high-quality RCTs support a harmful effect of highly-refined, high-glycemic-load carbohydrates.”

In the paper

“In East Asian countries, white rice consumption is associated with a 55% higher T2DM risk (111,112).”

What the sources say

• Not checked yetcites [111] Hu, 2012, White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review, BMJ source
• Not checked yetcites [112] Aune, 2013, Whole grain and refined grain consumption and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis of cohort studies, Eur J Epidemiol source

In the paper

“A meta-analysis of observational studies indicated that high–glycemic index (GI) foods are associated with T2DM (103).”

What the sources say

• Not checked yetcites [103] Bhupathiraju, 2014, Glycemic index, glycemic load, and risk of type 2 diabetes: results from 3 large US cohorts and an updated meta-analysis, Am J Clin Nutr source

In the paper

“Replacing white with brown rice (50 grams/day) reduced T2DM risk by 16% (113),”

What the sources say

• Not checked yetcites [113] Sun, 2010, White rice, brown rice, and risk of type 2 diabetes in US men and women, Arch Intern Med source

In the paper

“Overall, 77.6% of men and 78.4% of women consumed less than the minimum recommended five daily servings of fruits and vegetables.”

What the sources say

• Not checked yetcites [89] Hall, 2009, The progressive increase of food waste in America and its environmental impact, PLoS One source

In the paper

“Analysis of 52 LMIC countries taking part in the World Health Survey (2002–2003) (89) found that low fruit and vegetable consumption (i.e., less than 5 fruits and vegetables per day) prevalence ranged from 36.6% (Ghana) to 99.2% (Pakistan) for men and from 38.0% (Ghana) to 99.3% (Pakistan) for women.”

What the sources say

• Not checked yetcites [89] Hall, 2009, The progressive increase of food waste in America and its environmental impact, PLoS One source

In the paper

“However, a 16-week randomized trial of replacing white with brown rice in middle-aged Chinese men and women with or at high risk for T2DM only improved HDL-C and reduced DBP in the brown rice group.”

In the paper

“In the cross-sectional CURES 57 study, higher refined grain intake was associated with higher waist circumference, systolic and diastolic blood pressure (SBP and DBP), fasting glucose, triglycerides, and insulin resistance and lower HDL-C levels (61).”

What the sources say

• Not checked yetcites [61] Radhika, 2009, Refined grain consumption and the metabolic syndrome in urban Asian Indians (Chennai Urban Rural Epidemiology Study 57), Metabolism source

In the paper

“Waste affects the entire food system from production to post harvest (including inside the home) (102).”

What the sources say

• Not checked yetcites [102] Parfitt, 2010, Food waste within food supply chains: quantification and potential for change to 2050, Phil Trans R Soc B: Bio Sci source

In the paper

“and substituting beans for white rice reduced the odds of metabolic syndrome by 35% (108).”

What the sources say

• Not checked yetcites [108] Mattei, 2011, A higher ratio of beans to white rice is associated with lower cardiometabolic risk factors in Costa Rican adults, Am J Clin Nutr source

In the paper

“Traditional diets in LMIC, once rich in whole grains and dietary fiber, now include highly refined carbohydrates, such as polished white rice and refined flours.”

In the paper

“T2DM risk in individuals with the highest glycemic load (GL) and lowest cereal fiber is 2.5-fold that of those with the lowest GL and highest cereal fiber diet (105).”

What the sources say

• Not checked yetcites [105] Salmeron, 1997, Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women, JAMA source

In the paper

“for example, in the STOP-NIDDM trial, acarbose reduced progression to T2DM by 25% compared with placebo (104).”

What the sources say

• Not checked yetcites [104] Chiasson, 2002, Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial, Lancet source

In the paper

“Ecological evidence from the US demonstrates an association of refined carbohydrate (as corn syrup) with type 2 diabetes (T2DM) and obesity (54).”

What the sources say

• Not checked yetcites [54] Gross, 2004, Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment, Am J Clin Nutr source

In the paper

“After adjusting for important potential confounders, including body mass index (BMI), ≥ 1/d versus < 1 SSB/mo increased T2DM by 39% (127).”

What the sources say

• Not checked yetcites [127] Schulze, 2004, Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women, JAMA source

In the paper

“The epidemiological relationships between SSB consumption, overweight, obesity, hypertension, and T2DM are strong (122).”

What the sources say

• Not checked yetcites [122] World Health Organization. Draft Guidelines on free sugars released for public consultation. 2014. Geneva, Switzerland.

In the paper

“A meta-analysis of 4 cohort studies reported a linear association between SSB and hypertension risk [RR: 1.08 (95 % CI: 1.04, 1.12) per serving/d] (129).”

What the sources say

• Not checked yetcites [129] Johnson, 2007, Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease, Am J Clin Nutr source

In the paper

“and, after adjusting for dietary and non-dietary cardiovascular risk factors, a 16% increased stroke risk (134).”

What the sources say

• Not checked yetcites [134] Bernstein, 2012, Soda consumption and the risk of stroke in men and women, Am J Clin Nutr source

In the paper

“However, there are practically no data on the effects of SSBs on health outcomes from LMIC (136,137).”

What the sources say

• Not checked yetcites [136] Odegaard, 2010, Soft drink and juice consumption and risk of physician-diagnosed incident type 2 diabetes: the Singapore Chinese Health Study, Am J Epidemiol source
• Not checked yetcites [137] Hernández-Cordero, 2014, Substituting water for sugar-sweetened beverages reduces circulating triglycerides and the prevalence of metabolic syndrome in obese but not in overweight Mexican women in a randomized controlled trial, J Nutr

In the paper

“A meta-analysis of seven cohort studies and five randomized controlled trials (RCTs) found SSB’s increased weight by 0.12 kg/serving/year (95% confidence interval [CI]: 0.10–0.14) in adults (124).”

What the sources say

• Not checked yetcites [124] Malik, 2013, Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis, Am J Clin Nutr source

In the paper

“A meta-analysis of 310,819 participants and 15,043 cases of T2DM reported a 26% increased T2DM risk among those consuming 1–2 SSB servings/day compared to non-consumers (128).”

What the sources say

• Not checked yetcites [128] Malik, 2010, Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis, Diabetes Care source

In the paper

“The Framingham Offspring Study reported a 22% higher incidence of hypertension among those consuming ≥ 1 SSB serving/day compared with non-consumers (130).”

What the sources say

• Not checked yetcites [130] Dhingra, 2007, Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community, Circulation source

In the paper

“Facing health concerns, the beverage industry is shifting from full-calorie carbonated soft drinks (CSDs) to lower-calorie CSDs, coffees, and teas.”

In the paper

“Sugar-sweetened beverage (SSB) consumption accounts for up to 50% of added sugar in the American diet (120,121).”

What the sources say

• Not checked yetcites [120] Yang, 2014, Added sugar intake and cardiovascular diseases mortality among US adults, JAMA Intern Med source
• Not checked yetcites [121] 2014

In the paper

“A World Health Organization (WHO) systematic review reported similar positive associations (125).”

What the sources say

• Not checked yetcites [125] Te Morenga, 2013, Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies, Br Med J source

In the paper

“Both the HPFS and the NHS find a ≈20% increased CHD risk in the highest category of SSB consumption compared with the lowest category (132,133);”

What the sources say

• Not checked yetcites [132] De Koning, 2012, Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men, Circulation source
• Not checked yetcites [133] Fung, 2009, Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women, Circulation source

In the paper

“in large cohort studies, saturated fat is not associated with development of T2DM, after adjustment for BMI, total dietary fiber, or magnesium intake (144–149).”

What the sources say

• Not checked yetcites [144] Lindstrom, 2006, High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study, Diabetologia source
• Not checked yetcites [145] Meyer, 2001, Dietary fat and incidence of type 2 diabetes in older Iowa women, Diabetes Care source
• Not checked yetcites [146] Salmerón, 2001, Dietary fat intake and risk of type 2 diabetes in women, Am J Clin Nutr source
• Not checked yetcites [147] Simila, 2012, Carbohydrate substitution for fat or protein and risk of type 2 diabetes in male smokers, Eur J Clin Nutr source
• Not checked yetcites [148] Song, 2004, A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: The Women's Health study, Diabetes Care source
• Not checked yetcites [149] van Dam, 2002, Dietary fat and meat intake in relation to risk of type 2 diabetes in men, Diabetes Care source

In the paper

“A 2015 meta-analysis reported a relative risk for incident CHD of 1.17 (95 % CI: 1.10, 1.24) per serving/d increase in SSB consumption (129).”

What the sources say

• Not checked yetcites [129] Johnson, 2007, Potential role of sugar (fructose) in the epidemic of hypertension, obesity and the metabolic syndrome, diabetes, kidney disease, and cardiovascular disease, Am J Clin Nutr source

In the paper

“Similarly, two Swedish prospective cohort studies in women and men reported a relative risk (RR) of 1.19 (95% CI: 1.04 and 1.36) for stroke among those consuming ≥ 2 SSB servings/day (135).”

What the sources say

• Not checked yetcites [135] Larsson, 2014, Sweetened beverage consumption is associated with increased risk of stroke in women and men, J Nutr

In the paper

“Further, canola oil, as part of a low-glycemic index diet, improves glycemic control and blood lipids in type 2 diabetes (138).”

What the sources say

• Not checked yetcites [138] Jenkins, 2014, Effect of lowering the glycemic load with canola oil on glycemic control and cardiovascular risk factors: a randomized controlled trial, Diabetes Care source

In the paper

“Replacing saturated fat with high-GI carbohydrate increases MI risk by 33%, whereas replacing with low- and medium-GI carbohydrates appears neutral (106).”

What the sources say

• Not checked yetcites [106] Jakobsen, 2010, Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index, Am J Clin Nutr source

In the paper

“In a meta-analysis of 17 cohort studies (16 from Western countries), consumption of red and processed meat increased T2DM and CHD risk; but few included studies examined unprocessed red meat (169).”

What the sources say

• Not checked yetcites [169] Micha, 2010, Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus a systematic review and meta-analysis, Circulation source

In the paper

“The evidence suggests that processed meat consumption increases CHD risk, while unprocessed meat consumption has a small or no association with CHD, mainly when compared to refined starch and sugar.”

In the paper

“Saturated fats have not been consistently associated with CVD in meta-analyses of cohort studies (odds ratio [OR]: 1.07; 95% CI: 0.96–1.19) of higher compared with lower intakes (156).”

What the sources say

• Not checked yetcites [156] Siri-Tarino, 2010, Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease, Am J Clin Nutr source

In the paper

“The Lyon Diet Heart Study found regular consumption of ALA (canola oil) significantly reduced cardiac deaths and nonfatal CHD (163)”

What the sources say

• Not checked yetcites [163] de Lorgeril, 1994, Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease, Lancet source

In the paper

“Replacing saturated fat with highly refined carbohydrate is not associated with lower CHD risk, whereas replacing saturated fat with polyunsaturated fat reduces CHD risk (157,158).”

What the sources say

• Not checked yetcites [157] Mozaffarian, 2010, Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials, PLoS Med source
• Not checked yetcites [158] Jakobsen, 2009, Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies, Am J Clin Nutr source

In the paper

“Consumption of non-hydrogenated vegetable oils appears to be superior to consumption of animal fats (162).”

What the sources say

• Not checked yetcites [162] Halton, 2006, Low-carbohydrate diet score and the risk of coronary heart disease in women, N Engl J Med source

In the paper

“In a large meta-analysis of cohort studies (13,000 incident cases), and the EPIC InterAct case-cohort study (12,000 incident cases), fermented dairy (i.e., yogurt, cheese, and thick fermented milk), but not total dairy, was inversely associated with T2DM (155,183).”

What the sources say

• Not checked yetcites [155] Sluijs, 2012, The amount and type of dairy product intake and incident type 2 diabetes: results from the EPIC-InterAct Study, Am J Clin Nutr source
• Not checked yetcites [183] Chen, 2014, Dairy consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis, BMC Med source

In the paper

“Prospective studies consistently indicate adverse effects of trans-fats on CHD.”

In the paper

“Intake of red or processed meat was not associated with stroke, but only three studies evaluated these relationships (169).”

What the sources say

• Not checked yetcites [169] Micha, 2010, Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes mellitus a systematic review and meta-analysis, Circulation source

In the paper

“Potential mechanisms linking unprocessed red meat with CVD include saturated fat, cholesterol, iron, phosphatidylcholine, and carnitine; and cooking methods (e.g., barbecuing), that increase heterocyclic amine content and N-nitroso compounds, also implicated in colorectal cancer (167).”

What the sources say

• Not checked yetcites [167] Bastide, 2011, Heme iron from meat and risk of colorectal cancer: a meta-analysis and a review of the mechanisms involved, Cancer Prev Res source

In the paper

“One large case-control study in Costa Rica found that soybean oil consumption was associated with lower acute MI risk compared to palm oil consumption (165).”

What the sources say

• Not checked yetcites [165] Kabagambe, 2005, The type of oil used for cooking is associated with the risk of nonfatal acute myocardial infarction in Costa Rica, J Nutr

In the paper

“Both unprocessed and processed red meats are associated with greater CVD risk compared to poultry, fish, or vegetable protein sources.”

In the paper

“inclusion of n-3 fatty acids (ALA) with the vegetable oils is important for CHD prevention.”

In the paper

“The effect of replacing saturated fat with carbohydrate on CHD risk appears to depend on the quality of the carbohydrate.”

In the paper

“while the PREDIMED RCT found that a Mediterranean diet (50 grams/d extra virgin olive oil) reduced CVD events by 30% in over a five-year period (164).”

What the sources say

• Not checked yetcites [164] Estruch, 2013, Primary prevention of cardiovascular disease with a Mediterranean diet, N Engl J Med source

In the paper

“The consumption of dairy products has been associated with weight loss in small studies (174), but the overall literature does not confirm an important effect on body weight.”

What the sources say

• Not checked yetcites [174] Chen, 2012, Effects of dairy intake on body weight and fat: a meta-analysis of randomized controlled trials, Am J Clin Nutr source

In the paper

“The evidence suggests that processed meat consumption increases CHD risk, while unprocessed meat consumption has a small or no association with CHD, mainly when compared to refined starch and sugar.”

In the paper

“but palm oil would be preferred to partially hydrogenated oils high in trans-fatty acids.”

In the paper

“A recent pooled analysis of data from 296,721 individuals from Asian countries (i.e., Bangladesh, mainland China, Japan, Korea, and Taiwan) found no association between red meat and poultry consumption and CVD, cancer mortality, or all-cause mortality (173).”

What the sources say

• Not checked yetcites [173] Lee, 2013, Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies, Am J Clin Nutr source

In the paper

“However, in most of these studies the association of high saturated fat intake largely represents replacing highly refined carbohydrates.”

In the paper

“Based on controlled-feeding studies examining changes in blood lipids, replacing palm oil with unsaturated fatty acids would be expected to lower CHD risk (109)”

What the sources say

• Not checked yetcites [109] Mensink, 2003, Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials, Am J Clin Nutr source

In the paper

“extra virgin olive oil appears to reduce CVD.”

In the paper

“Replacing saturated fat with highly refined carbohydrate is not associated with lower CHD risk, whereas replacing saturated fat with polyunsaturated fat reduces CHD risk (157,158).”

What the sources say

• Not checked yetcites [157] Mozaffarian, 2010, Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials, PLoS Med source
• Not checked yetcites [158] Jakobsen, 2009, Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies, Am J Clin Nutr source

In the paper

“Emerging evidence suggests that the effect of a saturated fat on CHD may depend on the type of fatty acid and the specific food source (i.e., dairy vs. meat) (160,161).”

What the sources say

• Not checked yetcites [160] de Oliveira Otto, 2012, Dietary intake of saturated fat by food source and incident cardiovascular disease: the Multi-Ethnic Study of Atherosclerosis, Am J Clin Nutr source
• Not checked yetcites [161] Hu, 1999, Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women, Am J Clin Nutr source

In the paper

“This benefit of polyunsaturated fat includes the primary n-6 polyunsaturated fatty acid, linoleic acid (158,159).”

What the sources say

• Not checked yetcites [158] Jakobsen, 2009, Major types of dietary fat and risk of coronary heart disease: a pooled analysis of 11 cohort studies, Am J Clin Nutr source
• Not checked yetcites [159] Farvid, 2014, Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies, Circulation source

In the paper

“Consumption of plant oils in a Mediterranean diet reduced CVD in two RCTs.”

In the paper

“Replacing saturated fat with high-GI carbohydrate increases MI risk by 33%, whereas replacing with low- and medium-GI carbohydrates appears neutral (106).”

What the sources say

• Not checked yetcites [106] Jakobsen, 2010, Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index, Am J Clin Nutr source

In the paper

“In observational studies (133,217–220) and RCTs (164,221–223) a Mediterranean diet including nuts lowers CVD risk.”

What the sources say

• Not checked yetcites [133] Fung, 2009, Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women, Circulation source
• Not checked yetcites [217] Trichopoulou, 2003, Adherence to a Mediterranean diet and survival in a Greek population, N Engl J Med source
• Not checked yetcites [218] Dilis, 2012, Mediterranean diet and CHD: the Greek European prospective investigation into cancer and nutrition cohort, Br J Nutr source
• Not checked yetcites [219] Mitrou, 2007, Mediterranean dietary pattern and prediction of all-cause mortality in a US population: results from the NIH-AARP Diet and Health Study, Arch Intern Med source
• Not checked yetcites [220] Buckland, 2009, Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study, Am J Epidemiol source
• Not checked yetcites [164] Estruch, 2013, Primary prevention of cardiovascular disease with a Mediterranean diet, N Engl J Med source

In the paper

“Collectively, these studies do not suggest a strong or consistent relationship between consumption of dairy products and T2DM and CVD risk.”

In the paper

“Unpublished data from three large international studies, PURE, ONTARGET, and INTERHEART, with collectively 200,000 individuals and 22,000 CVD events from regions including China, India, and Africa, show that moderate egg consumption appears to be neutral or protective against CVD.”

In the paper

“No RCT has tested the effect of egg consumption on CVD events.”

In the paper

“In a prospective cohort of 2,091 middle-aged Chinese men and women monitored for six years, individuals who reported consuming > 1 dairy serving/day were 35% less likely to develop T2DM (RR: 0.65; 95% CI: 0.49 and 0.85) than nonconsumers (185).”

What the sources say

• Not checked yetcites [185] Zong, 2013, Dairy consumption, type 2 diabetes and changes in cardiometabolic traits-a prospective cohort study of middle-aged and older Chinese in Beijing and Shanghai, Diabetes Care source

In the paper

“Overall, consumption of eggs in moderation (one egg/day) is likely neutral for CVD.”

In the paper

“In clinical trials nuts improve serum lipids (209) (210,211).”

What the sources say

• Not checked yetcites [209] Kris-Etherton, 2008, The role of tree nuts and peanuts in the prevention of coronary heart disease: multiple potential mechanisms, J Nutr
• Not checked yetcites [210] Sabaté, 2010, Nut consumption and blood lipid levels: a pooled analysis of 25 intervention trials, Arch Intern Med source
• Not checked yetcites [211] Banel, 2009, Effects of walnut consumption on blood lipids and other cardiovascular risk factors: a meta-analysis and systematic review, Am J Clin Nutr source

In the paper

“We know of no primary prevention trial on fish intake and CVD outcomes, but a meta-analysis of fish oil supplement RCTs is neutral (203).”

In the paper

“A meta-analysis showed that eggs increase TC, HDL-C, and TC:HDL-C,(188) but five RCTs subsequently reported that egg consumption did not significantly alter these parameters (189–191) or endothelial function (192,193).”

What the sources say

• Not checked yetcites [188] Weggemans, 2001, Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a meta-analysis, Am J Clin Nutr source

In the paper

“In clinical trials and meta-analyses of these trials the long-chain omega-3 polyunsaturated fatty acids in fish reduced multiple CVD risk factors, including vascular resistance, BP, inflammation, serum lipids, and endothelial function (197).”

What the sources say

• Not checked yetcites [197] Mozaffarian, 2011, Omega-3 fatty acids and cardiovascular disease: Effects on risk factors, molecular pathways, and clinical events, J Am Coll Cardiol source

In the paper

“Some prospective cohort studies find an inverse association between fish intake and CVD mortality, whereas others do not (198).”

What the sources say

• Not checked yetcites [198] Mozaffarian, 2006, Fish intake, contaminants, and human health: evaluating the risks and the benefits, JAMA source

In the paper

“In one meta-analysis of prospective cohorts, nuts were not associated with T2DM (214), but in another, they were protective (207).”

What the sources say

• Not checked yetcites [214] Guo, 2015, Meta-analysis of prospective studies on the effects of nut consumption on hypertension and type 2 diabetes mellitus, J Diabetes
• Not checked yetcites [207] Iso, 2006, Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I, Circulation source

In the paper

“However, no RCTs have assessed the effects of nut consumption alone on CVD events.”

In the paper

“In a prospective cohort study of 53,387 Japanese men and women, higher dairy calcium (173 mg/d vs. none) reduced risk for hemorrhagic stroke, ischemic stroke, and stroke mortality by ≈50% over a 10-year follow-up (184).”

What the sources say

• Not checked yetcites [184] Umesawa, 2006, Dietary intake of calcium in relation to mortality from cardiovascular disease the JACC Study, Stroke source

In the paper

“Taken together, the published data from observational studies and clinical trials support nuts for lowering CVD risk.”

In the paper

“However, relative to other protein-rich foods that lower LDL cholesterol, such as whole grains and nuts, eggs would likely increase CVD risk.”

In the paper

“In a meta-analysis of prospective cohort studies, milk consumption was inversely associated with total CVD in a small subset of studies with few cases, but using a larger body of data with more specific endpoints, milk was not associated with CHD or stroke (173).”

What the sources say

• Not checked yetcites [173] Lee, 2013, Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies, Am J Clin Nutr source

In the paper

“We know of no primary prevention trial on fish intake and CVD outcomes, but a meta-analysis of fish oil supplement RCTs is neutral (203).”

What the sources say

• Not checked yetcites [203] Rizos, 2012, Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis, JAMA source

In the paper

“Unpublished data from the PURE cohort indicate that nut consumption is very low in LMIC (60% of individuals consume ≤ 1 nut serving/week).”

In the paper

“A meta-analysis showed that eggs increase TC, HDL-C, and TC:HDL-C,(188) but five RCTs subsequently reported that egg consumption did not significantly alter these parameters (189–191) or endothelial function (192,193).”

What the sources say

• Not checked yetcites [189] Reaven, 2001, Insulin resistance, dietary cholesterol, and cholesterol concentration in postmenopausal women, Metabolism source
• Not checked yetcites [190] Goodrow, 2006, Consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations, J Nutr
• Not checked yetcites [191] Wenzel, 2006, A 12-wk egg intervention increases serum zeaxanthin and macular pigment optical density in women, J Nutr
• Not checked yetcites [192] Katz, 2005, Egg consumption and endothelial function: a randomized controlled crossover trial, Int J Cardiol source
• Not checked yetcites [193] Njike, 2010, Daily egg consumption in hyperlipidemic adults-Effects on endothelial function and cardiovascular risk, Nutr J source

In the paper

“Large global studies and systematic reviews of prospective cohorts generally support a protective role of fruits and vegetables against CVD (244–246).”

What the sources say

• Not checked yetcites [244] O'Donnell, 2010, Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study, Lancet source
• Not checked yetcites [245] Hu, 2014, Fruits and vegetables consumption and risk of stroke a meta-analysis of prospective cohort studies, Stroke source
• Not checked yetcites [246] Wang, 2014, Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies, Br Med J source

In the paper

“A legume-rich diet reduced HbA1c (−0.3%; 95% CI: −1.4, −0.1%) in an RCT in participants with diabetes (226).”

What the sources say

• Not checked yetcites [226] Jenkins, 2012, Effect of legumes as part of a low glycemic index diet on glycemic control and cardiovascular risk factors in type 2 diabetes mellitus: a randomized controlled trial, Arch Internal Med source

In the paper

“This suggests that while legumes are valuable to reduce CHD risk, more research is required to understand their impact on total stroke risk.”

In the paper

“In a cohort of Chinese men and women, soy (the primary legume consumed in China) was negatively correlated with TC and LDL-C (235).”

What the sources say

• Not checked yetcites [235] Ho, 2000, Intake of soy products is associated with better plasma lipid profiles in the Hong Kong Chinese population, J Nutr

In the paper

“In the global INTERSTROKE study (3,000 stroke cases and 3,000 controls), compared with fewer than 1 serving per day, 1 serving of fruit was protective against stroke (OR: 0.61, 95% CI: 0.50 to 0.73), but the benefits were not clear with higher consumption of up to 3 servings/d of vegetables was not t (OR: 0·91; 95% CI: 0.75 to 1.10) (244).”

What the sources say

• Not checked yetcites [244] O'Donnell, 2010, Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study, Lancet source

In the paper

“In a meta-analysis of five observational studies, 100 grams of legumes four times/week is inversely associated with CHD (RR: 0.86; 95% CI: 0.78–0.94) (232).”

What the sources say

• Not checked yetcites [232] Afshin, 2014, Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis, Am J Clin Nutr source

In the paper

“A population-based cross-sectional study in India found that women consuming legumes once/day were less likely to develop T2DM (OR: 0.55; 95% CI: 0.34–0.88; n=99,574).”

What the sources say

• Not checked yetcites [236] Agrawal, 2013, Association between legume intake and self-reported diabetes among adult men and women in India, BMC Public Health source

In the paper

“In unpublished INTERHEART data a one-serving/day increase in fruit decreased MI risk by 12% (RR: 0.88; 95% CI: 0.84–0.92); a one-serving/day increase in vegetables decreased MI risk by 5% (RR: 0.95; 95% CI: 0.92–0.97).”

In the paper

“A strong evidence base from observational studies indicates that high consumption of vegetables and fruits reduces CHD and stroke (196).”

What the sources say

• Not checked yetcites [196] Mente, 2009, A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease, Arch Intern Med source

In the paper

“A meta-analysis of 26 RCTs (1,037 participants) finds that 130 grams legumes/d (~1 serving) reduced LDL-C by 0.17 mmol/L (95% CI: −0.25, −0.09) (228).”

What the sources say

• Not checked yetcites [228] Liu, 2014, Serum free fatty acid biomarkers of lung cancer, Chest source

In the paper

“No associations between nut consumption and CVD outcomes is seen at this low level.”

In the paper

“A similar but non-significant trend was observed in men (OR: 0.70; 95% CI: 0.39–1.26; n=56,742) (236).”

What the sources say

• Not checked yetcites [236] Agrawal, 2013, Association between legume intake and self-reported diabetes among adult men and women in India, BMC Public Health source

In the paper

“A large prospective study of two cohorts of US health professionals found a 45% increased risk of ischemic stroke per daily serving of legumes (RR: 1.45; 95% CI: 1.06–2.00) (234).”

What the sources say

• Not checked yetcites [234] Bernstein, 2012, Dietary protein sources and the risk of stroke in men and women, Stroke source

In the paper

“In the global INTERSTROKE study (3,000 stroke cases and 3,000 controls), compared with fewer than 1 serving per day, 1 serving of fruit was protective against stroke (OR: 0.61, 95% CI: 0.50 to 0.73), but the benefits were not clear with higher consumption of up to 3 servings/d of vegetables was not t (OR: 0·91; 95% CI: 0.75 to 1.10) (244).”

What the sources say

• Not checked yetcites [244] O'Donnell, 2010, Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study, Lancet source

In the paper

“In a prospective cohort study of middle-aged Shanghai women, a ~50 gram/day increase in legume consumption over 4.6 years reduced T2DM risk by 38% (RR: 0.62; 95% CI: 0.51–0.74) (237).”

What the sources say

• Not checked yetcites [237] Villegas, 2008, Legume and soy food intake and the incidence of type 2 diabetes in the Shanghai Women's Health Study, Am J Clin Nutr source

In the paper

“In unpublished INTERHEART data a one-serving/day increase in fruit decreased MI risk by 12% (RR: 0.88; 95% CI: 0.84–0.92); a one-serving/day increase in vegetables decreased MI risk by 5% (RR: 0.95; 95% CI: 0.92–0.97).”

In the paper

“A major issue has been the lack of success in encouraging increased fruit and vegetable consumption by the citizens of western nations (248).”

What the sources say

• Not checked yetcites [248] Krebs-Smith, 2010, Americans do not meet federal dietary recommendations, J Nutr

In the paper

“A prospective cohort study of 64,915 Chinese women aged 40 to 70 (n=62 cases; follow-up 2 y) found that individuals consuming ≥ 11.2 grams/day of soy protein were less likely to develop CHD (RR: 0.25; 95% CI: 0.10 to 0.63) than those consuming ≤ 4.5 grams/day (238).”

What the sources say

• Not checked yetcites [238] Zhang, 2003, Soy food consumption is associated with lower risk of coronary heart disease in Chinese women, J Nutr

In the paper

“Large meta-analyses of observational studies support a ≈5–10% reduction in CVD mortality per serving per day (246), and a protective association of green leafy vegetables with T2DM (RR per 0.2 servings/day: 0.87; 95% CI: 0.81–0.93) (247).”

What the sources say

• Not checked yetcites [246] Wang, 2014, Fruit and vegetable consumption and mortality from all causes, cardiovascular disease, and cancer: systematic review and dose-response meta-analysis of prospective cohort studies, Br Med J source

In the paper

“Large meta-analyses of observational studies support a ≈5–10% reduction in CVD mortality per serving per day (246), and a protective association of green leafy vegetables with T2DM (RR per 0.2 servings/day: 0.87; 95% CI: 0.81–0.93) (247).”

What the sources say

• Not checked yetcites [247] Nerbass, 2014, Demographic associations of high estimated sodium intake and frequency of consumption of high-sodium foods in people with chronic kidney disease stage 3 in England, J Renal Nutr

In the paper

“A meta-analysis of three prospective cohorts (3,415 cases) found high adherence to the DASH eating reduced T2DM risk by 27% (243).”

What the sources say

• Not checked yetcites [243] Esposito, 2014, Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies, Endocrine source

In the paper

“The beneficial effects of fruits and vegetables appear consistent across regions of the world.”

In the paper

“Meta-analyses of CVD event trials did not report a significant reduction in CVD with lower sodium intake, but the included trials were underpowered to detect moderate risk reductions (258).”

What the sources say

• Not checked yetcites [258] Aburto, 2013, Effect of lower sodium intake on health: systematic review and meta-analyses, BMJ source

In the paper

“In summary, small and inconsistent cardiovascular benefit is seen in moderate drinkers, but a strong increase in CVD and stroke risk is seen with regular heavy alcohol consumption and binge drinking.”

In the paper

“In a dose-response meta-analysis of 24 prospective cohort studies (275), the association of drinking with CHD was J-shaped: non-drinkers were at slightly increased risk; in men the greatest protection was at 31 g/d with a trend for increased risk beginning at 63 g/d; for women, the greatest protection was at 11 g/d with a trend for increased risk beginning at 14 g/d.”

What the sources say

• Not checked yetcites [275] Zhang, 2014, Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies, Int J Cardiol source

In the paper

“In a meta-analysis of 27 prospective studies of alcohol and stroke, no association was found between light or moderate alcohol use and stroke, but heavy alcohol use (>45 g/d) was shown to increase total stroke risk (RR: 1.20; 95% CI: 1.01 to 1.43), particularly hemorrhagic stroke (RR: 1.29; 95% CI: 0.98 to 1.71) (275).”

What the sources say

• Not checked yetcites [275] Zhang, 2014, Alcohol intake and risk of stroke: a dose-response meta-analysis of prospective studies, Int J Cardiol source

In the paper

“The changes in lipid and hemostatic risk factors align with lower cardiovascular risk.”

In the paper

“Total cholesterol, triglycerides, and lp (a) were not significantly affected.”

What the sources say

• Not checked yetcites [273] Brien, 2011, Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies, BMJ source

In the paper

“Higher levels of consumption increase CVD risk, beginning at 30 g/d in women and 45 g/d in men.”

In the paper

“No RCTs have determined whether low sodium intake reduces CVD events or deaths compared with moderate intake (249).”

What the sources say

• Not checked yetcites [249] Kotchen, 2013, Salt in health and disease–a delicate balance, N Engl J Med source

In the paper

“Results stratified by beverage type (wine/beer/spirits) were similar to the pooled analyses.”

What the sources say

• Not checked yetcites [273] Brien, 2011, Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies, BMJ source

In the paper

“In summary, small and inconsistent cardiovascular benefit is seen in moderate drinkers, but a strong increase in CVD and stroke risk is seen with regular heavy alcohol consumption and binge drinking.”

In the paper

“In LIC and LMIC, heavy episodic drinking pattern and higher intakes of alcohol were associated with a composite outcome of mortality, MI, stroke, cancer, injury, and hospitalization.”

In the paper

“In a recent Cochrane Review (266) of 23 epidemiological studies (n=274,683), the lowest risk of CVD events and deaths occurs at an intake between 2.7 and 5.0 grams/day.”

What the sources say

• Not checked yetcites [266] Graudal, 2014, Compared with usual sodium intake, low- and excessive-sodium diets are associated with increased mortality: a meta-analysis, Am J Hypertens source

In the paper

“The CVD risk benefits of moderate alcohol consumption (up to 5 g/d) compared with abstinence are small but consistent within individual study populations.”

In the paper

“However, methodological issues make studies of sodium intake particularly challenging (267).”

What the sources say

• Not checked yetcites [267] Cobb, 2014, Methodological issues in cohort studies that relate sodium intake to cardiovascular disease outcomes: a science advisory from the American Heart Association, Circulation source

In the paper

“Female never-drinkers were at increased risk of CVD death (RR: 1.31; 95% CI: 1.13 to 1.53) compared with moderate drinkers (0.1 to 4.9 g/d); but the association was not significant for male never-drinkers (RR: 1.20; 95% CI: 0.89 to 1.62).”

What the sources say

• Not checked yetcites [274] Ferrari, 2014, Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study, BMJ Open source

In the paper

“The increased risk of CVD events with higher sodium intake (> 5 grams/day) was most prominent in those with hypertension (263).”

What the sources say

• Not checked yetcites [263] O'Donnell, 2014, Urinary sodium and potassium excretion, mortality, and cardiovascular events, N Engl J Med source

In the paper

“Current drinking was associated with an increased risk of alcohol-related cancers.”

In the paper

“Female never-drinkers were at increased risk of CVD death (RR: 1.31; 95% CI: 1.13 to 1.53) compared with moderate drinkers (0.1 to 4.9 g/d); but the association was not significant for male never-drinkers (RR: 1.20; 95% CI: 0.89 to 1.62).”

What the sources say

• Not checked yetcites [274] Ferrari, 2014, Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study, BMJ Open source

In the paper

“Patterns of alcohol consumption may be a particularly important determinant of the magnitude of the association—in a meta-analysis of 10 prospective cohort and 4 case-control studies, irregular “binge” drinking (>60 g of pure alcohol or >=5 drinks per occasion at least monthly) increased CHD risk by 45% (RR: 1.45; 95% CI: 1.24 to 1.70) (276).”

What the sources say

• Not checked yetcites [276] Roerecke, 2010, Irregular heavy drinking occasions and risk of ischemic heart disease: a systematic review and meta-analysis, Am J Epidemiol source

In the paper

“Meta-analyses of CVD event trials did not report a significant reduction in CVD with lower sodium intake, but the included trials were underpowered to detect moderate risk reductions (258).”

What the sources say

• Not checked yetcites [258] Aburto, 2013, Effect of lower sodium intake on health: systematic review and meta-analyses, BMJ source

In the paper

“In HIC/UMIC in the PURE study (272), current drinking was protective against MI, but not in LIC/LMIC (p=0·02 for interaction); a similar trend was seen for stroke, but the between-region difference was not significant (P=0.15 for interaction).”

What the sources say

• Not checked yetcites [272] Smyth, 2015, Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality, Lancet source

In the paper

“Greater amounts of alcohol are consumed per capita by adults in HIC (9.6 litres/y) than in LMIC (4.1 litres/y), or LIC (3.1 litres/y), although this may be an underestimate in LMIC and LIC due to the use of homemade or unsafe alcohol products (e.g., industrial or medical) (271).”

What the sources say

• Not checked yetcites [271] 2014

In the paper

“In HIC/UMIC in the PURE study (272), current drinking was protective against MI, but not in LIC/LMIC (p=0·02 for interaction); a similar trend was seen for stroke, but the between-region difference was not significant (P=0.15 for interaction).”

What the sources say

• Not checked yetcites [272] Smyth, 2015, Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital, and mortality, Lancet source

In the paper

“While the evidence base for these policy option is growing, more, and more rigorous, evaluation of these actions are needed”

In the paper

“In addition, middle- and high-income countries have introduced measures to improve food environments, summarized at www.wcrf.org/NOURISHING.”

In the paper

“This is challenging in the modern global food system given the often extensive distance between production and consumption; multiple and complex transformations in ingredients and foods between farm and fork; and a multitude of other forces discouraging diversity and freshness.”

In the paper

“Producing more poultry, for example, may be seen as a way to enhance the quality of the food supply since it is healthier relative to red meat, but much chicken is transformed into fast food and other calorie-rich, ultra-processed, heavily-advertised presentations (286).”

What the sources say

• Not checked yetcites [286] Hawkes, 2010, The influence of trade liberalization on global dietary change: the case of vegetable oils, meat and highly processed foods

In the paper

“Based on the current evidence, the optimal dietary pattern to reduce CVD is one that emphasizes whole grains, fruits and vegetables, legumes, nuts, fish, poultry, and moderate dairy and heart-healthy vegetable oil intake; this pattern will likely reduce the CVD risk by about a third.”

In the paper

“Further improvements in cardiovascular risk factors were seen when part of the carbohydrate in DASH was replaced with either monounsaturated fat or protein (278).”

What the sources say

• Not checked yetcites [278] Appel, 2005, Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: results of the OmniHeart randomized trial, JAMA source

In the paper

“Nutrition labels, for example, have been shown to have a clear impact on reformulation (303,306).”

What the sources say

• Not checked yetcites [303] Roodenburg, 2011, Development of international criteria for a front of package nutrient profiling system: international Choices Programme, Eur J Clin Nutr source
• Not checked yetcites [306] Vyth, 2010, Front-of-pack nutrition label stimulates healthier product development: a quantitative analysis, Int J Behav Nutr Phys Act source