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A recent paper takes a fresh look at the diet and heart health. Tom Werner/Getty Images
  • A new literature review suggests refined dietary guidelines for the prevention of cardiovascular disease (CVD).
  • The paper emphasizes pleasure, education, and sustainability as key factors in long-term dietary success.
  • It is worth noting that funding sources and author affiliations present conflicts of interest.

In a recent article, researchers explored the findings of past studies into heart-healthy eating. Using keyword searches of PubMed, a database of biomedical articles, the authors sought to extract high-level insights from existing research.

They present their conclusions in a new article in the European Society of Cardiology’s journal Cardiovascular Research.

Before we outline the findings, it is important to mention that the authors disclose conflicts of interest. They explain that funding came from the Barilla Center for Food & Nutrition, a think tank created by pasta giant Barilla. This organization endorses the Mediterranean diet — an endorsement shared by the research team.

While a person’s diet isn’t the only factor influencing CVD, it is the single most significant contributor, the researchers observe.

“Food choices are the most important factors undermining health and well-being, accounting for as much as almost 50% of all CVD deaths,” they note in their paper. “Other lifestyle-related factors, such as smoking and low physical activity, as well as the individual’s genetic background, can modify [cardiovascular] risk and may also modulate the impact of diet on atherosclerosis; however, to review the role of these factors remains beyond the scope of this article.”

Atherosclerosis is a buildup of fatty plaques on the walls of arteries. Over time, as the plaques accumulate, they narrow the blood vessels. Atherosclerosis is the underlying cause of around 50% of all deaths in Westernized nations.

The current research is part of a broader effort toward a revamped food pyramid to prevent CVD.

Some of the paper’s conclusions align with typical dietary advice. For instance, the researchers found that consuming more plant-based foods and avoiding refined cereals and starchy foods can lead to better heart health than consuming predominantly animal-based foods.

But the paper also drew some less obvious conclusions.

For one, the study found no strong association between full-fat dairy products and poor cardiovascular health. In fact, the authors note that consumption of certain dairy products could lead to decreased cardiovascular disease risks.

This, they theorize, may result from the probiotic effect of fermented dairy products. In their paper, the authors explain:

”The intake of probiotics plays an important role in improving the intestinal flora, favoring the growth of beneficial bacteria and reducing the risk of chronic illnesses, such as CVDs. In particular, probiotics have antioxidative, antiplatelet aggregation and anti-inflammatory properties, and may lower the level of cholesterol and blood pressure.”

Chocolate fans may also have reason to rejoice. The data seem to suggest a beneficial relationship between certain types of chocolate and CVDs. However, the authors note that the data are not entirely clear about the finer points.

“Unfortunately, most existing studies do not distinguish between dark and milk chocolate, and this may be relevant to reliably evaluate the dose-response relationship between different cocoa sources and CVDs.”

The research also found that up to three cups of coffee and tea per day may yield improved cardiovascular health. On the other hand, soft drinks do not; the authors recommend treating them as occasional indulgences rather than regular dietary staples.

Turning their attention to alcohol, the researchers concluded that “Moderate alcohol consumption can be allowed to people already utilizing alcoholic beverages, since consumption of up to two glasses of wine per day in men and one glass in women or one can of beer is associated with a significantly lower risk of atherosclerosis, in comparison to abstainers or to those consuming higher amounts of alcohol.”

Also of note, the team emphasizes the importance of pragmatic approaches to public and individual health. Rather than focusing on food items in isolation, they believe that a more holistic approach to dietary wisdom may prove more fruitful.

“A mistake we made in the past was to consider one dietary component the enemy and the only thing we had to change. Instead, we need to look at diets as a whole, and if we reduce the amount of one food, it is important to choose a healthy replacement.”

There are limitations to the paper’s scope and depth. For one, it makes little mention of ethnic and racial representation in the analyzed studies. The research approach also excluded data from people with specific, restricted diets, such as people with diabetes and vegetarians.

The authors comment on the need for further research, given certain ambiguities in the existing data.

“For some food groups, inconsistencies between meta-analyses and a significant heterogeneity among the included studies represent relevant limitations of the available evidence. This indicates that the relationship with atherosclerotic outcomes may vary in relation to the study population, the background diet, the study outcome, and the specific food item within the broad food category.”

Taking this into account, the authors believe that “It seems appropriate to direct future epidemiological research toward the evaluation of possible sources of heterogeneity, in particular through targeted analyses on individual food items rather than on broad food groups.”