A priori dietary patterns and cardiovascular disease incidence in adult population-based studies: a review of recent evidence

Abstract

Cardiovascular disease (CVD) is the leading cause of death worldwide. Studies using the a priori dietary pattern approach have been criticized for the heterogeneity of their scoring methods. This review aimed to evaluate the evidence on the association between a priori dietary patterns and CVD incidence in recent adult population-based studies. Similar to the conclusions of previous systematic reviews and meta-analyses, our review found that the majority of recent studies suggested that Mediterranean diet (6 out of 10 studies), Dietary Approaches to Stop Hypertension diet (4 out of 6 studies), Dietary Guidelines-based (11 out of 13 studies) patterns, and other emerging dietary patterns, including carbohydrate quality, Dietary Inflammatory Index, Plant-based Diet Index and Healthy Nordic Food Index, were cardioprotective in the general population; however, there was substantial heterogeneity among the studies, possibly due to differences in scoring methods and analytical approaches used and inclusion of different confounders, as well as other methodological drawbacks, such as low numbers of cases and short follow-up periods. Future studies should simultaneously examine and compare multiple a priori dietary patterns in a specific population using a uniform statistical approach. A consensus on the scoring methods for each a priori dietary pattern is also necessary.

Keywords:

• Dietary pattern
• cardiovascular disease
• healthy diet
• Mediterranean diet
• DASH diet
• population-based studies

Acknowledgements

The authors’ responsibilities were as follows – MMHW and JCYL conceived the review; MMHW wrote the first draft of the manuscript; both authors contributed to the critical revision of the manuscript and have read and approved the final manuscript.

Disclosure statement

The authors declare they have no conflicts of interest.