Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T06:58:13.107Z Has data issue: false hasContentIssue false

Diet, nutrition and the prevention of hypertension and cardiovascular diseases

Published online by Cambridge University Press:  02 January 2007

K Srinath Reddy*
Affiliation:
Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India
Martijn B Katan
Affiliation:
Division of Human Nutrition and Epidemiology, Wageningen University, Wageningen, The Netherlands
*
*Corresponding author: Email ksreddy@ccdcindia.org
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cardiovascular diseases (CVD) are growing contributors to global disease burdens, with epidemics of CVD advancing across many regions of the world which are experiencing a rapid health transition. Diet and nutrition have been extensively investigated as risk factors for major cardiovascular diseases like coronary heart disease (CHD) and stroke and are also linked to other cardiovascular risk factors like diabetes, high blood pressure and obesity. The interpretation of evidence needs to involve a critical appraisal of methodological issues related to measurement of exposures, nature of outcome variables, types of research design and careful separation of cause, consequence and confounding as the basis for observed associations.

Adequate evidence is available, from studies conducted within and across populations, to link several nutrients, minerals, food groups and dietary patterns with an increased or decreased risk of CVD. Dietary fats associated with an increased risk of CHD include trans–fats and saturated fats, while polyunsaturated fats are known to be protective. Dietary sodium is associated with elevation of blood pressure, while dietary potassium lowers the risk of hypertension and stroke. Regular frequent intake of fruits and vegetables is protective against hypertension, CHD and stroke. Composite diets (such as DASH diets, Mediterranean diet, ‘prudent’ diet) have been demonstrated to reduce the risk of hypertension and CHD. Sufficient knowledge exists to recommend nutritional interventions, at both population and individual levels, to reduce cardiovascular risk. That knowledge should now be translated into policies which promote healthy diets and discourage unhealthy diets. This requires coordinated action at the level of governments, international organizations, civil society and responsible sections of the food industry.

Type
Research Article
Copyright
Copyright © CAB International 2004

References

1Reddy, KS. Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action. Public Health Nutrition 2002; 5: 231–7.CrossRefGoogle ScholarPubMed
2The World Health Report 1999: making a difference. Geneva: World Health Organization, 1999.Google Scholar
3Murray, CJL, Lopez, AD. Global Health Statistics. Global Burden of Disease and Injury Series. Boston, MA: Harvard School of Public Health, 1996.Google Scholar
4Reddy, KS, Yusuf, S. Emerging epidemic of cardiovascular disease in developing countries. Circulation 1998; 97: 569601.CrossRefGoogle ScholarPubMed
5Yusuf, S, Reddy, S, Ounpuu, S, Anand, S. Global burden of cardiovascular diseases. Part I: general considerations, the epidemiological transition, risk factors, and impact of urbanization. Circulation 2001; 104: 2746.CrossRefGoogle ScholarPubMed
6Yusuf, S, Reddy, S, Ounpuu, S, Anand, S. Global burden of cardiovascular diseases. Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001; 104: 2855.CrossRefGoogle ScholarPubMed
7Clayton, D, McKeigue, PM. Epidemiological methods for studying genes and environmental factors in complex diseases. Lancet 2001; 358(9290): 1356–60.CrossRefGoogle ScholarPubMed
8Krause, BR, Princen, HMG. Lack of predictability of classical animal models for hypolipidemic activity: a good time for mice?. Atherosclerosis 1998; 140: 1524.CrossRefGoogle ScholarPubMed
9Stephens, NG, Parsons, A, Schofield, PM, et al. Randomized controlled trial of Vitamin E in patients with coronary disease; Cambridge Heart Anti–oxidant Study (CHAOS). Lancet 1996; 347: 781–6.CrossRefGoogle ScholarPubMed
10Verschuren, WMM, Jacobs, DR, Bloemberg, BPM, et al. Serum total cholesterol and long–term coronary heart disease mortality in different cultures: twenty–five year follow–up of the Seven Country Study. Journal of the American Medical Association 1995; 274: 131–6.CrossRefGoogle Scholar
11De Lorgeril, M, Salen, P, Martin, JL, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of Lyon Diet Heart Study. Circulation 1999; 99: 779–85.CrossRefGoogle ScholarPubMed
12Willett, WC. Nutritional Epidemiology. New York: Oxford University Press, 1998.CrossRefGoogle Scholar
13Kris-Etherton, P, Daniels, SR, Eckel, RH, et al. for the Nutrition Committee of the American Heart Association, Summary of the Scientific Conference on Dietary Fatty Acids and Cardiovascular Health. Circulation 2001; 103: 1034–9.CrossRefGoogle ScholarPubMed
14Cutler, JA, Follmann, D, Allender, PS. Randomized trials of sodium reduction: an overview. American Journal of Clinical Nutrition 1997; 65(Suppl. 2): 643S–51S.CrossRefGoogle ScholarPubMed
15Assmann, G, Schulte, H. Relation of high–density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). American Journal of Cardiology 1992; 70: 733–7.CrossRefGoogle ScholarPubMed
16Hopkins, PN. Effects of dietary cholesterol on serum cholesterol: a meta–analysis and review. American Journal of Clinical Nutrition 1992; 55: 1060–70.CrossRefGoogle ScholarPubMed
17Weggemans, RM, Zock, PL, Katan, MB. Dietary cholesterol from eggs increases the ratio of total cholesterol to high–density lipoprotein cholesterol in humans: a meta–analysis. American Journal of Clinical Nutrition 2001; 73: 885–91.CrossRefGoogle ScholarPubMed
18Katan, MJ, Zock, PL, Mensink, RP. Dietary oils, serum lipoproteins and coronary heart disease. American Journal of Clinical Nutrition 1995; 61(Suppl.): 1368S–73S.CrossRefGoogle ScholarPubMed
19Hu, F, Stampfer, MJ, Manson, JE, et al. Dietary fat intake and the risk of coronary heart disease in women. New England Journal of Medicine 1994; 337: 1491–9.CrossRefGoogle Scholar
20Kromhout, D, Menotti, A, Bloemberg, B, et al. Dietary saturated and trans fatty acids and cholesterol and 25–year mortality from coronary heart disease: the Seven Countries Study. Preventive Medicine 1995; 24: 308–15.CrossRefGoogle ScholarPubMed
21Mensink, RP, Katan, MB. Effect of dietary fatty acids on serum lipids and lipoproteins—a meta–analysis of 27 trials. Arteriosclerosis and Thrombosis 1992; 12: 911–9.CrossRefGoogle ScholarPubMed
22Sacks, F. Dietary fats and coronary heart disease. Journal of Cardiovascular Risk 1994; 1: 38.CrossRefGoogle ScholarPubMed
23de Roos, NM, Schouten, EG, Katan, MB. Trans fatty acids, HDL–cholesterol, and cardiovascular disease. Effects of dietary changes on vascular reactivity. European Journal of Medical Research 2003; 8: 355–7.Google ScholarPubMed
24Judd, JT, Clevidence, BA, Muesing, RA, et al. Dietary trans fatty acids: effects of plasma lipids and lipoproteins on healthy men and women. American Journal of Clinical Nutrition 1994; 59: 861–8.CrossRefGoogle ScholarPubMed
25Willett, WC, Stampfer, MJ, Manson, JE, et al. Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 1993; 341: 581–5.CrossRefGoogle ScholarPubMed
26Ascherio, A, Rimm, EB, Giovannucci, EL, et al. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. British Medical Journal 1996; 313: 8490.CrossRefGoogle ScholarPubMed
27Oomen, CM, Ocke, MC, Feskens, EDM, et al. Association between trans fatty acid intake and 10–year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population—based study. Lancet 2001; 357: 746–51.CrossRefGoogle ScholarPubMed
28Katan, MB. Trans fatty acids and plasma lipoproteins. Nutrition Reviews 2000; 58: 188–91.CrossRefGoogle ScholarPubMed
29Kris-Etherton, PM. Monosaturated fatty acids and risk of cardiovascular disease. Circulation 1999; 100: 1253–8.CrossRefGoogle Scholar
30Mori, TA, Beilin, LJ. Long–chain omega 3 fatty acids, blood lipids and cardiovascular risk reduction. Current Opinion in Lipidology 2001; 12: 11–7.CrossRefGoogle ScholarPubMed
31Mori, TA, Bao, DQ, Burke, V, et al. Purified eicosapentaenoic acid and docosahexaenoic acid have differential effects on serum lipids and lipoproteins, LDL–particle size, glucose and insulin, in mildly hyperlipidaemic men. American Journal of Clinical Nutrition 2000; 71: 1085–94.CrossRefGoogle Scholar
32Harris, WS. n –3 Fatty acids and serum lipoproteins: human studies. American Journal of Clinical Nutrition 1997; 65: 1645S–54S.CrossRefGoogle ScholarPubMed
33GISSI-Prevenzione Investigators. Dietary supplementation with n -3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI Prevenzione Trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico. Lancet 1999; 354: 447–55.CrossRefGoogle Scholar
34Von Schacky, C. n-3 fatty acids and the prevention of coronary atherosclerosis. American Journal of Clinical Nutrition 2000; 71(Suppl. 1): 224S–7S.CrossRefGoogle ScholarPubMed
35Lemaitre, RN, King, IB, Raghunathan, TE, et al. Cell membrane trans –fatty acids and the risk of primary cardiac arrest. Circulation 2002; 105: 697701.CrossRefGoogle ScholarPubMed
36McLennan, PL, Abeywardena, MY, Charnock, JS. Dietary fish oil prevents ventricular fibrillation following coronary artery occlusion and reperfusion. American Heart Journal 1998; 116: 709–17.CrossRefGoogle Scholar
37Hetzel, BS, Charnock, JS, Dwyer, T, McLennan, PL. Fall in coronary heart disease mortality in U.S.A. and Australia due to sudden death: evidence for the role of polyunsaturated fat. Journal of Clinical Epidemiology 1989; 42: 885–93.CrossRefGoogle ScholarPubMed
38Grundy, SM. What is the desirable ratio of saturated, polyunsaturated, and monounsaturated fatty acids in the diet?. American Journal of Clinical Nutrition 1997; 66(Suppl.): 988S–90S.CrossRefGoogle ScholarPubMed
39Grundy, SM. The optimal ratio of fat–to–carbohydrate in the diet. Annual Review of Nutrition 1999; 19: 325–41.CrossRefGoogle ScholarPubMed
40Willett, WC. Dietary fat plays a major role in obesity: no. Obesity Reviews 2002; 3: 5968.CrossRefGoogle Scholar
41Mendis, S, Samarajeewa, U, Thattil, O. Coconut fat and serum lipoproteins: effects of partial replacement with unsaturated fats. British Journal of Nutrition 2001; 85: 583–9.CrossRefGoogle ScholarPubMed
42Knutzon, DS, Knauf, V. Manipulating seed oils for polyunsaturated fatty acid content. In: Harwood, J, ed. Plant Lipid Biosynthesis: Fundamentals and Agricultural Applications. Cambridge, UK: University Press Society for Experiment Biology Seminar Series, 1998; 287: 67.Google Scholar
43Truswell, AS. Food carbohydrates and plasma lipids—an update. American Journal of Clinical Nutrition 1994; 59(Suppl.): 710S–8S.CrossRefGoogle ScholarPubMed
44Jenkins, DJA, Jenkins, AL, Wolever, TMS, et al. Low glycemic index: lente carbohydrates and physiological effects of altered food frequency. American Journal of Clinical Nutrition 1994; 59(Suppl.): 706S–9S.CrossRefGoogle ScholarPubMed
45Liu, S, Willet, WC, Stampfer, MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. American Journal of Clinical Nutrition 2000; 71: 1455–61.CrossRefGoogle ScholarPubMed
46Marlett, JA. Content and composition of dietary fiber in 117 frequently consumed foods. Journal of the American Dietetic Association 1992; 92: 175–86.CrossRefGoogle ScholarPubMed
47Shikany, JM, Ala, B, White, GL. Dietary guidelines for chronic disease prevention. Southern Medical Journal 2000; 93: 1138–51.CrossRefGoogle ScholarPubMed
48Truswell, AS. Cereal grains and coronary heart disease. European Journal of Clinical Nutrition 2002; 56: 114.CrossRefGoogle ScholarPubMed
49Ludwig, DS, Pereira, MA, Kroenke, CH, et al. Dietary fiber, weight gain, and cardiovascular risk factors in young adults. Journal of the American Medical Association 1999; 282: 1539–46.CrossRefGoogle ScholarPubMed
50Liu, S, Stampfer, MJ, Hu, FB, et al. Whole grain consumption and the risk of coronary heart disease: from the Nurses' Health Study. American Journal of Clinical Nutrition 1999; 70: 412–9.CrossRefGoogle ScholarPubMed
51Rimm, EB, Ascherio, A, Giovannucci, E, et al. Vegetable, fruit and cereal fiber intake and risk of coronary heart disease among men. Journal of the American Medical Association 1996; 275: 447–51.CrossRefGoogle ScholarPubMed
52Rimm, EB, Stampfer, MJ. Antioxidants for vascular disease. Medical Clinics of North America 2000; 84: 239–49.CrossRefGoogle ScholarPubMed
53Ness, AR. Commentary: beyond beta–carotene—antioxidants and cardiovascular disease. International Journal of Epidemiology 2001; 30: 143–4.CrossRefGoogle ScholarPubMed
54Yusuf, S, Dagenais, G, Pogue, J, Sleight, P. Vitamin E supplementation and cardiovascular events in high–risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. New England Journal of Medicine 2000; 345: 154–60.Google Scholar
55Collaborative group, of the primary prevention project (PPP). Low–dose aspirin and vitamin E in people at cardiovascular risk: a randomized trial in general practice. Lancet 2001; 357: 8995.CrossRefGoogle Scholar
56Stampfer, MJ, Malinow, MR, Willett, WC, et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. Journal of the American Medical Association 1992; 268: 877–81.CrossRefGoogle ScholarPubMed
57Selhub, J, Jacques, PF, Bostom, AG, et al. Association between plasma homocysteine concentrations and extracranial carotid–artery stenosis. New England Journal of Medicine 1995; 332: 286–91.CrossRefGoogle ScholarPubMed
58Stampfer, MJ, Malinow, MR, Willett, WC, et al. A prospective study of plasma homocysteine and risk of myocardial infarction in US physicians. Journal of the American Medical Association 1992; 268: 877–81.CrossRefGoogle ScholarPubMed
59Welch, GN, Loscalzo, J. Homocysteine and atherothrombosis. New England Journal of Medicine 1998; 338: 1042–50.CrossRefGoogle ScholarPubMed
60Brouwer, IA, van Dusseldorp, M, Thomas, CM, et al. Low dose folic acid supplementation decreases plasma homocysteine concentrations: a randomized trial. American Journal of Clinical Nutrition 1999; 69: 99104.CrossRefGoogle ScholarPubMed
61Scott, JM. Homocysteine and cardiovascular risk. American Journal of Clinical Nutrition 2000; 72: 333–4.CrossRefGoogle ScholarPubMed
62Guttormsen, AB, Ueland, PM, Svarstad, E, Refsum, H. Kinetic basis of hyperhomocysteinemia in patients with chronic renal failure. Kidney International 1997; 52: 495502.CrossRefGoogle ScholarPubMed
63Celermajer, DS, Sorensen, K, Ryalls, M, et al. Impaired endothelial function occurs in the systemic arteries of children with homozygous homocystinuria but not in their heterozygous parents. Journal of the American College of Cardiology 1993; 22: 854–8.CrossRefGoogle Scholar
64Bellamy, MF, McDowell, IF, Ramsey, MW, et al. Oral folate enhances endothelial function in hyperhomocysteinaemic subjects. European Journal of Clinical Investigation 1999; 29: 659–62.CrossRefGoogle ScholarPubMed
65Rimm, EB, Willett, WC, Hu, FB, et al. Folate and Vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women. Journal of the American Medical Association 1998; 279: 359–64.CrossRefGoogle ScholarPubMed
66Tice, JA, Rose, E, Coxson, PG, et al. Cost–effectiveness of vitamin therapy to lower plasma homocysteine levels for the prevention of coronary heart disease. Effect of grain fortification and beyond. Journal of the American Medical Association 2001; 286: 936–43.CrossRefGoogle ScholarPubMed
67Seshadri, N, Robinson, K. Homocysteine, B Vitamins, and coronary artery disease. Medical Clinics of North America 2000; 84: 215–37.CrossRefGoogle ScholarPubMed
68Hertog, MGL, Feskens, EJM, Hollman, PCH, Katan, MB, Kromhout, D. Dietary antioxidant flavonoids and risk of coronary heart disease. The Zutphen elderly study. Lancet 1993; 342: 1007–11.CrossRefGoogle ScholarPubMed
69Keli, SO, Hertog, MGL, Feskens, EJM, Kromhout, D. Dietary flavonoids, antioxidant vitamins and incidence of stroke. Archives of Internal Medicine 1996; 154: 637–42.CrossRefGoogle Scholar
70Gibbs, CR, Lip, GYH, Beevers, DG. Salt and cardiovascular disease: clinical and epidemiological evidence. Journal of Cardiovascular Risk 2000; 7: 913.CrossRefGoogle ScholarPubMed
71INTERSALT Cooperative, Research Group. INTERSALT: an international study of electrolyte excretion and blood pressure. Results for 24hr urinary sodium and potassium excretion. British Medical Journal 1988; 297: 319–28.CrossRefGoogle Scholar
72Elliott, P, Stamler, J, Nicholas, R, Dyer, AR, Stamler, R, Marmot, M, et al. for the Intersalt Cooperative Research Group, Intersalt revisited: further analyses of 24hr sodium excretion and blood pressure within and across populations. British Medical Journal 1996; 312: 1249–55.CrossRefGoogle Scholar
73Mancilha Carvalho, JJ, Baruzzi, RG, Howard, PF. Blood pressure in four remote populations in the Intersalt study. Hypertension 1989; 14: 238–46.CrossRefGoogle Scholar
74Poulter, NK, Khaw, KT, Hopwood, BEC, Mugambi, M, Peart, WS, Rose, G, et al. The Kenyan Luo migration study: observations on the initiation of a rise in blood pressure. British Medical Journal 1990; 300: 967–72.CrossRefGoogle ScholarPubMed
75Law, MR, Frost, MD, Wald, NJ. By how much does salt reduction lower blood pressure? III. Analysis of data from trials of salt reduction. British Medical Journal 1991; 302: 819–24.CrossRefGoogle ScholarPubMed
76Tuomilehto, J, Jousilahti, P, Rastenyte, D, Moltchanov, V, Tanskanen, A, Pietinen, P, Nissinen, A. Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study. Lancet 2001; 357: 848–51.CrossRefGoogle ScholarPubMed
77Law, MR, Frost, CD, Wald, NJ 3rd. Analysis of data from trials of salt reduction. British Medical Journal 1991; 302: 819–24.CrossRefGoogle ScholarPubMed
78Geleijnse, JM, Hofman, A, Witteman, JC, Hazebroek, AA, Valkenburg, HA, Grobbee, DE. Long–term effects of neonatal sodium restriction on blood pressure. Hypertension 1997; 29: 913–7. (Published erratum in Hypertension 1997; 29: 1211.).CrossRefGoogle ScholarPubMed
79Whelton, PK, Appel, LJ, Espeland, MA, et al. Sodium reduction and weight loss in the treatment of hypertension in older persons. Journal of the American Medical Association 1998; 279: 839–46.CrossRefGoogle ScholarPubMed
80Sacks, FM, Svetkey, LP, Vollmer, WM, et al. Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. New England Journal of Medicine 2001; 344: 310.CrossRefGoogle ScholarPubMed
81Schmieder, RE, Messerli, FH, Garavaglia, GE, Nunez, BD. Dietary salt intake. A determinent of cardiac involvement in essential hypertension. Circulation 1988; 78: 951–6.CrossRefGoogle Scholar
82Liebson, PR, Grandits, GA, Dianzumba, S, et al. Comparision of five antihypertensive monotherapies and placebo for change in left ventricular mass in patients receiving nutritional–hygenic therapy in the Treatment of Mild Hypertension Study (TOHMS). Circulation 1995; 91: 698706.CrossRefGoogle Scholar
83Forte, JG, Miguel, JM, Miguel, MJ, et al. Salt and blood pressure: a community trial. Journal of Human Hypertension 1989; 3: 179–84.Google ScholarPubMed
84Tian, HG, Guo, ZY, Hu, G, et al. Changes in sodium intake and blood pressure in a community–based intervention project in China. Journal of Human Hypertension 1995; 9: 959–68.Google Scholar
85Staessen, J, Bulpitt, CJ, Fagard, R, et al. Salt intake and blood pressure in the general population: a controlled intervention trial in two towns. Journal of Hypertension 1988; 6: 965–73.CrossRefGoogle ScholarPubMed
86Tobian, L, Hanlon, S. High sodium chloride diets injure arteries and raise mortality without raising blood pressure. Hypertension 1990; 15: 900–3.CrossRefGoogle Scholar
87Xie, JX, Sasaki, S, Joossens, JV, Kesteloot, H. The relationship between urinary cations obtained from the INTERSALT study and cerebrovascular mortality. Journal of Human Hypertension 1992; 6: 1721.Google ScholarPubMed
88Young, DB, Lin, H, McCabe, RD. Potassium's cardiovascular protective mechanisms. American Journal of Physiology 1995; 268: R825–37.Google ScholarPubMed
89Krishna, GG, Miller, E, Kapoor, S. Increased blood pressure during potassium depletion in normotensive men. New England Journal of Medicine 1989; 320: 1177–82.CrossRefGoogle ScholarPubMed
90Whelton, PK, He, J, Cutler, JA, et al. Effects of oral potassium on blood pressure: meta–analysis of randomized controlled clinical trials. Journal of the American Medical Association 1996; 275: 1016–22.Google Scholar
91Khaw, KT, Barrett-Connor, E. Dietary potassium and stroke associated mortality. New England Journal of Medicine 1987; 316: 235–40.CrossRefGoogle ScholarPubMed
92Griffith, LE, Guyatt, GH, Cook, RJ, et al. The influence of dietary and non–dietary calcium supplementation on blood pressure. An updated meta–analysis of randomized controlled trials. Journal of Hypertension 1999; 12: 8492.CrossRefGoogle Scholar
93Mizushima, S, Cuppauccio, FP, Nichols, R, Elliott, P. Dietary magnesium intake and blood pressure: a qualitative overview of the observational studies. Journal of Human Hypertension 1998; 12: 447–53.CrossRefGoogle ScholarPubMed
94Nestle, M. Animal vs. plant foods in human diets and health: is the historical record unequivocal?. Proceedings of the Nutrition Society 1999; 58: 211–8.CrossRefGoogle Scholar
95Law, MR, Morris, JK. By how much does fruit and vegetable consumption reduce the risk of ischaemic heart disease? European Journal of Clinical Nutrition 1998; 52: 549–56.CrossRefGoogle ScholarPubMed
96Ness, AR, Powles, JW. Fruit and vegetables, and cardiovascular disease: a review. International Journal of Epidemiology 1997; 26: 113.CrossRefGoogle ScholarPubMed
97Liu, S, Manson, JE, Lee, I-M, et al. Fruit and vegetable intake and risk of cardiovascular disease: the Women's Health Study. American Journal of Clinical Nutrition 2000; 72: 922–8.CrossRefGoogle ScholarPubMed
98Liu, S, Lee, I-M, Ajani, U, et al. Intake of vegetables rich in carotenoids and risk of coronary heart disease in men: The Physicians' Health Study. International Journal of Epidemiology 2001; 30: 130–5.CrossRefGoogle Scholar
99Joshipura, KJ, Ascherio, A, Manson, JF, et al. Fruit and vegetable intake in relation to risk of ischemic stroke. Journal of the American Medical Association 1999; 282: 1233–9.CrossRefGoogle ScholarPubMed
100Appel, LJ, Moore, TJ, Obarzanek, E, et al. A clinical trial of the effects of dietary patterns on blood pressure. New England Journal of Medicine 1998; 336: 1117–24.CrossRefGoogle Scholar
101Kromhout, D, Bosschieter, Eb, de Lezenne Coulander, C. The inverse relation between fish consumption and 20 year mortality from coronary heart disease. New England Journal of Medicine 1985; 312: 1205–9.CrossRefGoogle ScholarPubMed
102Daviglus, ML, Stamler, J, Orencia, AJ, et al. Fish consumption and the 30–year risk of fatal myocardial infarction. New England Journal of Medicine 1997; 336: 1046–53.CrossRefGoogle ScholarPubMed
103Marckmann, P, Gronbaek, M. Fish consumption and coronary heart disease mortality. A systematic review of prospective cohort studies. European Journal of Clinical Nutrition 1999; 53: 585–90.CrossRefGoogle ScholarPubMed
104Burr, ML, Fehily, AM, Gilbert, JF, et al. Effects of changes in fat, fish and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989; 2: 757–61.CrossRefGoogle ScholarPubMed
105Gillman, MW, Cupples, LA, Millen, BE, et al. Inverse association of dietary fat with development of ischaemic stroke in men. Journal of the American Medical Association 1997; 278: 2145–50.CrossRefGoogle ScholarPubMed
106Orenica, AJ, Daviglus, ML, Dyer, AR, et al. Fish consumption and stroke in men. Stroke 1996; 27: 204–9.CrossRefGoogle Scholar
107Zhang, J, Sasaki, S, Amano, K, Kesteloot, H. Fish consumption and mortality from all causes, ischaemic heart disease and stroke: an epidemiological study. Preventive Medicine 1999; 28: 520–9.CrossRefGoogle Scholar
108Kris-Etherton, PM, Zhao, G, Binkoski, AE, et al. The effects of nuts on coronary heart disease risk. Nutrition Reviews 2001; 59: 103–11.CrossRefGoogle ScholarPubMed
109Fraser, GE, Sabate, J, Beeson, WL, Strahan, TM. A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. Archives of Internal Medicine 1992; 152: 1416–24.CrossRefGoogle ScholarPubMed
110Fraser, GE, Lindsted, KD, Beeson, WL. Effect of risk factor values on lifetime risk of and age at that first coronary event. The Adventist Health Study. American Journal of Epidemiology 1995; 142: 746–58.CrossRefGoogle ScholarPubMed
111Hu, FB, Stamfer, MJ. Nut consumption and risk of coronary heart disease: a review of epidemiologic evidence. Current Atherosclerosis Reports 1999; 1: 204–9.CrossRefGoogle ScholarPubMed
112Anderson, JW, Smith, BM, Washnok, CS. Cardiovascular and renal benefits of dry bean and soybean intake. American Journal of Clinical Nutrition 1999; 70(Suppl.): S464–74.CrossRefGoogle ScholarPubMed
113Third International, Symposium on the role of soy in preventing and treating chronic disease. Journal of Nutrition 2000; 130(Suppl.): S653711.CrossRefGoogle Scholar
114Anthony, MS, Clarkson, TB, Bullock, BC. Soy protein versus soy phitoestrogens (isoflavones) in the prevention of coronary artery atherosclerosis of cyno molgus monkeys (Abstract). Circulation 1996; 94(Suppl. 1): 1265.Google Scholar
115Crouse, JR III, Morgan, T, et al. Randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Archives of Internal Medicine 1999; 159: 2070–6.CrossRefGoogle ScholarPubMed
116Davies, DF. Cow's milk antibodies and coronary heart disease. Lancet 1980; 8179: 1190–1.CrossRefGoogle Scholar
117Law, MR, Wald, N. 1994; An ecological study of serum cholesterol and ischaemic heart disease between 1850 and 1990. European Journal of Clinical Nutrition 48: (5) 305–25.Google Scholar
118Seely, S. Diet and coronary disease. A survey of mortality rates and food consumption statistics of 24 countries. Medical Hypotheses 1981; 7: 907–18.CrossRefGoogle ScholarPubMed
119Abbott, RD, Curb, JD, Rodriguez, BL, et al. Effect of dietary calcium and milk consumption on risk of thromboembolic stroke in older middle aged men. Stroke 1996; 27: 813–8.CrossRefGoogle ScholarPubMed
120Gaziano, JM, Buring, JE, Breslow, JL, et al. Moderate alcohol intake, increased levels of high–density lipoprotein and its subfractions, and decreased risk of myocardial infarction. New England Journal of Medicine 1993; 329: 1829–34.CrossRefGoogle ScholarPubMed
121Rehm, J, Bondy, S. Alcohol and all cause mortality: an overview. Novartis Foundation Symposium 1998; 216: 223–32.Google ScholarPubMed
122Gaziano, JM, Godfried, S, Hennekens, CH. Alcohol and coronary heart disease. Trends in Cardiovascular Medicine 1996; 329: 1829–34.Google Scholar
123Maclure, M. Demonstration of deductive meta–analysis: ethanol intake and risk of myocardial infarction. Epidemiologic Reviews 1993; 15: 328–51.CrossRefGoogle ScholarPubMed
124Moore, RD, Pearson, T. Moderate alcohol consumption and coronary artery disease: a review. Medicine 1986; 65: 242–67.CrossRefGoogle ScholarPubMed
125Sacco, RL, Elkind, Mm, Boden-Albala, B, et al. The protective effect of moderate alcohol consumption on ischemic stroke. Journal of the American Medical Association 1999; 281: 5360.CrossRefGoogle ScholarPubMed
126Gaziano, JM, Buring, JE, Brestlow, JL, Goldhaber, SZ. Moderate alcohol intake increased levels of high–density lipoprotein and its subfractions, and decreased risk of myocardial infarction. New England Journal of Medicine 1993; 329: 1829–34.CrossRefGoogle ScholarPubMed
127Gaziano, JM, Hennekens, CH, Godfried, SL, et al. Type of alcoholic beverage and risk of myocardial infarction. American Journal of Cardiology 1999; 83: 52–7.CrossRefGoogle ScholarPubMed
128Miyagi, Y, Miwa, K, Inoue, H. Inhibition of human low–density lipoprotein oxidation by flavonoids in red wine and grape juice. American Journal of Cardiology 1997; 80: 1627–31.CrossRefGoogle ScholarPubMed
129Hu, FB, Stampfer, MJ, Rimm, EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. Journal of the American Medical Association 1999; 281(15): 1387–94.CrossRefGoogle ScholarPubMed
130Trichopoulou, A, Kouris-Blazos, A, Vassilakou, T, et al. The diet and survival of elderly Greeks; a link to the past. American Journal of Clinical Nutrition 1995; 61(Suppl. 1): 346S–50S.CrossRefGoogle ScholarPubMed
131Keys, A, Menotti, A, Karvonen, MJ, et al. The diet and 15–year death rate in the Seven Countries Study. American Journal of Epidemiology 1986; 124: 903–15.CrossRefGoogle ScholarPubMed
132Trichopoulou, A, Vasilopoulou, E. Mediterranean diet and longevity. British Journal of Nutrition 2000; 84(Suppl. 2): S2059.CrossRefGoogle Scholar
133De, Lorgeril, Renaud, S, Mamelle, N, et al. Mediterranean alpha–linolenic acid–rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343: 1454–9.Google Scholar
134Rimm, EB, Ascherio, A, Giovannucci, E, et al. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. Journal of the American Medical Association 1996; 275: 447.CrossRefGoogle ScholarPubMed
135Gilman, MW, Cupples, LA, Gagnon, DJ, et al. Protective effect of fruits and vegetables on development of stroke in men. Journal of the American Medical Association 1995; 273: 1113–7.CrossRefGoogle Scholar
136Willett, WC. Convergence of philosophy and science: the Third International Congress on Vegetarian Nutrition. American Journal of Clinical Nutrition 1999; 70(Suppl. 43): 4S–8S.CrossRefGoogle ScholarPubMed
137Pais, P, Pogue, J, Gerstein, H, Zachariah, E, et al. Risk factors for acute myocardial infarction in Indians: a case–control study. Lancet 1996; 348: 358–63.CrossRefGoogle ScholarPubMed
138Hu, FB, Rimm, EB, Stampfer, MJ, et al. Prospective study of major dietary patterns and risk of coronary heart disease in men. American Journal of Clinical Nutrition 2000; 72: 912–21.CrossRefGoogle ScholarPubMed
139Moore, TJ, Conlin, PR, Ard, J, Svetkey, LP. for DASH Collaborative Research Group, DASH (Dietary Approaches to Stop Hypertension) diet is effective treatment for stage 1 isolated systolic hypertension. Hypertension 2001; 38: 155–8.CrossRefGoogle Scholar
140Obarzanek, E, Sacks, FM, Vollmer, WM, et al. Effects on blood lipids of a blood pressure–lowering diet: the Dietary Approaches to Stop Hypertension (DASH) Trial. American Journal of Clinical Nutrition 2001; 74: 80–9.CrossRefGoogle ScholarPubMed
141Shimamoto, T, Komachi, Y, Inada, H, et al. Trends for coronary heart disease and stroke and their risk factors in Japan. Circulation 1989; 79: 503–15.CrossRefGoogle ScholarPubMed
142Truswell, AS. Review of dietary intervention studies: effect on coronary events and on total mortality. Australian and New Zealand Journal of Medicine 1994; 24: 98106.CrossRefGoogle ScholarPubMed
143Zatonski, WA, McMichael, AJ, Powles, JW. Ecological study of reasons for sharp decline in mortality for ischaemic heart disease in Poland since 1991. British Medical Journal 1998; 317: 678.Google Scholar
144Pietinen, P, Vartianinen, E, Seppanen, R, et al. Changes in diet in Finland from 1972 to 1992: impact on coronary heart disease risk. Preventive Medicine 1996; 25: 243–50.CrossRefGoogle ScholarPubMed
145Dowsen, GK, Gareeboo, H, George, K, et al. Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of non–communicable disease intervention programme in Mauritius. British Medical Journal 1995; 311: 1255–9.CrossRefGoogle Scholar
146Drewnowski, A, Popkin, BM. The nutrition transition: new trends in the global diet. Nutrition Reviews 1997; 55: 3143.CrossRefGoogle ScholarPubMed
147Indu, M, Ghafoornissa, . Fatty acids in Indian diets—comparison of the effects of precursor (alpha–linolenic acid) vs product (long chain n–3 poly unsaturated fatty acids). Nutrition Research 1992; 12: 569–82.CrossRefGoogle Scholar
148Lang, T. The public health impact of globalisation of food trade. In: Shetty, PS, McPherson, K, eds. Diet, Nutrition and Chronic Disease. Lessons from Contrasting Worlds. Chichester: Wiley, 1997; 173–87.Google Scholar
149 United Nations, Environment Programme. www.unep.ch/etu/doha/papers.htm.Google Scholar