Background: Despite the fact that comprehensive research has demonstrated that dietary behavior constitutes one of the primary risk factors for cardiovascular disease (CVD), earlier studies have exclusively concentrated on individual foods or nutrients. Therefore, to provide more effective guidance to residents in selecting heart-healthy foods, this study utilized data from the China Adult Chronic Disease and Nutrition Surveillance to analyze the relationship between 11 food categories (cereals and tubers, vegetables, fruits, poultry and livestock meat, aquatic products, eggs, dairy, soybeans and nuts, snacks, beverages, and alcoholic beverages) and CVD. Methods: This study used data from the 2015 Shandong Province Adult Chronic Disease and Nutrition Surveillance Programme, which involved 7817 participants in total. Logistic regression models were used to analyze the relationships between the identified food groups and CVD. Additionally, linear regression was used to explore the connections between these food groups and CVD markers, assessing the role of these markers as potential mediators. Mediator statistical models were constructed, and the robustness of the findings was further tested through sensitivity analyses. Results: The analysis revealed significant associations between fruits, livestock and poultry meat, fish, aquatic products, and beverages with CVD ( P < 0.05). In comparison with the lowest tertile (first tertile), individuals in the highest tertile (third tertile) demonstrated a reduced risk of CVD in relation to the consumption of fruits (odds ratio OR = 0.74, 95% confidence interval CI = 0.577–0.95), livestock and poultry meat (OR = 0.69, 95% CI = 0.53–0.89), aquatic products (OR = 0.75, 95% CI = 0.562–1.00), and beverages (OR = 0.46, 95% CI = 0.219–0.94). The percentage of the indirect effect of low-density lipoprotein cholesterol on the relationship between vegetables and eggs with CVD was determined to be 26.4% and 6.44%, respectively. The results of sensitivity analyses, restricted cubic spline curves, and stratified analyses were consistent with those observed in the logistic regression analyses. Conclusion: Participants who increased their intake of fruits, livestock and poultry meat, aquatic products, and beverages exhibited a lowered risk of CVD. Notably, enhanced consumption of fruits and aquatic foods was significantly linked to a reduced risk of CVD, particularly among participants aged ≥45 years, females, those residing in coastal areas, and individuals with a body mass index (BMI) < 24. This study provides a theoretical foundation for guiding dietary choices among residents of Shandong Province to mitigate the risk of CVD.
Hu et al. (Sun,) studied this question.