Components of a Cardioprotective Diet

The global burdens of cardiovascular diseases (CVD), type 2 diabetes mellitus (DM), and obesity are rising, producing enormous losses of life and disability-adjusted life-years in both developed and developing nations.1 Most of these burdens are preventable and are occurring at unnecessarily younger ages, largely owing to suboptimal lifestyle, which includes poor diet quality, excess caloric intake, physical inactivity, and smoking.2,–,5 Worldwide, striking differences in dietary habits and rates of chronic diseases exist. The identification and targeting of dietary factors with the greatest potential for reducing CVD, DM, and obesity are of major scientific and public health importance. The science of diet and chronic disease is relatively young, spanning perhaps only half a century.6 New advances offer substantial evidence from complementary research paradigms on cardiometabolic effects of specific dietary factors. Several recent evidence-based reviews conducted in conjunction with national and international policy-making efforts provide the context for the present report. The need to prioritize selected foods and overall dietary patterns rather than only individual nutrients, the relevance of carbohydrate and fat quality as well as quantity, the effects and policy implications of sodium consumption, the importance of energy balance, and the role of dietary supplements represent several key findings of interest. Evidence-based insights into successful individual and public health strategies for behavior change are also addressed. Overall, the present report is intended to provide a useful framework for health practitioners and policy makers to understand contemporary issues related to the effects of diet on CVD. Evidence for effects of dietary factors on cardiometabolic health was reviewed, often derived from recent comprehensive reviews performed for policy-making or similar activities, including those of the American Heart Association (AHA) 2020 Impact Goals Committee (D.M., L.J.A.),7 the AHA Nutrition Committee (D.M., L.J.A., L.V.H.),8,9 the …