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Food groups and risk of coronary heart disease, stroke and heart failure : a systematic review and dose-response meta-analysis of prospective studies

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Abstract
Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF). Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships. Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RRCHD: 0.95 (95% CI: 0.92-0.98), RRHF: 0.96 (0.95-0.97)), vegetables and fruits (RRCHD: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RRstroke: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RRCHD: 0.67 (0.43-1.05)), and fish consumption (RRCHD: 0.88 (0.79-0.99), RRstroke: 0.86 (0.75-0.99), and RRHF: 0.80 (0.67-0.95)), while a positive association was present for egg (RRHF: 1.16 (1.03-1.31)), red meat (RRCHD: 1.15 (1.08-1.23), RRstroke: 1.12 (1.06-1.17), RRHF: 1.08 (1.02-1.14)), processed meat (RRCHD: 1.27 (1.09-1.49), RRstroke: 1.17 (1.02-1.34), RRHF: 1.12 (1.05-1.19)), and SSB consumption (RRCHD: 1.17 (1.11-1.23), RRstroke: 1.07 (1.02-1.12), RRHF: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD. Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
Keywords
Cardiovascular, coronary heart disease, diet, dose-response, food, heart failure, meta-analysis, stroke, RED MEAT CONSUMPTION, SWEETENED BEVERAGE CONSUMPTION, N-3 FATTY-ACIDS, ALL-CAUSE MORTALITY, WHOLE-GRAIN INTAKE, DIETARY-PROTEIN SOURCES, TRIMETHYLAMINE-N-OXIDE, HEALTHY EATING INDEX, CENTER-BASED JPHC, FISH CONSUMPTION

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MLA
Bechthold, Angela, et al. “Food Groups and Risk of Coronary Heart Disease, Stroke and Heart Failure : A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION, vol. 59, no. 7, 2019, pp. 1071–90, doi:10.1080/10408398.2017.1392288.
APA
Bechthold, A., Boeing, H., Schwedhelm, C., Hoffmann, G., Knüppel, S., Iqbal, K., … Schwingshackl, L. (2019). Food groups and risk of coronary heart disease, stroke and heart failure : a systematic review and dose-response meta-analysis of prospective studies. CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION, 59(7), 1071–1090. https://doi.org/10.1080/10408398.2017.1392288
Chicago author-date
Bechthold, Angela, Heiner Boeing, Carolina Schwedhelm, Georg Hoffmann, Sven Knüppel, Khalid Iqbal, Stefaan De Henauw, et al. 2019. “Food Groups and Risk of Coronary Heart Disease, Stroke and Heart Failure : A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION 59 (7): 1071–90. https://doi.org/10.1080/10408398.2017.1392288.
Chicago author-date (all authors)
Bechthold, Angela, Heiner Boeing, Carolina Schwedhelm, Georg Hoffmann, Sven Knüppel, Khalid Iqbal, Stefaan De Henauw, Nathalie Michels, Brecht Devleesschauwer, Sabrina Schlesinger, and Lukas Schwingshackl. 2019. “Food Groups and Risk of Coronary Heart Disease, Stroke and Heart Failure : A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION 59 (7): 1071–1090. doi:10.1080/10408398.2017.1392288.
Vancouver
1.
Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, et al. Food groups and risk of coronary heart disease, stroke and heart failure : a systematic review and dose-response meta-analysis of prospective studies. CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION. 2019;59(7):1071–90.
IEEE
[1]
A. Bechthold et al., “Food groups and risk of coronary heart disease, stroke and heart failure : a systematic review and dose-response meta-analysis of prospective studies,” CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION, vol. 59, no. 7, pp. 1071–1090, 2019.
@article{8542107,
  abstract     = {{Background: Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF).
Methods: We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships.
Results: Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RRCHD: 0.95 (95% CI: 0.92-0.98), RRHF: 0.96 (0.95-0.97)), vegetables and fruits (RRCHD: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RRstroke: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RRCHD: 0.67 (0.43-1.05)), and fish consumption (RRCHD: 0.88 (0.79-0.99), RRstroke: 0.86 (0.75-0.99), and RRHF: 0.80 (0.67-0.95)), while a positive association was present for egg (RRHF: 1.16 (1.03-1.31)), red meat (RRCHD: 1.15 (1.08-1.23), RRstroke: 1.12 (1.06-1.17), RRHF: 1.08 (1.02-1.14)), processed meat (RRCHD: 1.27 (1.09-1.49), RRstroke: 1.17 (1.02-1.34), RRHF: 1.12 (1.05-1.19)), and SSB consumption (RRCHD: 1.17 (1.11-1.23), RRstroke: 1.07 (1.02-1.12), RRHF: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD.
Conclusion: An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.}},
  author       = {{Bechthold, Angela and Boeing, Heiner and Schwedhelm, Carolina and Hoffmann, Georg and Knüppel, Sven and Iqbal, Khalid and De Henauw, Stefaan and Michels, Nathalie and Devleesschauwer, Brecht and Schlesinger, Sabrina and Schwingshackl, Lukas}},
  issn         = {{1040-8398}},
  journal      = {{CRITICAL REVIEWS IN FOOD SCIENCE AND NUTRITION}},
  keywords     = {{Cardiovascular,coronary heart disease,diet,dose-response,food,heart failure,meta-analysis,stroke,RED MEAT CONSUMPTION,SWEETENED BEVERAGE CONSUMPTION,N-3 FATTY-ACIDS,ALL-CAUSE MORTALITY,WHOLE-GRAIN INTAKE,DIETARY-PROTEIN SOURCES,TRIMETHYLAMINE-N-OXIDE,HEALTHY EATING INDEX,CENTER-BASED JPHC,FISH CONSUMPTION}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1071--1090}},
  title        = {{Food groups and risk of coronary heart disease, stroke and heart failure : a systematic review and dose-response meta-analysis of prospective studies}},
  url          = {{http://doi.org/10.1080/10408398.2017.1392288}},
  volume       = {{59}},
  year         = {{2019}},
}

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