Mixed
Adherence to four major healthy dietary patterns (HEI-2015, AMED, HPDI, AHEI) is associated with a statistically significant reduction in the risk of incident cardiovascular disease (CVD), including coronary heart disease and stroke.
To lower your risk of heart disease and stroke, focus on long-term adherence to established healthy dietary patterns rather than chasing single 'superfoods' or nutrients. The four major patterns studied (HEI-2015, AMED, HPDI, AHEI) all share core components: high intake of vegetables, fruits, whole grains, legumes, and nuts, and lower intake of red/processed meats, sugar-sweetened beverages, and refined grains. You can choose the pattern that best fits your cultural background and personal preferences, as all were associated with a 14-21% lower risk of CVD when comparing the highest adherence to the lowest.
Comparing the highest with the lowest quintiles, the pooled multivariable-adjusted hazard ratios (HRs) of CVD were 0.83 (95% CI, 0.79-0.86) for the HEI-2015, 0.83 (95% CI, 0.79-0.86) for the AMED, 0.86 (95% CI, 0.82-0.89) for the HPDI, and 0.79 (95% CI, 0.75-0.82) for the AHEI (P for trend <.001 for all).
Why this rating
Large prospective cohort study (NHS, NHS II, HPFS) with over 200,000 participants, up to 32 years of follow-up, and rigorous multivariable adjustment.
Source
Association Between Healthy Eating Patterns and Risk of Cardiovascular Disease
Zhilei Shan et al. · JAMA Internal Medicine · 2020
DOI 10.1001/jamainternmed.2020.2176
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