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Nutrition and Cardiovascular Disease—an Update

Current Atherosclerosis Reports volume 20, Article number: 8 (2018) Cite this article

Abstract

Purpose of Review

This review summarizes recent developments in nutrition and cardiovascular disease (CVD) prevention.

Recent Findings

Contemporary dietary guidance recommends healthy dietary patterns with emphasis on food-based recommendations because the totality of the diet (i.e., the combinations and quantities of foods and nutrients consumed) is an important determinant of health. In many guidelines, recommendations are still made for saturated fat, added sugar, sodium, and dietary cholesterol because these are over-consumed by many people and are related to chronic disease development. Epidemiological research illustrates the importance of considering the total diet and the interrelatedness of nutrients in a dietary pattern. Traditionally, epidemiological research focused on individual nutrients in isolation, which can result in erroneous conclusions. An example of this, which has led to substantial controversy, is the evidence from studies evaluating the association between saturated fat and CVD without considering the replacement nutrient. Another controversial topic is the relationship between dietary cholesterol and CVD, which is confounded by saturated fat intake. Finally, the totality of evidence shows that high sodium intake is associated with greater CVD risk; however, some epidemiological research has suggested that a low-sodium intake is detrimental, which has caused some controversy. Overall, this reductionist approach has led to a debate about recommendations for saturated fat, cholesterol, and sodium. However, if approaches that accounted for the interrelatedness of nutrients had been taken, it is likely that there would be less controversy about these nutrients. To encourage dietary pattern-based approaches and consideration of total intake, dietary guidelines should emphasize food-based recommendations that meet nutrient targets. Thus, nutrient targets should underpin food-based dietary guidelines, and recommended dietary patterns should comply with nutrient-based targets.

Summary

The evidence reviewed shows that it is imperative to consider total dietary patterns for CVD prevention. Dietary guidance should be aligned with nutrient targets and recommendations should be food and dietary pattern based.

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  1. Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA

    Kate J. Bowen, Valerie K. Sullivan, Penny M. Kris-Etherton & Kristina S. Petersen

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Correspondence to Kristina S. Petersen.

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Kate Bowen, Valerie Sullivan, and Kristina Petersen declare no conflict of interest.

Penny Kris-Etherton reports that she is the Past Chair of the American Heart Association Nutrition Committee and Vice Chair of the Lifestyle & Cardiometabolic Health Council.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Bowen, K.J., Sullivan, V.K., Kris-Etherton, P.M. et al. Nutrition and Cardiovascular Disease—an Update. Curr Atheroscler Rep 20, 8 (2018). https://doi.org/10.1007/s11883-018-0704-3

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Keywords

  • Cardiovascular disease
  • Dietary patterns
  • Saturated fat
  • Dietary cholesterol
  • Dietary guidelines