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

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.

[1]  World Cancer Research Fund International , 2018, The Grants Register 2019.

[2]  H. Boeing,et al.  Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies , 2017, Advances in nutrition.

[3]  H. Boeing,et al.  Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies. , 2017, The American journal of clinical nutrition.

[4]  Marilyn Gentry,et al.  World Cancer Research Fund International (WCRF) , 2017 .

[5]  Zachary S Clayton,et al.  Egg Consumption and Heart Health: A Review, , 2016 .

[6]  Georg Hoffmann,et al.  Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies , 2017, European Journal of Epidemiology.

[7]  J. Gaziano,et al.  Egg Consumption and Incidence of Heart Failure: A Meta-Analysis of Prospective Cohort Studies , 2017, Front. Nutr..

[8]  G. Moradi,et al.  The effect of dairy consumption on the prevention of cardiovascular diseases: A meta-analysis of prospective studies , 2017, Journal of cardiovascular and thoracic research.

[9]  E. Riboli,et al.  Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies , 2017, International journal of epidemiology.

[10]  H. Boeing,et al.  An Umbrella Review of Nuts Intake and Risk of Cardiovascular Disease. , 2017, Current pharmaceutical design.

[11]  Z. Yan,et al.  Association between consumption of soy and risk of cardiovascular disease: A meta-analysis of observational studies , 2017, European journal of preventive cardiology.

[12]  E. Riboli,et al.  Nut consumption and risk of cardiovascular disease, total cancer, all-cause and cause-specific mortality: a systematic review and dose-response meta-analysis of prospective studies , 2016, BMC Medicine.

[13]  S. Lorkowski,et al.  Perspective: NutriGrade: A Scoring System to Assess and Judge the Meta-Evidence of Randomized Controlled Trials and Cohort Studies in Nutrition Research. , 2016, Advances in nutrition.

[14]  E. Rimm,et al.  Substitution of meat and fish with vegetables or potatoes and risk of myocardial infarction. , 2016, The British journal of nutrition.

[15]  Ashutosh Kumar Singh,et al.  Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 , 2016, Lancet.

[16]  G. Grosso,et al.  Legume consumption and CVD risk: a systematic review and meta-analysis , 2016, Public Health Nutrition.

[17]  H. Boeing,et al.  Food groups and risk of chronic disease: a protocol for a systematic review and network meta-analysis of cohort studies , 2016, Systematic Reviews.

[18]  M. Mamas,et al.  Soft drinks and sweetened beverages and the risk of cardiovascular disease and mortality: a systematic review and meta‐analysis , 2016, International journal of clinical practice.

[19]  J. Ard,et al.  Dietary fried fish intake increases risk of CVD: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study , 2016, Public Health Nutrition.

[20]  H. Boeing,et al.  Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies , 2016, PloS one.

[21]  Jian-Min Yuan,et al.  The Alternative Healthy Eating Index Is Associated with a Lower Risk of Fatal and Nonfatal Acute Myocardial Infarction in a Chinese Adult Population. , 2016, The Journal of nutrition.

[22]  E. Riboli,et al.  Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies , 2016, British Medical Journal.

[23]  Stanley L. Hazen,et al.  Plasma Trimethylamine N-Oxide, a Gut Microbe-Generated Phosphatidylcholine Metabolite, Is Associated With Atherosclerotic Burden. , 2016, Journal of the American College of Cardiology.

[24]  A. Tjønneland,et al.  Association of fish consumption and dietary intake of marine n-3 PUFA with myocardial infarction in a prospective Danish cohort study , 2016, British Journal of Nutrition.

[25]  Lei Pan,et al.  Red Meat Consumption and the Risk of Stroke: A Dose-Response Meta-analysis of Prospective Cohort Studies. , 2016, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[26]  Yunqi Weng,et al.  Association between nut consumption and coronary heart disease: a meta-analysis , 2016, Coronary artery disease.

[27]  J. Domingo Nutrients and Chemical Pollutants in Fish and Shellfish. Balancing Health Benefits and Risks of Regular Fish Consumption , 2016, Critical reviews in food science and nutrition.

[28]  M. Visser,et al.  The 2015 Dutch food-based dietary guidelines , 2016, European Journal of Clinical Nutrition.

[29]  R. Collins,et al.  Fresh Fruit Consumption and Major Cardiovascular Disease in China. , 2016, The New England journal of medicine.

[30]  A. Tjønneland,et al.  Intake of whole grains is associated with lower risk of myocardial infarction: the Danish Diet, Cancer and Health Cohort. , 2016, The American journal of clinical nutrition.

[31]  Haihui Wang,et al.  Soy Consumption with Risk of Coronary Heart Disease and Stroke: A Meta-Analysis of Observational Studies , 2016, Neuroepidemiology.

[32]  Mikael Fogelholm,et al.  Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. , 2016, The American journal of clinical nutrition.

[33]  S. Larsson,et al.  Adherence to a Mediterranean diet is associated with reduced risk of heart failure in men , 2016, European journal of heart failure.

[34]  C. González,et al.  Unprocessed red meat and processed meat consumption and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC) , 2016, European Journal of Clinical Nutrition.

[35]  Heather N Watson,et al.  Dairy consumption and CVD: a systematic review and meta-analysis. , 2016, The British journal of nutrition.

[36]  D. Mozaffarian Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review , 2016, Circulation.

[37]  D. Meyre,et al.  A systematic review and meta-analysis of nut consumption and incident risk of CVD and all-cause mortality , 2015, British Journal of Nutrition.

[38]  S. Larsson,et al.  The relationship between sweetened beverage consumption and risk of heart failure in men , 2015, Heart.

[39]  S. Larsson,et al.  A Mediterranean diet and risk of myocardial infarction, heart failure and stroke: A population-based cohort study. , 2015, Atherosclerosis.

[40]  S. Larsson,et al.  Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts. , 2015, The American journal of clinical nutrition.

[41]  T. Mosley,et al.  Association of Dietary Protein Consumption With Incident Silent Cerebral Infarcts and Stroke: The Atherosclerosis Risk in Communities (ARIC) Study , 2015, Stroke.

[42]  L. Schwingshackl,et al.  Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta‐analysis of observational studies , 2015, Cancer medicine.

[43]  D. Mozaffarian,et al.  Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. , 2015, Journal of the American College of Cardiology.

[44]  O. Franco,et al.  Dairy products and the risk of stroke and coronary heart disease: the Rotterdam Study , 2015, European Journal of Nutrition.

[45]  A. Wolk,et al.  Long-term processed and unprocessed red meat consumption and risk of heart failure: A prospective cohort study of women. , 2015, International journal of cardiology.

[46]  D. Mozaffarian,et al.  Contribution of Major Lifestyle Risk Factors for Incident Heart Failure in Older Adults , 2015, JACC. Heart failure.

[47]  C. González,et al.  No association between fish consumption and risk of stroke in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain): a 13·8-year follow-up study , 2015, Public Health Nutrition.

[48]  B. Nordestgaard,et al.  Genetically high plasma vitamin C, intake of fruit and vegetables, and risk of ischemic heart disease and all-cause mortality: a Mendelian randomization study. , 2015, The American journal of clinical nutrition.

[49]  L. Schwingshackl,et al.  Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. , 2015, Journal of the Academy of Nutrition and Dietetics.

[50]  M. Orho-Melander,et al.  The Association between Carbohydrate-Rich Foods and Risk of Cardiovascular Disease Is Not Modified by Genetic Susceptibility to Dyslipidemia as Determined by 80 Validated Variants , 2015, PloS one.

[51]  Anette Varbo,et al.  Milk intake is not associated with ischaemic heart disease in observational or Mendelian randomization analyses in 98,529 Danish adults. , 2015, International journal of epidemiology.

[52]  Shiyi Cao,et al.  Consumption of fruit and vegetable and risk of coronary heart disease: a meta-analysis of prospective cohort studies. , 2015, International journal of cardiology.

[53]  Gang Tang,et al.  Meta-analysis of the association between whole grain intake and coronary heart disease risk. , 2015, The American journal of cardiology.

[54]  A. Wolk,et al.  Fruit and vegetable intake and rate of heart failure: a population‐based prospective cohort of women , 2015, European journal of heart failure.

[55]  E. Rimm,et al.  Rice consumption and risk of cardiovascular disease: results from a pooled analysis of 3 U.S. cohorts , 2014, The American journal of clinical nutrition.

[56]  M. Malaguti,et al.  Bioactive Peptides in Cereals and Legumes: Agronomical, Biochemical and Clinical Aspects , 2014, International journal of molecular sciences.

[57]  B. Heitmann,et al.  Sugar-sweetened beverages, vascular risk factors and events: a systematic literature review , 2014, Public Health Nutrition.

[58]  Á. Alonso,et al.  Dietary Protein Intake and Coronary Heart Disease in a Large Community Based Cohort: Results from the Atherosclerosis Risk in Communities (ARIC) Study , 2014, PloS one.

[59]  H. Boeing,et al.  The association between nut consumption and the risk of total and ischemic stroke in a German cohort study , 2014, European Journal of Clinical Nutrition.

[60]  Wenyun Guo,et al.  Nut consumption and the risk of coronary artery disease: a dose-response meta-analysis of 13 prospective studies. , 2014, Thrombosis research.

[61]  Brian J. Bennett,et al.  Effect of egg ingestion on trimethylamine-N-oxide production in humans: a randomized, controlled, dose-response study. , 2014, The American journal of clinical nutrition.

[62]  L. Pilote,et al.  Fish consumption and acute coronary syndrome: a meta-analysis. , 2014, The American journal of medicine.

[63]  Georg Hoffmann,et al.  Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis , 2014, Public Health Nutrition.

[64]  R. Sacco,et al.  Egg consumption and carotid atherosclerosis in the Northern Manhattan study. , 2014, Atherosclerosis.

[65]  Y. Kokubo,et al.  Rice consumption is not associated with risk of cardiovascular disease morbidity or mortality in Japanese men and women: a large population-based, prospective cohort study. , 2014, The American journal of clinical nutrition.

[66]  D. Mozaffarian,et al.  Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. , 2014, The American journal of clinical nutrition.

[67]  Janusz Wnek,et al.  2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. , 2014, Circulation.

[68]  A. Wolk,et al.  Processed and Unprocessed Red Meat Consumption and Risk of Heart Failure: Prospective Study of Men , 2014, Circulation. Heart failure.

[69]  Dongfeng Zhang,et al.  Fruits and Vegetables Consumption and Risk of Stroke: A Meta-Analysis of Prospective Cohort Studies , 2014, Stroke.

[70]  S. Larsson,et al.  Sweetened beverage consumption is associated with increased risk of stroke in women and men. , 2014, The Journal of nutrition.

[71]  Simon G Thompson,et al.  Association of dietary, circulating, and supplement fatty acids with coronary risk: a systematic review and meta-analysis. , 2014, Annals of internal medicine.

[72]  G. Mensah,et al.  1990-2010 global cardiovascular disease atlas. , 2014, Global heart.

[73]  J. Manson,et al.  Quantity and variety in fruit and vegetable intake and risk of coronary heart disease. , 2013, The American journal of clinical nutrition.

[74]  X. Shu,et al.  Dietary carbohydrates, refined grains, glycemic load, and risk of coronary heart disease in Chinese adults. , 2013, American journal of epidemiology.

[75]  W. Willett,et al.  Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. , 2013, The American journal of clinical nutrition.

[76]  J. Boer,et al.  Dairy intake and coronary heart disease or stroke--a population-based cohort study. , 2013, International journal of cardiology.

[77]  P. Lin,et al.  Dietary intakes consistent with the DASH dietary pattern reduce blood pressure increase with age and risk for stroke in a Chinese population. , 2013, Asia Pacific journal of clinical nutrition.

[78]  X. Shu,et al.  Fruit and vegetable intake and risk of CHD: results from prospective cohort studies of Chinese adults in Shanghai , 2013, British Journal of Nutrition.

[79]  L. Lissner,et al.  The Mediterranean diet in relation to mortality and CVD: a Danish cohort study , 2013, British Journal of Nutrition.

[80]  Yong-Jian Wu,et al.  Fish consumption and incidence of heart failure: a meta-analysis of prospective cohort studies. , 2013, Chinese medical journal.

[81]  Alicja Wolk,et al.  Total and specific fruit and vegetable consumption and risk of stroke: a prospective study. , 2013, Atherosclerosis.

[82]  J. Geleijnse,et al.  Consumption of dairy products and associations with incident diabetes, CHD and mortality in the Whitehall II study. , 2013, The British journal of nutrition.

[83]  H. Boeing,et al.  Fish consumption and the risk of myocardial infarction and stroke in the German arm of the European Prospective Investigation into Cancer and Nutrition (EPIC-Germany) , 2013, British Journal of Nutrition.

[84]  Robert Dufour,et al.  2012 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia for the prevention of cardiovascular disease in the adult. , 2013, The Canadian journal of cardiology.

[85]  A. Trichopoulou,et al.  Relation of the traditional Mediterranean diet to cerebrovascular disease in a Mediterranean population. , 2012, American journal of epidemiology.

[86]  E. Ding,et al.  Fish consumption, omega-3 fatty acids and risk of heart failure: a meta-analysis. , 2012, Clinical nutrition.

[87]  Y. Kokubo,et al.  Soft drink intake in relation to incident ischemic heart disease, stroke, and stroke subtypes in Japanese men and women: the Japan Public Health Centre-based study cohort I. , 2012, The American journal of clinical nutrition.

[88]  W. Rosamond,et al.  Trans fat, aspirin, and ischemic stroke in postmenopausal women , 2012, Annals of neurology.

[89]  Donal N. Gorman,et al.  Association between fish consumption, long chain omega 3 fatty acids, and risk of cerebrovascular disease: systematic review and meta-analysis , 2012, BMJ : British Medical Journal.

[90]  T. Kurth,et al.  Fish consumption and risk of stroke and its subtypes: accumulative evidence from a meta-analysis of prospective cohort studies , 2012, European Journal of Clinical Nutrition.

[91]  E. Barrett-Connor,et al.  Is dairy product consumption associated with the incidence of CHD? , 2012, Public Health Nutrition.

[92]  S. Larsson,et al.  Red Meat Consumption and Risk of Stroke: A Meta-Analysis of Prospective Studies , 2012, Stroke.

[93]  J. Gaziano,et al.  Plasma and dietary omega-3 fatty acids, fish intake, and heart failure risk in the Physicians' Health Study. , 2012, The American journal of clinical nutrition.

[94]  A. Wolk,et al.  Total antioxidant capacity from diet and risk of myocardial infarction: a prospective cohort of women. , 2012, The American journal of medicine.

[95]  D. Mozaffarian,et al.  Unprocessed Red and Processed Meats and Risk of Coronary Artery Disease and Type 2 Diabetes – An Updated Review of the Evidence , 2012, Current Atherosclerosis Reports.

[96]  A. Naska,et al.  Mediterranean diet and CHD: the Greek European Prospective Investigation into Cancer and Nutrition cohort , 2012, British Journal of Nutrition.

[97]  S. Larsson,et al.  Dairy Consumption and Risk of Stroke in Swedish Women and Men , 2012, Stroke.

[98]  Shah Ebrahim,et al.  European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012) , 2012, International Journal of Behavioral Medicine.

[99]  M. Schulze,et al.  Critical review: vegetables and fruit in the prevention of chronic diseases , 2012, European Journal of Nutrition.

[100]  W. Willett,et al.  Soda consumption and the risk of stroke in men and women. , 2012, The American journal of clinical nutrition.

[101]  Walter C Willett,et al.  Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in Men , 2012, Circulation.

[102]  J. Boer,et al.  Gender-Specific Associations of Marine n-3 Fatty Acids and Fish Consumption with 10-Year Incidence of Stroke , 2012, PloS one.

[103]  Marga C Ocké,et al.  Variety in fruit and vegetable consumption and 10-year incidence of CHD and stroke , 2012, Public Health Nutrition.

[104]  D. Mozaffarian,et al.  Dietary Protein Sources and the Risk of Stroke in Men and Women , 2012, Stroke.

[105]  J. Gaziano,et al.  Red meat consumption and risk of heart failure in male physicians. , 2011, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[106]  S. Larsson,et al.  Fish Consumption and the Risk of Stroke: A Dose–Response Meta-Analysis , 2011, Stroke.

[107]  J. Tuomilehto,et al.  Lifestyle factors on the risks of ischemic and hemorrhagic stroke. , 2011, Archives of internal medicine.

[108]  P. Scarborough,et al.  Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition , 2011, BMJ Open.

[109]  S. Larsson,et al.  Red meat consumption and risk of stroke in Swedish men. , 2011, The American journal of clinical nutrition.

[110]  Jennifer G. Robinson,et al.  Fish Intake and the Risk of Incident Heart Failure: The Women's Health Initiative , 2011, Circulation. Heart failure.

[111]  B. Howard,et al.  Diet quality and the risk of cardiovascular disease: the Women's Health Initiative (WHI). , 2011, The American journal of clinical nutrition.

[112]  M. Orho-Melander,et al.  Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort , 2011, European Journal of Epidemiology.

[113]  E. Whitley,et al.  Associations between types of dietary fat and fish intake and risk of stroke in the Caerphilly Prospective Study (CaPS). , 2011, Public health.

[114]  M. Martínez-González,et al.  Nut consumption, weight gain and obesity: Epidemiological evidence. , 2011, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[115]  James W. Anderson,et al.  Soy Protein Effects on Serum Lipoproteins: A Quality Assessment and Meta-Analysis of Randomized, Controlled Studies , 2011, Journal of the American College of Nutrition.

[116]  Simin Liu,et al.  Putting the Whole Grain Puzzle Together: Health Benefits Associated with Whole Grains—Summary of American Society for Nutrition 2010 Satellite Symposium123 , 2011, The Journal of nutrition.

[117]  K. Kayaba,et al.  Frequency of Citrus Fruit Intake Is Associated With the Incidence of Cardiovascular Disease: The Jichi Medical School Cohort Study , 2011, Journal of epidemiology.

[118]  S. Larsson,et al.  Fish consumption and risk of stroke in Swedish women. , 2011, The American journal of clinical nutrition.

[119]  Paolo Vineis,et al.  Fruit, vegetables, and olive oil and risk of coronary heart disease in Italian women: the EPICOR Study. , 2011, The American journal of clinical nutrition.

[120]  S. Larsson,et al.  Red Meat Consumption and Risk of Stroke in Swedish Women , 2011, Stroke.

[121]  T. Kurth,et al.  Nut consumption and risk of stroke in US male physicians. , 2010, Clinical nutrition.

[122]  JoAnn E. Manson,et al.  Coronary Heart Disease Major Dietary Protein Sources and Risk of Coronary Heart Disease in Women , 2017 .

[123]  P. Calder,et al.  Cardiovascular effects of marine omega-3 fatty acids , 2010, The Lancet.

[124]  Y. Xiang,et al.  [A meta-analysis of cohort studies on the association between diabetes and the risk of primary liver cancer]. , 2010, Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine].

[125]  A. Tjønneland,et al.  Fruit and vegetable intake and risk of acute coronary syndrome. , 2010, The British journal of nutrition.

[126]  Bridget B. Kelly,et al.  Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health , 2010 .

[127]  Dariush Mozaffarian,et al.  Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus: A Systematic Review and Meta-Analysis , 2010, Circulation.

[128]  J. Boer,et al.  Marine (n-3) fatty acids, fish consumption, and the 10-year risk of fatal and nonfatal coronary heart disease in a large population of Dutch adults with low fish intake. , 2010, The Journal of nutrition.

[129]  Efsa Panel on Dietetic Products Scientific Opinion on establishing Food-Based Dietary Guidelines , 2010 .

[130]  A. Wolk,et al.  Fatty fish, marine omega-3 fatty acids, and incidence of heart failure , 2010, European Journal of Clinical Nutrition.

[131]  M. Delgado-Rodríguez,et al.  Mediterranean diet and the incidence of cardiovascular disease: a Spanish cohort. , 2010, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[132]  A. Berenguer,et al.  Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study. , 2009, American journal of epidemiology.

[133]  E. Stiernström,et al.  Food Choices and Coronary Heart Disease: A Population Based Cohort Study of Rural Swedish Men with 12 Years of Follow-up , 2009, International journal of environmental research and public health.

[134]  A. Hofman,et al.  Intake of very long chain n‐3 fatty acids from fish and the incidence of heart failure: the Rotterdam Study , 2009, European journal of heart failure.

[135]  A. Reunanen,et al.  Fish consumption and the incidence of cerebrovascular disease , 2009, British Journal of Nutrition.

[136]  P. Knekt,et al.  Plant foods and the risk of cerebrovascular diseases: a potential protection of fruit consumption , 2009, British Journal of Nutrition.

[137]  A. Wolk,et al.  Fish consumption, marine omega-3 fatty acids, and incidence of heart failure: a population-based prospective study of middle-aged and elderly men. , 2009, European heart journal.

[138]  S. Larsson,et al.  Dairy Foods and Risk of Stroke , 2009, Epidemiology.

[139]  N. Sheard Fish consumption and risk of sudden cardiac death. , 2009, Nutrition reviews.

[140]  Sonia S Anand,et al.  A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. , 2009, Archives of internal medicine.

[141]  J. Manson,et al.  Sweetened beverage consumption and risk of coronary heart disease in women. , 2009, The American journal of clinical nutrition.

[142]  S. Larsson,et al.  Dietary fiber and fiber-rich food intake in relation to risk of stroke in male smokers , 2009, European Journal of Clinical Nutrition.

[143]  A. Folsom,et al.  Incident heart failure is associated with lower whole-grain intake and greater high-fat dairy and egg intake in the Atherosclerosis Risk in Communities (ARIC) study. , 2008, Journal of the American Dietetic Association.

[144]  J. Gaziano,et al.  Nut consumption and risk of heart failure in the Physicians' Health Study I. , 2008, The American journal of clinical nutrition.

[145]  Adam Drewnowski,et al.  Does social class predict diet quality? , 2008, The American journal of clinical nutrition.

[146]  D. Herrington,et al.  Whole grain intake and cardiovascular disease: a meta-analysis. , 2008, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[147]  J. Gaziano,et al.  Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study. , 2008, The American journal of clinical nutrition.

[148]  J. Gaziano,et al.  Egg Consumption and Risk of Heart Failure in the Physicians' Health Study , 2008, Circulation.

[149]  Y. Kokubo,et al.  Association of Dietary Intake of Soy, Beans, and Isoflavones With Risk of Cerebral and Myocardial Infarctions in Japanese Populations: The Japan Public Health Center–Based (JPHC) Study Cohort I , 2007, Circulation.

[150]  G. Hallmans,et al.  Fish intake, mercury, long-chain n-3 polyunsaturated fatty acids and risk of stroke in northern Sweden , 2007, British Journal of Nutrition.

[151]  J. Gaziano,et al.  Breakfast cereals and risk of heart failure in the physicians' health study I. , 2007, Archives of internal medicine.

[152]  Yun Zhao,et al.  Health-related behaviours as predictors of mortality and morbidity in Australian Aborigines. , 2007, Preventive medicine.

[153]  A. Divani,et al.  Regular egg consumption does not increase the risk of stroke and cardiovascular diseases. , 2006, Medical science monitor : international medical journal of experimental and clinical research.

[154]  J. Sabaté,et al.  Nuts and coronary heart disease: an epidemiological perspective , 2006, British Journal of Nutrition.

[155]  N. Day,et al.  Habitual fish consumption and risk of incident stroke: the European Prospective Investigation into Cancer (EPIC)–Norfolk prospective population study , 2006, Public Health Nutrition.

[156]  Philippe Amouyel,et al.  Fruit and vegetable consumption and risk of coronary heart disease: a meta-analysis of cohort studies. , 2006, The Journal of nutrition.

[157]  C. Nowson,et al.  Fruit and vegetable consumption and stroke: meta-analysis of cohort studies , 2006, The Lancet.

[158]  Y. Kokubo,et al.  Intake of Fish and n3 Fatty Acids and Risk of Coronary Heart Disease Among Japanese: The Japan Public Health Center-Based (JPHC) Study Cohort I , 2006, Circulation.

[159]  Joshua T. Cohen,et al.  A quantitative analysis of fish consumption and stroke risk. , 2005, American journal of preventive medicine.

[160]  D. Mozaffarian,et al.  Fish intake and risk of incident heart failure. , 2005, Journal of the American College of Cardiology.

[161]  D. Mozaffarian,et al.  Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. , 2005, Archives of internal medicine.

[162]  A. Evans,et al.  Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study. , 2004, The British journal of nutrition.

[163]  Frank B Hu,et al.  Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. , 2004, The American journal of clinical nutrition.

[164]  A. Dyer,et al.  Fish Consumption and Incidence of Stroke: A Meta-Analysis of Cohort Studies , 2004, Stroke.

[165]  Jiang He,et al.  Meta-analysis of observational studies on fish intake and coronary heart disease. , 2004, The American journal of cardiology.

[166]  P. Elwood,et al.  Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort , 2004, European Journal of Clinical Nutrition.

[167]  A. Folsom,et al.  Associations of whole-grain, refined-grain, and fruit and vegetable consumption with risks of all-cause mortality and incident coronary artery disease and ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. , 2003, The American journal of clinical nutrition.

[168]  A. Tjønneland,et al.  Intake of fruit and vegetables and the risk of ischemic stroke in a cohort of Danish men and women. , 2003, The American journal of clinical nutrition.

[169]  D. Mozaffarian,et al.  Cardiac Benefits of Fish Consumption May Depend on the Type of Fish Meal Consumed: The Cardiovascular Health Study , 2003, Circulation.

[170]  M. Osler,et al.  No inverse association between fish consumption and risk of death from all-causes, and incidence of coronary heart disease in middle-aged, Danish adults. , 2003, Journal of clinical epidemiology.

[171]  J. Manson,et al.  Nut consumption and decreased risk of sudden cardiac death in the Physicians' Health Study. , 2002, Archives of internal medicine.

[172]  S. Thompson,et al.  Quantifying heterogeneity in a meta‐analysis , 2002, Statistics in medicine.

[173]  P. Whelton,et al.  Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. , 2001, Archives of internal medicine.

[174]  P. Amiano,et al.  Very-long-chain ω-3 fatty acids as markers for habitual fish intake in a population consuming mainly lean fish: the EPIC cohort of Gipuzkoa , 2001, European Journal of Clinical Nutrition.

[175]  S. Cole,et al.  Intake of vegetables rich in carotenoids and risk of coronary heart disease in men: The Physicians' Health Study. , 2001, International journal of epidemiology.

[176]  D. Albanes,et al.  Intake of Flavonols and Flavones and Risk of Coronary Heart Disease in Male Smokers , 2001, Epidemiology.

[177]  S. Cole,et al.  Fruit and vegetable intake and risk of cardiovascular disease: the Women's Health Study. , 2000, The American journal of clinical nutrition.

[178]  Y. Kokubo,et al.  Serum Vitamin C Concentration Was Inversely Associated With Subsequent 20-Year Incidence of Stroke in a Japanese Rural Community: The Shibata Study , 2000, Stroke.

[179]  J. Manson,et al.  Whole grain consumption and risk of ischemic stroke in women: A prospective study. , 2000, JAMA.

[180]  R. Mattes,et al.  Liquid versus solid carbohydrate: effects on food intake and body weight , 2000, International Journal of Obesity.

[181]  James W. Anderson,et al.  Whole Grain Foods and Heart Disease Risk , 2000, Journal of the American College of Nutrition.

[182]  I. Olkin,et al.  Meta-analysis of observational studies in epidemiology - A proposal for reporting , 2000 .

[183]  R. Gillum,et al.  The relation between fish consumption, death from all causes, and incidence of coronary heart disease. the NHANES I Epidemiologic Follow-up Study. , 2000, Journal of clinical epidemiology.

[184]  D Spiegelman,et al.  Fruit and vegetable intake in relation to risk of ischemic stroke. , 1999, JAMA.

[185]  J. Manson,et al.  Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. , 1999, The American journal of clinical nutrition.

[186]  J. Manson,et al.  A prospective study of egg consumption and risk of cardiovascular disease in men and women. , 1999, JAMA.

[187]  G. Smith,et al.  Bias in meta-analysis detected by a simple, graphical test , 1997, BMJ.

[188]  E. Feskens,et al.  Dietary Flavonoids, Antioxidant Vitamins, and Incidence of Stroke: The Zutphen Study , 1996 .

[189]  R. Gillum,et al.  The relationship between fish consumption and stroke incidence. The NHANES I Epidemiologic Follow-up Study (National Health and Nutrition Examination Survey). , 1996, Archives of internal medicine.

[190]  A. Dyer,et al.  Fish consumption and stroke in men. 30-year findings of the Chicago Western Electric Study. , 1996, Stroke.

[191]  J. Manson,et al.  Fish consumption and cardiovascular disease in the physicians' health study: a prospective study. , 1995, American journal of epidemiology.

[192]  D Kromhout,et al.  Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. , 1995, JAMA.

[193]  E. Rimm,et al.  Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. , 1995, The New England journal of medicine.

[194]  P. Wolf,et al.  Protective effect of fruits and vegetables on development of stroke in men. , 1995, JAMA.

[195]  J. Salonen,et al.  Intake of mercury from fish, lipid peroxidation, and the risk of myocardial infarction and coronary, cardiovascular, and any death in eastern Finnish men. , 1995, Circulation.

[196]  E. Rimm,et al.  Dietary iron intake and risk of coronary disease among men. , 1994, Circulation.

[197]  S. Keli,et al.  Fish Consumption and Risk of Stroke: The Zutphen Study , 1994, Stroke.

[198]  J. Sabaté,et al.  A possible protective effect of nut consumption on risk of coronary heart disease. The Adventist Health Study. , 1992, Archives of internal medicine.

[199]  S. Greenland,et al.  Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. , 1992, American journal of epidemiology.

[200]  R. Simon,et al.  Flexible regression models with cubic splines. , 1989, Statistics in medicine.

[201]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[202]  A. Tjønneland,et al.  Adherence to a Healthy Nordic Diet and Risk of Stroke: A Danish Cohort Study , 2017, Stroke.

[203]  S. McGuire,et al.  Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Washington, DC: US Departments of Agriculture and Health and Human Services, 2015. , 2016, Advances in nutrition.

[204]  S. Larsson,et al.  Association between dairy food consumption and risk of myocardial infarction in women differs by type of dairy food. , 2013, The Journal of nutrition.

[205]  Z. Pang,et al.  Red and processed meat consumption and risk of stroke: a meta-analysis of prospective cohort studies , 2013, European Journal of Clinical Nutrition.

[206]  G. Hallmans,et al.  Fish consumption and myocardial infarction: a second prospective biomarker study from northern Sweden. , 2011, The American journal of clinical nutrition.

[207]  Hannah Gardener ScD,et al.  Diet Soft Drink Consumption is Associated with an Increased Risk of Vascular Events in the Northern Manhattan Study , 2011, Journal of General Internal Medicine.

[208]  K. He,et al.  Meta-analysis of prospective cohort studies , 2011 .

[209]  J. Higgins Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration , 2011 .

[210]  Eric Boerwinkle,et al.  The Atherosclerosis Risk in Communities (ARIC) Study , 2011 .

[211]  Bridget B. Kelly,et al.  Promoting Cardiovascular Health in the Developing World , 2010 .

[212]  C. Dethlefsen,et al.  Fish intake and acute coronary syndrome. , 2010, European heart journal.

[213]  J. Lupton,et al.  Immunomodulatory effects of (n-3) fatty acids: putative link to inflammation and colon cancer. , 2007, The Journal of nutrition.

[214]  C. Nowson,et al.  Increased consumption of fruit and vegetables is related to a reduced risk of coronary heart disease: meta-analysis of cohort studies , 2007, Journal of Human Hypertension.

[215]  H. Meltzer,et al.  Nordic Nutrition Recommendations 2004 – integrating nutrition and physical activity , 2004 .

[216]  Alan D. Lopez,et al.  The Global Burden of Disease Study , 2003 .

[217]  P. Amiano,et al.  Very-long-chain omega-3 fatty acids as markers for habitual fish intake in a population consuming mainly lean fish: the EPIC cohort of Gipuzkoa. European Prospective Investigation into Cancer and Nutrition. , 2001, European journal of clinical nutrition.

[218]  I. Milsom,et al.  [Swedish women]. , 1994, Jordemodern.