PURE - Cardiovascular Diseases Studies - Publications

 

2017

https://www.thelancet.com/article/S0140-6736(17)32252-3/fulltext

2022

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01441-6/fulltext

https://www.thehindu.com/sci-tech/health/similar-strategies-required-to-handle-cardiovascular-disease-in-men-and-women-lancet-study/article65875126.ece

Pure Diet score

https://ipccs.org/2018/09/04/higher-healthy-diet-score-reduced-cv-disease-and-mortality-worldwide/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7435701/

WHO guidelines on foods

https://www.who.int/news-room/fact-sheets/detail/healthy-diet

Practical advice on maintaining a healthy diet

Fruit and vegetables

Eating at least 400 g, or five portions, of fruit and vegetables per day reduces the risk of NCDs (2) and helps to ensure an adequate daily intake of dietary fibre.

Fruit and vegetable intake can be improved by:

always including vegetables in meals;

eating fresh fruit and raw vegetables as snacks;

eating fresh fruit and vegetables that are in season; and

eating a variety of fruit and vegetables.

Fats

Reducing the amount of total fat intake to less than 30% of total energy intake helps to prevent unhealthy weight gain in the adult population (1, 2, 3). Also, the risk of developing NCDs is lowered by:

reducing saturated fats to less than 10% of total energy intake;

reducing trans-fats to less than 1% of total energy intake; and

replacing both saturated fats and trans-fats with unsaturated fats (2, 3) – in particular, with polyunsaturated fats.

Fat intake, especially saturated fat and industrially-produced trans-fat intake, can be reduced by:

steaming or boiling instead of frying when cooking;

replacing butter, lard and ghee with oils rich in polyunsaturated fats, such as soybean, canola (rapeseed), corn, safflower and sunflower oils;

eating reduced-fat dairy foods and lean meats, or trimming visible fat from meat; and

limiting the consumption of baked and fried foods, and pre-packaged snacks and foods (e.g. doughnuts, cakes, pies, cookies, biscuits and wafers) that contain industrially-produced trans-fats.

Salt, sodium and potassium

Most people consume too much sodium through salt (corresponding to consuming an average of 9–12 g of salt per day) and not enough potassium (less than 3.5 g). High sodium intake and insufficient potassium intake contribute to high blood pressure, which in turn increases the risk of heart disease and stroke (8, 11).

Reducing salt intake to the recommended level of less than 5 g per day could prevent 1.7 million deaths each year (12).

People are often unaware of the amount of salt they consume. In many countries, most salt  comes from processed foods (e.g. ready meals; processed meats such as bacon, ham and salami; cheese; and salty snacks) or from foods consumed frequently in large amounts (e.g. bread). Salt is also added to foods during cooking (e.g. bouillon, stock cubes, soy sauce and fish sauce) or at the point of consumption (e.g. table salt).

Salt intake can be reduced by:

limiting the amount of salt and high-sodium condiments (e.g. soy sauce, fish sauce and bouillon) when cooking and preparing foods;

not having salt or high-sodium sauces on the table;

limiting the consumption of salty snacks; and

choosing products with lower sodium content.

Some food manufacturers are reformulating recipes to reduce the sodium content of their products, and people should be encouraged to check nutrition labels to see how much sodium is in a product before purchasing or consuming it.

Potassium can mitigate the negative effects of elevated sodium consumption on blood pressure. Intake of potassium can be increased by consuming fresh fruit and vegetables.

Sugars

In both adults and children, the intake of free sugars should be reduced to less than 10% of total energy intake (2, 7).  A reduction to less than 5% of total energy intake would provide additional health benefits (7).

Consuming free sugars increases the risk of dental caries (tooth decay). Excess calories from foods and drinks high in free sugars also contribute to unhealthy weight gain, which can lead to overweight and obesity. Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases (13).

Sugars intake can be reduced by:

limiting the consumption of foods and drinks containing high amounts of sugars, such as sugary snacks, candies and sugar-sweetened beverages (i.e. all types of beverages containing free sugars – these include carbonated or non‐carbonated soft drinks, fruit or vegetable juices and drinks, liquid and powder concentrates, flavoured water, energy and sports drinks, ready‐to‐drink tea, ready‐to‐drink coffee and flavoured milk drinks); and

eating fresh fruit and raw vegetables as snacks instead of sugary snacks.