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What is the relationship between adherence to dietary guidelines or recommendations or specific dietary patterns (assessed using methods other than index or score, cluster or factor, or reduced rank regression analyses) and risk of cardiovascular disease?


There is strong and consistent evidence that consumption of a DASH diet results in reduced blood pressure in adults with above optimal blood pressure, up to and including stage 1 hypertension. A dietary pattern consistent with the DASH diet is rich in fruits, vegetables, low-fat dairy, fish, whole grains, fiber, potassium and other minerals at recommended levels and low in red and processed meat, sugar-sweetened foods and drinks, saturated fat, cholesterol and sodium. There is limited evidence that adherence to vegetarian diets is associated with decreased death from ischemic heart disease, with the association being stronger in men than in women.


  • I-Strong: DASH and Blood Pressure
  • III-Limited: Vegetarian and Ischemic Heart Disease.
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Research Recommendations

  • Vegetarian diets are often defined by what is excluded from the diet rather than what is included; therefore, researchers should make efforts to characterize the diets of self-identified vegetarians more fully in terms of their patterns of food choice
  • Standardization of the various definitions of vegetarian diets across different populations and locations would further advance knowledge in this area. The benefits of vegetarian diets are associated, in part, with decreased consumption of animal products; given this, it would help to inform policy if investigators could determine how much of a decrease in animal product consumption is most beneficial related to CVD risk.
  • Methodologically, research in this area could be further improved by measuring dietary intake at regular intervals over the course of prospective studies, rather than just at baseline
  • Further research needs to be done to clarify the effect of a DASH diet on blood pressure outcomes by racial/ethnic subgroups, as well as gender differences in blood lipid measures
  • The potential gender difference in the association between vegetarian diets and CHD mortality (i.e., more pronounced in men) needs to be further clarified, and this could be informed by detailed analyses of different forms of vegetarian diets including vegan, lacto-ovo vegetarian, and pesco-vegetarian diets, together with a fuller accounting of what these diets include as well as exclude. Women’s diets tend to have higher diet quality with regard to a number of dietary dimensions other than protein sources, which could explain why this particular exclusion does not have as pronounced an effect among them.

Search Plan and Results

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Dietary Patterns & Cardiovascular Disease