ABSTRACT
Appropriate dietary recommendations are essential to the prevention and management of cardiovascular disease. Dietary patterns attempt to encompass the synergistic and cumulative effects of the whole diet and, as such, may be more easily translated into guidelines for healthful nutrition than knowledge of the disease associations of single foods or nutrients. In this chapter, we describe the methodology used to study dietary patterns, synthesize the evidence for the most commonly studied dietary patterns and cardiovascular health, and describe the emerging role of dietary patterns in national nutrition policy. The benefits of a Mediterranean dietary pattern characterized by the abundant consumption of olive oil, fruits, and vegetables and moderate consumption of fish, dairy, and alcohol and low intake of red and processed meats are among the best studied, strongest, and the most consistent. While the Mediterranean diet is the only dietary pattern to have been tested in a large, randomized controlled trial for the primary prevention of cardiovascular endpoints, there are other patterns, such as the Dietary Approaches to Stop Hypertension (DASH), whose effects on cardiovascular disease risk factors such as blood pressure, blood lipids, and glycemic control have been rigorously tested and show compelling benefits. Across healthful dietary patterns, there are common elements that likely drive their protective associations with 398cardiovascular disease, including an emphasis on plant foods including fruits, vegetables, and whole grains. Often, fish is a signature component, while red and processed meat and added sugar are limited and nuts, legumes, and moderate alcohol consumption are considered beneficial. In sum, the study of dietary patterns provides a complementary evidence base to the study of individual foods and nutrients and has great potential for informing nutrition policy to reduce cardiovascular disease risk.
