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"During these last 75 years, an enormous amount of clinical, epidemiological and laboratory follow-up research has promoted, directly and indirectly, the idea that ‘fat’ is a (if not ‘the’) cause of cardiovascular disease. ... [this] mostly arose from population-based studies that do not translate into estimates of disease risk for individuals ... Dietary fat strongly correlates with breast and other cancers[6],[49]–[51] but, similar to heart disease, these correlations occur for total and saturated fats, not for unsaturated fat,[52] thus favoring an association of these cancers with animal-based foods. Also, among these countries, dietary fat and animal protein consumption are highly correlated,[53] thus the observed association of these cancers with dietary fat could just as easily be an association with animal protein. Indeed, in a survey of 37 countries, the correlations of animal protein and saturated fat with breast and colon cancer exceeded those with socio-economic factors that typically characterize Western societies.[54] Similarly, in rural China, affluent cancers are much less common than in the U.S.[53] In these areas, dietary animal protein consumption is only about 10% that in the U.S. and mean plasma cholesterol [a surrogate for more animal and less plant protein consumption and the variable that is mainly correlated with this aggregate group of cancers and other affluent diseases (P < 0.001)] is only 127 mg/dL.[54] This is an impressive finding in an environment with such low statistical sensitivity."
"This programme led to significant improvements in BMI, cholesterol and other risk factors. To the best of our knowledge, this research has achieved greater weight loss at 6 and 12 months than any other trial that does not limit energy intake or mandate regular exercise."
"During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio [HR]: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities"
"Recent studies have suggested that the intestinal microbiome plays an important role in modulating risk of several chronic diseases, including inflammatory bowel disease, obesity, type 2 diabetes, cardiovascular disease, and cancer ... This review systematically evaluates current data regarding the effects of several common dietary components on intestinal microbiota. We show that consumption of particular types of food produces predictable shifts in existing host bacterial genera"
"The intakes of anthocyanidins (RR 0·89, 95 % CI 0·83, 0·96), proanthocyanidins (RR 0·90, 95 % CI 0·82, 0·98), flavones (RR 0·88, 95 % CI 0·82, 0·96), flavanones (RR 0·88, 95 % CI 0·82, 0·96) and flavan-3-ols (RR 0·87, 95 % CI 0·80, 0·95) were inversely associated with the risk of CVD when comparing the highest and lowest categories of intake. A similar association was observed for flavonol intake and CVD risk. Sensitivity and subgroup analyses further supported this association. The summary RR for CVD for every 10 mg/d increment in flavonol intake was 0·95 (95 % CI 0·91, 0·99). The present systematic review suggests that the dietary intakes of six classes of flavonoids, namely flavonols, anthocyanidins, proanthocyanidins, flavones, flavanones and flavan-3-ols, significantly decrease the risk of CVD."
"After 12 years, we reviewed the CVD events of our 18 adherent patients. During the eight years prior to entering our study, while in the care of expert cardiologists, they had sustained 49 cardiac events, which was indicative of disease progression. In contrast, 17 of the 18 patients sustained no further events during the 12 years they spent in our study"
"In summary, randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced CVD by ≈30%, similar to the reduction achieved by statin treatment...Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD"
"This comprehensive meta-analysis reports a significant protective effect of a vegetarian diet versus the incidence and/or mortality from ischemic heart disease (−25%) and incidence from total cancer (−8%). Vegan diet conferred a significant reduced risk (−15%) of incidence from total cancer"
"Vegetarians have a lower prevalence of overweight and obesity and a lower risk of IHD compared with non-vegetarians from a similar background, whereas the data are equivocal for stroke. For cancer, there is some evidence that the risk for all cancer sites combined is slightly lower in vegetarians than in non-vegetarians, but findings for individual cancer sites are inconclusive. Vegetarians have also been found to have lower risks for diabetes, diverticular disease and eye cataract. Overall mortality is similar for vegetarians and comparable non-vegetarians, but vegetarian groups compare favourably with the general population. The long-term health of vegetarians appears to be generally good, and for some diseases and medical conditions it may be better than that of comparable omnivores. Much more research is needed, particularly on the long-term health of vegans."
"Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease."
"We suggest that a shift toward a plant-based diet may confer protective effects against atherosclerotic CAD by increasing endothelial protective factors in the circulation while reducing factors that are injurious to endothelial cells ... This review provides a mechanistic perspective of the evidence for protection by a plant-based diet against atherosclerotic CAD."
"This review evaluates the current evidence from observational and intervention studies, focusing on the specific protein-providing foods and populations studied ... Evidence to date is inconclusive, and additional studies are needed to further advance our understanding of the complexity of plant protein vs. animal protein comparisons. Nonetheless, current evidence supports the idea that CVD risk can be reduced by a dietary pattern that provides more plant sources of protein compared with the typical American diet and also includes animal-based protein foods that are unprocessed and low in saturated fat."
"The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies ... we observed no consistent association between milk consumption and all-cause or cause-specific mortality."
"high adherence on each [diet] index was protective for CVD and cancer mortality examined separately. These findings indicate that multiple scores reflect core tenets of a healthy diet that may lower the risk of mortality outcomes"
"Age-dependent and societal differences in the intestinal microbiota could result from differences in diet. Examples include differences in the intestinal microbiota of breast- vs formula-fed infants, or differences in microbial richness in individuals consuming an agrarian plant-based vs a Western diet, which is high in meat and fat. We review how diet affects the structure and metabolome of the human intestinal microbiome, and may contribute to health or pathogenesis of disorders such as coronary vascular disease and inflammatory bowel diseases."
"This meta-analysis provides further evidence that a higher consumption of fruit and vegetables is associated with a lower risk of all cause mortality, particularly cardiovascular mortality."
"Recent studies indicated that high dietary intake of six main carotenoids (i.e., lycopene, <- and®-carotene, lutein, zeaxanthin, and astaxanthin) was associated with reduced risk of stroke and other cardiovascular outcomes. However, the main mechanism of the action of these nutrients was not identified, and multiple mechanisms except antioxidant activity were suggested to be involved in the observed beneficial effects. The dietary intake of six major carotenoids should be promoted as this may have a substantial positive effect on stroke prevention and stroke mortality reduction."
"Comparison of PO [palm oil] diets with diets rich in stearic acid, monounsaturated fatty acids (MUFAs), and polyunsaturated fatty acids (PUFAs) showed significantly higher TC [total cholesterol], LDL cholesterol, apolipoprotein B, HDL cholesterol, and apolipoprotein A-I, whereas most of the same biomarkers were significantly lower when compared with diets rich in myristic/lauric acid. Comparison of PO-rich diets with diets rich in trans fatty acids showed significantly higher concentrations of HDL cholesterol and apolipoprotein A-I and significantly lower apolipoprotein B, triacylglycerols, and TC/HDL cholesterol. ... Both favorable and unfavorable changes in CHD/CVD risk markers occurred when PO was substituted for the primary dietary fats, whereas only favorable changes occurred when PO was substituted for trans fatty acids."
"Of the 198 patients with CVD, 177 (89%) were adherent. Major cardiac events judged to be recurrent disease totaled one stroke in the adherent cardiovascular participants—a recurrent event rate of .6%, significantly less than reported by other studies of plant-based nutrition therapy. Thirteen of 21 (62%) nonadherent participants experienced adverse events."
"Vegetarian diets confer protection against cardiovascular diseases, cardiometabolic risk factors, some cancers and total mortality. Compared to lacto-ovo-vegetarian diets, vegan diets seem to offer additional protection for obesity, hypertension, type-2 diabetes, and cardiovascular mortality. Males experience greater health benefits than females."
"A healthy vegan diet has many health benefits including lower rates of obesity, heart disease, high blood pressure, high blood cholesterol, type 2 diabetes and certain types of cancer. It may take planning to get enough protein, iron, zinc, calcium, vitamins D and B12 and omega-3 fats from foods or supplements. A healthy vegan diet can meet all your nutrient needs at any stage of life including when you are pregnant, breastfeeding or for older adults"
"An 18-week dietary intervention using a low-fat plant-based diet in a corporate setting improves body weight, plasma lipids, and, in individuals with diabetes, glycemic control."
"Despite the contradictions, there are many data supporting the anti-inflammatory action of carotenoids and their protective effect on cardiovascular events. The unfavourable findings may arise from the use of synthetic molecules slightly different from natural ones or by the competition between the plasma concentrations of carotenoids synthetically derived and of those normally taken with foods. The current data are promising, although further studies and a better standardization of methods are needed to obtain clearer results."
"Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD"
"In the African population of Uganda coronary heart disease is almost non-existent ... In the Asian community, on the other hand, coronary heart disease is a major problem. ... [In African population] The staple foods, green plantain and sweet potatoes, are steamed in banana leaves; cassava, yams, maize, and millet are also staple commodities in particular of the non-Baganda groups, while pumpkins, tomatoes, and green leafy vegetables are taken by all. The adequacy of protein in the diet depends almost entirely on the extent to which pulses, groundnuts, and cereals are used. ... [Asian] community is on the whole economically prosperous as compared with the Africans ... [In Hindus] eggs are eaten in small quantities in most families, especially by the men. The Muslim diet differs in that meat, fish, and poultry are taken and eggs are more freely used. ... this particular survey the average estimated quantities of fats taken per person weekly are: 1 lb (454 g) cottonseed oil; ½ – ¾ lb. (230-340 g) ghee; ¼ lb. (114 g) butter; 6–8 pints milk; and 1 oz (30 g) cheese. It is evident that fats and oils provide a large proportion of the total caloric intake."
"Meta-analyses of combined flavonoid subclasses showed significant improvements in FMD [endothelial/vein/blood flow function] (chronic, 0.73% (0.17, 1.30) 14 RCTs; acute, 2.33% (1.58, 3.08) 18 RCTs) and blood pressures (systolic, -1.46 mmHg (-2.38, -0.53) 63 RCTs; diastolic, -1.25 mmHg (-1.82, -0.67) 63 RCTs). Similar benefits were observed for the flavan-3-ol, catechol flavonoids (catechins, quercetin, cyanidin etc.), procyanidins, epicatechin and catechin subgroups. ... The present analysis suggests that flavonoid bioactivity does not follow a classical linear dose-response association and this may have important biological implications."
"Overall, omega-3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction, or stroke based on relative and absolute measures of association."
"Among this population of US male physicians, taking a daily multivitamin did not reduce major cardiovascular events, MI, stroke, and CVD mortality after more than a decade of treatment and follow-up."
"The modern Western-type diet is deficient in fruits and vegetables and contains excessive animal products, generating the accumulation of non-metabolizable anions and a lifespan state of overlooked metabolic acidosis ... Even a very mild degree of metabolic acidosis induces skeletal muscle resistance to the insulin action and dietary acid load may be an important variable in predicting the metabolic abnormalities and the cardiovascular risk of the general population, the overweight and obese persons, and other patient populations including diabetes and chronic kidney failure"
"Our meta-analysis suggests that lycopene taken in doses ≥25mg daily is effective in reducing LDL cholesterol by about 10% which is comparable to the effect of low doses of statins in patient with slightly elevated cholesterol levels. More research is needed to confirm suggested beneficial effects on total serum cholesterol and systolic blood pressure."
"it is possible to advocate a potential pleiotropic effect of ALA beyond the more conventional cholesterol-lowering actions of most cardiovascular drugs. Most importantly, the body of ALA research now argues persuasively for the initiation of careful, randomized, controlled trials of dietary flaxseed and/or ALA in a patient population with symptoms of atherosclerotic heart disease."
"Published data suggest that all fatty acids with a double bond in the trans configuration raise the ratio of plasma LDL to HDL cholesterol. ... Removing all such ruminant trans fatty acids from the diet would lower the total trans fatty acid intake in the United States and Europe by about 0.5% of energy and might therefore reduce cardiovascular disease risk by 1.5 to 6%"
"Benefits and cost are distributed rather unevenly ... Demand for meat ... is projected to double between 2000 and 2050. ... the livestock revolution has been fed by inexpensive, often subsidixed grains, cheap fuel, and rapid technological change. ... Livestock occupy over one-fourth of the terrestrial surface of the planet, on pasture and grazing land, of which a significant part is degraded. Expansion of pasture occurs in Latin America at the expense of forests. Concentrate feed demand occupies about one-third of total arable land. ... [Livestock production is] associated with pollution, habitat destruction, and greenhouse gas emissions. Livestock are also an important contributor to water pollution"
"Vegans are thinner, have lower serum cholesterol and blood pressure, and enjoy a lower risk of CVD"
"Post-mortem studies showed an association between atheromatous lesions in the aorta and DD [disk degeneration], as well as between occluded lumbar arteries and life-time LBP [low back pain]. In clinical studies, aortic calcification was associated with LBP, and stenosis of lumbar arteries was associated with both DD and LBP. In epidemiological studies, smoking and high serum cholesterol levels were found to have the most consistent associations with DD and LBP."
" Women's Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women."
"Long-term consumption of a low-calorie low-protein vegan diet or regular endurance exercise training is associated with low cardiometabolic risk. Moreover, our data suggest that specific components of a low-calorie low-protein vegan diet provide additional beneficial effects on blood pressure."
"Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer."
"Available observational data indicate moderate, inverse associations of fish consumption and long chain omega 3 fatty acids with cerebrovascular risk. Long chain omega 3 fatty acids measured as circulating biomarkers in observational studies or supplements in primary and secondary prevention trials were not associated with cerebrovascular disease. The beneficial effect of fish intake on cerebrovascular risk is likely to be mediated through the interplay of a wide range of nutrients abundant in fish."
"A long-term vegetarian diet is associated with markedly higher fasting plasma AA [ascorbic acid] concentrations and lower concentrations of TAG, UA, and hsCRP. Long-term vegetarians have a better antioxidant status and coronary heart disease risk profile than do apparently healthy omnivores. Plasma AA may act a useful marker of overall health status."
"There is a positive linear relation between LDL cholesterol and annual changes in plaque size, with an LDL value of 75 mg/dL predicting, on average, no plaque progression. HDL cholesterol shows an inverse relation with annual changes in plaque size."
"Evidence from prospective cohort studies indicates that a high consumption of plant-based foods such as fruit and vegetables, nuts, and whole grains is associated with a significantly lower risk of coronary artery disease and stroke...Such diets, which also have many other health benefits, deserve more emphasis in dietary recommendations to prevent chronic diseases."
"The world's advanced countries have easy access to plentiful high-fat food; ironically, it is this rich diet that produces atherosclerosis. In the world's poorer nations, many people subsist on a primarily plant-based diet, which is far healthier, especially in terms of heart disease. ... compelling data from nutritional studies, population surveys, and interventional studies support the effectiveness of a plant-based diet and aggressive lipid lowering to arrest, prevent, and selectively reverse heart disease. In essence, this is an offensive strategy."
"More regression of coronary atherosclerosis occurred after 5 years than after 1 year in the experimental group. In contrast, in the control group, coronary atherosclerosis continued to progress and more than twice as many cardiac events occurred."
"Investigators collected and analyzed mortality data for >50 diseases, including 7 different cancers, from 65 counties and 130 villages in rural mainland China ... The combined coronary artery disease mortality rates for both genders in rural China were inversely associated with the frequency of intake of green vegetables and plasma erythrocyte monounsaturated fatty acids, but positively associated with a combined index of salt intake plus urinary sodium and plasma apolipoprotein B. These apolipoproteins, in turn, are positively associated with animal protein intake and the frequency of meat intake and inversely associated with plant protein, legume, and light-colored vegetable intake."
"In a controlled trial, 21 strict vegetarians were studied prospectively for eight weeks: a two-week control period of the usual vegetarian diet was followed by four weeks, during which 250 g of beef was added isocalorically to the daily vegetarian diet and then by two weeks of the control diet. Plasma high-density lipoprotein-cholesterol did not change during the study, whereas plasma total cholesterol rose significantly by 19% at the end of the meat-eating period. Systolic blood pressure (BP) increased significantly during the meat eating by 3% over control values, whereas diastolic BP showed no major changes."