Interpretation of the 2022 American Society for Preventive Cardiology clinical practice dietary guidelines for the prevention of atherosclerotic cardiovascular disease_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Jing ¹ , ZHU Haiyan ² , WU Yang ¹ , KONG Lingqi ¹ , YANG Qingshu ¹ ,  CHANG Peifen ²

1. The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100700, P. R. China;
2. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, P. R. China;

Corresponding author：

CHANG Peifen, Email: 13661022016@163.com

Keywords：

Atherosclerotic cardiovascular disease; Diet; Prevention

DOI：

10.7507/1672-2531.202210151

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Cardiovascular disease is the leading cause of death in the world. The influence of diet on atherosclerotic cardiovascular disease (ASCVD) should not be underestimated. In 2022, the American College for Preventive Cardiology (ASPC) issued guidelines, which emphasized the importance of changing dietary patterns for the prevention of ASCVD and its risk factors, recommended the best diet for ASCVD prevention, and discussed dietary recommendations for ASCVD prevention in special populations. This paper interprets this guideline, aiming to provide help for clinical practice.

1.	Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics-2021 update: a report from the American heart association. Circulation, 2021, 143(8): e254-e743.
2.	Belardo D, Michos ED, Blankstein R, et al. Practical, evidence-based approaches to nutritional modifications to reduce atherosclerotic cardiovascular disease: an american society for preventive cardiology clinical practice statement. Am J Prev Cardiol, 2022, 10: 100323.
3.	Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 2002, 346(6): 393-403.
4.	Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004, 364(9438): 937-952.
5.	Miller V, Mente A, Dehghan M, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet, 2017, 390(10107): 2037-2049.
6.	Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J, 2021, 42(34): 3227-3337.
7.	Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol, 2019, 74(10): e177-e232.
8.	Stewart RAH. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med, 2018, 379(14): 1388.
9.	Menotti A, Puddu PE. How the seven countries study contributed to the definition and development of the Mediterranean diet concept: a 50-year journey. Nutr Metab Cardiovasc Dis, 2015, 25(3): 245-252.
10.	Stewart RA, Wallentin L, Benatar J, et al. Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease. Eur Heart J, 2016, 37(25): 1993-2001.
11.	Trichopoulou A, Costacou T, Bamia C, et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med, 2003, 348(26): 2599-2608.
12.	de Lorgeril M, Salen P, Martin JL, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation, 1999, 99(6): 779-785.
13.	Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses. Nutrients, 2019, 11(2): 338.
14.	Henzel J, Kępka C, Kruk M, et al. High-risk coronary plaque regression after intensive lifestyle intervention in nonobstructive coronary disease: a randomized study. JACC Cardiovasc Imaging, 2021, 14(6): 1192-1202.
15.	Jabri A, Kumar A, Verghese E, et al. Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality. Am J Prev Cardiol, 2021, 7: 100182.
16.	Satija A, Bhupathiraju SN, Spiegelman D, et al. Healthful and unhealthful plant-based diets and the risk of coronary heart disease in U. S. adults. J Am Coll Cardiol, 2017, 70(4): 411-422.
17.	Barnard ND, Alwarith J, Rembert E, et al. A Mediterranean diet and low-fat vegan diet to improve body weight and cardiometabolic risk factors: a randomized, cross-over trial. J Am Nutr Assoc, 2022, 41(2): 127-139.
18.	Li S, Flint A, Pai JK, et al. Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. J Am Heart Assoc, 2014, 3(5): e001169.
19.	O'Neill B, Raggi P. The ketogenic diet: Pros and cons. Atherosclerosis, 2020, 292: 119-126.
20.	Rynders CA, Thomas EA, Zaman A, et al. Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients, 2019, 11(10): 2442.
21.	Lowe DA, Wu N, Rohdin-Bibby L, et al. Effects of time-restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity: the TREAT randomized clinical trial. JAMA Intern Med, 2020, 180(11): 1491-1499.
22.	Fatahi S, Kord-Varkaneh H, Talaei S, et al. Impact of phytosterol supplementation on plasma lipoprotein(a) and free fatty acid (FFA) concentrations: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis, 2019, 29(11): 1168-1175.
23.	Balk EM, Adams GP, Langberg V, et al. Omega-3 fatty acids and cardiovascular disease: an updated systematic review. Evid Rep Technol Assess (Full Rep), 2016, (223): 1-1252.
24.	Vincent MJ, Allen B, Palacios OM, et al. Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol. Am J Clin Nutr, 2019, 109(1): 7-16.
25.	Amir Shaghaghi M, Abumweis SS, Jones PJH. Cholesterol-lowering efficacy of plant sterols/stanols provided in capsule and tablet formats: results of a systematic review and meta-analysis. J Acad Nutr Diet, 2013, 113(11): 1494-1503.
26.	Jacobson TA, Maki KC, Orringer CE, et al. National lipid association recommendations for patient-centered management of dyslipidemia: Part 2. J Clin Lipidol, 2015, 9(6 Suppl): S1-S122.
27.	Margetts BM, Beilin LJ, Vandongen R, et al. Vegetarian diet in mild hypertension: a randomised controlled trial. Br Med J (Clin Res Ed), 1986, 293(6560): 1468-1471.
28.	Sacks FM, Kass EH. Low blood pressure in vegetarians: effects of specific foods and nutrients. Am J Clin Nutr, 1988, 48(3 Suppl): 795-800.
29.	Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med, 1997, 336(16): 1117-1124.
30.	Alexander S, Ostfeld RJ, Allen K, et al. A plant-based diet and hypertension. J Geriatr Cardiol, 2017, 14(5): 327-330.
31.	Jeong S, Kim JY, Cho Y, et al. Genetically, dietary sodium intake is causally associated with salt-sensitive hypertension risk in a community-based cohort study: a Mendelian randomization approach. Curr Hypertens Rep, 2020, 22(7): 45.
32.	Juraschek SP, Miller ER, Weaver CM, et al. Effects of sodium reduction and the DASH diet in relation to baseline blood pressure. J Am Coll Cardiol, 2017, 70(23): 2841-2848.
33.	Bondonno CP, Dalgaard F, Blekkenhorst LC, et al. Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study. Eur J Epidemiol, 2021, 36(8): 813-825.
34.	Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med, 2021, 385(12): 1067-1077.
35.	Liu X, Li Y, Tobias DK, et al. Changes in types of dietary fats influence long-term weight change in US women and men. J Nutr, 2018, 148(11): 1821-1829.
36.	Ogden CL, Fryar CD, Martin CB, et al. Trends in obesity prevalence by race and Hispanic origin-1999-2000 to 2017-2018. JAMA, 2020, 324(12): 1208-1210.
37.	Estruch R, Ros E, Salas-Salvadó J, et al. Retraction and republication: primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med, 2018, 378(25): 2441-2442.
38.	de Koning L, Fung TT, Liao X, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr, 2011, 93(4): 844-850.
39.	Kim J, Choi J, Kwon SY, et al. Association of multivitamin and mineral supplementation and risk of cardiovascular disease: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes, 2018, 11(7): e004224.
40.	Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol, 2018, 71(22): 2570-2584.
41.	Michos ED, Cainzos-Achirica M, Heravi AS, et al. Vitamin D, calcium supplements, and implications for cardiovascular health: JACC focus seminar. J Am Coll Cardiol, 2021, 77(4): 437-449.
42.	Brum J, Ramsey D, McRorie J, et al. Meta-analysis of usefulness of psyllium fiber as adjuvant antilipid therapy to enhance cholesterol lowering efficacy of statins. Am J Cardiol, 2018, 122(7): 1169-1174.
43.	Adolescents EPOI. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics, 2011, 128(Suppl 5): S213-S256.
44.	Strong JP, Malcom GT, McMahan CA, et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA, 1999, 281(8): 727-735.
45.	Freedman DS, Mei Z, Srinivasan SR, et al. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr, 2007, 150(1): 12-17.

1. Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics-2021 update: a report from the American heart association. Circulation, 2021, 143(8): e254-e743.
2. Belardo D, Michos ED, Blankstein R, et al. Practical, evidence-based approaches to nutritional modifications to reduce atherosclerotic cardiovascular disease: an american society for preventive cardiology clinical practice statement. Am J Prev Cardiol, 2022, 10: 100323.
3. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 2002, 346(6): 393-403.
4. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 2004, 364(9438): 937-952.
5. Miller V, Mente A, Dehghan M, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet, 2017, 390(10107): 2037-2049.
6. Visseren FLJ, Mach F, Smulders YM, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J, 2021, 42(34): 3227-3337.
7. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American college of cardiology/American heart association task force on clinical practice guidelines. J Am Coll Cardiol, 2019, 74(10): e177-e232.
8. Stewart RAH. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med, 2018, 379(14): 1388.
9. Menotti A, Puddu PE. How the seven countries study contributed to the definition and development of the Mediterranean diet concept: a 50-year journey. Nutr Metab Cardiovasc Dis, 2015, 25(3): 245-252.
10. Stewart RA, Wallentin L, Benatar J, et al. Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease. Eur Heart J, 2016, 37(25): 1993-2001.
11. Trichopoulou A, Costacou T, Bamia C, et al. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med, 2003, 348(26): 2599-2608.
12. de Lorgeril M, Salen P, Martin JL, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation, 1999, 99(6): 779-785.
13. Chiavaroli L, Viguiliouk E, Nishi SK, et al. DASH dietary pattern and cardiometabolic outcomes: an umbrella review of systematic reviews and meta-analyses. Nutrients, 2019, 11(2): 338.
14. Henzel J, Kępka C, Kruk M, et al. High-risk coronary plaque regression after intensive lifestyle intervention in nonobstructive coronary disease: a randomized study. JACC Cardiovasc Imaging, 2021, 14(6): 1192-1202.
15. Jabri A, Kumar A, Verghese E, et al. Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality. Am J Prev Cardiol, 2021, 7: 100182.
16. Satija A, Bhupathiraju SN, Spiegelman D, et al. Healthful and unhealthful plant-based diets and the risk of coronary heart disease in U. S. adults. J Am Coll Cardiol, 2017, 70(4): 411-422.
17. Barnard ND, Alwarith J, Rembert E, et al. A Mediterranean diet and low-fat vegan diet to improve body weight and cardiometabolic risk factors: a randomized, cross-over trial. J Am Nutr Assoc, 2022, 41(2): 127-139.
18. Li S, Flint A, Pai JK, et al. Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. J Am Heart Assoc, 2014, 3(5): e001169.
19. O'Neill B, Raggi P. The ketogenic diet: Pros and cons. Atherosclerosis, 2020, 292: 119-126.
20. Rynders CA, Thomas EA, Zaman A, et al. Effectiveness of intermittent fasting and time-restricted feeding compared to continuous energy restriction for weight loss. Nutrients, 2019, 11(10): 2442.
21. Lowe DA, Wu N, Rohdin-Bibby L, et al. Effects of time-restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity: the TREAT randomized clinical trial. JAMA Intern Med, 2020, 180(11): 1491-1499.
22. Fatahi S, Kord-Varkaneh H, Talaei S, et al. Impact of phytosterol supplementation on plasma lipoprotein(a) and free fatty acid (FFA) concentrations: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis, 2019, 29(11): 1168-1175.
23. Balk EM, Adams GP, Langberg V, et al. Omega-3 fatty acids and cardiovascular disease: an updated systematic review. Evid Rep Technol Assess (Full Rep), 2016, (223): 1-1252.
24. Vincent MJ, Allen B, Palacios OM, et al. Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol. Am J Clin Nutr, 2019, 109(1): 7-16.
25. Amir Shaghaghi M, Abumweis SS, Jones PJH. Cholesterol-lowering efficacy of plant sterols/stanols provided in capsule and tablet formats: results of a systematic review and meta-analysis. J Acad Nutr Diet, 2013, 113(11): 1494-1503.
26. Jacobson TA, Maki KC, Orringer CE, et al. National lipid association recommendations for patient-centered management of dyslipidemia: Part 2. J Clin Lipidol, 2015, 9(6 Suppl): S1-S122.
27. Margetts BM, Beilin LJ, Vandongen R, et al. Vegetarian diet in mild hypertension: a randomised controlled trial. Br Med J (Clin Res Ed), 1986, 293(6560): 1468-1471.
28. Sacks FM, Kass EH. Low blood pressure in vegetarians: effects of specific foods and nutrients. Am J Clin Nutr, 1988, 48(3 Suppl): 795-800.
29. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med, 1997, 336(16): 1117-1124.
30. Alexander S, Ostfeld RJ, Allen K, et al. A plant-based diet and hypertension. J Geriatr Cardiol, 2017, 14(5): 327-330.
31. Jeong S, Kim JY, Cho Y, et al. Genetically, dietary sodium intake is causally associated with salt-sensitive hypertension risk in a community-based cohort study: a Mendelian randomization approach. Curr Hypertens Rep, 2020, 22(7): 45.
32. Juraschek SP, Miller ER, Weaver CM, et al. Effects of sodium reduction and the DASH diet in relation to baseline blood pressure. J Am Coll Cardiol, 2017, 70(23): 2841-2848.
33. Bondonno CP, Dalgaard F, Blekkenhorst LC, et al. Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study. Eur J Epidemiol, 2021, 36(8): 813-825.
34. Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med, 2021, 385(12): 1067-1077.
35. Liu X, Li Y, Tobias DK, et al. Changes in types of dietary fats influence long-term weight change in US women and men. J Nutr, 2018, 148(11): 1821-1829.
36. Ogden CL, Fryar CD, Martin CB, et al. Trends in obesity prevalence by race and Hispanic origin-1999-2000 to 2017-2018. JAMA, 2020, 324(12): 1208-1210.
37. Estruch R, Ros E, Salas-Salvadó J, et al. Retraction and republication: primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med, 2018, 378(25): 2441-2442.
38. de Koning L, Fung TT, Liao X, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr, 2011, 93(4): 844-850.
39. Kim J, Choi J, Kwon SY, et al. Association of multivitamin and mineral supplementation and risk of cardiovascular disease: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes, 2018, 11(7): e004224.
40. Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental vitamins and minerals for CVD prevention and treatment. J Am Coll Cardiol, 2018, 71(22): 2570-2584.
41. Michos ED, Cainzos-Achirica M, Heravi AS, et al. Vitamin D, calcium supplements, and implications for cardiovascular health: JACC focus seminar. J Am Coll Cardiol, 2021, 77(4): 437-449.
42. Brum J, Ramsey D, McRorie J, et al. Meta-analysis of usefulness of psyllium fiber as adjuvant antilipid therapy to enhance cholesterol lowering efficacy of statins. Am J Cardiol, 2018, 122(7): 1169-1174.
43. Adolescents EPOI. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics, 2011, 128(Suppl 5): S213-S256.
44. Strong JP, Malcom GT, McMahan CA, et al. Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA, 1999, 281(8): 727-735.
45. Freedman DS, Mei Z, Srinivasan SR, et al. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr, 2007, 150(1): 12-17.

Chinese Journal of Evidence-Based Medicine

Latest ArticlesInterpretation of the 2022 American Society for Preventive Cardiology clinical practice dietary guidelines for the prevention of atherosclerotic cardiovascular disease

Abstract Full text Figures/Tables Video References Cited by

Format

Content