A recent review published in Advances in Nutrition has highlighted the association between high-quality dietary patterns and reduced cardiovascular disease (CVD) risk across South, Southeast, and East Asian populations. This comprehensive analysis, which examined 41 studies, is the first to evaluate the impact of both Asian and non-Asian dietary quality indices on cardiovascular health in these regions.
The review shifts focus from individual foods and nutrients to broader dietary patterns, which provide a more holistic view of the complex interactions between various dietary components and health outcomes. Dietary patterns are often assessed using predefined quality indices that gauge adherence to specific dietary guidelines, or through data-driven approaches based on population-specific consumption habits.
Cardiovascular diseases are a leading cause of mortality worldwide, with a significant proportion of premature CVD deaths occurring in Asia. Historically, research into dietary patterns and CVD risk has relied on indices developed from data predominantly gathered in non-Asian populations. Recently, Asian countries have developed their own dietary quality indices, such as Japan’s Food Guide Spinning Top and China’s Food Pagoda, which reflect local dietary practices and food availability.
The study titled “Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis” provides new insights into how adherence to various dietary patterns affects cardiovascular risk. This analysis is noted for being the first to compare non-Asian and Asian diet quality indices as well as data-driven patterns in relation to CVD risk in these regions.
Key findings indicate that adherence to high-quality dietary patterns, whether defined by non-Asian indices, Asian indices, or data-driven approaches, is consistently associated with lower CVD risk. These high-quality patterns generally include higher intakes of fruits, vegetables, whole grains, legumes, nuts, fish, seafood, low-fat dairy, lean meat, poultry, and liquid plant oils.
However, the review also found that the associations between Asian-derived dietary indices and cardiovascular risk were less robust compared to established non-Asian indices like the Alternative Healthy Eating Index and the Dietary Approaches to Stop Hypertension (DASH) diet. This suggests that current dietary guidelines and indices in Asian countries may need updating to better align with contemporary cardiovascular health recommendations.
Interestingly, the review did not find a significant link between plant-based dietary indices and reduced cardiovascular risk, contrasting with previous meta-analyses from non-Asian countries which reported a 13% lower risk with adherence to plant-based diets. The authors acknowledge that this discrepancy may be due to the limited number of studies on plant-based diets in Asian populations and recommend further research in this area.
The review was published alongside an Editorial titled “Dietary Patterns in Asia: Current Evidence and Future Directions,” which discusses some limitations of the study, including the absence of formal statistical tests for subgroup differences. Despite these limitations, the Editorial commends the review for its methodological rigor and comprehensive approach.