Diet and lifestyle interventions for CVD prevention

Dietary habits and their influence on CVD risk have been extensively reviewed and the European guidelines on CVD prevention and the management of dyslipidaemias state that dietary modifications should form the basis for CVD prevention1,2,3. Some dietary modifications directly result

in measurable changes in blood cholesterol levels (see Table 2), as well as in BP and BMI. Even where changes in these risk factors are not observed, dietary modifications still appear to make an important contribution to CVD prevention1,2,3.

 

Table 2: Approximate LDL-cholesterol reduction achievable by dietary modifications
Dietary Component Dose or change in intake/dietary habit Approximate LDL-Cholesterol Reduction Level of evidence Approved health claim*
Reduce saturated fat  (SFA) and replace with unsaturated fats, namely polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA)   Exchange 5% energy of SFA with PUFA Exchange 5% energy  of SFA with MUFA 7%a

6%a
star star star tick "Replacing saturated fats with unsaturated fats in the diet has been shown to lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease"
Reduce dietary cholesterol <300 mg/day 3%b star star  
Other LDL-lowering options
Increase dietary fibre intake from foods rich in soluble fibre

≥3 g/day β-glucan

5-6%c,d

star star star tick 1. "Barley beta-glucans has been shown to lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease"

2. "Oat beta-glucan has been shown to lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease"
Consider plants sterols/stanols

1.5-3 g/day

7-12%e,f

star star star tick "Plant sterols and plant stanol esters have been shown to lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease"
Consider soy protein

≥25 g/day

3-4%g, h star star X
star star star Level of Evidence A = Data derived from multiple randomized clinical trials or meta-analysis
star star Level of Evidence B = Data derived from a single randomized clinical trial or large non-randomized studies

Table adapted in parts from ESC/EAS Guidelines for the management of dyslipidaemias2 LDL-cholesterol reductions were adapted from aMensink RP et al., 20034; bWeggemans RM et al.,20015; cWhitehead A. et al., 20146; dZhu x. et al., 20157; eRas RT et al., 20148; fCommission Regulation No 686/20149; gSacks FM et al., 200610; hBenkhedda et al, 201411

*There are different types of health claims such as general health (function) claims and disease risk reduction claims. Disease risk reduction claims are statements that link a food (component) to a reduced risk of developing a diet-related disease or condition. The European Commission authorizes different health claims provided they are based on scientific evidence and can be easily understood by consumers. The European Food Safety Authority (EFSA) is responsible for evaluating the scientific evidence supporting health claims.

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