Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis

Area of Science:

• Nutrition Science
• Epidemiology
• Cardiovascular Health

Background:

• Cardiovascular diseases (CVDs) remain a significant health concern in Asian populations.
• Emerging Asian-derived diet quality indices and data-driven dietary patterns necessitate synthesis and evaluation.
• Understanding the association between dietary patterns and CVD risk is crucial for public health interventions.

Purpose of the Study:

• To systematically review and synthesize various dietary patterns in Asian populations.
• To quantify the association between different dietary patterns and cardiovascular disease (CVD) risk.
• To evaluate the effectiveness of Asian-derived versus non-Asian dietary indices in predicting CVD risk.

Main Methods:

• Systematic literature search across PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia.
• Categorization of dietary patterns into 'high-quality' (fruits, vegetables, whole grains, healthy proteins, plant oils) and 'low-quality' (ultraprocessed foods, added sugars, salt, alcohol).
• Meta-analysis using random-effects models to pool study-specific effect estimates for CVD risk.

Main Results:

• Higher adherence to high-quality dietary patterns was associated with lower CVD risk, with notable associations for patterns defined by non-Asian indices (RR: 0.78), Asian indices (RR: 0.84), and data-driven patterns (RR: 0.81).
• Plant-based, low-quality, animal-based, and diet diversity indices dietary patterns showed no significant association with CVD risk.
• Associations between Asian diet quality indices and CVD risk were weaker compared to non-Asian indices.

Conclusions:

• High-quality dietary patterns are associated with reduced cardiovascular disease risk in Asian populations.
• Existing Asian diet quality criteria may require refinement to accurately assess CVD risk.
• Further research is needed to develop and validate culturally relevant dietary assessment tools for cardiovascular health in Asia.