Macronutrients and cardiovascular diseases: A narrative review of recent scientific literature

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. This narrative review explores the relationship between macronutrient intake and CVD risk, focusing on carbohydrates, proteins, and fats. The goal is to examine how specific types of macronutrients influence cardiovascular health and how dietary guidelines, such as those from the World Health Organization (WHO), can reduce the incidence of both fatal and non-fatal cardiovascular events.

This narrative review draws upon existing research and WHO dietary guidelines to assess the impact of various macronutrients on cardiovascular outcomes. We searched the relevant literature up to December 2024 using Pubmed and Google Scholar. Key macronutrient groups-carbohydrates (with a focus on glycemic index and glycemic load), proteins (plant-based vs. animal-based), and fats (saturated, trans, polyunsaturated, and monounsaturated)-were analyzed to understand their roles in CVD prevention.

Low glycemic index (GI) and glycemic load (GL) were found to be associated with reduced CVD risk. Protein intake showed no significant direct association with CVD risk, but higher consumption of plant-based proteins was correlated with a reduced risk. Replacing animal proteins with plant-based alternatives led to improved lipid profiles, including reductions in total and low-density lipoprotein (LDL) cholesterol levels. Fats, particularly saturated and trans fats, were strongly linked to increased CVD risk. WHO guidelines recommend limiting these fats and replacing them with healthier alternatives, such as polyunsaturated and monounsaturated fats or slow-digesting carbohydrates, to lower CVD risk.

Macronutrients play a critical role in cardiovascular health, with specific types of carbohydrates, proteins, and fats having varying impacts on CVD risk. Future research should explore the complex interactions between these macronutrients, dietary patterns, and cultural factors to optimize global dietary guidelines for CVD prevention. Replacing high-GI carbohydrates, saturated fats, and trans fats with healthier alternatives is crucial for reducing cardiovascular risk globally.