ArticleEuropean heart journal2023
Diet, cardiovascular disease, and mortality in 80 countries.
Article in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 5 of them syntheses that pooled it.
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Who cites it
86 citing papers in PubMed, 5 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- Association of 15 common dietary factors with tinnitus: a systematic review and meta-analysis of observational studies.BMJ open · 2025Pooled it
- Impact of Oral Hygiene Practices in Reducing Cardiometabolic Risk, Incidence, and Mortality: A Systematic Review.International journal of environmental research and public health · 2024Pooled it
- Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis.Advances in nutrition (Bethesda, Md.) · 2024Pooled it
- Latin-American guidelines of recommendations at discharge from an acute coronary syndrome.Archivos de cardiologia de Mexico · 2024Guideline
- Diet Quality and Risk of SARS-CoV-2 Infection or COVID-19: A Systematic Review of Observational Studies.Advances in nutrition (Bethesda, Md.) · 2023Pooled it
- Healthy lifestyle factors and recurrent cardiovascular events in patients with OSA: the SAVE study.BMC medicine · 2025Trial
- Generation of contrast-enhanced cardiac MRI from contrast-free scans: a multi-center, multi-manufacturer study.European radiology · 2026Article
- Time-Varying Impact of Steatosis and Alcohol on Mortality: A Marginal Structural Model of the Canadian Longitudinal Study on Aging.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Alignment of Food Policies and Cardiovascular Disease Burden: Insights from the Literature.Current atherosclerosis reports · 2026Review
- Article
- Navigating plant-based diets: increased cardiovascular risk in those with unhealthy plant-based dietary plans in people with pre-diabetes or diabetes.Evidence-based nursing · 2026Article
- Polyphenols and Cardiovascular Health: Emerging Relevance for Blueberries, Grapes, and Red-Fleshed Table Grapes.Nutrients · 2026Review
- Adherence to the DASH Diet in the Spanish Population and Its Environmental Impact: An Ecological Study.Nutrients · 2026Article
- Adherence to the eat-lancet planetary health diet and sustainability impacts of the Swiss diet.European journal of nutrition · 2026Article
- Circulating Rhythmic Metabolites and Causal Risk of Type 2 Diabetes in Adults in the Canadian Longitudinal Study on Aging.Diabetes, obesity & metabolism · 2026Article
- Association of Legume Intake with Incident Hyperuricemia: A Prospective Cohort Study in Shanghai Adult Residents.Nutrients · 2026Article
- Ibero-American position statement on therapeutic recommendations for the preventive management of cardiovascular complications in latin-American patients with type 2 diabetes mellitus: consensus of the prevention council of the inter-American society of cardiology (SIAC-PREVENT).Diabetology & metabolic syndrome · 2026Review
- The association between the Prospective Urban Rural Epidemiology (PURE) healthy diet score and cognitive decline in Chinese older adults.NPJ science of food · 2026Article
- Associations and interaction effects of socioeconomic, lifestyle, and genetic factors on intrinsic capacity.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Programmable Pentamolecular Cross-Scale Imaging Reveals the Multiplicative Synergistic Effect of High-Fat / High-Salt Diet on Atherosclerosis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
26 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
35 authors at 20 institutions in 19 countries.
Funding
Abstract
aimsTo develop a healthy diet score that is associated with health outcomes and is globally applicable using data from the Prospective Urban Rural Epidemiology (PURE) study and replicate it in five independent studies on a total of 245 000 people from 80 countries. METHODS AND
resultsA healthy diet score was developed in 147 642 people from the general population, from 21 countries in the PURE study, and the consistency of the associations of the score with events was examined in five large independent studies from 70 countries. The healthy diet score was developed based on six foods each of which has been associated with a significantly lower risk of mortality [i.e. fruit, vegetables, nuts, legumes, fish, and dairy (mainly whole-fat); range of scores, 0-6]. The main outcome measures were all-cause mortality and major cardiovascular events [cardiovascular disease (CVD)]. During a median follow-up of 9.3 years in PURE, compared with a diet score of ≤1 points, a diet score of ≥5 points was associated with a lower risk of mortality [hazard ratio (HR) 0.70; 95% confidence interval (CI) 0.63-0.77)], CVD (HR 0.82; 0.75-0.91), myocardial infarction (HR 0.86; 0.75-0.99), and stroke (HR 0.81; 0.71-0.93). In three independent studies in vascular patients, similar results were found, with a higher diet score being associated with lower mortality (HR 0.73; 0.66-0.81), CVD (HR 0.79; 0.72-0.87), myocardial infarction (HR 0.85; 0.71-0.99), and a non-statistically significant lower risk of stroke (HR 0.87; 0.73-1.03). Additionally, in two case-control studies, a higher diet score was associated with lower first myocardial infarction [odds ratio (OR) 0.72; 0.65-0.80] and stroke (OR 0.57; 0.50-0.65). A higher diet score was associated with a significantly lower risk of death or CVD in regions with lower than with higher gross national incomes (P for heterogeneity <0.0001). The PURE score showed slightly stronger associations with death or CVD than several other common diet scores (P < 0.001 for each comparison).
conclusionA diet comprised of higher amounts of fruit, vegetables, nuts, legumes, fish, and whole-fat dairy is associated with lower CVD and mortality in all world regions, especially in countries with lower income where consumption of these foods is low.
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