Differences in risk are only partially explained by ‘classical’ risk factors, such as raised cholesterol and blood pressure, inactivity, obesity and diabetes. A new report from the British Nutrition Foundation explores the role of novel risk factors, such as influence of the gut microbiome, early nutrition and foetal development, sleep, and body fat distribution.
Emphasis on dietary patterns
It also discusses the increased emphasis on dietary patterns compared to the role of specific nutrients in CVD risk – for example, the finding that trials with antioxidant supplements failed to reduce CVD events, whereas dietary patterns rich in fruits and vegetables are associated with reduced risk.
There is now strong evidence that higher dietary fibre intake is associated with lower CVD mortality, and it is thought that the gut microbiota’s interaction with dietary fibre has a role to play, positively affecting blood cholesterol and the body’s immune response.
Risk into adulthood
Lower birthweight coupled with faster growth in childhood and adolescence is now consistently linked with higher risk of CVD in adulthood. There is also consistent evidence linking maternal obesity and gestational diabetes with high risk of obesity, early-onset diabetes and CVD in offspring. This underlines the need for a healthy diet and lifestyle in childhood and for young women.
Chronic low-grade inflammation, often linked with obesity, is associated with fat deposition in artery walls. Weight loss and improving the vitamin and mineral quality of the diet, specifically by choice of foods, reduce markers of inflammation. Their potential to benefit CVD risk is being explored.
Judy Buttriss is director general of the British Nutrition Foundation.