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Higher intake of six key foods —including nuts— is linked to lower risk of major cardiovascular events and all-cause mortality

In a recent study published in the European Heart Journal, researchers developed a healthy diet score using data from the Prospective Urban Rural Epidemiology (PURE) study and set out to determine whether this score is consistently associated with better health outcomes across different regions of the world and predictive of outcomes in people both with and without vascular disease or diabetes.

The PURE study, which included 147,642 people from 21 countries and had a median follow-up time of 9.3 years, formed the basis of the PURE healthy diet score. Ranging from 0 (worst) to 6 (best) points, the PURE scale assesses intake levels of six foods —fruit, vegetables, nuts, legumes, fish and dairy— all of which are linked to a significantly lower risk of death.

The authors then assessed the link between the PURE healthy diet score and major cardiovascular events and all-cause mortality using data from five independent studies that together had a total of 96,955 participants, bringing the total number of participants involved in the development and validation of the scoring system to 244,597. The researchers found that the PURE scale was associated with a lower risk of death or major cardiovascular event in people both with and without vascular disease or diabetes, as well as across geographic regions and income levels. The association was stronger, however, in South Asia, China, and Africa —countries with low PURE healthy diet scores.

Specifically, the study showed that a 20% improvement in diet, as measured by the PURE healthy diet score, is associated with an 8% lower risk of death and a 6% lower risk of major cardiovascular events. The findings underscore the importance of consuming these six healthy foods —including nuts.

Mente, A., Dehghan, M., Rangarajan, S., O’Donnell, M., Hu, W., Dagenais, G., Wielgosz, A., A Lear, S., Wei, L., Diaz, R., Avezum, A., Lopez-Jaramillo, P., Lanas, F., Swaminathan, S., Kaur, M., Vijayakumar, K., Mohan, V., Gupta, R., Szuba, A., Iqbal, R., … Yusuf, S. (2023). Diet, cardiovascular disease, and mortality in 80 countries. European Heart Journal, 44(28), 2560–2579.

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