Findings from a prospective cohort study challenge current global dietary guidelines. A total of 135 335 individuals aged 35 to 70 years without cardiovascular disease (CVD) were enrolled between Jan 1, 2003, and March 31, 2013 from 613 communities in 18 low-income, middle-income, and high-income countries in seven geographical regions globally. Validated questionnaires were used to collect dietary intake and other relevant information. During a median 7·4 years of follow-up, 5796 total deaths, 4784 major CVD events, and 1649 CVD deaths were documented. High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Higher saturated fat intake was associated with lower risk of stroke. Reducing saturated fatty acid intake and replacing it with carbohydrate had an adverse effect on blood lipids. Higher fruit, vegetable, and legume consumption was associated with a lower risk of non-CVD, and total mortality. Benefits appeared to be maximum for both non-CVD mortality and total mortality at three to four servings per day (equivalent to 375–500 g/day). Dietary exposures in general have modest effects on individual clinical outcomes but have very large long-term population effects. Source: http://www.thelancet.com/
