Controversial Dietary Patterns: A High Yield Primer for Clinicians - 24/05/22

Doi : 10.1016/j.amjmed.2022.01.028

Monica Aggarwal, MD ^a,^⁎ , Emilio Ros, MD, PhD ^b, Kathleen Allen, MS, RD ^c, Geeta Sikand, MA, RD ^d, Anandita Agarwala, MD ^e, Karen Aspry, MD ^f,^g, Penny Kris-Etherton, RD, PhD ^h, Stephen Devries, MD ^i,^j, Koushik Reddy, MD ^k, Tamanna Singh, MD ^l, Sheldon E. Litwin, MD ^m,ⁿ, James O’ Keefe, MD ^o, Michael Miller, MD ^p, Bruce Andrus, MD ^q, Ron Blankstein, MD ^r, Columbus Batiste, MD ^s, Danielle Belardo, MD ^t, Christopher Wenger, DO ^u, Travis Batts, MD ^v, Neal D. Barnard, MD ^w,^x, Beth A. White, DNP, NP-C ^y, Dean Ornish, MD ^z,^aa, Kim A. Williams, MD ^bb, Robert J. Ostfeld, MDMSc ^cc, Andrew M. Freeman, MD ^dd
^a Division of Cardiology, University of Florida, Gainesville
^b Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona and Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
^c Geisel School of Medicine at Dartmouth, Hanover, NH
^d Heart Disease Prevention Program, University of California Irvine
^e Cardiovascular Division, Baylor Scott and White the Heart Hospital – Plano, Texas
^f Division of Cardiology, Lifespan Cardiovascular Institute, East Providence, RI
^g Brown University, Providence, RI
^h Department of Nutritional Sciences, Penn State University, University Park, Pa
ⁱ Gaples Institute for Integrative Cardiology, Deerfield, Ill
^j Northwestern University Feinberg School of Medicine, Chicago, Ill
^k Division of Cardiology, James A Haley VA Medical Center, University of South Florida, Tampa
^l Division of Cardiovascular Medicine, Heart, Vascular, Thoracic Institute Cleveland Clinic, Ohio
^m Division of Cardiology, Medical University of South Carolina, Charleston
ⁿ Division of Cardiology, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
^o Saint Luke's Mid America Heart Institute, Kansas City, Mo
^p Division of Cardiology, University of Maryland School of Medicine, Baltimore
^q Division of Cardiology, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebanon, NH
^r Division of Cardiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass
^s Division of Cardiology, Kaiser Permanente Riverside Medical Center, Charleston, SC
^t Institute of Plant-Based Medicine, Newport Beach, Calif
^u Division of Cardiology, WellSpan Health, York, Pa
^v Division of Cardiology, Department of Medicine, Wilford Hall Ambulatory Surgical Center, San Antonio, Texas
^w George Washington University School of Medicine, Washington, DC
^x Physicians Committee for Responsible Medicine, Washington, DC
^y Division of Cardiology Marshall Health, Joan C. Edward School of Medicine, Huntington, WV
^z Preventive Medicine Research Institute, Sausalito, Calif
^aa University of California, San Francisco
^bb Division of Cardiology, Rush University Medical Center, Chicago, Ill
^cc Division of Cardiology, Montefiore Health System, Bronx, NY
^dd Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colo

^⁎Requests for reprints should be addressed to Monica Aggarwal, MD, Division of Cardiovascular Medicine, Cardiology, University of Florida, 4037 NW 86th Terrace, PO Box 100288, 1329 SW 16th Street, RM 5120.2, Gainesville, FL 32606.Division of Cardiovascular MedicineCardiologyUniversity of Florida4037 NW 86th Terrace, PO Box 100288, 1329 SW 16th Street RM 5120.2GainesvilleFL32606

Abstract

In cardiology clinic visits, the discussion of optimal dietary patterns for prevention and management of cardiovascular disease is usually very limited. Herein, we explore the benefits and risks of various dietary patterns, including intermittent fasting, low carbohydrate, Paleolithic, whole food plant-based diet, and Mediterranean dietary patterns within the context of cardiovascular disease to empower clinicians with the evidence and information they need to maximally benefit their patients.

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Keywords : Cardiovascular disease, Diet, Dietary patterns, Education, Heart disease, Nutrition

Plan

Intermittent Fasting

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Low-Carbohydrate and Ketogenic Diets

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The Paleolithic or Paleo Diet

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Whole Food Plant-Based Diet

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Mediterranean Diet

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Dietary Approaches to Stop Hypertension (DASH) Diet

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Conclusions

	Funding: None.
	Conflicts of Interest: MA receives royalties as an author and honoraria as a speaker. ER has received grants for research through his institution and honoraria as a speaker from the California Walnut Commission and is a nonpaid member of its Scientific Advisory Committee. NDB serves without financial compensation as president of the Physicians Committee for Responsible Medicine and Barnard Medical Center, nonprofit organizations providing education, research, and medical care related to nutrition. He receives royalties as an author and honoraria as a speaker. SD is the executive director of the educational nonprofit Gaples Institute that offers continuing medical education-approved nutrition courses for sale to health professionals. Courses are developed entirely through philanthropy to the Gaples Institute, a nonprofit that does not seek or receive corporate support. SD receives no royalties or personal consideration of any kind from the sale of these courses. CB is President Inland Empire Chapter of the American Heart Association—no compensation; serves on The Plantrician Project Board of Advisors, Heart Health Nation Board of Directors, and Game Changers Foundation Board of Directors—no compensation. JO has an ownership interest in CardioTabs. DO consults with Sharecare and Beyond Meat and receives royalties as an author and honoraria as a speaker. PK-E serves on the Seafood Nutrition Partnership Scientific and Nutrition Advisory Council, and has research funding from the Hass Avocado Board and the McCormick Science Institute. RJO received research grants from the Purjes and Greenbaum Foundations and consulted for Better Therapeutics (2018). He is also a speaker for Main Street Vegan Academy and the International Plant-Based Nutrition Healthcare Conference. He is on the Board of Directors (uncompensated) for T. Colin Campbell Center for Nutrition Studies, sits on the Scientific Advisory Board (uncompensated) for Physician Committee for Responsible Medicine, and consulted for Brightplate. AMF has done non-promotional speaking and consulting with Boehringer Ingelheim and Medtronic, and has served on advisory boards with Regeneron, The Medicines Company, and United Therapeutics.
	All other authors have no conflicts of interest to report.
	Authorship: All authors had access to the data and a role in writing the manuscript.