Nutrition advice often feels complicated, with new trends and conflicting recommendations appearing regularly. A new global analysis suggests the biggest risks to heart health are far less exotic and far more familiar.
Researchers found that three dietary factors — high sodium intake, low fruit consumption and low intake of whole grains — were linked to an estimated 5.9 million cardiovascular deaths worldwide in 2023. The findings, published in The Innovation Nutrition and based on data from 204 countries and territories, highlight how a small number of widespread dietary patterns can have an outsized impact at a population level.
“Our findings underscore that improving dietary quality must remain a central pillar of global heart disease prevention,” said corresponding author Guoshuang Feng of Beijing Children’s Hospital.
The study draws on data from the Global Burden of Disease project, which tracks health outcomes and risk factors over time. Researchers analyzed 13 dietary risks across more than three decades to estimate how eating patterns contribute to conditions such as heart disease and stroke.
While age-adjusted death rates from cardiovascular disease have declined in many regions, the total number of deaths continues to rise. Researchers attribute this to population growth and aging, which increase the number of people at risk even as care improves.
The analysis also highlights how these dietary risks show up differently around the world. Countries such as China and India had the highest total number of diet-related cardiovascular deaths, reflecting their large populations. Smaller nations, particularly in the Pacific Islands, experienced some of the highest rates relative to population size, a pattern researchers link to shifts away from traditional diets toward more processed foods.
The findings do not point to a single food or eating pattern as the cause of heart disease. Instead, they reflect broader gaps in dietary quality. High sodium intake often comes from packaged and restaurant foods, while low intake of fruit and whole grains suggests that more nutrient-dense foods are being replaced or crowded out in daily eating habits.
Because the study relies on large-scale modeling, the results are estimates rather than direct measurements. They also do not account for every factor that influences heart health, including physical activity, access to health care and socioeconomic conditions.
Still, the scale of the findings offers a reminder that the most consistent dietary risks are not necessarily the most talked about. Rather than emerging trends, they reflect long-standing patterns in how people eat.
This study was supported by the National Natural Science Foundation of China and the Open Project of the Hebei Key Laboratory of Environment and Human Health.