Evolving Research Focus on Diet and Cardiovascular Disease: A Systematic Review of 298 Cohort Studies Published from 2019 to 2024

Background/Objectives: Cardiovascular diseases (CVDs) are a leading cause of mortality globally. Growing studies have been conducted to examine the diet–CVD association to alleviate the health and economic burdens associated with CVDs, but beneficial dietary factors may vary by study region and cohort. There was a need to identify the trends in diet–CVD research by study region and current emerging dietary exposures of interest, which could inform areas for future research and the regions where evidence is relatively limited. Methods: A comprehensive search of multiple databases was performed to identify eligible prospective cohorts examining diet–CVD associations published between 2019 and 2024. Trends in dietary exposure, including dietary patterns, food groups, and nutrients, were analyzed by publication year and geographical distribution. Results: A total of 298 studies were included in the review. While the United States continued to lead in the number of CVD–diet cohort studies, China has significantly increased its contributions over the past five years, increasing from 2.1% to 14.3%. The cohorts that contributed the most to the literature included the Nurses’ Health Study and the Danish Diet, Cancer, and Health cohort. Although food groups accounted for the highest number with respect to dietary exposure overall, there was a notable shift in diet–CVD cohort studies from a focus on nutrients to dietary patterns. Plant-based and Mediterranean diets were the most frequently investigated, while ultra-processed foods and country-specific dietary indices also gained prominence. Conclusions: This systematic review highlighted the shift towards dietary patterns in nutritional epidemiology, emphasizing the importance of understanding the role of nutrition in health through holistic dietary approaches. The observed trends in dietary exposure research suggested the need for future studies to delve deeper into the complexities of dietary patterns, including how cultural and socioeconomic elements defined the nuances of country-specific dietary patterns.