Sex differences in cardiovascular risk may be related to sex differences in diet patterns: a narrative review

Context Cardiovascular disease (CVD) is the leading cause of death in the United States and globally. The social and biological differences in diet patterns among men and women may play a role in their differential cardiovascular risk.Objective To describe the dietary patterns associated with CVD risk and investigate the differences in diet patterns between men and women, if these differences affect cardiovascular risk, and to explore potential mechanisms of action.Methods Diet patterns associated with CVD risk were described based on epidemiological and experimental trials. Observational and experimental studies together with systematic and non-systematic reviews were synthesised to examine sex differences in diet and cardiovascular risk factors.Results Differences in vasculature and body composition between sexes may be mediated by dissimilarities in adherence to diet patterns and nutrient metabolism. Salt sensitivity and breakdown and storage of lipids may account for some differences in CVD risk between men and women. Sex differences in social norms, cognitive processing, and odour perception may be affected by biological differences and contribute to differences in cardiovascular risk and dietary patterns.Conclusion The relation between diet patterns and cardiovascular risk is well-established and sex differences in diet patterns likely differentially affect CVD risk between men and women.