"This study indicates that the same relationships that are observed in Western countries exist in different regions of the world," says the study's senior author, Salim Yusuf, a professor of medicine at McMaster University in Hamilton.
For the study in Tuesday's issue of the journal Circulation, Yusuf and his colleagues surveyed 16,000 people in 52 countries, and analyzed 5,761 cases of heart attack.
Participants gave blood samples and filled in detailed diaries on what they ate between February 1999 and March 2003. Depending on what participants reported, they were divided into three dietary groups.
After adjusting for known risk factors, the researchers found:
People who consumed the "prudent" diet of more fruits and vegetables had a 30 per cent lower risk of heart attack compared with people who ate few or no fruits and vegetables.
People who consumed the "Western" diet had a 35 per cent greater risk of having a heart attack compared with people who consumed few fried foods and little meat.
The "Oriental" diet, which is loaded with tofu but also high in salty soy sauce, showed no relationship with heart attack risk.
The results clarify that it's the eating of Western food that drives up the risk of heart attacks, rather than other lifestyle factors such as lack of exercise, Yusuf and his colleagues say.
"Diet is serious for the individual, but also if we can make population-level changes, we can prevent a lot of heart attacks, using, you know, relatively simple measures," said study author Dr. Sonia Anand, a medical professor at McMaster.
Also on Monday, a series of reports published in the medical journal the Lancet concluded that worsening diets and unhealthy habits in China are contributing to a looming health crisis in the increasingly wealthy country, CBC News reports.
"The pace and spread of behavioural changes including changing diets, decreased physical activity, high rates of male smoking and other high-risk behaviours has accelerated to an unprecedented degree," one report says.
The journal said 177 million Chinese adults suffer from hypertension, which it blamed in part on high salt consumption.
"People don't want to eat boring when they eat healthy," says Julie Lau of the B.C. Heart and Stroke Foundation in Vancouver. Lau consults with large restaurant chains to help them offer healthier choices.
"They want to have lots of flavour, so we tried to recreate the flavour without using a lot of salt, without using a lot of fat."
Yusuf's study was funded by the Canadian Institutes of Health Research; the Heart and Stroke Foundation of Ontario; the International Clinical Epidemiology Network; and unrestricted grants from several pharmaceutical companies.