Previous and similar research has focused on Western countries and diets that combined harmful, ultra-processed foods with nutrient-dense foods. This research was global in scope and focused on foods commonly considered to be healthy. Researchers derived a diet score from PHRI's ongoing, large-scale global Prospective Urban and Rural Epidemiological (PURE) study, then replicated that in five independent studies to measure health outcomes in different world regions and in people with and without prior CVD.

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