Table 1.

Selected Environmental Variables Associated with CVD Outcomes.

Exposure	Direction of Association with CVD
Diet	Positively associated with saturated and trans fat and cholesterol content and inversely associated with vegetable, fruit, whole grain, lean protein, and polyunsaturated fat content. Certain species of gut bacteria are positively associated through their nutrients, such as choline, L-carnitine, and phenylalanine.
Physical activity	Negatively associated with increased levels
Smoking	Positively associated with increased levels and accounts for ~250,000 annual premature deaths due to CVD in the United States alone.
Air pollution	Positively associated with increased exposure levels of particulate matter, aerosols, and volatile organic chemicals.
Sex	Men are more susceptible than women until menopause at which point risk becomes equivalent.