The researchers also note that possible substitutes include whole grains in one serving per day and unprocessed red meat or poultry in one serving per day.

Simply put, the closer participants were to this ideal cadence, the higher their score.

A higher PURE diet score was associated with a significantly lower risk of death or cardiovascular disease in regions with lower than with higher gross national income, supporting the importance of diet in low-income regions.

However, it is equally important to encourage access to whole and natural foods in low-income areas and in areas far from supermarkets.

In two additional controlled studies, a higher dietary score was also associated with a lower risk of heart attack and stroke.

The study found that a 20% improvement was associated with an 8% lower risk of death and a 6% lower risk of major cardiovascular events. So the PURE diet doesn’t have to be perfect, any improvement counts.