PORTLAND, Oregon — Diets filled with too much salt and not enough vegetables, fruits and whole grains contributed to 400,000 deaths in 2015 from heart and blood vessel diseases, according to an analysis presented Thursday.

Researchers investigating how diet impacts cardiovascular disease found that unhealthy choices – both a lack of nutritious foods and an excess of less healthy foods – played a role in the deaths of an estimated 222,100 men and 193,400 women.

“Low intake of healthy foods such as nuts, vegetables, whole grains and fruits combined with higher intake of unhealthy dietary components, such as salt and trans fat, is a major contributor to deaths from cardiovascular disease in the United States,” said Ashkan Afshin, M.D., the study’s lead author.

“Our results show that nearly half of cardiovascular disease deaths in the United States can be prevented by improving diet,” said Afshin, who also is acting assistant professor of global health at the University of Washington’s Institute for Health Metrics and Evaluation in Seattle. The institute is home of the Global Burden of Diseases, Injuries and Risk Factors Study, which conducted the new analysis.

The study relied on several sources, including 1990-2012 data from the federal government’s National Health and Nutrition Examination Survey, which is a combination of interviews and physicals to assess the health and nutritional status of adults and children. It also used food availability data from the Food and Agriculture Organization of the United Nations.

The researchers evaluated to what extent leading risk factors in diet were linked to heart and blood vessel disease deaths. They found low intake of nuts and seeds was linked to 11.6 percent of deaths, low vegetable intake was linked to 11.5 percent of deaths and low intake of whole grains was tied to 10.4 percent of deaths. Excess salt was linked to 9 percent of deaths.

The new research’s key strengths, Afshin said, is that it quantifies how diet can contribute to heart disease deaths and defines the healthiest diet to prevent it.

In 2013, the American College of Cardiology and the American Heart Association issued guidelines to encourage a healthy eating pattern. It included suggestions for eating a variety of fruits and vegetables, whole grains, non- and low-fat dairy products, skinless poultry, fish, nuts, beans and non-tropical vegetable oils. It also cautioned about limiting red and processed meat, sweets and sugary drinks.

Last October, a set of AHA recommendations used those 2013 guidelines to make practical, food-based suggestions to help people make healthier choices and achieve a heart-healthy eating pattern. It listed portion sizes for commonly purchased items, such as different types of vegetables, whole grains, meat, poultry and eggs.

This week, a separate study published in the Journal of the American Medical Association, found that nearly half of all U.S. deaths — almost 320,000 deaths — from heart disease, stroke and Type 2 diabetes in 2012 were tied to a poor diet.

The new analysis of eating patterns released Thursday was funded by the Bill and Melinda Gates Foundation. It was presented at the AHA’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2017 Scientific Sessions.