This article is more than 5 years old. Information may no longer be current.
Plant-based diet yields positive effect on HF risk
ANAHEIM, Calif. — Adherence to a mostly plant-based diet lowered the risk for HF compared with diets that incorporate fewer plant-based foods among adults without CAD, researchers reported at the American Heart Association Scientific Sessions.
In an analysis of black and white adult participants of the REGARDS study, high adherence to a mostly plant-based diet reduced the risk for HF by 28% during a median follow-up period of 8.5 years vs. four other dietary patterns.
The new data suggest that “eating at least five to seven servings of fruits and vegetables every day while avoiding processed foods, which are loaded with salt, and fried foods, and eating lean proteins like fish and poultry provide a well-balanced, heart-healthy diet,” Kyla M. Lara, MD, internal medicine resident at Icahn School of Medicine at Mount Sinai, said during a press conference.
The researchers used data collected for the NIH-funded REGARDS study of adults aged at least 45 years, who were recruited from 2003 to 2007 and followed for several years. The participants did not have a diagnosis of CAD or HF at the start of the study. Fifty-six percent of participants were women, 48% were black and 56% resided in the “stroke belt” or “stroke buckle” regions in the southeastern U.S.
“This was a great group to study because people who live in this particular geographic area of the southeastern United States, also known as the stroke belt — or the stroke buckle — suffer from a higher risk of death from stroke. It’s extremely important for us to better understand the major risk factors that contribute to this and also cardiovascular disease,” Lara said.
More than 18,000 participants reported their diets using a food-frequency questionnaire. Each participant received a score for each pattern to reflect how closely their diet resembled their dietary pattern. Lara told Cardiology Today that this approach “reflects the real world and how people actually eat.”
The five dietary patterns were:
- alcohol/salads: wine, beer, liquor, salad dressings, nuts and seeds, green leafy vegetables;
- convenience: fast foods, red meats, pastas, fried potatoes;
- plant-based: fruits, vegetables, lean poultry, fish, cereal, fruit juice;
- Southern: added fats, fried foods, organ and processed meats, fatty milk, eggs/egg dishes; and
- sweets: added fats, bread, chocolate, desserts, sweet breakfast foods.
During approximately 8.5 years of median follow-up, 594 participants were hospitalized for incident HF. Using multivariable analysis, the researchers determined that greatest adherence to the plant-based dietary pattern during the study period was the only diet associated with reduced risk for developing HF. Lara and colleagues observed a positive association with the Southern dietary pattern and incident HF, but this finding was attenuated and was no longer significant after multivariable adjustment for age, sex, race, education, region, smoking, physical activity and other factors.
“We’re hearing a lot in the news about specific diets like low-fat, high-protein, low-carb and other diets that decrease cardiovascular risk. We would love it, as physicians, if we could prescribe a specific diet to limit cardiovascular risk in our patients. I’m excited about our study because, instead of examining patterns of what we already know are healthy, we looked at foods people were regularly consuming in the United States and developed dietary patterns from this,” Lara said. “This study is similar to other work we have done with stroke and heart attack.”
However, the researchers caution that this is an observational study, so it does not prove cause and effect of these diets on HF risk.
“The take-home message is that counseling our patients who have risk factors for developing heart disease and HF — even for a couple minutes during every visit — about improving their diet, in terms of implementing plant-based foods, cruciferous vegetables, thinking about serving sizes and how they’re cooking these vegetables, and being mindful about how many servings of fruits and vegetables, quality of type of protein they’re eating, can have implications down the road in terms of whether or not they develop HF,” Lara told Cardiology Today. – by Katie Kalvaitis, with additional reporting by Darlene Dobkowski
Reference:
Lara K, et al. M2081. Presented at: American Heart Association Scientific Sessions; Nov. 11-15, 2017; Anaheim, Calif.
Disclosure: Lara reports no relevant financial disclosures.
Perspective
Back to Top
For us, it’s about a good dietary approach. A plant-based diet has less salt. There’s not a profound connection there, but that the salt piece is powerful. In a lot patients with HF, it is dietary indiscretion that has them land back in the hospital.
Perspective
Back to Top
The way the researchers identified the five dietary patterns was of interest, and that could be accepted as is or criticized a little bit. The last diet was just alcohol and salads. The presenter said she knows a lot of young people who don’t eat any carbohydrates, but then they drink a lot.
My assessment of that study is that fruits, vegetables, whole grains and limited amounts of red meats are good for you, and that’s consistent with the 2013 AHA/American College of Cardiology Guideline on Lifestyle Management to Reduce Cardiovascular Risk — I co-chaired the writing committee with John M. Jakicic, PhD — in terms of LDL and BP lowering.
These people didn’t have HF [at baseline]. Somebody asked a question after the presentation as to whether dietary sodium played into this, but it didn’t. When she analyzed these various diets, sodium restriction for people with HF is indicated, but in people without HF, BP tends to be a bit lower, but that wasn’t a predictor of the outcome.
To be conclusive, a heart-healthy diet is one that is like the Mediterranean-style diet or the DASH (Dietary Approaches to Stop Hypertension) diet, and that’s really what the presenter was describing.