Plant-based food consumption associated with lower CVD risk
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Consuming a more plant-centered diet was associated with lower risk for CVD among both young adults and postmenopausal women, according to two studies published in the Journal of the American Heart Association.
“Earlier research was focused on single nutrients or single foods, yet there is little data about a plant-centered diet and the long-term risk of cardiovascular disease,” Yuni Choi, PhD, postdoctoral researcher in the division of epidemiology and community health and the department of food sciences and nutrition at the University of Minnesota School of Public Health, Minneapolis, said in a press release.
Young adults
The multicenter, prospective cohort study by Choi and colleagues included 4,946 adults initially aged 18 to 30 years without CVD. All participants were followed until 2018 and had their diets evaluated by interview-administered, validated diet history. The quality of a plant-centered diet was assessed through the A Priori Diet Quality Score, with higher scores indicating higher nutritionally rich plant food consumption and lower consumption of high-fat meat products and less healthy plant-based foods.
Researchers observed 289 incident CVD cases during the 32-year follow-up. A lower risk for CVD was associated with long-term consumption and changes toward plant-based diets. Those in the highest quintile of time-varying average diet scores had reduced CVD incidence compared with the lowest quintile (HR = 0.48; 95% CI, 0.28-0.81). In the subsequent 12 years in change analyses, an increase in diet scores over 13 years was also associated with lower CVD risk (HR = 0.33; 95% CI, 0.16-0.68).
Compared with the lowest quintile, the highest quintile of 13-year change in diet score was associated with a 61% lower subsequent 12-year CVD risk (HR = 0.39; 95% CI, 0.19-0.81). In addition, researchers noted strong inverse associations for CHD (HR = 0.21; 95% CI, 0.06-0.75) and hypertension-related CVD (HR = 0.34; 95% CI, 0.16-0.74) with time-varying average or change in diet score favoring those with a healthy plant-centered diet.
“A nutritionally rich, plant-centered diet is beneficial for cardiovascular health. A plant-centered diet is not necessarily vegetarian,” Choi said in the release. “People can choose among plant foods that are as close to natural as possible, not highly processed. We think that individuals can include animal products in moderation from time to time, such as nonfried poultry, nonfried fish, eggs and low-fat dairy.”
Postmenopausal women
In another study, Andrea J. Glenn, MSc, from the department of nutritional sciences at the University of Toronto, the Clinical Nutrition and Risk Factor Modification Center and Toronto 3D Knowledge Synthesis and Clinical Trials Unit, and colleagues prospectively followed a cohort of 123,330 postmenopausal women without CVD from the Women’s Health Initiative from 1993 to 2017. Participants were evaluated to assess the association of adhering to a Portfolio diet score with CVD outcomes.
The primary outcomes were total CVD, CHD and stroke, and secondary outcomes included HF and atrial fibrillation.
Researchers observed 13,365 total CVD events, 5,640 CHD events, 4,440 stroke events, 1,907 HF events and 929 AF events during a mean follow-up of 15.3 years.
There was an association between women who adhered to the Portfolio diet score and lower risk for total CVD (HR = 0.89; 95% CI, 0.83-0.94), CHD (HR = 0.86; 95% CI, 0.78-0.95) and HF (HR = 0.83; 95% CI, 0.71-0.99) when comparing the highest quartile of adherence to the lowest. However, there was no association between adherence to the Portfolio diet score and stroke (HR = 0.97; 95% CI, 0.87-1.08) or AF (HR = 1.1; 95% CI, 0.87-1.38).
These results remained statistically significant, even after several sensitivity analyses.
“These findings provide the strongest evidence to date on the long-term benefits of a Portfolio diet in the primary prevention of CVD, although our Portfolio diet score needs to be assessed in other cohorts/populations to confirm these findings,” the researchers wrote.
According to the researchers, results of the PortfolioEX trial assessing effects of the Portfolio diet plus exercise on a surrogate marker of atherosclerotic CVD risk are underway.
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