Higher plant-to-animal protein ratio linked to lower risk for CVD, CAD among U.S. adults
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Key takeaways:
- A higher plant-to-animal protein ratio was tied to a 19% lower risk for CVD and 27% lower risk for CAD.
- Replacing red and processed meats with plant protein sources provided additional heart health benefits.
A higher plant-to-animal protein ratio was associated with lower risks for CVD and CAD among adults in three ongoing U.S. prospective cohort studies, according to a study published in the American Journal of Clinical Nutrition.
“The average American eats a 1:3 plant-to-animal protein ratio,” Andrea J. Glenn, MSc, RD, PhD, visiting scientist in the department of nutrition at Harvard T.H. Chan School of Public Health and assistant professor in the department of nutrition and food studies at New York University, said in a press release. “Our findings suggest a ratio of at least 1:2 is much more effective in preventing CVD. For CHD prevention, a ratio of 1:1.3 or higher should come from plants.”
To examine associations between plant-to-animal protein ratios and incident CVD, CAD and stroke, Glenn and colleagues analyzed data from 70,918 women in the Nurses’ Health Study, 89,205 women in the Nurses’ Health Study II and 42,740 men in the Health Professionals Follow-up Study.
To determine participants’ dietary intake, a validated semiquantitative food frequency questionnaire was administered every 4 years until 2016 to 2017 starting in 1984 in the Nurses’ Health Study, 1991 in the Nurses’ Health Study II and 1986 in the Health Professionals Follow-up Study.
The researchers defined CVD as a composite of incident nonfatal MI, fatal CAD and fatal and nonfatal stroke.
During 30 years of follow-up, 16,118 incident CVD cases occurred, including 10,187 CAD cases and 6,137 stroke cases, according to the study.
Across all cohorts, the top contributors to animal protein were poultry, red meat and dairy, whereas the top contributors to plant protein were refined grains, whole grains, potatoes, nuts and beans, according to the researchers.
Pooled multivariable-adjusted models comparing highest to lowest deciles of the plant-to-animal ratio (approximate ratio, 0.76 vs. 0.24) revealed that participants had a lower risk for total CVD (HR = 0.81; 95% CI, 0.76-0.87) and CAD (HR = 0.73; 95% CI, 0.67-0.79), but not stroke (HR = 0.98; 95% CI, 0.88-1.09).
In dose-response analyses, total CVD (P linearity < .001; P curvature < .001) and CAD (P linearity < .001; P curvature < .001) showed evidence of linear and nonlinear relationships with marked risk reductions observed early in the dose-response curve, according to the researchers.
They also observed a lower risk for CVD (HR = 0.72; 95% CI, 0.64-0.82) and CAD (HR = 0.64; 95% CI, 0.55-0.75) when higher ratios (> 0.5) were combined with higher protein density (median, 20.8%).
Additionally, substitution analyses revealed that replacing 3% of energy from animal protein with 3% of energy from plant protein was associated with an 18% lower risk for CVD and a 24% lower risk for CAD.
“Most of us need to begin shifting our diets toward plant-based proteins,” Frank B. Hu, MD, MPH, PhD, Fredrick J. Stare Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health, said in the release. “We can do so by cutting down on meat, especially red and processed meats, and eating more legumes and nuts. Such a dietary pattern is beneficial not just for human health but also the health of our planet.”
Glenn and colleagues acknowledged several study limitations, including “the number of participants excluded from the analysis, reliance on self-reported dietary intake and the observational study design; therefore, measurement errors and residual confounding cannot be ruled out.”
Reference:
- Higher ratio of plant protein to animal protein may improve heart health. https://www.hsph.harvard.edu/news/press-releases/higher-ratio-of-plant-protein-to-animal-protein-may-improve-heart-health/. Published Dec. 2, 2024. Accessed Dec. 4, 2024.
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