Participants who ate a healthier plant-based diet had a decreased risk for CHD, according to a study published in the Journal of the American College of Cardiology.
“When we examined the associations of the three food categories with heart disease risk, we found that healthy plant foods were associated with lower risk, whereas less healthy plant foods and animal foods were associated with higher risk,” Ambika Satija, ScD, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health, said in a press release. “It’s apparent that there is a wide variation in the nutritional quality of plant foods, making it crucial to take into consideration the quality of foods in a plant-based diet.”
Researchers reviewed data from 73,710 women from the Nurses’ Health Study, 92,329 women from the Nurses’ Health Study II and 43,259 men from the Health Professionals Follow-Up Study who did not have chronic diseases at baseline. Participants completed a semiquantitative food frequency questionnaire every 2 to 4 years.
Plant-based diet indices
Three kinds of a plant-based diet were developed based on questionnaire responses: plant-based diet index, healthful plant-based diet index and unhealthful plant-based diet index. The overall plant-based diet index included mainly plant-based foods with no animal-based foods, including dairy, fish and meat. The healthful plant-based diet included everything from the overall plant-based diet without less healthy foods such as refined grains, potatoes, sugar-sweetened beverages and fruit juices. The unhealthful plant-based diet featured less healthful plant-based foods known to be associated with elevated risk for certain diseases.
Throughout 4,833,042 person-years of follow-up, CHD occurred in 8,631 participants. A pooled multivariable analysis showed that an overall plant-based diet index was inversely linked to CHD (HR comparing extreme deciles = 0.92; 95% CI, 0.83-1.01). The association was stronger in the healthful plant-based diet index (HR comparing extreme deciles = 0.75; 95% CI, 0.68-0.83). The unhealthful plant-based diet index had a positive association with CHD (HR comparing extreme deciles = 1.32; 95% CI, 1.2-1.46).
The links between the risk for CHD and either overall plant-based diet index or healthful plant-based diet index were similar by age, sex, family history of CHD and BMI.
“Dietary guidelines and lifestyle interventions could recommend increasing intake of healthy plant foods while reducing intake of less healthy plant foods and certain animal foods for improved cardiometabolic health,” Satija and colleagues wrote.
Kim Allan Williams
The healthful plant-based diet index “means both a challenge and an opportunity for cardiology,” Kim Allan Williams Sr., MD, professor of cardiovascular disease at Rush University Medical Center in Chicago, past president of the American College of Cardiology and a Cardiology Today Editorial Board Member, and Hena Patel, MD, a cardiologist at Rush University Medical Center, wrote in a related editorial. “Until recently, as a group, cardiologists have not delved deeply into nutrition, treating CVD’s downstream effects rather than obliterating its roots, leaving primary and secondary prevention opportunities on the table. It is time that we educate ourselves on dietary patterns, risk and outcomes and focus more on ‘turning off the faucet’ instead of ‘mopping up the floor.’” – by Darlene Dobkowski
This study was supported by research grants from NIH. Patel, Satija and Williams report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.