Rx Nutrition Resource Center

Rx Nutrition Resource Center

Perspective from Monica Aggarwal, MD, FACC
Disclosures: Hu reports he received personal fees from Diet Quality Photo Navigation and Standard Process. Shan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
June 15, 2020
3 min read
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Strong adherence to healthy eating patterns yields CV benefit

Perspective from Monica Aggarwal, MD, FACC
Disclosures: Hu reports he received personal fees from Diet Quality Photo Navigation and Standard Process. Shan reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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People with greater adherence to healthy eating patterns had a lower risk for CVD, according to a study published in JAMA Internal Medicine.

“We found that following a variety of healthy eating patterns such as the Mediterranean diet or plant-based diet significantly lowered the risk of cardiovascular disease in both men and women and in different racial and ethnic groups,” Frank B. Hu, MD, PhD, professor and chair of the department of nutrition at Harvard T.H. Chan School of Public Health, told Healio. “Although these patterns vary in specific constituents, they share common components such as increased consumption of fruits, vegetables, whole grains, legumes and nuts, and lower consumption of red and processed meats and added sugar.”

Healthy Foods in Container
Source: Adobe Stock.

Food frequency data

Zhilei Shan, MD, PhD, postdoctoral fellow in the department of nutrition at Harvard T.H. Chan School of Public Health, and colleagues analyzed data from 74,930 women (mean age, 50 years) from the Nurses’ Health Study, 90,864 women from the Nurses’ Health Study II (mean age, 36 years) and 43,339 men from the Health Professionals Follow-Up Study (mean age, 53 years).

All participants completed a validated semiquantitative food frequency questionnaire at baseline and were asked about their dietary habits every 2 to 4 years. This information was used to calculate adherence to different dietary patterns with the healthy eating index-2015, the healthful plant-based diet index, the alternate Mediterranean diet score and the alternate healthy eating index.

Researchers assessed incident cases of CVD, defined as fatal and nonfatal stroke, and fatal and nonfatal CHD, which included CABG and nonfatal MI.

Zhilei Shan

There were 23,366 cases of incident CVD during 5,257,190 person-years of follow-up. Of these events, 5,687 were stroke and 18,092 were CHD, and some patients had both stroke and CHD.

Researchers compared the highest quintiles with the lowest quintiles for the scores that were calculated. The pooled multivariable-adjusted HR for CVD was 0.83 for the alternate Mediterranean diet score (95% CI, 0.79-0.86), 0.83 for the healthy eating index-2015 (95% CI, 0.79-0.86), 0.79 for the alternate healthy eating index (95% CI, 0.75-0.82) and 0.86 for the healthful plant-based diet index (95% CI, 0.82-0.89; P for trend for all < .001).

The risk for CVD decreased by 10% to 20% with a 25-percentile higher dietary score according to the alternate Mediterranean diet score (HR = 0.9; 95% CI, 0.87-0.92), the healthy eating index-2015 (HR = 0.8; 95% CI, 0.77-0.83), for the alternate healthy eating index (HR = 0.81; 95% CI, 0.78-0.84) and for the healthful plant-based diet index (HR = 0.86; 95% CI, 0.82-0.89).

Frank B. Hu
Source: Harvard T.H. Chan School of Public Health

The four dietary scores were significantly linked to a lower risk for both stroke and CHD. The inverse association between the scores and the risk for CVD were consistent in most subgroups when analyses were stratified by race/ethnicity and other CVD risk factors.

Healthy eating patterns

“A common misconception is that there is a magic bullet diet to health and longevity, but no such magic diet solution exists,” Hu said in an interview. “To improve health, there is no one-size-fits-all diet that is best for everyone. One can combine a wide range of healthy foods in a variety of flexible ways to achieve healthily and balanced eating patterns according to individuals’ health needs, food preferences and cultural traditions.”

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For more information:

Frank B. Hu, MD, PhD, can be reached at fhu@hsph.harvard.edu.