A Plant-based Diet May Decrease Risk of CVD in Young Adults, Older Women

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Long-term consumption of a healthy plant-based diet can help young adults and older women reduce their risk of developing cardiovascular disease (CVD), according to 2 new studies published in the Journal of the American Heart Association.

In the first study, researchers aimed to determine whether the long-term intake of a plant-based diet and shifting toward such a diet starting in young adulthood was associated with a lower risk of CVD in midlife.

“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,” said lead author Yuni Choi, PhD, postdoctoral researcher, Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, in an American Heart Association press release.

Choi and colleagues analyzed diet and the incidence of CVD in 4946 adults (54.9% women, 50.7% Black) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants were aged between 18 and 30 years and did not have CVD at the time of enrollment (1985-1986).

There were 8 follow-up exams conducted from 1987-1988 to 2015-2016 that included laboratory tests, physical measurements, medical histories, and lifestyle factors.

Plant‐centered diet quality was assessed utilizing the A Priori Diet Quality Score (APDQS), in which higher scores indicate higher intake of nutritionally rich plant foods and limited intake of high‐fat meat products and less healthy plant foods.

APDQS was comprised of 46 food groups which were classified into beneficial (eg, fruit, avocado, vegetables, whole grains), adverse (eg, fried fish/poultry, high-fat red meats, pastries), and neutral (eg, potatoes, refined grains, lean meats, shellfish) based on their known link to CVD.

During the 32-year follow-up, 289 participants were diagnosed with CVD.

Participants who scored in the top 20% of the APDQS—meaning those who consumed the most nutritionally rich plant-based foods and fewer adversely rated animal products—were 52% less likely to develop CVD.

Between years 7 and 20 of the study, when participants were aged between 25 and 50 years, those with a “beneficial” APDQS score were 61% less likely to develop CVD in the subsequent 12 years compared to those with an “adverse” diet quality score, according to the study.

“Our findings support a recommendation of eating primarily nutritionally rich plant foods, but allowing small amounts of animal products (eg, low‐fat dairy products, nonfried fish, and nonfried poultry), to prevent early cardiovascular disease,” wrote study authors.

In a separate study, researchers followed over 123 000 postmenopausal women participating in the Women’s Health Initiative. Participants were initially free of CVD from 1993-2017 to determine whether higher adherence to the “Portfolio Diet”—consuming more plant-based foods that lower cholesterol—is associated with a decreased risk of CVD. Average age was 62 years at enrollment.

Researchers found that a higher Portfolio Diet score was associated with a 11%, 14%, and 17% lower risk of total CVD, coronary heart disease, and heart failure, respectively, but no associated was found with stroke or atrial fibrillation.

“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. Evidence from randomized trials with clinical CVD events is also needed,” concluded researchers.

References: 1. Choi Y, Larson N, Steffen LM, et al. Plant‐centered diet and risk of incident cardiovascular disease during young to middle adulthood. JAMA. 2021;0:e020718.

2. Glenn AJ, Lo K, Jenkins DJA, et al. Relationship between a plant-based dietary portfolio and risk of cardiovascular disease: Findings from the women's health initiative prospective cohort study. JAMA. 2021;0:e021515.