Eating more plant-based foods may lower the risk of cardiovascular disease

Eating more nutritious, plant-based foods is healthy for the heart at any age. In two separate studies that analyzed different measures of healthy plant-based food consumption, researchers found that both young adults and postmenopausal women had fewer heart attacks and were less likely to develop cardiovascular disease when they ate more healthy plant-based foods.

The American Heart Association's diet and lifestyle recommendations suggest an overall healthy diet that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and non-tropical vegetable oils. It also recommends limited consumption of saturated fat, trans fat, sodium, red meat, sweets and sugary drinks.

The study evaluated whether long-term consumption of a plant-based diet and a shift to a plant-based diet from young adulthood are associated with a lower risk of cardiovascular disease in middle age.

“Previous research has focused on single nutrients or single foods, but there is little data on a plant-based diet and long-term risk of cardiovascular disease,” said Yuni Choi, Ph.D., the study's lead author and a postdoctoral researcher at the University of Groningen. University of Minnesota School of Public Health in Minneapolis.

Choi and colleagues examined diet and the occurrence of heart disease in 4,946 adults who participated in the Coronary Artery Risk Development in Young Adults (CARDIA) study. The participants were 18 to 30 years old at the time of entry (1985-1986) in this study and were free of cardiovascular disease at the time. Participants were 2,509 black adults and 2,437 white adults (54.9% women in total) who were also analyzed by education level (equivalent to more than high school versus high school or less). Participants had eight follow-up studies from 1987-88 to 2015-16, which included lab tests, physical measurements, medical history, and assessment of lifestyle factors. Unlike randomized controlled trials, participants were not instructed to eat certain foods or told their dietary measures scores, allowing the researchers to collect unbiased, long-term habitual nutritional data.

After detailed diet history interviews, the quality of the participants' diets was scored based on the A Priori Diet Quality Score (APDQS), composed of 46 food groups at years 0, 7 and 20 of the study. The food groups were classified into beneficial foods (such as fruits, vegetables, beans, nuts, and whole grains); unwanted foods (such as baked potatoes, high-fat red meat, salty snacks, baked goods, and sodas); and bland foods (such as potatoes, refined grains, lean meats and shellfish) based on their known association with cardiovascular disease.

Participants who got higher scores ate a variety of beneficial foods, while those with lower scores ate more unfavorable foods. In general, higher values ​​correspond to a nutrient-rich, plant-based diet.

Researchers found:

• During 32 years of follow-up, 289 of the participants developed cardiovascular disease (including heart attack, stroke, heart failure, heart-related chest pain or clogged arteries anywhere in the body).
• People who scored in the top 20% on the long-term food quality score (meaning they ate the most nutrient-rich plant foods and fewer animal products with a negative rating) were 52% less likely to develop cardiovascular disease, after taking into account several factors (including age, gender, race, average calorie consumption, education, parental history of heart disease, smoking, and average physical activity).
In addition, between years 7 and 20 of the study, when the participants were ages 25 to 50, those who improved their diet the most (eating more beneficial plant foods and less poorly rated animal products) 61% less likely to develop subsequent cardiovascular disease, compared to the participants whose diet quality declined the most during that time.
• There were few vegetarians among the participants, so the study was unable to assess the potential benefits of a strict vegetarian diet, which excludes all animal products, including meat, dairy and eggs.

“A nutrient-rich, plant-based diet is beneficial for cardiovascular health. A plant-based diet is not necessarily vegetarian,” Choi said. “People can choose from plant-based foods that are as natural as possible, not highly processed. We believe that from time to time individuals may consume animal products in moderation, such as non-fried poultry, non-fried fish, eggs and low-fat dairy.”