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Dietary Patterns and Subclinical Cardiac Injury
Quick Takes
- A dietary pattern high in fruits and vegetables is associated with lower markers of cardiac damage and cardiac strain compared to a typical Western dietary pattern.
- A dietary pattern high in fruits and vegetables was not associated with lower levels of C-reactive protein, a marker of inflammation, compared to a typical Western dietary pattern.
Study Questions:
Are specific dietary patterns associated with subclinical cardiac injury?
Methods:
An observational study design was used to examine data collected between 1994 and 1996 as part of a randomized trial (e.g., the DASH study). Participants from three of the four original randomized clinical trial study centers were included if they had available stored biospecimens. The initial trial randomly assigned 459 participants to a control diet, a fruit and vegetable diet, or the DASH diet. The control diet was a typical American diet, with potassium, magnesium, and calcium levels reflecting the 25th percentile of US consumption and macronutrient profiles and fiber amounts reflecting the average US consumption. The fruit and vegetable diet provided potassium and magnesium levels at the 75th percentile of US consumption and provided higher amounts of fiber. The DASH diet provided potassium and magnesium at levels reflecting the 75th percentile of US consumption and was higher in fiber and protein. The DASH diet also provided calcium at a level reflecting the 75th percentile of US consumption, and emphasized fat-free or low-fat dairy products. All three diets were designed to provide a similar amount of sodium (approximately 3 g/d) and were isocaloric. For the present study, the outcomes of interest were markers of subclinical cardiovascular disease (CVD), including high-sensitivity cardiac troponin I (hs-cTnI), N-terminal pro–B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP), which were measured in 2019 from stored specimens. These specimens had been collected at baseline and 8 weeks.
Results:
A total of 326 of the original 459 participants were included in the present analysis. The mean age of participants was 45.2 years, 48% were women, 49% were black, and the mean baseline blood pressure was 131/85 mm Hg. Compared with the control diet, the fruit and vegetable diet reduced hs-cTnI levels by 0.5 ng/L (95% confidence interval [CI], -0.9 to -0.2 ng/L) and NT-proBNP levels by 0.3 pg/ml (95% CI, -0.5 to -0.1 pg/ml). Compared with the control diet, the DASH diet reduced hs-cTnI levels by 0.5 ng/L (95% CI, -0.9 to -0.1 ng/L) and NT-proBNP levels by 0.3 pg/ml (95% CI, -0.5 to -0.04 pg/ml). Levels of hs-CRP did not differ among diets. No difference for any of the markers was observed between the fruit and vegetable and DASH diets.
Conclusions:
The authors concluded that diets rich in fruits and vegetables consumed over 8 weeks were associated with lower levels of markers for subclinical cardiac damage and strain in adults without pre-existing CVD.
Perspective:
These data support the inclusion of a dietary pattern high in fruits and vegetables for primary prevention of CVD. It is interesting to note that although markers of cardiac damage and strain were lowered among those randomized to diets high in fruits and vegetables, no difference in CRP, a marker of inflammation, was noted between those diets and a Western dietary pattern. As the authors note, other studies have found reductions in CRP with diets high in fruits and vegetables, suggesting that the lack of intentional weight loss may have played a role.
Clinical Topics: Prevention, Diet
Keywords: Blood Pressure, C-Reactive Protein, Diet, Fruit, Inflammation, Magnesium, Natriuretic Peptide, Brain, Potassium, Primary Prevention, Sodium, Troponin I, Vegetables, Weight Loss
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