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Plant-Centered Diet and Risk of Incident CVD
Quick Takes
- Long-term consumption of a plant-based diet, starting in young adulthood, is associated with a significantly lower risk for CVD events.
- Increasing plant-based foods over time is associated with lower risk for CVD events.
- These data support current recommendations to adhere to a diet rich in plant-based foods with lower amounts of animal products.
Study Questions:
Is cumulative intake of a plant-centered diet associated with incident cardiovascular disease (CVD)?
Methods:
Participants enrolled in the CARDIA (Coronary Artery Risk Development in Young Adults) study were included in the present analysis. Black and White participants ages 18-30 years residing in one of four US cities were included. All were free of CVD at baseline (1985–1986, exam year [year 0]). Follow-up was complete in 2018. Diet was assessed by an interviewer-administered, validated diet history. Plant-centered diet quality was assessed using the A Priori Diet Quality Score (APDQS), in which higher scores indicate higher consumption of nutritionally rich plant foods and limited consumption of high-fat meat products and less healthy plant foods. The primary outcome of interest was incident CVD.
Results:
A total of 4,946 adults were included in the present analysis. During the 32-year follow-up, 289 incident CVD cases were identified. Both long-term consumption and a change toward such a diet were associated with a lower risk of CVD. Multivariable-adjusted hazard ratio was 0.48 (95% confidence interval [CI], 0.28–0.81) when comparing the highest quintile of the time-varying average APDQS with lowest quintiles. The 13-year change in APDQS was associated with a lower subsequent risk of CVD, with a hazard ratio of 0.39 (95% CI, 0.19–0.81) comparing the extreme quintiles. Similarly, strong inverse associations were found for coronary heart disease and hypertension-related CVD with either the time-varying average or change in APDQS.
Conclusions:
The investigators concluded that consumption of a plant-centered, high-quality diet starting in young adulthood is associated with a lower risk of CVD by middle age.
Perspective:
These data support the long-term consumption of a plant-based diet to lower CV risk. Advising adults, starting early in life, to consume higher amounts of plant-based foods, with lower intake of animal products, is consistent with current clinical guidelines.
Clinical Topics: Cardiovascular Care Team, Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Prevention, CHD and Pediatrics and Arrhythmias, CHD and Pediatrics and Prevention, CHD and Pediatrics and Quality Improvement, Diet, Hypertension
Keywords: Cardiovascular Diseases, Coronary Disease, Diet, Diet, Vegetarian, Hypertension, Meat Products, Middle Aged, Nutrition Assessment, Plants, Edible, Primary Prevention, Young Adult
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