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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: 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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