Higher carbohydrate (CHO) quality and greater fiber-rich food intake are favorably associated with left ventricular (LV) structure and LV function, according to the CARDIA Diet History, published July 8 in the European Heart Journal.

Among 3,171 participants from the CARDIA study (baseline mean age, 25 years; 57% women), trained interviewers conducted repeated assessment of dietary intake at years 0, 7 and 20, and echocardiography assessed cardiac structure and function at years 25 and 30. So-Yun Yi, MD, et al., used the CHO:fiber ratio as a measure of CHO quality, with a higher ratio indicating a lower CHO quality, and a fiber-rich food score to examine the association between cardiac phenotypes and intake of whole grains, fruits, vegetables, nuts, and legumes (plant-based foods).

The mean CHO:fiber ratio and fiber-rich food score were 17.3 and 9.8, respectively.

After adjusting for demographic and lifestyle factors, results showed that higher CHO quality was linked to lower LV mass index (LVMI) and better global longitudinal strain (GLS) (p for trend <0.001 for both). Likewise, a higher fiber-rich food score was associated with lower LVMI (p for trend <0.001), higher LVEF (p for trend = 0.008), better GLS (p for trend <0.001), lower E/e′ ratio (p for trend = 0.02) and smaller left atrial volume index (p for trend = 0.02).

In other findings, higher CHO quality and a higher fiber-rich food score were associated with less cardiac remodeling at year 30.

Notably, those with the highest CHO quality were more likely to be older, women, White, educated, physically active, current drinker, noncurrent smoker, and supplement user and have lower BMI vs. participants with the lowest CHO quality. Participants with the highest CHO quality were also more likely to consume a plant-based diet and diet beverages and less likely to consume added sugar, saturated fat, refined grains, sugar-sweetened beverages, candy, dairy products, and red and processed meat.

Yi and colleagues note that the study findings support U.S. and European dietary guidelines to help prevent cardiovascular disease. They write, "The fiber-rich food score was a better predictor of cardiac structure and function than the [CHO]:fiber ratio, indicating that categorizing [CHO] and fiber by food groups ... offers a useful measure of [CHO] quality, as both ... are predominantly present in plant-based foods."