Adherence to a healthy dietary pattern was associated with a significantly reduced risk of cardiovascular disease among cancer survivors, according to results from a cohort study using UK Biobank data, published Oct. 29 in JACC: Advances. These findings underscore the potential for diet to support cardio-oncology care.

In this study, Qing-Yuan Gao, PhD, et al., examined the association between eight common healthy dietary patterns and cardiovascular disease among cancer survivors to determine which dietary pattern was more predictive of incident cardiovascular disease as well as life expectancy. Researchers used 24-hour dietary recall data along with Cox proportional hazards models and Fine-Gray competing risks models to calculate a score for each dietary pattern.

The analysis cohort consisted of some 8,700 survivors of cancer included in the UK Biobank who were free of ischemic heart disease, heart failure or stroke at baseline; their mean age was 60 years, and two-thirds were women.

After a median follow-up of 12 years, 1,116 of the study participants experienced a primary outcome event, defined as the first occurrence of ischemic heart disease, heart failure or stroke.

Looking at the impact of specific dietary patterns, comparing the top quintile with the bottom quintile, the hazard ratio (HR) for total cardiovascular disease was 0.72 for Mediterranean diet; 0.74 for Mediterranean-Dietary Approaches to stop Hypertension Diet Intervention for Neurodegenerative Delay (MIND); 0.63 for Alternate Healthy Eating Index-2010 (AHEI-2010); 0.65 for DASH; 0.82 for Healthful Plant-Based Diet Index (hPDI); 0.67 for reversed energy-adjusted diet inflammatory index (E-DII); and 0.80 for Healthy Low-Fat diet (HLFD).

A protective association was observed between each of the dietary patterns and cardiovascular events.

No significant benefit was seen with a healthy low-carbohydrate diet. The AHEI-2010 was associated with a lower risk of ischemic heart disease and stroke and DASH with a lower risk of heart failure. MIND was associated with the lowest risk for all-cause mortality and the largest gains in life expectancy.

Notably, findings remained robust after fitting the generalized propensity score model. Additionally, at age 45, participants with the highest adherence to a healthy dietary pattern gained an estimated life expectancy of 1.7 to 3.3 years more than those with the lowest adherence.

“Our findings suggest that the cardiovascular benefits of diet in cancer survivors are not confined to one ‘ideal’ diet but are observed across several evidence-based healthy dietary patterns, supporting a flexible rather than prescriptive nutritional approach in cancer survivorship care,” the authors write.