medwireNews: Diet quality has a large impact on the cardioprotective effects of a plant-based diet, shows research published in the Journal of the American College of Cardiology.
The study of more than 160,000 women in the Nurses’ Health Studies and 40,000 men in the Health Professionals Follow-up Study also shows an incremental effect, rather than an all-or-nothing effect, with stronger adherence to a plant-based diet delivering increasingly large benefits for cardiovascular health.
The authors of an accompanying editorial, Kim Allan Williams Sr and Hena Patel, both from Rush University Medical Center in Chicago, Illinois, USA, liken this to physical activity, for which some is acknowledged to be better than none, even if patients do not achieve recommended targets.
“Just as physical activity is a continuum, perhaps an emphasis on starting with smaller dietary tweaks rather than major changes would be more encouraging and sustainable for those finding it difficult to make a complete and precipitous change in dietary habits,” they suggest.
The study authors, led by Ambika Satija (Harvard TH Chan School of Public Health, Boston, Massachusetts, USA), divided the participants into 10 groups according to their adherence to a plant-based diet. They found that, relative to participants in the first decile (lowest adherence), those in the 10th decile (highest adherence) had a significant 8% reduction in the risk for coronary heart disease (CHD) over nearly 5 million person–years of follow-up.
They also found a significant trend across the 10 deciles, with the benefits becoming apparent between the sixth and seventh deciles. These relationships were independent of variables including age, physical activity, hypertension, diabetes, and body mass index.
The cardioprotective effect of a plant-based diet was even stronger when the researchers considered adherence to healthy plant-based foods, such as whole grains, fruits and vegetables, nuts and legumes, oils, and tea or coffee. In this case, the benefits became apparent from the third decile, and there was a 25% risk reduction for participants in the 10th versus the first decile.
By contrast, greater adherence to a diet of unhealthy plant-based foods, such as fruit juices, refined grains, potatoes/fries, and sweets, and animal-based foods was associated with a higher risk for CHD, with a 32% increased risk for participants in the highest versus the lowest decile of adherence, and the effect appearing from the second decile onwards.
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