June 15, 2020
2 min read
People with greater adherence to healthy eating patterns had a lower risk for CVD, according to a study published in JAMA Internal Medicine.
Zhilei Shan, MD, PhD, postdoctoral fellow in the department of nutrition at Harvard T.H. Chan School of Public Health, and colleagues analyzed data from 74,930 women (mean age, 50 years) from the Nurses’ Health Study, 90,864 women from the Nurses’ Health Study II (mean age, 36 years) and 43,339 men from the Health Professionals Follow-Up Study (mean age, 53 years).
All participants completed a validated semiquantitative food frequency questionnaire at baseline and were asked about their dietary habits every 2 to 4 years. This information was used to calculate adherence to different dietary patterns with the healthy eating index-2015, the healthful plant-based diet index, the alternate Mediterranean diet score and the alternate healthy eating index.
Researchers assessed incident cases of CVD, defined as fatal and nonfatal stroke, and fatal and nonfatal CHD, which included CABG and nonfatal MI.
There were 23,366 cases of incident CVD during 5,257,190 person-years of follow-up. Of these events, 5,687 were stroke and 18,092 were CHD, and some patients had both stroke and CHD.
Researchers compared the highest quintiles with the lowest quintiles for the scores that were calculated. The pooled multivariable-adjusted HR for CVD was 0.83 for the alternate Mediterranean diet score (95% CI, 0.79-0.86), 0.83 for the healthy eating index-2015 (95% CI, 0.79-0.86), 0.79 for the alternate healthy eating index (95% CI, 0.75-0.82) and 0.86 for the healthful plant-based diet index (95% CI, 0.82-0.89; P for trend for all < .001).
The risk for CVD decreased by 10% to 20% with a 25-percentile higher dietary score according to the alternate Mediterranean diet score (HR = 0.9; 95% CI, 0.87-0.92), the healthy eating index-2015 (HR = 0.8; 95% CI, 0.77-0.83), for the alternate healthy eating index (HR = 0.81; 95% CI, 0.78-0.84) and for the healthful plant-based diet index (HR = 0.86; 95% CI, 0.82-0.89).
The four dietary scores were significantly linked to a lower risk for both stroke and CHD. The inverse association between the scores and the risk for CVD were consistent in most subgroups when analyses were stratified by race/ethnicity and other CVD risk factors.
“Our findings support the 2015-2020 Dietary Guidelines for Americans, which recommend multiple healthy eating patterns for individuals to adapt according to personal food traditions and preferences,” Shan and colleagues wrote.