A ‘Nutrient-Rich’ Plant-Based Diet Reduces the Risk of CVD

Source: Choi Y, et al. What predicts incident cardiovascular disease best: a plant-based diet or a diet low in saturated fat? The CARDIA study (Development of coronary artery risk in young adults). Presented at: Nutrition Live Online 2021. June 7-10, 2021 (virtual meeting).

Disclosures: Choi and Jacobs do not report any relevant financial disclosures.

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A plant-based diet was associated with a reduced risk of CVD in adults, but a diet consisting mostly of low-fat foods was not, according to a study that spanned 3 decades.

However, both diets were linked to lower levels of LDL cholesterol (LDL-C), the researchers reported.

Maintaining low cholesterol levels to prevent coronary heart disease has been a medical principle since the 1950s, Yuni Choi, PhD, a postdoctoral researcher in the division of epidemiology and community health at the University of Minnesota, told Healio Primary Care. In the 1980s, dietary guidelines encouraged Americans to avoid saturated fat to help prevent coronary heart disease, she said.

Yuni Choi

“However, several recently published meta-analyzes of prospective studies and randomized controlled trials have consistently reported that saturated fat is not associated with CVD outcomes,” she said.

Choi and colleagues analyzed data from 4,700 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study. According to the researchers, CARDIA included black and white men between the ages of 18 and 30 when they were recruited from four US cities in the mid-1980s. Specifically, the researchers analyzed the extent to which CARDIA adults adhered to a diet low in saturated fat or on a plant-based diet. They also looked at how each diet reduced LDL-C in their blood and rated the quality of the participants’ diet using the A Priori Diet Quality Score (APDQS). According to the co-author of the study David R. Jacobs, Jr., PhD, professor of public health in the Division of Epidemiology and Community Health at the University of Minnesota, a higher APDQS means higher consumption of nutrient-rich plant foods and lower consumption of high-fat meat products, and less healthy plant foods.

The researchers also determined the nutrient levels of the participants using a key score, because “this is a good wording of the message of low saturated fat, motivated by saturated fat, but also including [polyunsaturated fats] and dietary cholesterol, ”Jacobs said.

The results showed that during the 32 years of follow-up, there were 280, 135 and 92 documented cases of CVD, coronary artery disease and stroke, respectively. Over a 7-year period, 13-point increases in APDQS corresponded to an improvement in LDL-C levels (0.91 mg / dL lower) in the participants’ blood. In addition, multivariate fitted models showed that each 13 point increase in APDQS was associated with a 19% reduction (95% CI, 4-32) in CVD risk, a risk reduction of 22 % (95% CI, 0-39) for coronary heart disease and a 29% (95% CI: 2-48) reduction in stroke risk. These models also indicated that for each one-point increase in APDQS, the RRs were 0.81 (95% CI 0.68-0.96) for CVD, 0.78 (CI at 95%, 0.61-1) for coronary heart disease and 0.71 (95% CI, 0.52-0.98) for stroke.

“Our message is that a nutrient-dense, plant-centered diet is beneficial for cardiovascular health,” said Jacobs. “In order to understand changes in blood cholesterol, saturated fat may be helpful but is not complete. Single nutrient messages overlook many aspects of diets and do not predict CVD. “

The results were presented virtually during Nutrition Live Online, the annual meeting of the American Society of Nutrition.

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