No single dietary pattern dominates among healthy diets for reduced CVD risk

  • Shan Z & al.
  • JAMA Intern Med
  • 15 Jun 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Healthy diets, regardless of pattern, are all linked to decreased cardiovascular disease (CVD) risk at a 3+ decade follow-up in this analysis of data from 3 large prospective cohorts.

Why this matters

  • Clinicians can talk with patients about a variety of diet choices to fit their lifestyle and cultural needs while limiting CVD risk.

Key results

  • 5,257,190 person-years of follow-up.
  • 23,366 incident CVD cases identified.
  • For highest vs lowest quintiles, pooled multivariable adjusted HRs (95% CIs) for CVD by diet:
    • Healthy Eating Index 2015: 0.83 (0.79-0.86).
    • Alternate Mediterranean Diet Score: 0.83 (0.79-0.86).
    • Healthy Plant-Based Diet Index: 0.86 (0.82-0.89).
    • Alternate Healthy Eating Index: 0.79 (0.75-0.82).
    • Pfor trend<.001 for all.>
  • With a 25 percentile increase in dietary score, CVD risk (pooled HRs; 95% CIs) by diet:
    • Healthy Eating Index 2015: 0.80 (0.77-0.83).
    • Alternate Mediterranean Diet Score: 0.90 (0.87-0.92).
    • Healthy Plant-Based Diet Index: 0.86 (0.82-0.89).
    • Alternate Healthy Eating Index: 0.81 (0.78-0.84).
  • The findings held with separate analyses for coronary heart disease and stroke.
  • Subgroup (race/ethnicity) and sensitivity analyses yielded similar results.

Study design

  • Included 3 cohorts:

Limitations

  • Diet based on self-report.
  • Observational; residual confounding possible.