Plant-based diet in young adulthood helps prevent CVD in middle age

13 Aug 2021
Plant-based diet in young adulthood helps prevent CVD in middle age

Individuals who have been consuming a plant‐centred diet long-term are at lower risk of cardiovascular disease (CVD), according to a study. Similarly, shifting to such a diet, starting in young adulthood, proves to be protective against CVD by middle age.

The analysis included 4,946 adults in the CARDIA (Coronary Artery Risk Development in Young Adults) prospective study. These participants were aged 18–30 years old and free of CVD at baseline (1985–1986, exam year [year 0]). They were followed until 2018.

Diet was assessed using an interviewer‐administered, validated diet history. Plant‐centred diet quality was defined using the A Priori Diet Quality Score (APDQS), in which higher scores indicate higher consumption of nutritionally rich plant foods and limited consumption of high‐fat meat products and less healthy plant foods.

The mean cumulative APDQS was 65.1, with a mean 13‐year change of 3.6. Participants with higher vs lower APDQS were more likely to be older, female, more educated, more physically active, consume more alcohol, and consume less energy. Furthermore, those with higher APDQS were less likely to smoke cigarettes, have a lower body mass index, and have a history of dyslipidaemia.

Over the 32‐year follow‐up, 289 incident CVD cases occurred. Both long‐term consumption of and a change toward a plant-centred diet contributed to a lower risk of CVD.

In multivariable Cox models, the highest vs lowest quintile of the time‐varying average ADPQS reduced the risk of CVD by more than 60 percent (hazard ratio [HR], 0.48, 95 percent confidence interval [CI], 0.28–0.81). The 13‐year change in APDQS was also associated with a decreased risk of CVD (highest vs lowest quartiles: HR, 0.39, 95 percent CI, 0.19–0.81).

Likewise, strong inverse associations were found for coronary heart disease and hypertension‐related CVD with either the time‐varying average or 13-year change in APDQS.

J Am Heart Assoc 2021;doi:10.1161/JAHA.120.020718