Plant-based diets are recommended to reduce the risk of heart disease, but some may be associated with a higher risk, according to a study published July 17 in the Journal of the American College of Cardiology.

Ambika Satija, ScD, et al.,created three versions of a plant-based diet: an overall plant-based diet which emphasized the consumption of all plant food and reduced (but did not eliminate) animal food intake; a healthful plant-based diet that emphasized the intake of healthy plant foods such as whole grains, fruits and vegetables; and an unhealthful plant-based diet which emphasized consumption of less healthy plant foods such as refined grains.

The researchers used a baseline sample of 73,710 women from the Nurses' Health Study, 92,320 women from the Nurses' Health Study 2 and 43,259 men from the Health Professionals Follow-Up Study. The participants responded to a follow-up questionnaire every two years for over two decades on lifestyle, health behaviors and medical history.

During follow-up, 8,631 participants developed coronary heart disease. Overall, adherence to a plant-based diet was associated with a lower risk of heart disease. A higher intake of a more healthful plant-based diet – one rich in whole grains, fruits, vegetables, etc. – was associated with a substantially lower risk of heart disease. However, a plant-based diet that emphasized less healthy plant foods like sweetened beverages, refined grains, potatoes and sweets had the opposite effect.

In an accompanying editorial, Kim Allan Williams, Sr., MD, MACC, past president of the ACC, said the study adds to the substantial evidence that a predominately plant-based diet reduces heart disease risk. Not all plant-based foods are equally healthy, but plant-based diets with whole grains, unsaturated fats and an abundance of fruits and vegetables "deserve more emphasis in dietary recommendations." He adds that the long-term follow up allowed authors to examine dietary patterns and analyze the effect of gradual adherence to a plant-based diet through reduced animal food intake and increased plant food intake on heart disease risk.

Keywords: Vegetables, Fruit, Solanum tuberosum, Follow-Up Studies, Sweetening Agents, Fats, Unsaturated, Research Personnel, Diet, Animal Feed, Coronary Disease, Life Style, Beverages, Health Behavior, Epidemiologic Studies

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