Green light for heart health: The portfolio diet reduces CVD risk

Green light for heart health: The portfolio diet reduces CVD risk

A large study examined the impact of a plant-based dietary pattern, known as the portfolio diet pattern, on the risk of cardiovascular disease (CVD). This dietary pattern emphasizes the consumption of certain cholesterol-lowering foods, including plant proteins, nuts, gel-forming fibers (viscous fibers), phytosterols (plant substances similar to cholesterol), and unsaturated fatty acids from plants. The study collected and evaluated data from over 200,000 participants, both women and men, working in healthcare professions who did not have CVD or cancer at the start of the study, over a period of up to 30 years.

The results clearly show that people who adhered more closely to this portfolio diet pattern had a lower risk of cardiovascular disease, including a lower risk of coronary heart disease (CHD) and stroke. Interestingly, there was also a positive effect on blood lipid profile and inflammatory markers, indicating overall improved health.

These results could have important implications for public health and dietary guidelines as they highlight the benefits of a plant-based dietary pattern for the prevention of cardiovascular disease. In the future, such findings could lead to dietary recommendations increasing the consumption of plant-based foods to reduce the risk of CVD.

Basic terms and concepts:

• CVD (Herz-Kreislauf-Erkrankungen): Eine Gruppe von Erkrankungen, die das Herz und die Blutgefäße betreffen, einschließlich Schlaganfall und Koronarer Herzkrankheit.
• Portfolio-Diätmuster: Ein Ernährungsmuster, das spezifische pflanzenbasierte Lebensmittel umfasst, von denen bekannt ist, dass sie den Cholesterinspiegel senken können.
• Phytosterole: Pflanzliche Stoffe, deren Struktur dem Cholesterin ähnlich ist und die dazu beitragen können, den Cholesterinspiegel im Blut zu senken.
• Viskose Fasern: Eine Art von Ballaststoffen, die im Verdauungstrakt ein Gel bilden kann und dazu beiträgt, den Cholesterinspiegel und den Blutzuckerspiegel zu regulieren.
• Koronare Herzkrankheit (CHD): Eine Erkrankung, die durch die Verengung der Koronararterien verursacht wird, was zu einer eingeschränkten Blutversorgung des Herzens führt.
• Schlaganfall: Ein medizinischer Notfall, der auftritt, wenn die Blutversorgung eines Teils des Gehirns unterbrochen wird.

Association between portfolio diet score and reduced risk of cardiovascular disease

Conducting a large prospective cohort study including participants from the Nurses' Health Study, the Nurses' Health Study II and the Health Professionals Follow-up Study provided significant insights into the effects of a plant-based portfolio diet on the risk of cardiovascular disease (CVD), including coronary artery disease (CHD) and stroke. This study aimed to investigate the long-term effects of the portfolio diet – characterized by high intakes of plant proteins, nuts, viscous fibers, phytosterols and plant monounsaturated fats – on CVD susceptibility.

methodology

Participants' Portfolio Diet Score (PDS) was assessed using validated food frequency questionnaires at baseline and every four years thereafter. The PDS positively evaluates the intake of plant protein, nuts and seeds, viscous fiber sources, phytosterols and sources of plant monounsaturated fats. Foods high in saturated fat and cholesterol were viewed negatively. 73,924 women from the Nurses' Health Study (1984-2016), 92,346 women from the Nurses' Health Study II (1991-2017) and 43,970 men from the Health Professionals Follow-up Study (1986-2016) who did not have CVD or cancer at the start of the study were examined.

Results

During up to 30 years of follow-up, 16,917 cases of CVD were documented, including 10,666 cases of CHD and 6,473 strokes. After multivariate adjustment for lifestyle factors and a modified Alternate Healthy Eating Index (excluding overlapping components), participants in the highest quintile of the PDS had a reduced risk of CVD (pooled hazard ratio [HR], 0.86 [95% CI, 0.81-0.92]; <0.001), CHD (pooled HR, 0.86 [95% CI, 0.80-0.93]; =0.0001) and stroke (pooled HR, 0.86 [95% CI, 0.78-0.95]; =0.0003) compared with those in the lowest quintile. A 25 percentile increase in PDS was associated with a lower risk of CVD (pooled HR, 0.92 [95% CI, 0.89-0.95]), CHD (pooled HR, 0.92 [95% CI, 0.88-0.95]), and stroke (pooled HR, 0.92 [95% CI, 0.87-0.96]). These results remained consistent in sensitivity and most subgroup analyses, and there was no evidence of deviation from linearity for CVD, CHD, or stroke. In a subset of participants, higher PDS was associated with a more favorable blood lipid and inflammatory profile.

Conclusions

The results highlight that higher adherence to the portfolio diet is associated with a lower risk of CVD, including CHD and stroke, as well as a more favorable blood lipid and inflammatory profile. These findings add to the existing literature by providing detailed evidence for the benefits of long-term dietary changes as part of the portfolio diet, thereby demonstrating a promising approach for the prevention of CVD.

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