Adherence to plant-based diet and risk of heart failure among middle-aged and older population

Xiao-Xin Chang¹Yiming Li^2*WENLIANG CHE^1*Yong-Jian Zhu³

• ¹Department of Cardiology, Shanghai Tenth People's Hospital, Shanghai, China
• ²Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
• ³The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Abstract Background: Plant-based diets have been demonstrated to be associated with lower risk of several chronic diseases. However, a comprehensive assessment of plant-based diet quality and its association with heart failure (HF) is limited. This study aimed to investigate whether healthful and unhealthful plant-based dietary patterns are associated with overall HF risk among middle-aged and older adults in the United Kingdom. Methods: We included a total of 190,092 UK Biobank participants without HF at baseline. Three plant-based diet indices were calculated using 24-hour dietary recalls based on 17 food groups: the overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Multivariable Cox regression models were applied to assess the association between these indices and incident HF. Results: Over a median follow-up of 13.04 years, 4,351 cases of new-onset HF were recorded. Compared to the lowest tertile, the multivariable-adjusted hazard ratios (HRs) with 95% confidence interval (CI) for HF in the highest tertile were 0.94 (0.88 - 1.02) for overall PDI, 0.84 (0.78 - 0.91) for hPDI, and 1.11 (1.03 - 1.19) for uPDI. Conclusions: A higher intake of healthful plant-based diets was associated with a lower risk of HF, while follow unhealthful plant-based diet was linked to a higher overall HF risk. Adhering to a high-quality diet primarily based on healthy plant-based foods may be helpful prevent HF.