Variety of healthy eating patterns associated with lower heart disease risk

Greater adherence to a variety of healthy eating patterns was associated with a lower risk of cardiovascular disease (CVD), according to new research led by Harvard T.H. Chan School of Public Health in Boston, Massachusetts and published in the journal JAMA Internal Medicine.

For this study, researchers focused on dietary scores for four healthy eating patterns: Healthy Eating Index-2015 (HEI-2015); Alternate Mediterranean Diet Score (AMED); Healthful Plant-Based Diet Index (HPDI); and Alternate Healthy Eating Index (AHEI). Despite different scoring methods, each of these patterns emphasizes higher intake of whole grains, vegetables, fruits, legumes, and nuts, and lower intakes of red and processed meats and sugar-sweetened beverages.

To assess the associations of each pattern with CVD risk, the researchers looked at data from 74,930 women enrolled in the Nurses' Health Study, 90,864 women in the Nurses' Health Study II, and 43,339 men in the Health Professionals Follow-Up Study. Participants in each study were asked every two to four years about their dietary habits, including how often, on average, they consumed a standard portion size of various foods.

Using the dietary data, which was collected over several decades via validated dietary questionnaires, the researchers created four dietary scores for each participant. Higher dietary scores represented greater adherence to healthy eating patterns. After adjusting for numerous factors, including age, body mass index, and smoking status, the analysis found that greater adherence to any of the healthy eating patterns was consistently associated with lower risk of CVD.

The study found that participants who adhered most to healthy eating patterns had a 14 percent to 21 percent lower risk of CVD when compared with those who adhered least. The findings also showed that these different healthy eating patterns were similarly effective at lowering CVD risk across racial and ethnic groups and other subgroups studied, and that they were statistically significantly associated with lower risk of both coronary heart disease and stroke.

“These data provide further evidence to support current dietary guidelines that following healthy eating patterns confers long-term health benefits on cardiovascular disease prevention," said Frank Hu, MD, PhD, professor of nutrition and epidemiology and corresponding author of the study, in a statement. "There is no one-size-fits-all diet that is best for everyone. One can combine foods in a variety of flexible ways to achieve healthy eating patterns according to individuals' health needs, food preferences, and cultural traditions.”