Cardiovascular Journal of Africa: Vol 31 No 4 (July/August 2020)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 4, July/August 2020 204 AFRICA
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Association between healthy eating patterns and lower heart disease risk
Four different healthy eating patterns, all emphasising higher
intake of whole grains, vegetables, fruits, legumes and nuts,
and lower intakes of red and processed meats and sugar-
sweetened beverages, were found to be associated with a
lower risk of cardiovascular disease, according to a large
Harvard analysis.
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 TH Chan
School of Public Health. The findings add support for the
2015–2020 Dietary Guidelines for Americans, which focus on
healthy eating patterns rather than individual ingredients and
nutrients to better account for diverse cultural and personal
food traditions and preferences.
‘Although each healthy eating pattern represents a different
combination of dietary constituents, our study indicates that
greater adherence to any of the four healthy eating patterns
we looked at is associated with lower risk of cardiovascular
disease and the health benefits persist across racial and ethnic
groups,’ said Zhilei Shan, first author on the article and a
research associate in the nutrition department.
Few studies have examined how adhering to recommended
healthy eating patterns influence long-term risk of CVD.
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 emphasises 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 (those in the top quartile of the scores) had a 14
to 21% lower risk of CVD when compared with those who
adhered least (in the bottom quartile of the scores).
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 corresponding author Frank Hu, Fredrick
J Stare, professor of nutrition and epidemiology and chair of
the department of nutrition. ‘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.’
Source: Medical Brief 2020