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 People on plant-based diets who consume lots of refined grains and
sweets may be significantly more likely to develop heart disease
than vegetarians whose diets include the least amount of these types
of foods, the study suggests.
"Most studies that examine vegetarian diets found them generally to
be protective of cardiovascular disease, but they didn’t really look
at the quality of plant food," said lead author Ambika Satija, of
the Harvard T.H. Chan School of Public Health in Boston. "It’s
possible to be a vegetarian and eat low-quality plant food."
As reported in the Journal of the American College of Cardiology,
Satija and colleagues analyzed data from three past studies that
asked people about their diets every few years and included
information on how many developed heart disease.
The three studies included a total of 210,298 people. Over about 20
years, 8,631 participants developed coronary heart disease due to
plaque build-up in the arteries that carry blood to the heart. The
condition can lead to chest pain, heart attacks and other health
issues.
The researchers divided participants into 10 groups according to how
closely they adhered to a plant-based diet. People whose diets were
the most plant-based had an 8 percent lower risk of heart disease
than those whose diets were the least plant-based - but that finding
could have been due to chance.
Next, they compared groups of people whose diets included the most
healthy plant-based foods like whole grains, fruits, vegetables and
nuts, versus people whose diets contained the least amount of those
foods. Those with the healthiest plant-based diets were 25 percent
less likely to end up with heart disease than those with the
least-healthy plant-based diets.
Similarly, those whose diets included the most unhealthy plant-based
foods (refined grains, sugary beverages, potatoes and sweets) were
32 percent more likely to develop heart disease, compared to those
whose plant-based diets included the least amount of those unhealthy
options.
People who eat unhealthy plant foods "could consider changing their
diet and switching out the less healthy plant foods for healthy
plant based foods," Satija told Reuters Health.
She also said modestly lowering the amount of animal foods in a
person's diet was linked to a decreased risk of heart disease.
"Make small changes and you might be able to benefit," said Satija.
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In an editorial accompanying the new study, Drs. Kim Allan Williams
and Hena Patel, of the Rush University Medical Center in Chicago,
say healthy plant-based diets can play an important role in
preventing cardiovascular disease.
"Such diets, which have many other health benefits including the
prevention of several chronic diseases, deserve more emphasis in
dietary recommendations," they write.
The conclusions of the new analysis may be correct, but the study
doesn't prove it, said Dr. Steve Nissen, who is chair of the Robert
and Suzanne Tomsich Department of Cardiovascular Medicine at the
Cleveland Clinic in Ohio.
"There are so many confounding variables," said Nissen, who wasn't
involved with the new study.
People may have misreported what they ate on their food
questionnaires, for example, or there could be other factors that
explain differences in outcomes like social and economic status, he
said.
Nissen told Reuters Health that the best evidence on a diet to
prevent heart disease is from the PREDIMED Study that supports a
Mediterranean diet, which focuses on unrefined grains, legumes,
nuts, fruits, vegetables, fish, moderate amounts of alcohol like red
wine and a high amount of monounsaturated fats like olive oil.
"It's prospective, randomized and shows a large reduction in
morbidity and mortality with a Mediterranean diet," said Nissen.
The American Heart Association recommends diets that include fruits
and vegetables, nuts and legumes, whole grains, low-fat dairy
products, non-tropical vegetable oils and skinless poultry and fish.
SOURCE: http://bit.ly/2uvP7Nh and http://bit.ly/2uwnaF3 Journal of
the American College or Cardiology, online July 17, 2017.
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