Journal article
Relationship Between a Plant‐Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study
Journal of the American Heart Association, Vol.10(16), pp.e021515-e021515
08/17/2021
DOI: 10.1161/JAHA.121.021515
PMCID: PMC8475059
PMID: 34346245
Abstract
Background The plant‐based Dietary Portfolio combines established cholesterol‐lowering foods (plant protein, nuts, viscous fiber, and phytosterols), plus monounsaturated fat, and has been shown to improve low‐density lipoprotein cholesterol and other cardiovascular disease (CVD) risk factors. No studies have evaluated the relation of the Dietary Portfolio with incident CVD events. Methods and Results We followed 123 330 postmenopausal women initially free of CVD in the Women's Health Initiative from 1993 through 2017. We used Cox proportional‐hazard models to estimate adjusted hazard ratios (HRs) and 95% CI of the association of adherence to a Portfolio Diet score with CVD outcomes. Primary outcomes were total CVD, coronary heart disease, and stroke. Secondary outcomes were heart failure and atrial fibrillation. Over a mean follow‐up of 15.3 years, 13 365 total CVD, 5640 coronary heart disease, 4440 strokes, 1907 heart failure, and 929 atrial fibrillation events occurred. After multiple adjustments, adherence to the Portfolio Diet score was associated with lower risk of total CVD (HR, 0.89; 95% CI, 0.83–0.94), coronary heart disease (HR, 0.86; 95% CI, 0.78–0.95), and heart failure (HR, 0.83; 95% CI, 0.71–0.99), comparing the highest to lowest quartile of adherence. There was no association with stroke (HR, 0.97; 95% CI, 0.87–1.08) or atrial fibrillation (HR, 1.10; 95% CI, 0.87–1.38). These results remained statistically significant after several sensitivity analyses. Conclusions In this prospective cohort of postmenopausal women in the United States, higher adherence to the Portfolio Diet was associated with a reduction in incident cardiovascular and coronary events, as well as heart failure. These findings warrant further investigation in other populations.
Details
- Title: Subtitle
- Relationship Between a Plant‐Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study
- Creators
- Andrea J Glenn - Department of Nutritional Sciences University of Toronto Ontario Canada, Clinical Nutrition and Risk Factor Modification Center St. Michael's Hospital Toronto Ontario Canada, Toronto 3D Knowledge Synthesis and Clinical Trials Unit St. Michael's Hospital Toronto Ontario CanadaKenneth Lo - Department of Applied Biology and Chemical Technology The Hong Kong Polytechnic University Hung Hom Hong Kong China, Centre for Global Cardiometabolic Health Brown University Providence RIDavid J. A Jenkins - Department of Nutritional Sciences University of Toronto Ontario Canada, Clinical Nutrition and Risk Factor Modification Center St. Michael's Hospital Toronto Ontario Canada, Toronto 3D Knowledge Synthesis and Clinical Trials Unit St. Michael's Hospital Toronto Ontario Canada, Li Ka Shing Knowledge InstituteSt. Michael's Hospital Toronto Ontario Canada, Division of Endocrinology and Metabolism St. Michael's Hospital Toronto Ontario CanadaBeatrice A Boucher - Department of Nutritional Sciences University of Toronto Ontario CanadaAnthony J Hanley - Department of Nutritional Sciences University of Toronto Ontario Canada, Dalla Lana School of Public Health and Department of Medicine University of Toronto Ontario Canada, Leadership Sinai Centre for Diabetes Mount Sinai Hospital Toronto Ontario CanadaCyril W. C Kendall - Department of Nutritional Sciences University of Toronto Ontario Canada, Clinical Nutrition and Risk Factor Modification Center St. Michael's Hospital Toronto Ontario Canada, Toronto 3D Knowledge Synthesis and Clinical Trials Unit St. Michael's Hospital Toronto Ontario Canada, College of Pharmacy and Nutrition University of Saskatchewan Saskatoon Saskatchewan CanadaJoAnn E Manson - Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA, Department of Epidemiology Harvard T.H. Chan School of Public Health Boston MA, Division of Preventive Medicine Brigham and Women's Hospital and Harvard Medical School Boston MAMara Z Vitolins - Department of Epidemiology and Prevention Wake Forest School of Medicine Winston‐Salem NCLinda G Snetselaar - Department of Epidemiology University of Iowa College of Public Health Iowa City IASimin Liu - Centre for Global Cardiometabolic Health Brown University Providence RI, Division of Endocrinology Department of Medicine, and Division of Cardiothoracic Surgery Department of Surgery The Warren Alpert School of Medicine and Rhode Island Hospital Providence RI, Department of Epidemiology Brown University School of Public Health Providence RIJohn L Sievenpiper - Department of Nutritional Sciences University of Toronto Ontario Canada, Clinical Nutrition and Risk Factor Modification Center St. Michael's Hospital Toronto Ontario Canada, Toronto 3D Knowledge Synthesis and Clinical Trials Unit St. Michael's Hospital Toronto Ontario Canada, Li Ka Shing Knowledge InstituteSt. Michael's Hospital Toronto Ontario Canada, Division of Endocrinology and Metabolism St. Michael's Hospital Toronto Ontario Canada
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.10(16), pp.e021515-e021515
- DOI
- 10.1161/JAHA.121.021515
- PMID
- 34346245
- PMCID
- PMC8475059
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Language
- English
- Date published
- 08/17/2021
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984215044702771
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