Diets Rich in Fruits and Vegetables Lower Cardiac Strain, Damage

A new analysis of data from the Dietary Approaches to Stop Hypertension (DASH) trial is shedding new light on the benefits of a diet rich in fruits and vegetables.

Led by a team of clinicians from Beth Israel Deaconess Medical Center, results of the study indicate increased consumption of fruits and vegetables was associated with lower levels of markers for subclinical cardiac damage and strain in adults without a history of cardiovascular disease.

In an effort to further describe the impact of increased fruit and vegetable consumption, investigators designed an observational analysis to compare the effects of 3 different diets on serum biomarkers of cardiac damage. Using a 3-group, parallel-designed, randomized DASH trial, investigators identified a cohort of 326 patients with stored serum specimens from a visit during week 8 of the trial

The 3 diet types examined in the study were defined as a fruit-and-vegetable diet, the DASH diet, or a typical American diet. The typical American diet was used as a control and the DASH diet was defined as a diet rich in fruits, vegetables, low-fat dairy, and fiber and containing lower levels of saturated fat and cholesterol.

Investigators examined 3 biomarkers as part of their analysis—high-sensitivity cardiac troponin I (hs-cTnI), N-terminal pro—Btype natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hs-CRP). These biomarkers were used to assess the impact of different diets on subclinical heart damage (hs-cTnl), cardiac strain (N-terminal pro-B-type natriuretic peptide (NT-proBNP), and inflammation (hs-CRP).

The mean age of participants in the study wasn’t 45.2 years, 48% of participants were women, 49% were black, and the mean baseline blood pressure was 131/85 mmHg. Of the 326 included in the analysis, 108 had been randomized to control diet, 109 to the fruit-and-vegetable diet, and 109 to the DASH diet.

Compared with patients on the control diet, the fruit-and-vegetable diet was associated with a 0.5 ng/L (95% CI, -0.9 to -0.2 ng/L) reduction in hs-cTnl levels and a 0.3 pg/mL (95% CI, -0.5 to -0.1 pg/mL) reduction in NT-proBNP levels. Results also indicated the DASH diet was associated with reduced hs-cTnI levels by 0.5 ng/L (CI, 0.9 to 0.1 ng/L) and NT-proBNP levels by 0.3 pg/mL (CI, 0.5 to 0.04 pg/mL) when compared against the control diet.

Investigators pointed out levels of hs-CRP did not differ between any of the diets examined as part of the analysis. Additionally, none of the levels of biomarkers included differed between those on the fruit-and-vegetable or DASH diets.

In an editorial, Ramon Estruch, MD, PhD, and Rosa Casas, MD, PhD, both of the University of Barcelona, write the results of the current analysis underscore the benefits of fruits and vegetables on cardiovascular health—even in healthy patients.

“Eating fruits and vegetables seems to attenuate subclinical cardiac damage, even in persons in good cardiovascular health, such as those included in the DASH study, furthering our knowledge about the power of food to improve cardiovascular outcomes,” wrote the pair. “Recommendations to increase the intake of fruits and vegetables to at least 10 servings per day should be generalized to the overall population, regardless of health status.”

This study, “Associations Between Dietary Patterns and Subclinical Cardiac Injury,” was published in the Annals of Internal Medicine.