Plant-Based Diet Can Reduce Heart Failure Risk By 41%

A recent study of more than 5000 participants found that plant-based diet can reduce the risk of heart failure in adults by up to 41%.

Investigators found that those who had a plant-based diet had a 41% lower risk of heart failure (HF), while those who had a “southern” diet heavy in fried food, added fats, and eggs had a 72% greater risk.

Investigators drew data obtained from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) to examine a cohort of 30,329 adults who were 45 years old or older and had no history of coronary heart disease. Investigators noted that 56 participants were excluded due to a lack of baseline forms. An additional 8344 were because they were taking HF-related medications at the time, they lacked HF follow-up or baseline HF was undetermined, or had coronary heart disease at baseline. A final group of 5771 participants were removed for missing or incomplete food frequency questionnaires. The final sample size consisted of 16,068 participants.

Investigators created five categories based upon the dietary patterns of participants, those categories were classified as “convenience”, “plant-based”, “sweets/fats”, “southern”, and “alcohol/salads”. Convenience was characterized by being heavy in things such as mostly meat dishes, pizza, and fast food. Sweets and fats was a diet with a high concentration of candy, chocolate, bread, and solid fats and oils. Southern was of a similar culinary pattern to the Southeastern US which is heavy in fried food, organ meats, processed meats, eggs, and added fats. Alcohol and salads were characterized by having a diet heavy in wine, liquor, beer, leafy greens and salad dressing.

Participants were given a score for each dietary pattern based on factor loadings and were group into 1 of 4 quartiles of adherence to each pattern. Quartile 1 was defined as the lowest adherence while quartile 4 was defined as having the highest adherence.

After 8.7 years of follow-up, investigators determined that convenience, sweets, and alcohol and salads diets had no association with heart failure risk. Additionally, plant-based diets were associated with a decrease in the risk of HF and southern diets were associated with an increased risk of HF.

In fully-adjusted analyses, investigators observed a 41% lower risk of new HF hospitalizations in participants in quartile 4 of the plant-based diet. Participants in quartile 4 of the southern dietary pattern were associated with a 72% greater risk of HF hospitalizations.

When the Southern diet was adjusted for body mass index, hypertension, dyslipidemia and other factors, the association was no longer statistically significant. Investigators said this could mean that the Southern dietary pattern could increase heart failure risk through factors such as obesity and excess abdominal fat.

In a related editorial comment, Dong Wang, ScD, MD, a research fellow at Harvard T.H. Chan School of Public Health, remarked that the study results are promising but more research is needed to confirm the results of the study. 



“These findings, if confirmed in future studies, will not only contribute to in-depth biological understanding and phenotypic refinement of HF, but also inform dietary prevention approaches customized for specific HF phenotypes. In addition, they perfectly fit into key missions of precision medicine,” Wang said.

Authors noted several limitations within their study. It is likely that misclassification from inaccuracies of reporting dietary intake on the food frequency questionnaire occurred. Diet was only assessed at the beginning of the study and dietary changes may have occurred at any time after initial assessment.



This study, “Dietary Patterns and Incident Heart Failure in U.S. Adults Without Known Coronary Disease,” was published in the Journal of the American College of Cardiology.