Plant-based foods, dietary fibre and heart disease risk in a large European cohort study

Alpro Foundation Supported Research

Dr Marinka Steur - Senior nutritional scientist at Erasmus MRC Epidemiology Unit, University of Cambridge, UK

Healthy eating is a key driver for optimum heart health. Research has repeatedly demonstrated the potential of plant-based eating patterns to reduce risk of heart disease by improving cardiometabolic risk factors including blood pressure and blood lipids.

Plant-based foods such as fruit, vegetables, legumes, nuts and seeds contain nutrients which may support cardiovascular health, including vitamins and minerals, unsaturated fatty acids, flavonoids and dietary fibre.

This Alpro Foundation supported research aimed to identify associations between specific plant-based foods and ischaemic heart disease (IHD) risk.

Study overview

The researchers analysed data from almost 500,000 individuals who took part in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study, with an average follow-up of 12.6 years. Participants’ completed dietary (food frequency) and lifestyle questionnaires as well as their blood pressure measures were collated.

In a sub cohort of 16,000 participants, the EPIC-cardiovascular disease (EPIC-CVD) study, blood samples were also provided and assessed for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and HbA1c.

Data on heart disease incidence and mortality was collected and compared to dietary intakes of:

1. Fruits (total, citrus, hard fruit and bananas)

2. Vegetables (total, fruiting, leafy, cruciferous and root vegetables)

3. Legumes, nuts, seeds

4. Fibre (total, fruit, vegetable, and cereal fibre)

Heart disease risk was calculated using Cox proportional hazards regression modelling.

Key findings

During the study, 8,504 incidences of heart disease occurred amongst the participants. Lower risk of IHD was associated with higher intakes of:

• Fruit and vegetable consumption (6% reduction for each 200g/day)

• Fruit intake (3% reduction for each 100g/day)

• Nuts and seeds (10% for each 10g/day)

• Fibre (9% for each 10g/day) and fruit and vegetable fibre (5% per 4g/day)

No associations were observed between vegetables, legumes, cereals and risk of heart disease.

The dietary questionnaire did not differentiate between whole and refined grains, thus no associations could be determined between wholegrain consumption and CVD outcomes.

Participants with the highest fruit and vegetable intakes also had lower blood pressure and non-HDL cholesterol levels, compared to those with the lowest intakes.

Conclusion

The authors concluded that specific plant-based foods, including fruits and vegetables, nuts and seeds as well as fibre intake, are associated with small but significant decreases in risk of heart disease. This study supports international recommendations to increase intakes of specific plant-based foods to help prevent heart disease.

Read the orignal study.

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