People who eat healthy have a 14% to 21% lower risk of heart disease and stroke, according to one of the largest studies by Harvard that followed participants for up to 32 years. The results support the notion that individuals could choose different healthy eating patterns based on their personal food traditions or preferences for the prevention of cardiovascular disease (CVD) risk, says the study by researchers from the Harvard TH Chan School of Public Health, Boston.

“These data provide further evidence to support current dietary guidelines that following healthy eating patterns confer long-term health benefits on cardiovascular disease prevention. There is no one-size-fits-all diet that is best for everyone. One can combine foods in a variety of flexible ways to achieve healthy eating patterns according to individuals' health needs, food preferences, and cultural traditions,” says study author Frank Hu, Fredrick J Stare professor of nutrition and epidemiology and chair of the Department of Nutrition, in the analysis published in JAMA Internal Medicine.

Heart disease is the leading cause of death for men, women and people of most racial and ethnic groups in the US. According to the US Centers for Disease Control and Prevention (CDC), one person dies every 37 seconds in the US from cardiovascular disease. About 647,000 Americans die from heart disease each year, which is one in every four deaths.

Heart disease in the US. (CDC)

The 2015-20 Dietary Guidelines for Americans highlight a shift from focusing on individual nutrients or foods to emphasizing healthy eating patterns as a whole to better account for diverse cultural and personal food traditions and preferences. But few studies have examined how sticking to recommended healthy eating patterns influence the long-term risk of cardiovascular disease. 

For this study, the team focused on dietary scores for four healthy eating patterns: Healthy Eating Index-2015 (HEI-2015), Alternate Mediterranean Diet Score (AMED), Healthful Plant-Based Diet Index (HPDI), and Alternate Healthy Eating Index (AHEI). Despite different scoring methods, each of these patterns emphasizes a higher intake of whole grains, vegetables, fruits, legumes, and nuts, and lower intakes of red and processed meats and sugar-sweetened beverages, say researchers. To assess the associations of each pattern with cardiovascular disease risk, the research team looked at data from 74,930 women enrolled in the Nurses' Health Study (1984-2016), 90,864 women in the Nurses' Health Study II (1991-2017), and 43,339 men in the Health Professionals Follow-Up Study (1986-2012). Participants in each study were asked every two to four years about their dietary habits, including how often, on average, they consumed a standard portion size of various foods. The analysis was conducted between July 25 to December 4, 2019. 

Using the dietary data, which was collected over several decades via validated dietary questionnaires, the researchers created four dietary scores for each participant. Higher dietary scores represented greater adherence to healthy eating patterns. During a total of 5,257,190 person-years of follow-up, 23,366 cardiovascular cases were documented, including 18,092 coronary heart disease, and 5,687 strokes. 

Different healthy eating patterns emphasize a higher intake of whole grains, vegetables, fruits, legumes, and nuts, and lower intakes of red and processed meats and sugar-sweetened beverages. (Getty Images)

After adjusting for numerous factors, including age, body mass index (BMI) and smoking status, the analysis found that greater adherence to any of the healthy eating patterns was consistently associated with a lower risk of cardiovascular disease. The study found that participants who adhered most to healthy eating patterns (those in the top quartile of the scores) had a 14% to 21% lower risk of CVD when compared with those who adhered least (in the bottom quartile of the scores). “In 3 large prospective cohorts with up to 32 years of follow-up, greater adherence to various healthy eating patterns was consistently associated with a lower risk of CVD. These findings support the recommendations of the 2015-20 Dietary Guidelines for Americans that multiple healthy eating patterns can be adapted to individual food traditions and preferences,” says the study.

“To facilitate a comparison of the associations between the 4 dietary scores of healthy eating patterns, we reported a 25-percentile increment in each dietary score as a common unit that was associated with a statistically significantly lower CVD risk: 20% for Healthy Eating Index-2015, 10% for the Alternate Mediterranean Diet Score, 14% for the Healthful Plant-Based Diet Index, and 19% for the Alternate Healthy Eating Index,” the findings state. It adds, “Because of the differences in the scoring systems, it is difficult to conclude that one healthy eating pattern is superior to another.”

The findings also state that despite representing a different combination of dietary constituents, these healthy eating patterns were similarly effective at lowering cardiovascular disease risk across racial and ethnic groups and other subgroups studied and that they were statistically significantly associated with a lower risk of both coronary heart disease and stroke.

Disclaimer : This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.