Eating More Plant Foods May Lower Heart Disease Risk in Young Adults, Older Women


Compared to women who followed the Portfolio Diet less frequently, those with the closest alignment were 11% less likely to develop any type of cardiovascular disease, 14% less likely to develop coronary heart disease, and 17% less likely to develop heart failure.

According to a pair of recent research studies published in the Journal of American Heart Association, eating more nutritious, plant-based foods is heart healthy at any age.

The studies, which analyzed different measures of healthy plant food consumption, found that young adults and postmenopausal women had fewer heart attacks and were less likely to develop cardiovascular disease when they ate healthier plant foods.

The American Heart Association and Lifestyle Recommendations suggests an overall healthy dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes, and non-tropical vegetable oils. Further, it advises limited consumption of saturated fat, trans fat, sodium, red meat, sweets, and sugary drinks.

The first study, “A Plant-Centered Diet and Risk of Incident Cardiovascular Disease during Young to Middle Adulthood,” measured whether long-term consumption of a plant-centered diet and a shift toward a plant-centered diet starting in young adulthood are associated with a lower risk of cardiovascular disease in midlife.

“Earlier research was focused on single nutrients or single foods, yet there is little data about a plant-centered diet and the long-term risk of cardiovascular disease,” said lead author Yuni Choi, PhD, in a press release.

Choi and her team examined diet and the occurrence of heart disease in 4946 adults enrolled in the Coronary Artery Risk Development in Young Adults study, with participants aged 18 to 30 years at the time of enrollment and free of cardiovascular disease at that time. The participants included 2509 Black adults and 2437 white adults who were evaluated by education level.

Further, there were 8 follow-up exams from 1987-88 to 2015-16 that included lab tests, physical measurements, medical histories, and assessment of lifestyle factors.

Diet history interviews were conducted, and the quality of participants’ diets was scored based on the A Priori Diet Quality Score composed of 46 food groups at years 0, 7, and 20 of the study. The food groups were classified into beneficial foods (fruits, vegetables, beans, nuts, and whole grains); adverse foods (fried potatoes, high-fat red meat, salty snacks, pastries, and soft drinks); and neutral foods (potatoes, refined grains, lean meats, and shellfish) based on their connection to cardiovascular disease.

Some highlights of this study included:

  • During 32 years of follow-up, 289 of the participants developed cardiovascular disease, including heart attack, stroke, heart failure, heart-related chest pain or clogged arteries anywhere in the body.
  • The top 20% of participants on the long-term diet quality score were 52% less likely to develop cardiovascular disease after considering several factors, such as age, sex, race, and average caloric consumption.
  • Between years 7 and 20 of the study when participants ranged from 25 to 50 years of age, those who had the greatest improvement in diet quality were 61% less likely to develop subsequent cardiovascular disease versus the participants whose diet quality declined the most during that time.

The second study, “Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings from the Women’s Health Initiative Prospective Cohort Study,” looked at whether diets that included a dietary portfolio of plant-based foods with FDA health claims for lowering “bad” cholesterol levels, or the “Portfolio Diet,” were associated with fewer cardiovascular disease events in a large group of postmenopausal women.

The “Portfolio Diet” includes nuts; plant protein from soy, beans, or tofu; viscous soluble fiber from oats, barley, okra, eggplant, oranges, apples, and berries; plant sterols from enriched foods and monounsaturated fats found in olive and canola oils and avocados; and limited consumption of saturated fats and dietary cholesterol.

This study evaluated whether postmenopausal women who followed the Portfolio Diet experienced fewer heart disease events and included 123,330 women in the United States who participated in the Women’s Health Initiative. The women enrolled in the study between 1993 and 1998, were between 50 and 79 years of age, and did not have cardiovascular disease. The group was followed until 2017, and researchers used self-reported food-frequency questionnaires data to score each woman on adherence to the Portfolio Diet.

Compared to women who followed the Portfolio Diet less frequently, those with the closest alignment were 11% less likely to develop any type of cardiovascular disease, 14% less likely to develop coronary heart disease, and 17% less likely to develop heart failure. Additionally, there was no association between following the Portfolio Diet more closely and the occurrence of stroke or atrial fibrillation, according to the study.

“These results present an important opportunity, as there is still room for people to incorporate more cholesterol-lowering plant foods into their diets. With even greater adherence to the Portfolio dietary pattern, one would expect an association with even less cardiovascular events, perhaps as much as cholesterol-lowering medications,” said senior author John Sievenpiper, MD, PhD, in a press release. “Still, an 11% reduction is clinically meaningful and would meet anyone’s minimum threshold for a benefit. The results indicate the Portfolio Diet yields heart-health benefits.”

The researchers noted that the results highlight possible opportunities to lower heart disease by encouraging people to consume more foods in the Portfolio Diet.

“We also found a dose response in our study, meaning that you can start small, adding one component of the Portfolio Diet at a time, and gain more heart-health benefits as you add more components,” said lead study author Andrea J. Glenn, MSc, RD, in a press release.


Eating more plant foods may lower heart disease risk in young adults, older women. American Heart Association. August 4, 2021. Accessed August 5, 2021.

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