Higher diet quality helps prevent blocked arteries, researchers find

A colourful array of fruit, nuts and vegetables on a grey tabletop.

A diet rich in plant-based foods with less red meat can help patients with coronary and peripheral artery disease, a McMaster-led study shows. (Shutterstock photo)

A diet rich in plant-based foods with less red meats can help patients with coronary and peripheral artery disease (PAD), says a study led by McMaster researchers.

PAD occurs when fatty plaques block arteries in the legs. Left untreated, it can lead to limb amputations.

Until now, the medical advice for people with PAD was only to take their prescribed medications, walk more and stop smoking. But a diet that includes large amounts of fruit, nuts, vegetables, other high-fibre foods and white meat instead of red meat can help prevent PAD.

The study, whose findings were published in the European Journal of Preventative Cardiology on April 20, was co-led by McMaster experts Sonia Anand, John Eikelboom, Jackie Bosch, Mahshid Dehghan, Russ DeSouza and Salim Yusuf.

“A higher-quality diet means a lower chance of developing adverse cardiovascular or limb events that can result in amputation. These diets are associated with improved cardiovascular health,” said Anand, a professor of medicine and senior scientist at the Population Health Research Institute.

“Now we reaffirm our advice for coronary artery disease (CAD) patients, and have more specificity for people with PAD, who previously did not get as much attention in research as those living with CAD,” she said.

“We usually recommend the Mediterranean diet for people with PAD and other types of cardiovascular disease (CVD) and now we have greater confidence to provide dietary recommendations.”

Patients often ask what they should eat, “and what this study tells us is that dietary quality is important,” said first author Darryl Wan, who completed his vascular medicine fellowship at McMaster and is now a clinical assistant professor at the University of British Columbia.

“I think this is highly applicable globally because rather than saying people need to stick to one rigid diet, these principles can be applied across multiple cultures, countries and ethnicities.”

The study tracked 26,539 people from 33 countries in Asia, Europe, Australia, North America and South America, with both CAD and PAD. Of the patients tracked, 24,119 had CAD and 7,163 had PAD, with some having both. Participants’ average age was 68 years old and 78 per cent were men.

Over the 30 months that participants were monitored, 1,391 adverse events occurred, of which 1,262 were cardiovascular-related and 140 were PAD-related, with some people having both.

Researchers found the incidence of CVD and PAD events was highest in patients with a poor diet, measured by the Alternate Healthy Eating Index (AHEI) metric, with zero being the worst diet score and 70 being the best.

Each five-point reduction in a person’s AHEI score was associated with a seven per cent increase in adverse CVD and limb events. The average AHEI score was 23.

When patients were divided into four groups based on their AHEI score, those in the lowest quartile had a 27 per cent increased risk of both CAD and PAD events compared to patients in the highest quartile. This increased risk was mainly driven by CVD events in those with poor diets.

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