Plant-based Diet on Cardiovascular Disease

Abstract

Cardiovascular diseases (CVDs) remain the leading cause of disease burden and premature death globally. Past research has demonstrated that high-quality plant-based diets exert a strong protective influence against cardiovascular risks. However, most evidence is based on observational studies with mixed findings. Present data from RCTs and meta-analyses of RCTs primarily focus on general populations, and there is a paucity of data on the secondary prevention of CVD.

To explore these mixed findings, this thesis aims to investigate the associations between plant-based diets and cardiovascular health, with a particular focus on individuals with or at high risk of CVD. A meta-analysis (20 RCTs) of vegetarian diets in populations at high risk of CVDs (n=1878) illustrates that consuming a vegetarian diet significantly improves cardiometabolic outcomes (LDL-C: -0.18mmol/L, HbA1c: -0.25%, and body weight: -3.4 kg). From the meta-analysis, we identified that: a) most trials failed to document detailed dietary intake; b) the duration of most trials was <6 months; c) limited data in secondary prevention of CVD. To address this, we developed a heart-protective diet score and tested it in the UK Biobank cohort (n=192274). We demonstrated that individuals who consumed a high-quality plant-based diet experienced a significantly lower risk of CVD events (HR: 0.92) and mortality (HR: 0.72). Finally, we further addressed research gaps by designing the LIVEPLUS trial, aiming to evaluate the effects of an intensive lifestyle program in patients with stable coronary heart disease. The preliminary findings (n=9) show that all patients patients significantly reduced body weight and BMI after one-month of intervention.

Overall, we demonstrate the protective effects of a high-quality plant-based diet on cardiovascular health. Our findings contribute significantly to the development of current guidelines in lifestyle prevention and management of CVDs.