Recent JACC: Heart failure This study determined whether the EAT-Lancet dietary index influences the risk of heart failure (HF) and plasma proteins that may influence this association.

study: EAT-Lancet Diet Index, plasma proteins, and risk of heart failure in a population-based cohort. Image credit: monticello / Shutterstock.com

background

The rapidly increasing prevalence of heart failure, especially in the aging population, remains a global health concern. Patients with heart failure often experience a decreased quality of life and are at increased risk of severe morbidity and mortality. Therefore, it is essential to identify effective modifiable risk factors that can prevent heart failure.

Previous studies have shown that diet is a modifiable factor that can significantly influence the risk of heart failure. In 2019, the EAT-Lancet Committee proposed EAT-Lancet to prevent certain diseases and promote environmental sustainability.

The EAT-Lancet reference diet encourages increasing intake of fruits, vegetables, legumes, nuts, and whole grains while reducing intake of sugary foods and animal products. Compared to the Mediterranean diet, the EAT-Lancet diet focuses on grains and legumes.

It is important to understand whether adhering to the EAT-Lancet diet can reduce the risk of heart failure. To date, few studies have evaluated the association between the EAT-Lancet diet and the risk of heart failure.

About research

In the current study, it was hypothesized that adherence to the EAT-Lancet diet would reduce the risk of developing heart failure. Because plasma proteins play important roles in disease development and are influenced by environmental factors, proteomics has the potential to elucidate mechanisms linking diet and specific diseases.

The current study obtained all relevant data from the Malmö Diet and Cancer (MDC) and MDC Cardiovascular Cohort (MDC-CC) studies. At baseline, blood samples were collected and participants’ diets were assessed.

A total of 23,260 participants met all eligibility criteria and participated in the study. A proteomics study involving 4,742 people was also conducted.

The EAT-Lancet diet index included <13 points, 14–16 points, 17–19 points, 20–22 points, and ≥23 points. Study participants were divided into five groups according to baseline adherence to the EAT-Lancet dietary index.

The International Classification of Diseases (ICD) coding system of the Swedish Hospital Discharge Register was used to assess the prevalence and incidence of heart failure cases in Sweden. Blood samples were used to extract plasma and a total of 149 plasma proteins were evaluated using the Olink proximity expansion assay.

research result

The average age of the study participants was 57.8 years, and approximately 39% of them were male. Female participants with a university degree were more likely to adhere to the EAT-Lancet diet index, consume fewer calories, be nonsmokers, and engage in more leisure-time physical activity.

The current prospective cohort study lasted nearly 30 years. Higher adherence to the EAT-Lancet dietary index was associated with a decreased risk of developing heart failure.

This association was more significant among participants without a family history of myocardial infarction (MI), thus suggesting that the protective effect of the EAT-Lancet diet against heart failure may be attenuated by genetic factors. are doing. In the future, further research is needed to elucidate the association between the EAT-Lancet diet and heart failure, taking into account different genetic susceptibilities.

adrenomedullin (AM), interleukin 6 (IL-6), growth differentiation factor 15 (GDF15), transmembrane immunoglobulin and mucin domain (TIM), chemokine (CC) motif ligand 20 (CCL20), cathepsin D (CTSD) Eight plasma proteins, including follistatin (FS) and iron uptake regulator (FUR), were associated with the EAT-Lancet dietary index and the risk of heart failure.

The findings are consistent with previous research showing that a plant-based diet similar to the EAT-Lancet diet reduces the risk of heart failure. Several components of the EAT-Lancet dietary index, particularly fruits and unsaturated oils, significantly contribute to the inverse association between the EAT-Lancet diet and the risk of heart failure. Compared with higher intakes, moderate dairy intake at baseline also reduced the risk of heart failure.

conclusion

The study shows that adhering to the EAT-Lancet diet reduces the risk of developing heart failure, in addition to promoting a sustainable environment by reducing land/water use and greenhouse gas emissions. It is emphasized that it will be reduced. The identified plasma proteins also indicate the underlying mechanism underlying the inverse association between the EAT-Lancet diet and reduced risk of heart failure.