Association between Planetary Health Diet and Cardiovascular Disease: A Prospective Study from the UK Biobank.

ABSTRACT

BACKGROUND: The Planetary Health Diet index (PHDI) prioritizes the well-being of both individuals and the planet but has yielded mixed results on cardiovascular disease (CVD). Our aim was to assess the association between the PHDI and risk of CVD. METHODS: A cohort of 118,469 individuals aged 40-69 years from the UK Biobank, who were free of CVD at 2009-2012 and followed-up to 2021. The PHDI was calculated using at least two 24-h dietary assessments and included 14 food groups, with a possible range from 0 to130 points. CVD incidence was defined as primary myocardial infarction or stroke and obtained from clinical records and death registries. RESULTS: During a 9.4-year follow-up, 5,257 incident cases of CVD were ascertained. When comparing the highest (89.9-128.5 points) versus the lowest quartile (21.1-71.1 points) of PHDI adherence, the multivariable-adjusted hazard ratio (95% confidence interval) was 0.86 (0.79, 0.94) for CVD, 0.88 (0.80, 0.97) for myocardial infarction, and 0.82 (0.70, 0.97) for stroke. The association was linear until a plateau effect was reached at 80 points of adherence to PHDI. Results remained robust when excluding participants with type 2 diabetes, including only those with three or more diet assessments, or excluding CVD cases in the first three years of follow-up. The food group components of the PHDI more strongly associated with reduced CVD risk were higher consumption of whole grains, whole fruits, fish and lower consumption of added sugars and fruit juices. CONCLUSION: In this large cohort of middle-aged and older British adults, adherence to the PHDI was associated with lower risk of CVD. These results provide empirical evidence that this dietary pattern, thought to be environmentally sustainable, benefits cardiovascular health.

This study found that adherence to the Planetary Health Diet Index (PHDI) was associated with a reduced risk of cardiovascular disease (CVD) among middle-aged and older adults in the UK. Key Findings:Higher adherence to the PHDI, which emphasizes whole grains, fruits, fish, and reduced intake of added sugars and fruit juices, is linked to a significantly lower risk of CVD, myocardial infarction, and stroke.The results were consistent even after accounting for various factors, including excluding participants with type 2 diabetes and focusing on those with more dietary assessments, highlighting the robustness of the association between the PHDI and cardiovascular health.