Aug. 5, 2021 — Younger adults and postmenopausal women who ate more nutrient-rich “healthy” plant-based foods, and avoided unhealthy foods, had a lower risk of later heart disease, research shows.
These findings from two studies in two populations were posted online Wednesday in the Journal of the American Heart Association.
‘Portfolio Diet’ in Postmenopausal Women
While earlier research found that eating nutrient-dense plant-based foods helps lower blood cholesterol levels, it was not clear if this can also lower the risk of “hard” outcomes, such as heart attacks.
The findings are “very reassuring,” David J.A. Jenkins, MD, co-author of the study in postmenopausal women, tells WebMD.
“We always say that cholesterol-lowering is a good thing. Here it’s nice to see the proof,” says Jenkins, a professor in the Departments of Nutritional Sciences and Medicine at the University of Toronto in Ontario, Canada.
Jenkins designed the “Portfolio Diet”– rich in five types of cholesterol-lowering, nutrient-dense, plant-based foods — in the early 2000s.
The new study showed that postmenopausal women whose eating pattern most closely followed the Portfolio Diet were 11% less likely to develop heart disease in the next 15 years than women whose diet was least aligned with this way of eating.
Senior study author John L. Sievenpiper, MD, says that in clinical practice, he tries to shift patients toward eating more of a plant-based diet.
For example, a patient could start by aiming to eat 45 grams of nuts or nut butters each day.
Each component “buys you about 5% to 10% cholesterol lowering,” says Sievenpiper, who is an associate professor in the Department of Nutritional Sciences at the University of Toronto.
Lead author Andrea J. Glenn, a registered dietitian and a PhD candidate in nutritional studies, says that people can “start small by having oats for breakfast in the morning, adding some tofu to your dinner, and then increase as you get used to eating those foods.”
A Priori Diet Quality Score (APDQS) in Young Adults
In a second study, 18- to 30-year-olds who had the highest A Priori Diet Quality Score (APDQS) — meaning they frequently ate nutrient-dense plant-based foods — were 52% less likely to have heart disease in middle age that those with the lowest scores.
“Quite a lot of our food supply is plant-based, but it tends to be highly processed and to have low-quality ingredients such as sugars or refined grains,” says senior author David R. Jacobs Jr., PhD.
“What we are proposing is very similar to the U.S. dietary guideline” and the Mediterranean diet, but importantly, it emphasizes “nutritionally rich” plant foods, says Jacobs, a professor of public health in the Division of Epidemiology and Community Health at the University of Minnesota in Minneapolis.
The group developed the APDQS score in 2007.
“Our findings support the shift towards plant-centered diet patterns,” Jacobs says, echoing the authors of the “Portfolio Diet.”
“When you go to the grocery store and get your grocery bag, 70% of it should be nutritionally rich plant food, like broccoli and frozen peas,” he advises.
“We really emphasize that it should not be a chore for people to eat this kind of diet; it should be the kind of diet that they would pick [for taste] and even for convenience.”
Rather, “what we emphasize is the foods and putting those foods together to have a tasty and healthy meal — that’s our goal,” says Jacobs.
The top 20% group of the APDQS are those who made nutritionally rich plant foods a central part of their diet, but they also ate some animal-based foods such as non-fried poultry and low-fat dairy products, he says.
“If, generally speaking, you are eating a lot of nutritionally rich plant foods, and if they are the center of your plate rather than meat, you can have some of the refined products” and sugar and salt to taste, he says. But “there’s so much salt in everything that industry and restaurants prepare,” you need to be careful.
People should make nutritious plant foods a central part of their diet, adding small amounts of lean meats, fish, seafood, and dairy products from time to time, he says.
“We discourage people from eating added sugar, sweet foods, soft drinks, and high-fat meats, especially, processed meats (e.g., ham, sausage, salami, etc.),” Jacobs says.
‘Plant-Based Eating Keeps People Well’
“The abundance of evidence, particularly in the last 5 to 10 years, really points to the fact that the best diet for human consumption