The global rise in heart failure (HF) cases, particularly among the aging population, remains a significant health concern. Patients grappling with HF often face diminished quality of life and heightened risks of severe morbidity and mortality. Thus, it becomes pivotal to identify modifiable risk factors that could potentially avert HF.
Numerous studies have underscored the pivotal role of diet as a modifiable factor significantly influencing HF risk. In 2019, the EAT-Lancet Commission introduced the EAT-Lancet diet, aimed at preventing specific diseases while promoting environmental sustainability.
This dietary model encourages increased consumption of fruits, vegetables, legumes, nuts, and whole grains, while advocating for reduced intake of sugary and animal-sourced foods. Distinguished from the Mediterranean diet, the EAT-Lancet diet places greater emphasis on cereals and legumes.
Given the scarcity of research on the association between the EAT-Lancet diet and HF risk, it becomes imperative to explore whether adherence to this dietary pattern could indeed mitigate the risk of HF.
The study, rooted in the hypothesis that adherence to the EAT-Lancet diet could lower HF risk, delves into the intricate interplay between diet and disease manifestation, leveraging proteomics to unveil potential mechanisms linking diet with certain illnesses.
Gleaning pertinent data from the Malmö Diet and Cancer (MDC) and MDC Cardiovascular Cohort (MDC-CC) study, researchers meticulously collected blood samples and assessed participants’ dietary habits at baseline.
Of the extensive pool, 23,260 participants met the stringent eligibility criteria, with a subset of 4,742 individuals subjected to proteomic scrutiny.
Participants were categorized into five groups based on their adherence to the EAT-Lancet diet index, which ranged from less than 13 to over 23 points. The prevalence and incidence of HF cases were evaluated using the International Classification of Diseases (ICD) coding system from the Swedish Hospital Discharge Register.
Furthermore, plasma samples were scrutinized to evaluate 149 plasma proteins using Olink proximity extension assays.
The study cohort, with a mean age of 57.8 years, predominantly comprised females, accounting for approximately 39% of the total. Notably, female participants with university degrees exhibited a higher propensity towards adherence to the EAT-Lancet diet index, consuming fewer calories, refraining from smoking, and engaging more in leisure-time physical activities.
Over the span of nearly three decades, the prospective cohort study revealed a notable association between greater adherence to the EAT-Lancet diet index and reduced HF risk. This association proved more pronounced among participants devoid of a family history of myocardial infarction (MI), suggesting a potential attenuation of the EAT-Lancet diet’s protective effect on HF owing to genetic predispositions.
The study also identified eight plasma proteins, including adrenomedullin (AM), interleukin 6 (IL-6), growth differentiation factor 15 (GDF15), transmembrane immunoglobulin and mucin domain (TIM), chemokine (C-C) motif ligand 20 (CCL20), cathepsin D (CTSD), follistatin (FS), and ferric uptake regulator (FUR), associated with the EAT-Lancet diet index and HF risk.
These findings are consistent with prior research indicating that plant-based diets akin to the EAT-Lancet diet mitigate HF risk. Notably, several components of the EAT-Lancet diet index, particularly fruits and unsaturated oils, significantly contributed to the inverse association between the diet and HF risk. Furthermore, a moderate dairy intake at baseline demonstrated a lowered risk of HF as opposed to higher intake levels.
In conclusion, the study underscores the efficacy of adhering to the EAT-Lancet diet in reducing HF risk while concurrently fostering environmental sustainability by curbing land/water usage and greenhouse gas emissions. The discerned plasma proteins also offer valuable insights into the underlying mechanisms underscoring the inverse association between the EAT-Lancet diet and HF risk.