Adherence to a planetary health diet, genetic susceptibility, and incident cardiovascular disease: a prospective cohort study from the UK Biobank

IF 6.5 1区医学 Q1 NUTRITION & DIETETICS

American Journal of Clinical Nutrition Pub Date : 2024-09-01 DOI:10.1016/j.ajcnut.2024.06.014

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引用次数: 0

Abstract

Background

The influence of adherence to a planetary health diet (PHD) proposed by the EAT-Lancet Commission on cardiovascular disease (CVD) is inconclusive. Besides, whether genetic susceptibility to CVD can modify the association of PHD with CVD remains unknown.

Objective

We aimed to investigate the association between adherence to PHD and CVD, and to evaluate the interaction between PHD and genetic predisposition to CVD.

Methods

This study included 114,165 participants who completed at least two 24-h dietary recalls and were initially free of CVD from the UK Biobank. PHD score was calculated to assess adherence to PHD. Genetic risk was evaluated using the polygenic risk score. Incidence of total CVD, ischemic heart disease (IHD), atrial fibrillation (AF), heart failure (HF), and stroke were identified via electronic health records. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

During a median follow-up of 9.9 y, 10,071 (8.8%) incident CVD cases were documented. Compared with participants with the lowest adherence to PHD, HRs (95% CIs) for total CVD, IHD, AF, HF, and stroke among those with the highest adherence were 0.79 (0.74, 0.84), 0.73 (0.67, 0.79), 0.90 (0.82, 0.99), 0.69 (0.59, 0.82), and 0.88 (0.75, 1.04), respectively. No significant interaction between the genetic risk of CVD and PHD was observed. Participants with high genetic risk and low PHD score, as compared with those with low genetic risk and high PHD score, had a 48% (95% CI: 40%, 56%) higher risk of CVD. The population-attributable risk (95% CI) of CVD for poor adherence to PHD ranged from 8.79% (5.36%, 12.51%) to 14.00% (9.00%, 18.88%).

Conclusions

These findings suggest that higher adherence to PHD was associated with lower risk of total CVD, IHD, AF, and HF in populations across all genetic risk categories.

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坚持行星健康饮食、遗传易感性和心血管疾病发病率：英国生物库前瞻性队列研究。

背景：EAT-Lancet委员会提出的行星健康饮食（PHD）对心血管疾病（CVD）的影响尚无定论。此外，心血管疾病的遗传易感性是否会改变 PHD 与心血管疾病的关系仍是未知数：我们的目的是研究坚持健康饮食与心血管疾病之间的关系，并评估健康饮食与心血管疾病遗传易感性之间的相互作用：本研究纳入了英国生物库中至少完成两次 24 小时饮食回顾且最初未患心血管疾病的 114,165 名参与者。计算 PHD 分数以评估 PHD 的遵守情况。使用多基因风险评分评估遗传风险。总心血管疾病、缺血性心脏病（IHD）、心房颤动（AF）、心力衰竭（HF）和中风的发病率是通过电子健康记录确定的。采用 Cox 比例危险回归模型估算危险比（HRs）和 95% 置信区间（CIs）：在中位随访 9.9 年期间，共记录了 10,071 例（8.8%）心血管疾病病例。与PHD依从性最低的参与者相比，依从性最高的参与者的总心血管疾病、IHD、房颤、高频和中风的HRs（95% CIs）分别为0.79（0.74，0.84）、0.73（0.67，0.79）、0.90（0.82，0.99）、0.69（0.59，0.82）和0.88（0.75，1.04）。心血管疾病遗传风险与 PHD 之间没有明显的交互作用。遗传风险高且 PHD 得分低的参与者与遗传风险低且 PHD 得分高的参与者相比，患心血管疾病的风险高出 48% (95% CI, 40%, 56%)。PHD依从性差的人群心血管疾病风险（95% CI）从8.79%（5.36%，12.51%）到14.00%（9.00%，18.88%）不等：这些研究结果表明，在所有遗传风险类别的人群中，较高的PHD依从性与较低的总心血管疾病、IHD、房颤和心房颤动风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Clinical Nutrition 医学-营养学

CiteScore

12.40

自引率

4.20%

发文量

332

审稿时长

38 days

期刊介绍： American Journal of Clinical Nutrition is recognized as the most highly rated peer-reviewed, primary research journal in nutrition and dietetics.It focuses on publishing the latest research on various topics in nutrition, including but not limited to obesity, vitamins and minerals, nutrition and disease, and energy metabolism. Purpose: The purpose of AJCN is to: Publish original research studies relevant to human and clinical nutrition. Consider well-controlled clinical studies describing scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention or health benefits. Encourage public health and epidemiologic studies relevant to human nutrition. Promote innovative investigations of nutritional questions employing epigenetic, genomic, proteomic, and metabolomic approaches. Include solicited editorials, book reviews, solicited or unsolicited review articles, invited controversy position papers, and letters to the Editor related to prior AJCN articles. Peer Review Process: All submitted material with scientific content undergoes peer review by the Editors or their designees before acceptance for publication.