Vegan diet better than recommended diets for risk reduction of heart attack

New York: Vegan diet has been found to be better at reducing heart attack and CV risk compared to other recommended diets, according to a new study. Patients with coronary artery disease on guideline‐directed medical therapy may benefit from a plant‐based vegan diet as an adjunctive treatment and hence, may be considered in such patients. The diet may significantly lower high‐sensitivity C‐reactive protein (hsCRP) as a risk marker of adverse outcomes.

It is well-documented that hsCRP is a clinical marker of general and cardiac-related inflammation.
• Apparently healthy individuals with elevated hsCRP values are up to 4X as likely to have coronary heart disease.
• Elevated hsCRP is associated with the risk of future adverse cardiovascular events (heart attack, stroke and death)
in apparently healthy individuals and in individuals with stable coronary artery disease.

Results of the study, published in the Journal of the American Heart Association, however, suggests that a vegan diet does not appear to provide greater benefit when compared with the American Heart Association–recommended diet in terms of weight loss, glycemic control, or dyslipidemia.

Dietary interventions may play a role in secondary cardiovascular prevention. Binita Shah, interventional cardiologist and assistant professor of medicine at the NYU Langone Health Center, New York, and colleagues conducted this open‐label, blinded end‐point, EVADE CAD (Effects of a Vegan Versus the American Heart Association-recommended Diet in Coronary Artery Disease) trial in which they randomly assigned 100 participants with CAD to 8 weeks of a vegan diet or an AHA-recommended diet.

All participants received a provision of groceries, tools to measure dietary intake and dietary counseling. Although not powered for clinical endpoints, none had an MI, underwent unplanned coronary revascularization or died during the study period, and no participants had a cerebrovascular event in the vegan diet group. Two participants in the AHA diet group had a probable transient ischemic attack as determined by a clinical neurologist consultant.

The primary endpoint was high‐sensitivity C‐reactive protein. A linear regression model compared endpoints after 8 weeks of a vegan versus American Heart Association diet and adjusted for baseline concentration of the endpoint. Significance levels for the primary and secondary endpoints were set at 0.05 and 0.0015, respectively.

Key Findings:

• A vegan diet resulted in a significant 32% lower high‐sensitivity C‐reactive protein (β, 0.68) when compared with the American Heart Association diet.


• Results were consistent after adjustment for age, race, baseline waist circumference, diabetes mellitus, and prior myocardial infarction (adjusted β, 0.67). The degree of reduction in body mass index and waist circumference did not significantly differ between the 2 diet groups (adjusted β, 0.99; and adjusted β, 1.00 respectively).


• There were also no significant differences in markers of glycemic control between the 2 diet groups.


• There was a nonsignificant 13% reduction in low‐density lipoprotein cholesterol with the vegan diet when compared with the American Heart Association diet (adjusted β, 0.87).


• There were no significant differences in other lipid parameters.

"In patients with CAD and an elevated hsCRP despite guideline‐directed medical therapy, a vegan diet may be considered to further lower this marker of adverse outcomes. The vegan diet does not appear to provide significant added benefit when compared with the AHA‐recommended diet in terms of weight loss, glycemic control, or lipid profile improvement," concluded the authors.

For further reference log on to https://doi.org/10.1161/JAHA.118.011367