(PTFS13-05-26) Mediterranean Diet Components and Heart Failure Among High-Risk Adults

Objectives: To examine the association between Mediterranean diet components and incident heart failure (HF) among adults at risk for HF.

Methods: We included 93,541 UK Biobank participants at risk for HF, defined as a history of hypertension, diabetes, obesity, or atherosclerotic cardiovascular disease, who completed ≥2 valid 24-hour dietary recalls (2006–2010). Mediterranean diet component intakes (grams/day) were classified into sex-specific quartiles; however, alcohol, fish, legumes, and nuts were categorized as non-consumers and sex-specific tertiles among those with nonzero intake. Incident HF through 2023 was ascertained using linked health records. Cause-specific Cox models accounting for competing risk estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle, and clinical factors. Effect modification by socioeconomic deprivation was evaluated.

Results: Over a median of 13.7 years, 2,801 participants developed HF. Higher intakes of vegetables (HR 0.85; 95% CI 0.76–0.94), nuts (HR 0.77; 95% CI 0.69–0.86), and whole grains (HR 0.91; 95% CI 0.82–1.00), and lower intakes of red and processed meats (HR 1.16; 95% CI 1.05–1.30), were independently associated with lower HF risk. Fruits, fish, legumes, and the monounsaturated-to-saturated fat ratio were not significantly associated with HF risk. Alcohol intake showed an inverse association (HR 0.66; 95% CI 0.59–0.74) that was attenuated after adjustment for baseline 10-year PREVENT-HF predicted risk score. Associations were stronger among participants living in more deprived areas. Findings were consistent across sensitivity analyses, including ≥ 3 dietary assessments and alternative exposure definitions.

Conclusions: Among adults at risk for HF, higher intake of plant-based foods and lower red/processed meat consumption was associated with lower risk of incident HF. Dietary quality may be especially relevant in socioeconomically deprived populations.

Funding Sources: This research was supported by the Intramural Research Program of the National Institutes of Health (NIH). The findings and conclusions presented in this paper are those of the author(s) and do not necessarily reflect the views of the NIH or the U.S. Department of Health and Human Services.