A new study suggests that to reduce the risk of coronary heart disease it is simply not enough to eat a plant-based diet but that the foods in that diet must be high quality^[1].

After 2 decades of follow-up in more than 200,000 adults, researchers found that adherence to a plant-based diet rich in whole grains, fruits, vegetables, nuts, and legumes was associated with a substantially lower relative risk of coronary heart disease (CHD), whereas following a plant-based diet emphasizing less healthy foods such as refined grains and sugar-sweetened beverages had an adverse effect.

Their findings were published July 17, 2017 in the Journal of the American College of Cardiology.

“I think an important contribution of this paper is about the public-health message,” lead author Dr Ambika Satija (Harvard School of Public Health, Boston, MA) told theheart.org | Medscape Cardiology. “Just because you’re vegetarian or eating more plant-based foods doesn’t necessarily mean you have a healthy diet. It’s important to think about the quality of foods you’re consuming; more whole grains rather than refined grains, more whole foods rather than juices—that’s the right direction to take.”

She noted that this approach is already reflected in the latest 2015–2020 Dietary Guidelines for Americans, which recommends focusing on nutrient-dense foods across all food groups.

Dr Alice Lichtenstein (Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA) was vice-chair of the US dietary guidelines committee. “What the guidelines said is that there are a number of different dietary approaches—Mediterranean, [Dietary Approaches to Stop Hypertension] DASH, or vegetarian, which will get you to the same end, and that’s not inconsistent with what this is saying,” Dr Lichtenstein said, commenting on the current findings.

“Because it doesn’t matter what basic diet you consume; but if you consume more plant-based foods, you’re going to have a better outcome,” she added. “The new factor here is that not all plant-based diets are created equal and you have to use some judgement in choosing the plant-based foods you’re going to include in that diet, just as you use judgment in the animal foods you include in your diet.”

Previous studies have linked plant-based diets with a lower risk of CHD but have defined these diets dichotomously as being vegetarian or not and treated all plant foods equally, the investigators note in the article.

A new study suggests that to reduce the risk of coronary heart disease it is simply not enough to eat a plant-based diet but that the foods in that diet must be high quality^[1].

After 2 decades of follow-up in more than 200,000 adults, researchers found that adherence to a plant-based diet rich in whole grains, fruits, vegetables, nuts, and legumes was associated with a substantially lower relative risk of coronary heart disease (CHD), whereas following a plant-based diet emphasizing less healthy foods such as refined grains and sugar-sweetened beverages had an adverse effect.

Their findings were published July 17, 2017 in the Journal of the American College of Cardiology.

“I think an important contribution of this paper is about the public-health message,” lead author Dr Ambika Satija (Harvard School of Public Health, Boston, MA) told theheart.org | Medscape Cardiology. “Just because you’re vegetarian or eating more plant-based foods doesn’t necessarily mean you have a healthy diet. It’s important to think about the quality of foods you’re consuming; more whole grains rather than refined grains, more whole foods rather than juices—that’s the right direction to take.”

She noted that this approach is already reflected in the latest 2015–2020 Dietary Guidelines for Americans, which recommends focusing on nutrient-dense foods across all food groups.

Dr Alice Lichtenstein (Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA) was vice-chair of the US dietary guidelines committee. “What the guidelines said is that there are a number of different dietary approaches—Mediterranean, [Dietary Approaches to Stop Hypertension] DASH, or vegetarian, which will get you to the same end, and that’s not inconsistent with what this is saying,” Dr Lichtenstein said, commenting on the current findings.

“Because it doesn’t matter what basic diet you consume; but if you consume more plant-based foods, you’re going to have a better outcome,” she added. “The new factor here is that not all plant-based diets are created equal and you have to use some judgement in choosing the plant-based foods you’re going to include in that diet, just as you use judgment in the animal foods you include in your diet.”

Previous studies have linked plant-based diets with a lower risk of CHD but have defined these diets dichotomously as being vegetarian or not and treated all plant foods equally, the investigators note in the article.