Adherence to EAT-Lancet reference diet and risk of premature coronary artery diseases: a multi-center case-control study.

Ataei Kachouei, Amirhossein; Mohammadifard, Noushin; Haghighatdoost, Fahimeh; Hajihashemi, Parisa; Zarepur, Ehsan; Nouhi, Fereydoon; Kazemi, Tooba; Salehi, Nahid; Solati, Kamal; Ghaffari, Samad; Gholipour, Mahboobeh; Heybar, Habib; Alikhasi, Hassan; Sarrafzadegan, Nizal

Background: In 2019, a globally sustainable dietary pattern that primarily emphasizes the consumption of plant-based foods was proposed by the EAT-Lancet Commission. However, there is limited evidence regarding the association of this diet with coronary events. Objectives: To determine the association between the EAT-Lancet Reference Diet (ELD) and premature coronary artery disease (PCAD) risk and its severity. Methods: This multi-center, case-control study was conducted within the framework of the Iran premature coronary artery disease (I-PAD). A total of 3185 participants aged under 70 years in women and 60 years in men were included. Cases were those whose coronary angiography showed stenosis ≥ 75% in at least one vessel or ≥ 50% in the left main artery (n = 2033), while the controls had normal angiography results (n = 1152). Dietary intake was assessed using a validated food frequency questionnaire. Logistic regression was utilized to examine the association between ELD and presence of PCAD. Results: Compared with individuals in the first quartile, those in the highest quartile of ELD (OR = 0.29, 95% CI: 0.21, 0.39; P for trend < 0.001) and ELD calculated with minimum intake (OR = 0.39, 95% CI: 0.29, 0.52; P < 0.001) had lower risk of PCAD. Individuals in the highest quartile of adherence to the ELD and ELD with minimum intake had 78% and 72% lower risk of having severe PCAD compared with those in the lowest quartile, respectively. Conclusion: An inverse association was observed between adherence to the ELD and PCAD risk and its severity. Large-scale prospective cohort studies are required to confirm these findings.

IRAN; RISK assessment; RESEARCH funding; NUTRITIONAL assessment; QUESTIONNAIRES; LOGISTIC regression analysis; NUTRITIONAL requirements; SEVERITY of illness index; DESCRIPTIVE statistics; ODDS ratio; RESEARCH; CASE-control method; CORONARY artery disease; CORONARY angiography; CONFIDENCE intervals; DIET; DISEASE risk factors

European Journal of Nutrition, 2024, Vol 63, Issue 8, p2933

1436-6207

Academic Journal

10.1007/s00394-024-03475-y