Prospective cohort study in UK Biobank of 10,414 cancer survivors free of prior CVD who had completed ≥2 dietary recalls (mean age 59.5 years, 37% men). Over a median follow-up of 13.1 years, 1,331 incident CV events occurred. Higher adherence to four healthy dietary patterns reduced CV risk (highest vs lowest tertile): alternate Mediterranean diet HR 0.83, Alternative Healthy Eating Index 2010 HR 0.76, Dietary Approaches to Stop Hypertension HR 0.82, EAT-Lancet HR 0.85. Effects were consistent for ischaemic heart disease (HR 0.77-0.85); AHEI-2010, DASH, and EAT-Lancet also reduced heart failure risk (HR 0.74-0.88); AHEI-2010 and EAT-Lancet also reduced stroke risk. There was no interaction with genetic CVD risk. Healthy eating thus benefits cancer survivors regardless of genetic predisposition — a growing high-risk population.
The extent to which diet influences cardiovascular risk in survivors of cancer is not well established. We therefore assessed how adherence to various dietary patterns relates to the development of cardiovascular disease (CVD) in this population.
This study included 10 414 survivors of cancer from the UK Biobank who were free of CVD and had completed at least two 24-hour dietary recalls. Adherence at baseline to the Alternative Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean diet, dietary approaches to stop hypertension, and EAT-Lancet diet was examined in relation to incident CVD, and Cox models were used to derive hazard ratios (HRs) with 95% CIs for CVD incidence.
The mean age of participants was 59.49±7.00 years, and 37% were men in our study. Over a median follow-up of 13.12 years, 1331 incident CVD events were documented. In the fully adjusted model, the HRs for the highest versus lowest tertiles of adherence were 0.83 (95% CI, 0.72-0.97) for alternate Mediterranean diet, 0.76 (95% CI, 0.66-0.87) for AHEI-2010, 0.82 (95% CI, 0.72-0.94) for dietary approaches to stop hypertension, and 0.85 (95% CI, 0.74-0.97) for EAT-Lancet. Specifically, higher adherence to the alternate Mediterranean diet, AHEI-2010, dietary approaches to stop hypertension, and EAT-Lancet diets was associated with lower risks of ischemic heart disease (HR, 0.77-0.85), while the AHEI-2010, dietary approaches to stop hypertension, and EAT-Lancet diets were also linked to reduced risk of heart failure (HR, 0.74-0.88) and the AHEI-2010 and EAT-Lancet diets with lower stroke risk (HR, 0.81-0.83). No significant interaction between the genetic risk of CVD and diet pattern was observed.
These results indicate that following a healthy diet is linked to a reduced risk of CVD among survivors of cancer, regardless of their genetic risk.
