Abstract
Background and objectives: Cardiovascular diseases (CVD) are the leading cause of death globally. A shift from animal-based diets to more plant-based diets is likely to reduce the risk of CVD. This modelling study aimed to assess the impacts of the partial substitution of processed meat with plant-based foods on CVD risk. Methods: We used pooled data from five Finnish cohorts (n = 42868, 78% men, aged ≥25 years at baseline, 7.9 years median follow-up time with 4421 incident CVD cases). Diet was assessed using a validated food frequency questionnaire at baseline and CVD cases were ascertained from national health registers. In the substitution models, 50 g/week of processed meat were substituted with similar amounts of plant-based foods (legumes, vegetables, fruits, cereals, or a combination of these). Cohort-specific hazard ratios (HRs) were calculated using a Cox proportional hazards multivariate model adjusted for relevant confounding factors. Pooled HRs were estimated from the cohort-specific HRs using a random-effects model. Results: There was a small yet statistically significant reduction in CVD risk when processed meat was partially substituted with legumes (men: HR 0.96, 95% CI 0.93–1.00, p = 0.03), vegetables (men: HR 0.99, 95% CI 0.99–1.00, p < 0.001, women: HR 0.98, 95% CI 0.96–0.99, p < 0.01), fruits (women: HR 0.98, 95% CI 0.96–0.99, p < 0.01), cereals (women: HR 0.96, 95% CI 0.94–0.98, p < 0.01), or a combination of plant-based foods (women: HR 0.98, 95% CI 0.96–0.99, p < 0.01). Discussion: The modelled partial substitution of processed meat with several plant-based foods was associated with lower CVD risk. Our findings suggest that even a small change towards a more plant-based diet may contribute to cardiovascular health at the population level and, moreover, environmental sustainability.
Author Contributions
Conceptualization, M.S., N.E.K., M.M., K.H., H.T., A.-M.P. and S.M.; formal analysis, K.H. and H.T.; investigation, M.S., N.E.K., M.M., K.H., H.T., A.-M.P. and S.M.; resources and data curation, A.-M.P. and S.M.; writing—original draft preparation, M.S.; writing—review and editing, M.S., N.E.K., M.M., K.H., H.T., A.-M.P. and S.M. All authors have read and agreed to the published version of the manuscript.
Funding
This research is part of the Leg4Life project (Legumes for Sustainable Food System and Healthy Life) funded by the Strategic Research Council at the Academy of Finland under Grant number 327698, 327699, 352481, and 352483.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki. Each cohort study followed the ethical code of its time. For the most recent cohort (the National FINRISK 2012 Study), the Ethics Committee of the Hospital District of Helsinki and Uusimaa approved the research procedure (162/13/03/00/2011, 20 September 2011).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data is available upon request through the Findata permit procedure at https://www.findata.fi/en/.
Conflicts of Interest
The authors declare no conflict of interest.
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