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Background: Previous research examining the effects of omnivorous and plant-based diets on cardiovascular disease (CVD) outcomes has produced inconsistent findings, and the importance of diet quality is overlooked. Our study aimed to develop a novel heart-protective diet index to assess the association of a high-quality, predominantly plant-based diet—including fish, eggs, and low-fat dairy products—with CVD incidence and mortality. Methods: This study included 192,274 participants in the UK Biobank (mean age: 56.3 ± 7.9 years) without CVD at baseline who completed a 24 h recall Oxford WebQ questionnaire. Using the Oxford WebQ questionnaire, we developed and validated a novel heart-protective diet score (HPDS) based on 22 food groups. Cox proportional hazard models were used to study the associations between HPDS and outcomes. Results: During a median follow-up of 12.3 years, 20,692 CVD events and 1131 CVD deaths were observed. After adjusting for demographics, Townsend deprivation index, lifestyle, and history of chronic diseases, participants in the top HPDS quartile were at lower risk, compared to those in the bottom quartile, of overall CVD (HR: 0.92 [95%CI: 0.88, 0.95]), IHD (HR: 0.89 [95%CI: 0.84, 0.94]), MI (HR: 0.85 [95%CI: 0.77, 0.94]), and HF (HR: 0.86 [95%CI: 0.77, 0.95]). Conclusions: Adherence to a healthy, predominantly plant-based heart-protective diet rich in non-starchy vegetables, fruits, wholegrains, fish, eggs, and low-fat dairy products is associated with a reduced cardiovascular disease incidence and mortality. Further research in diverse ethnic populations is necessary to examine the reproducibility of our findings and enhance generalizability. Full article

Background: Polyamines, including spermidine (SPD), spermine (SPM) and putrescine (PUT), are essential for cellular physiology and various cellular processes. This study aimed to examine the associations of dietary polyamines intake and all-cause mortality and incident cardiovascular disease (CVD). Methods: This prospective cohort study included 184,732 participants without CVD at baseline from the UK Biobank who had completed at least one dietary questionnaire. Diet was assessed using Oxford WebQ, a web-based 24 h recall questionnaire, with polyamines intakes estimated from previous studies. Cox proportional models with restricted cubic splines were employed to investigate nonlinear associations. The primary endpoint was all-cause mortality or incident CVD (including CVD death, coronary heart disease and stroke). Results: During a median follow-up period of 11.5 years, 7348 (3.9%) participants died and 12,316 (6.5%) developed incident CVD. Polyamines intake showed nonlinear associations with all-cause mortality and incident CVD (P for nonlinear < 0.01). Compared to the lowest quintile group of dietary polyamines intake (≤17.4 mg/day), the quintile 2 to 5 groups demonstrated a reduced risk of all-cause mortality, with the lowest risk in quintile 2 group (>17.4–22.3 mg/day) (HR:0.82, 95% CI: 0.76–0.88). Similar results were observed for incident CVD, with the lowest risk in the quintile 4 group (>27.1–33.5 mg/day) (HR: 0.86, 95% CI: 0.82–0.92). Conclusions: We found that dietary polyamines intake was associated with a lower risk of all-cause mortality or incident CVD. Furthermore, our study identified an optimal range of dietary polyamines intake. Full article

The Oxford WebQ is an online 24 h dietary assessment tool used by several large prospective studies. This study describes the creation of the new individual fatty acid (FA) dataset for the Oxford WebQ and reports intakes and sources of dietary individual FAs in the UK Biobank. Participants who completed ≥1 (maximum of five) 24 h dietary assessments were included (n = 207,997). Nutrient intakes were obtained from the average of all completed 24 h dietary assessments. Nutrient data from the UK McCance and Widdowson’s The Composition of Foods and the US Department of Agriculture food composition tables were used to calculate intakes of 21 individual FAs. The individual FA dataset included 10 saturated fatty acids (SFAs), 4 monounsaturated fatty acids (MUFAs), and 7 polyunsaturated fatty acids (PUFAs; including alpha-linolenic (18:3), eicosapentaenoic (20:5), and docosahexaenoic (22:6) acids). Palmitic (16:0; mean ± standard deviation (SD): 13.5 ± 5.7 g/d) and stearic (18:0; 5.2 ± 2.5) acids were the main contributors to SFAs, and the main sources of these were cereals and cereal products (mostly desserts/cakes/pastries), milk and milk products (mostly cheese and milk), and meat and meat products. Oleic acid (18:1; 24.2 ± 9.8) was the main MUFA, derived mainly from cereals and cereal products, and meat and meat products. Linoleic acid (18:2; 9.7 ± 4.3) was the main PUFA, derived mostly from cereals and cereal products, and vegetables (including potatoes) and vegetable dishes. The individual FA dataset for the Oxford WebQ will allow future investigations on individual FAs and disease risk. Full article