Cardiovascular
Diet quality and incident heart failure among individuals with preclinical heart failure: a prospective UK Biobank cohort study Fang Zhu* Fang Zhu Zhu Zhu Zhu Zhu Zhu Zhu Epidemiology and Community Health Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
Background: The preclinical stage of heart failure (HF), affecting over half of adults, represents a critical window for preventive intervention, yet the effects of diet quality on subsequent HF risk in this population remain unexplored.
Objective: To examine the association of the alternative Mediterranean diet (AMED) score with incident clinical HF among preclinical HF individuals.
Methods: Using UK Biobank data (2006-2010), we analyzed 93,541 participants (51.1% women) with preclinical HF with ≥2 valid 24-hour dietary recalls, followed through 2023. AMED scores (0-9 points) were calculated from 9 food items, with higher scores indicating greater adherence. Cause-specific hazard models were used to examine the associations of AMED scores with incident clinical HF, accounting for competing risk and adjusting for potential confounders. We examined potential interaction effects with age, sex, Townsend Deprivation Index (TDI), and baseline10-year predicted HF risk.
Results: During a median of 13.7-year follow-up, 2,801 incident HF events occurred. Each one-point increase in AMED score was associated with a 6% lower risk of HF (HR: 0.94; 95% CI: 0.92-0.96). Compared with the lowest adherence group (scores 0-2), those with the highest adherence (scores 7-9) had a 25% lower HF risk in the fully adjusted model (HR: 0.75; 95% CI: 0.65-0.86). A significant interaction with TDI was observed (p for interaction=0.006). Subgroup analyses indicated that the association between AMED scores and HF risk was present only among the most deprived participants (HR: 0.56; 95% CI, 0.44-0.72 for scores 7-9 compared with scores 0-2). No significant interaction effects between AMED score and sex, age, and HF risk were observed.
Conclusion: In preclinical HF, higher adherence to the AMED was associated with a lower risk of HF, particularly among those who live in more deprived areas. Higher adherence to a healthy dietary pattern supports diet as a potential strategy for early HF prevention.