A diet rich in plant-based foods with less red meats can help patients with coronary and peripheral artery disease (PAD), says a study led by McMaster University researchers.

PAD is when fatty plaques block arteries in the legs. It can lead to limb amputations if left untreated. A diet including large amounts of fruits, nuts, vegetables, other high-fibre foods and white instead of red meat can help prevent this outcome. Until now, the medical advice for people with PAD was only to take their prescribed medications, walk more and stop smoking.

The findings were published in the European Journal of Preventative Cardiology on April 20. The study was co-led by McMaster experts Sonia Anand, John Eikelboom, Jackie Bosch, Mahshid Dehghan, Russ DeSouza and Salim Yusuf.

“A higher-quality diet means a lower chance of developing adverse cardiovascular or limb events that can result in amputation. These diets are associated with improved cardiovascular health,” said Anand, a professor of the Department of Medicine and senior scientist at the Population Health Research Institute.

“Now we reaffirm our advice for coronary artery disease (CAD) patients, and have more specificity for people with PAD, who previously did not get as much attention in research as those living with CAD,” she said.

“We usually recommend the Mediterranean diet for people with PAD and other types of cardiovascular disease (CVD) and now we have greater confidence to provide dietary recommendations.”

First author Darryl Wan, who completed his vascular medicine fellowship at McMaster and is now a clinical assistant professor at the University of British Columbia, said that “Patients often ask what they should eat, and what this study tells us is that dietary quality is important.”

“I think this is highly applicable globally because rather than saying people need to stick to one rigid diet, these principles can be applied across multiple cultures, countries and ethnicities.”

The study tracked 26,539 people from 33 countries in Asia, Europe, Australia North and South America with both CAD and PAD. Of the patients tracked, 24,119 had CAD and 7,163 had PAD, with some having both. Participants’ average age was 68 years old and 78 per cent were men.

Over the 30 months that participants were monitored, a total of 1,391 adverse events occurred, of which 1,262 were CVD-related and 140 were PAD-related, with some people having both.

Researchers found the incidence of CVD and PAD events was highest in patients with a poor diet, measured by the Alternate Healthy Eating Index (AHEI) metric, with zero being the worst diet score and 70 being the best.

Each five-point reduction in a person’s AHEI score was associated with a seven per cent increase in adverse CVD and limb events. The average AHEI score was 23.

When patients were divided into four groups based on their AHEI score, those in the lowest quartile had a 27 per cent increased risk of both CAD and PAD events compared to patients in the highest quartile. This increased risk was mainly driven by CVD events in those with poor diets.

Learn more about Sonia Anand on her McMaster Experts profile.

Learn more about the PHRI’s research and its members here.

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