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Low-fibre diet is associated with high-risk coronary plaque features

Larsson, Ingrid ; Sun, Jiangming LU orcid ; Ahmad, Shafqat LU ; Bergström, Göran ; Carlhäll, Carl-Johan ; Cederlund, Kerstin ; Drake, Isabel LU ; Engvall, Jan E ; Eriksson, Mats and Hagström, Henrik , et al. (2025) In Cardiovascular Research
Abstract

AIMS: Diet is a determinant of cardiovascular diseases (CVD) with coronary disease as predominant cause of pre-mature death. To analyse how diet was associated with coronary atherosclerosis, including plaque features.

METHODS AND RESULTS: The cross-sectional population-based study using data from the Swedish CArdioPulmonary BioImage Study (SCAPIS) included 24 079 adults aged 50-64 years, recruited in 2013 to 2018 who were free of clinical cardiovascular disease. The recruitment and comprehensive examinations were conducted at six locations in Sweden. A dietary index (DI) based on a previously published anti-inflammatory DI including high proportion of plant-based foods, and low in red or processed meat and sugar-sweetened... (More)

AIMS: Diet is a determinant of cardiovascular diseases (CVD) with coronary disease as predominant cause of pre-mature death. To analyse how diet was associated with coronary atherosclerosis, including plaque features.

METHODS AND RESULTS: The cross-sectional population-based study using data from the Swedish CArdioPulmonary BioImage Study (SCAPIS) included 24 079 adults aged 50-64 years, recruited in 2013 to 2018 who were free of clinical cardiovascular disease. The recruitment and comprehensive examinations were conducted at six locations in Sweden. A dietary index (DI) based on a previously published anti-inflammatory DI including high proportion of plant-based foods, and low in red or processed meat and sugar-sweetened beverages was constructed. The reference group was within lowest DI tertile. Coronary atherosclerosis assessed by coronary computed tomography angiography, including any-, significant-, and adverse or high-risk coronary plaque, which is non-calcified with a significant stenosis ≥50%. Lowest, compared to highest DI tertile was associated with younger age, more often men (62.2% vs. 32.9%), higher high-sensitive C-reactive protein, more cardiometabolic risk and smokers, higher alcohol-, and higher energy-intake. In the highest and lowest tertile, coronary plaques were present in 36.3% and 44.3%, respectively, stenosis ≥ 50% in 3.7% and 6.0%. Non-calcified coronary plaques with stenosis ≥50% were present in 0.9% and 1.5% in highest and lowest tertiles. In multivariable analyses, the lowest tertile of DI was associated with high-risk plaque features after adjusting for age, sex, smoking, with waist circumference, triglycerides (TGs), and hypertension as possible mediators.

CONCLUSION: A low-fibre diet with high red meat content was associated with high-risk plaques features, increased coronary calcification and significant stenosis. Waist circumference, TGs, and hypertension emerged as potential mediators of these associations, underscoring the role of metabolic and hemodynamic factors in the dietary impact on coronary atherosclerosis. Our findings strengthen the importance of cardioprotective dietary recommendations.

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organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Cardiovascular Research
article number
cvaf088
publisher
Oxford University Press
external identifiers
  • pmid:40518615
ISSN
1755-3245
DOI
10.1093/cvr/cvaf088
language
English
LU publication?
yes
additional info
© The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.
id
91443249-58c3-4fe7-bd19-4f6a6b26cccc
date added to LUP
2025-06-18 09:03:37
date last changed
2025-06-25 08:40:58
@article{91443249-58c3-4fe7-bd19-4f6a6b26cccc,
  abstract     = {{<p>AIMS: Diet is a determinant of cardiovascular diseases (CVD) with coronary disease as predominant cause of pre-mature death. To analyse how diet was associated with coronary atherosclerosis, including plaque features.</p><p>METHODS AND RESULTS: The cross-sectional population-based study using data from the Swedish CArdioPulmonary BioImage Study (SCAPIS) included 24 079 adults aged 50-64 years, recruited in 2013 to 2018 who were free of clinical cardiovascular disease. The recruitment and comprehensive examinations were conducted at six locations in Sweden. A dietary index (DI) based on a previously published anti-inflammatory DI including high proportion of plant-based foods, and low in red or processed meat and sugar-sweetened beverages was constructed. The reference group was within lowest DI tertile. Coronary atherosclerosis assessed by coronary computed tomography angiography, including any-, significant-, and adverse or high-risk coronary plaque, which is non-calcified with a significant stenosis ≥50%. Lowest, compared to highest DI tertile was associated with younger age, more often men (62.2% vs. 32.9%), higher high-sensitive C-reactive protein, more cardiometabolic risk and smokers, higher alcohol-, and higher energy-intake. In the highest and lowest tertile, coronary plaques were present in 36.3% and 44.3%, respectively, stenosis ≥ 50% in 3.7% and 6.0%. Non-calcified coronary plaques with stenosis ≥50% were present in 0.9% and 1.5% in highest and lowest tertiles. In multivariable analyses, the lowest tertile of DI was associated with high-risk plaque features after adjusting for age, sex, smoking, with waist circumference, triglycerides (TGs), and hypertension as possible mediators.</p><p>CONCLUSION: A low-fibre diet with high red meat content was associated with high-risk plaques features, increased coronary calcification and significant stenosis. Waist circumference, TGs, and hypertension emerged as potential mediators of these associations, underscoring the role of metabolic and hemodynamic factors in the dietary impact on coronary atherosclerosis. Our findings strengthen the importance of cardioprotective dietary recommendations.</p>}},
  author       = {{Larsson, Ingrid and Sun, Jiangming and Ahmad, Shafqat and Bergström, Göran and Carlhäll, Carl-Johan and Cederlund, Kerstin and Drake, Isabel and Engvall, Jan E and Eriksson, Mats and Hagström, Henrik and Jernberg, Tomas and Kero, Tanja and Lindmark, Krister and Mannila, Maria and Orho-Melander, Marju and Rawshani, Araz and Risérus, Ulf and Rosengren, Annika and Ryberg, Mats and Schmidt, Caroline and Sonestedt, Emily and Wennberg, Maria and Östgren, Carl Johan and Goncalves, Isabel}},
  issn         = {{1755-3245}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Oxford University Press}},
  series       = {{Cardiovascular Research}},
  title        = {{Low-fibre diet is associated with high-risk coronary plaque features}},
  url          = {{http://dx.doi.org/10.1093/cvr/cvaf088}},
  doi          = {{10.1093/cvr/cvaf088}},
  year         = {{2025}},
}