Healthy Plant-Based Diet, Genetic Predisposition, and the Risk of Incident Venous Thromboembolism

Plant-based dietary patterns are becoming increasingly popular due to environmental and health impacts, yet there are few studies exploring the relationship between plant-based dietary patterns and venous thromboembolism (VTE) in different genetic backgrounds.

The aim of this study was to investigate how plant-based dietary pattern and genetic susceptibility independently or jointly affect VTE and its subtypes of pulmonary embolism and deep vein thrombosis.

A total of 183,510 participants who were White British ethnicity background and free of VTE at baseline in the UK Biobank were recruited, in consideration that the selection of genetic variants for VTE was based on results of White European individuals. The healthy plant-based diet index (hPDI) was calculated based on the 17 foods in the Oxford webQ. Genetic risk was quantified by a polygenic risk score (PRS) consisting of 297 single-nucleotide polymorphisms. Incident VTE was identified through hospital inpatient and death databases records from the UK Biobank. Cox regression analyses were conducted to estimate the associations between hPDI and PRS with the incident risk of VTE.

During a mean follow-up of 13 years, a total of 4,587 cases of VTE were recorded. Compared to individuals in the lowest tertile of hPDI, multivariable-adjusted HRs of VTE in the highest tertile were 0.86 (95% CI: 0.80, 0.92; P trend = 0.02). And high PRS was associated with a 47% increase in VTE risk (adjusted HR: 1.47, 95% CI: 1.37, 1.58). No significant interaction between hPDI and PRS (P interaction = 0.540) was observed, even though participants with low hPDI an high PRS had the highest risk of VTE compared to those with high hPDI and low PRS (HR: 1.72, 95% CI: 1.52, 1.95).

Adherence to a healthy plant-based dietary pattern could reduce the risk of developing VTE independent of genetic background, lifestyles, sociodemographic features, and multiple morbidities. Our findings underline the importance of diet in VTE prevention interventions.