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

Area of Science:

• Cardiovascular disease research
• Nutritional science
• Medical imaging

Background:

• Diet significantly influences cardiovascular diseases (CVD), with coronary disease being a leading cause of premature death.
• Understanding the dietary impact on coronary atherosclerosis, including plaque characteristics, is crucial for public health.

Purpose of the Study:

• To investigate the association between dietary patterns and coronary atherosclerosis, specifically focusing on plaque features.
• To identify potential mediators in the diet-atherosclerosis relationship.

Main Methods:

• A cross-sectional study of 24,079 adults (aged 50-64) from the Swedish CArdioPulmonary BioImage Study (SCAPIS).
• Dietary index (DI) constructed based on anti-inflammatory principles (high plant-based foods, low red/processed meat and sugar-sweetened beverages).
• Coronary atherosclerosis assessed using computed tomography angiography, analyzing plaque types and stenosis severity.

Main Results:

• The lowest DI tertile (compared to highest) was associated with higher prevalence of coronary plaques (44.3% vs. 36.3%) and stenosis ≥50% (6.0% vs. 3.7%).
• Low DI was linked to high-risk, non-calcified plaques with significant stenosis (1.5% vs. 0.9%).
• Multivariable analyses indicated that low DI was associated with high-risk plaque features, with waist circumference, triglycerides, and hypertension as potential mediators.

Conclusions:

• A diet low in fiber and high in red meat is associated with high-risk plaque features, increased coronary calcification, and significant stenosis.
• Metabolic factors (waist circumference, triglycerides, hypertension) may mediate the link between diet and coronary atherosclerosis.
• Findings reinforce the importance of adopting cardioprotective dietary recommendations.