Healthy Dietary Patterns and Incident Cardiovascular Disease in Cancer Survivors: A Prospective Cohort Study

Cardiovascular disease (CVD) is the leading cause of noncancer mortality among cancer survivors. The potential influence of healthy dietary patterns on CVD risk among cancer survivors remains poorly understood.

This study aims to investigate the association between healthy dietary patterns and incident CVD among cancer survivors.

We analyzed data from 8,716 cancer survivors initially free of CVD in the UK Biobank cohort. We used 24-hour dietary recall data to calculate 8 dietary pattern scores. Cox proportional hazards models and Fine-Gray competing risks models were used to investigate the association between dietary patterns and incident CVD.

During a median follow-up of 12.3 (Q1-Q3: 11.6-13.0) years, 1,116 individuals experienced incident CVD events. When comparing the top quintile with the bottom quintile, HRs (95% CI) for total CVD were 0.72 (0.58-0.88) for Mediterranean diet score, 0.74 (0.61-0.89) for Mediterranean-Dietary Approaches to stop Hypertension Diet Intervention for Neurodegenerative Delay score, 0.63 (0.52-0.76) for Alternate Healthy Eating Index-2010, 0.65 (0.53-0.79) for Dietary Approaches to Stop Hypertension score, 0.82 (0.68-0.99) for healthful Plant-Based Diet Index, 0.67 (0.55-0.80) for reversed energy-adjusted diet inflammatory index, and 0.80 (0.67-0.96) for healthy low-fat diet score. The findings remain robust after fitting the generalized propensity score model. At age 45, participants with the highest adherence to healthy dietary patterns gained an estimated life expectancy of 1.66 to 3.32 years more than those with the lowest adherence.

Adherence to healthy dietary patterns is associated with reduced CVD risk among cancer survivors, underscoring the potential for diet to support cardio-oncology care.