In the progression of atherosclerosis, inflammation is a major factor which can influence adverse cardiovascular events. Treatment regimens to reduce inflammation and hsCRP (high sensitivity C-reactive protein) have shown to reduce coronary artery disease (CAD) and poor cardiovascular events. One third of patients with known CAD have an elevated hsCRP. The American Heart Association (AHA) diet (Heart Healthy Diet) is designed to reduce the risk and advancement of CAD and hsCRP, however, multiple dietary factors influence CAD. 45% of patients with known stable CAD and who are being treated with the standard of care including diet and lifestyle modification will continue to have elevated hsCRP.
A plant-based vegan diet has been shown to significantly reduce adverse markers of poor cardiovascular health over time, but limited comparisons with other heart-healthy diets remain. A recent study of 100 participants was published in The Journal of the American Heart Association (JAHA) and directly compared the effects of a vegan versus AHA-recommended diet on hsCRP, as well as other markers of inflammation, glucometabolic markers, and lipid profiles in patients with established CAD on guideline-directed medical therapy.
The trial demonstrated a significantly greater reduction in hsCRP with a vegan vs. AHA-recommended diet. There was a 28% reduction in hsCRP with a vegan diet versus a 7% with an AHA recommended diet. Weight loss measures by body mass index (BMI) and waist circumference did not significantly differ between the two diet groups. Markers of glycemic control and lipid profiles, overall, did not differ greatly.
A vegan diet has significantly higher amount of dietary fiber and studies have shown that a diet high in fiber and low in fat is associated with less inflammation and lower incidence of major cardiovascular outcomes. The anti-inflammatory effect of fiber is well established, but the underlying mechanism remains unclear, and data suggests increased fiber intake may restore gut microbiota, which may in turn, improve the inflammatory profile.