{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:46:16Z","timestamp":1784328376405,"version":"3.55.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The association between diets that focus on plant foods and restrict animal products and cardiovascular disease (CVD) is inconclusive. We investigated whether cumulative intake of a plant\u2010centered diet and shifting toward such a diet are associated with incident CVD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Participants were 4946 adults in the CARDIA (Coronary Artery Risk Development in Young Adults) prospective study. They were initially 18 to 30\u00a0years old and free of CVD (1985\u20131986, exam year [year 0]) and followed until 2018. Diet was assessed by an interviewer\u2010administered, validated diet history. Plant\u2010centered diet quality was assessed using the A Priori Diet Quality Score (APDQS), in which higher scores indicate higher consumption of nutritionally rich plant foods and limited consumption of high\u2010fat meat products and less healthy plant foods. Proportional hazards models estimated hazard ratios of CVD associated with both time\u2010varying average APDQS and a 13\u2010year change in APDQS score (difference between the year 7 and year 20 assessments). During the 32\u2010year follow\u2010up, 289 incident CVD cases were identified. Both long\u2010term consumption and a change toward such a diet were associated with a lower risk of CVD. Multivariable\u2010adjusted hazard ratio was 0.48 (95% CI, 0.28\u20130.81) when comparing the highest quintile of the time\u2010varying average ADPQS with lowest quintiles. The 13\u2010year change in APDQS was associated with a lower subsequent risk of CVD, with a hazard ratio of 0.39 (95% CI, 0.19\u20130.81) comparing the extreme quintiles. Similarly, strong inverse associations were found for coronary heart disease and hypertension\u2010related CVD with either the time\u2010varying average or change APDQS.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Consumption of a plant\u2010centered, high\u2010quality diet starting in young adulthood is associated with a lower risk of CVD by middle age.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020718","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T09:01:30Z","timestamp":1628067690000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Plant\u2010Centered Diet and Risk of Incident Cardiovascular Disease During Young to Middle Adulthood"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0926-5331","authenticated-orcid":false,"given":"Yuni","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition University of Minnesota\u2013Twin Cities St Paul MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Larson","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota\u2013Twin Cities Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyn M.","family":"Steffen","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota\u2013Twin Cities Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9920-6257","authenticated-orcid":false,"given":"Pamela J.","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota\u2013Twin Cities Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel D.","family":"Gallaher","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition University of Minnesota\u2013Twin Cities St Paul MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Duprez","sequence":"additional","affiliation":[{"name":"Cardiovascular Division Department of Medicine University of Minnesota\u2013Twin Cities Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2424-9308","authenticated-orcid":false,"given":"James M.","family":"Shikany","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine School of Medicine University of Alabama at Birmingham Birmingham AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamal S.","family":"Rana","sequence":"additional","affiliation":[{"name":"Divisions of Cardiology and Research Kaiser Permanente Northern California Oakland CA"},{"name":"Department of Medicine University of California San Francisco CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7232-0543","authenticated-orcid":false,"suffix":"Jr","given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health University of Minnesota\u2013Twin Cities Minneapolis MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"1","article-title":"Changes in mortality in top 10 causes of death from 2011 to 2018","author":"Rana JS","year":"2020","unstructured":"Rana JS, Khan SS, Lloyd\u2010Jones DM, Sidney S. Changes in mortality in top 10 causes of death from 2011 to 2018. J Gen Intern Med. 2020;1\u20132. Jul 23 [Epub ahead of print]. DOI: 10.1007\/s11606\u2010020\u201006070\u2010z.","journal-title":"J Gen Intern Med"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32225-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2016.1138447"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.2176"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/nxy019"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012865"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041014"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005445"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017158"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc20-1005"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.08.026"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.112.055681"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.113.071340"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90080-7"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(21)01299-2"},{"key":"e_1_3_2_17_2","first-page":"15","article-title":"A study of the reliability and comparative validity of the cardia dietary history","volume":"4","author":"Liu K","year":"1994","unstructured":"Liu K, Slattery M, Jacobs D, Cutter G, McDonald A, Van Horn L, Hilner JE, Caan B, Bragg C, Dyer A. A study of the reliability and comparative validity of the cardia dietary history. Ethn Dis. 1994;4:15\u201327.","journal-title":"Ethn Dis"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/78.3.508S"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.111.020719"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114507701654"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-198911000-00003"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002039"},{"key":"e_1_3_2_23_2","unstructured":"Hertzmark E Pazaris M Spiegelman D. The SAS mediate macro. 2018. https:\/\/www.hsph.harvard.edu\/donna\u2010spiegelman\/software\/mediate\/. Accessed April 15 2021."},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780080504"},{"key":"e_1_3_2_25_2","unstructured":"Li R Hertzmark E Louie M Chen L Spiegelman D. The SAS lgtphcurv9 Macro. 2011. https:\/\/www.hsph.harvard.edu\/donna\u2010spiegelman\/software\/lgtphcurv9\/. Accessed October 15 2020."},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.05.047"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.6969"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.005983"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017003834"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m513"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.3945\/an.115.011403"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.038813"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613502"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1017\/S136898001900212X"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.26.021304.144505"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/53.4.1050S"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/jhn.12177"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/131.2.374S"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0024-3205(01)01482-5"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.3390\/antiox7100133"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1089\/15230860050192279"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1079\/BJN20041327"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:04:58Z","timestamp":1715598298000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,17]]},"references-count":41,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2021,8,17]]}},"alternative-id":["10.1161\/JAHA.120.020718"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020718","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,17]]},"assertion":[{"value":"2020-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020718"}}