{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T12:39:41Z","timestamp":1790339981356,"version":"4.1.0"},"reference-count":57,"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 plant\u2010based Dietary Portfolio combines established cholesterol\u2010lowering foods (plant protein, nuts, viscous fiber, and phytosterols), plus monounsaturated fat, and has been shown to improve low\u2010density lipoprotein cholesterol and other cardiovascular disease (CVD) risk factors. No studies have evaluated the relation of the Dietary Portfolio with incident CVD events.<\/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\">We followed 123 330 postmenopausal women initially free of CVD in the Women's Health Initiative from 1993 through 2017. We used Cox proportional\u2010hazard models to estimate adjusted hazard ratios (HRs) and 95% CI of the association of adherence to a Portfolio Diet score with CVD outcomes. Primary outcomes were total CVD, coronary heart disease, and stroke. Secondary outcomes were heart failure and atrial fibrillation. Over a mean follow\u2010up of 15.3\u00a0years, 13\u00a0365 total CVD, 5640 coronary heart disease, 4440 strokes, 1907 heart failure, and 929 atrial fibrillation events occurred. After multiple adjustments, adherence to the Portfolio Diet score was associated with lower risk of total CVD (HR, 0.89; 95% CI, 0.83\u20130.94), coronary heart disease (HR, 0.86; 95% CI, 0.78\u20130.95), and heart failure (HR, 0.83; 95% CI, 0.71\u20130.99), comparing the highest to lowest quartile of adherence. There was no association with stroke (HR, 0.97; 95% CI, 0.87\u20131.08) or atrial fibrillation (HR, 1.10; 95% CI, 0.87\u20131.38). These results remained statistically significant after several sensitivity analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this prospective cohort of postmenopausal women in the United States, higher adherence to the Portfolio Diet was associated with a reduction in incident cardiovascular and coronary events, as well as heart failure. These findings warrant further investigation in other populations.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.021515","type":"journal-article","created":{"date-parts":[[2021,8,4]],"date-time":"2021-08-04T09:02:22Z","timestamp":1628067742000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Relationship Between a Plant\u2010Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study"],"prefix":"10.1161","volume":"10","author":[{"given":"Andrea J.","family":"Glenn","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences University of Toronto Ontario Canada"},{"name":"Clinical Nutrition and Risk Factor Modification Center St. Michael's Hospital Toronto Ontario Canada"},{"name":"Toronto 3D Knowledge Synthesis and Clinical Trials Unit St. Michael's Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4624-2737","authenticated-orcid":false,"given":"Kenneth","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Applied Biology and Chemical Technology The Hong Kong Polytechnic University Hung Hom Hong Kong China"},{"name":"Centre for Global Cardiometabolic Health Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J. 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