Abstract
Background and Study Objectives: The rising incidence of cardiovascular disease (CVD) over the last 25 years has become a public health priority, especially its prevention through lifestyle interventions. Many studies have reported that higher adherence to Mediterranean, vegan or whole-food, plant based (WFPB) diets may decrease CVD incidence and mortality. However evidence on the health effects of various diets on CVD health is equivocal. The objective of this study is to compare and assess the relative impact of four different types of diets; i.e. a) WFPB; b) Mediterranean; c) Paleolithic; and d) Dietary Approaches to Stop Hypertension (DASH) diets on CVD health. Methods: This is a 6-month prospective clinical trial examining 280 participants stratified into four nonrandomized groups over a two month intervention with a follow up at six months of encouraged diet compliance. Clinical and behavioral measures related to CVD were collected; including, HDL, LDL, Total Cholesterol and Triglycerides. 60-day difference in CVD factors were analyzed using Repeated Measures ANOVA between all diets and two-tailed t-test to compare the WFPB diet vs. all other diets. Results: Significant 60-day differences between all diets were seen for HDL (p<0.0001), LDL (p<0.0002), Triglycerides (p<0.0001) and total cholesterol (p<0.0001). Between group analysis further revealed that participants on the WFPB diet had greater significant differences in LDL (14% decrease), triglycerides (18% decrease) and total cholesterol (13% decrease) compared to all other diets. Conversely, after 60 days, the Mediterranean diet (5% increase) followed by the DASH diet (3% increase) had significant greater increases in HDL when compared to the WFPB diet (10% decrease). After 6 months, significant decreases in HDL remained in the WFPB diet (20% decrease) compared to DASH and Paleo diets (both 8% decrease). Conclusion: Participants in the WFPB diet group demonstrated significant improvements in modifiable CVD risk factors compared to other diet categories over 60 days. Future research exploring the impact of quality of WFPB diets on long-term health outcomes is necessary
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