Abstract

Introduction: Left ventricular diastolic dysfunction (LVDD) is one key subclinical precursor of heart failure with preserved ejection fraction (HFpEF). Whether dietary correlates serve as independent predictors of LVDD in adults without HFpEF is unknown. Hypothesis: We hypothesized that dietary habits in young adulthood would prospectively influence the likelihood of LVDD in middle age. Methods: The analysis included 456 individuals of the Bogalusa Heart Study (26.5% black, 62.7% female, baseline age=36.1 + 4.4 years) with an ejection fraction > 55%. Diet was measured at baseline via food frequency questionnaires. LVDD was defined at follow-up (median=12.9 years) through echocardiographic measurement of the E/A ratio, E/e’ ratio, isovolumic relaxation time, and deceleration time. Logistic regression estimated the odds of LVDD according to protein source, adjusting for cardiovascular disease risk factors and total energy intake. Results: There were 72 cases of LVDD. Using the lowest tertile as reference, persons in the middle tertile of total protein (OR=3.31, 95% CI: 1.47, 7.46; p=8.5x10 -3 ) and animal protein (OR=2.93, 95% CI: 1.35, 6.37; p=0.03) intake had the highest likelihoods of LVDD. We observed 54% and 57% lower odds of LVDD for persons in the highest vs. lowest tertile of vegetable (OR=0.46, 95% CI: 0.22, 0.95; p=8.0x10 -4 ) and legume consumption (OR=0.43, 95% CI: 0.20, 0.92; p=0.02), respectively. Total protein, animal protein, processed meat, and eggs indicated a significant quadratic trend towards increased odds of LVDD, while legumes and vegetables indicated a significant quadratic trend toward decreased odds of LVDD ( Table ). There were no significant relationships of LVDD with other animal or plant foods. Conclusions: Animal and plant food consumption result in an increased and decreased likelihood of LVDD, respectively. Adherence to plant-based diets in young adulthood may protect against the development of LVDD, and thus future HFpEF, later in life.

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