DASH and Alternative Healthy Eating Index Lower Cardiovascular Risk in Cancer Survivors
Cancer survivors who adhered closely to the DASH diet and the Alternate Healthy Eating Index experienced up to a one-third lower risk of developing cardiovascular disease over 12 years compared to peers with low dietary adherence, according to research published in JACC: Advances.
Understanding the Dietary Patterns and Clinical Implications
Led by Qing-Yuan Gao, PhD, of Sun Yat-sen University in Guangzhou, China, researchers evaluated data from 8,716 cancer survivors in the UK Biobank. Participants had a mean age of 59 years and were free of cardiovascular disease at baseline. The most common cancer diagnoses within the cohort were breast cancer at 31.4%, prostate cancer at 9.8%, and colorectal cancer at 8.3%. Investigators tracked dietary patterns using 24-hour dietary recall assessments and calculated scores for several recognized regimens, including the Dietary Approaches to Stop Hypertension (DASH) diet, the Alternate Healthy Eating Index-2010 (AHEI-2010), the Mediterranean diet, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and healthy low-carbohydrate and low-fat diets.
During a median follow-up of 12.3 years, the study recorded 1,116 incident cardiovascular events. This total included 858 cases of ischemic heart disease, 251 cases of heart failure, and 181 strokes. When comparing the highest quintile of dietary adherence to the lowest, the adjusted hazard ratios demonstrated substantial risk reductions. For the DASH diet, the hazard ratio stood at 0.65, while the Alternate Healthy Eating Index-2010 showed a hazard ratio of 0.63. Similar protective associations appeared with the Mediterranean diet at 0.72 and the MIND diet at 0.74. Specific food group analyses revealed that higher intake of vegetables, whole grains, legumes, fish, and dairy all correlated with a lower overall risk of cardiovascular disease.
| Dietary Pattern | Adjusted Hazard Ratio (Highest vs. Lowest Quintile) | Primary Associated Risk Reduction |
|---|---|---|
| Alternate Healthy Eating Index-2010 (AHEI-2010) | 0.63 | Ischemic heart disease (HR, 0.63) and Stroke (HR, 0.49) |
| DASH Diet | 0.65 | Heart Failure (HR, 0.54) |
| Mediterranean Diet | 0.72 | Overall Cardiovascular Disease |
| MIND Diet | 0.74 | Overall Cardiovascular Disease |
Life Expectancy Gains Associated with Dietary Adherence
Beyond lowering cardiovascular incidence, the research team modeled estimated gains in life expectancy linked to dietary patterns. For individuals at age 45, those with the highest adherence to healthy eating patterns gained between 1.7 and 3.3 additional years of life expectancy compared to participants with the lowest adherence scores. The MIND diet demonstrated the longest estimated gain at 3.3 years.
Cancer survivors face an elevated baseline risk of cardiovascular complications, a vulnerability that persists even among individuals who never undergo cardiotoxic chemotherapy or radiation therapy. The findings offer concrete data supporting the integration of structured nutritional guidance into survivorship care pathways. “Adherence to healthy dietary patterns is associated with reduced CVD risk among cancer survivors, underscoring the potential for diet to support cardio-oncology care,” the study authors wrote.
Methodological Limitations and Funding Details
The study possesses notable limitations. Because the UK Biobank comprises predominantly white European participants with inherent healthy volunteer bias, the findings may not translate directly to broader, more diverse global populations. Additionally, the absence of longitudinal dietary data precluded assessment of how temporal changes in dietary habits influence CVD risk over follow-up. Ascertaining cardiovascular events exclusively through hospital inpatient records and national death registries may also have resulted in an underestimation of total disease incidence.
Financial support for this investigation was provided by the National Natural Science Foundation of China and the Guangzhou Science and Technology Plan Project. The authors declared no relevant conflicts of interest.
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