Healthy plant eating was linked to less heart disease. Not stroke.

Cohort study. 14,776 people. baseline 2003-2007, follow-up to 31 Dec 2019; median follow-up 6.3 y (stroke), 6.9 y (incident CHD), 9.5 y (CHD death).

People were watched for years. Nobody was told what to do. A clue, not proof.

Who: Black and White US adults aged 45+ at enrolment (mean age 64.0, 35.0% Black, 59.5% women, 78.6% urban), free of stroke and heart disease at baseline; Black adults and the US 'stroke belt/buckle' oversampled

• Healthiest plant diets-28%heart disease risk
• Fewer strokesnoneno clear link
• Sugary, refined plantsnoneheart link unclear

More to know, from our read of the paper:

• Observational: linked, not proven. Authors name reverse causation and residual confounding as possible explanations
• Diet self-reported once (Block 98 FFQ) almost 20 years ago; the plant-food market has changed a lot since
• Main = fully adjusted Model 2 (age, sex, race, region, calories, urbanicity, income, education, physical activity, alcohol, stress). In the exploratory model that also adjusted for Framingham risk factors and obesity (diabetes, smoking, AF, LVH, hypertension), the hPDI-incident CHD link was no longer found, and the PDI-CHD death link was not seen. Say this in the caption
• Quintile-based (relative) scores: even the top hPDI quintile ate fruit, vegetables and fiber below recommendations. Results compare top vs bottom fifth, not a specific diet
• Not generalisable to the US population: only Black and White middle-aged/older adults; excluded participants differed from included ones; survivor bias possible (mean age 64, free of CVD)

Researchers followed 14,776 Black and White US adults over 45 (REGARDS study) who reported their diet once, for a median of about 7 to 10 years. Those with the healthiest plant-based diets (whole grains, fruit, vegetables, nuts, beans) had 28% lower risk of heart disease than those with the least healthy. No plant-based diet was clearly linked to stroke, and diets heavy in sugary drinks, refined grains and sweets showed no clear heart link. When blood pressure, diabetes and similar risk factors were also adjusted for, the healthy-diet link was no longer clear. This is an observational study: linked, not proven.

We read the abstract and the full text of this paper and checked every number on this page against it (17 facts, checked on 2026-10-29). The study design is named above. Cohort and other observational studies are described as linked, not proven. Found an error? Email theis@onestudyaday.com.