Planetary Health Diet Adherence and Cardiovascular Disease Risk in Postmenopausal Women

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Summary of  American Journal of Preventive Cardiology, https://doi.org/10.1016/j.ajpc.2026.101750 
Dr. Donya Shahamati  et al.

Points

University of California, Irvine researchers analyzed 66,892 postmenopausal participants from the Women’s Health Initiative to evaluate dietary impacts on long-term heart health.
Quantitative scoring using the Planetary Health Diet Index assessed alignment with EAT-Lancet guidelines emphasizing plant-rich foods, unsaturated fats, and limited red meats.
Women with the highest dietary adherence scores experienced a 28% lower risk of developing total cardiovascular disease compared to those in the lowest group.
Multivariable analysis revealed that each 10-point increase in dietary score provided dose-dependent risk reductions across coronary heart disease, stroke, and heart failure.
Study authors noted that non-restrictive, incremental dietary shifts toward plant-forward nutrition yield substantial cardioprotection during the higher-risk postmenopausal years.

Summary

Theassociation between baseline adherence to the Planetary Health Diet (PHD) and the prospective incidence of total cardiovascular disease (CVD), coronary heart disease (CHD), stroke, and heart failure among postmenopausal women. During the menopausal transition, adverse cardiometabolic shifts—including increased central adiposity, atherogenic dyslipidemia, impaired insulin sensitivity, and vascular dysfunction—substantially elevate cardiovascular risk. Given that dietary habits remain a primary modifiable factor, researchers investigated whether quantitative alignment with the EAT-Lancet reference diet, measured via the Planetary Health Diet Index (PHDI), confers long-term cardioprotection in this vulnerable demographic.

The prospective cohort analysis evaluated 66,892 postmenopausal participants from the Women’s Health Initiative Observational Study (WHI-OS) who were free of baseline cardiovascular disease at enrollment (1994–1998; mean baseline age approximately 63 years). Baseline dietary intake assessed via food frequency questionnaires was quantified into quintiles of PHDI scores, which score consumption of plant-forward foods, unsaturated fats, refined grains, and animal products. Multivariable Cox proportional hazards models adjusted for key confounders including age, ethnicity, education, income, smoking, alcohol intake, physical activity, body mass index, and total energy intake across a 20-year follow-up period.

Results demonstrated a significant inverse relationship between PHDI scores and incident cardiovascular events. Participants in the highest adherence quintile exhibited a 28% reduction in overall CVD risk compared to those in the lowest quintile. Furthermore, each 10-point increment in PHDI score was associated with a continuous stepwise decrease in risk across all secondary endpoints, including CHD, stroke, and heart failure. These findings demonstrate that even moderate adherence to sustainable, plant-forward dietary patterns provides robust long-term cardioprotection for postmenopausal women.

Link to the article: https://www.sciencedirect.com/science/article/pii/S2666667726003259?via%3Dihub

References

Shahamati, D., Yang, B., Liu, S., Odegaard, A. O., Allison, M., Glenn, A. J., Jung, S. Y., Nudy, M., Schnatz, P. F., Shadyab, A. H., Shikany, J. M., Tinker, L. F., Wallace, R. B., Wang, Y., & Landry, M. J. (2026). Association between the planetary health diet index and risk of cardiovascular diseases in postmenopausal women: Findings from the Women’s Health Initiative Observational Study. American Journal of Preventive Cardiology, 101750. https://doi.org/10.1016/j.ajpc.2026.101750