{
  "abstract": "Background/Objectives: Diet quality is a potentially modifiable determinant of heart failure (HF), yet evidence regarding its long-term association with HF incidence remains limited. This study examined the association between baseline diet quality and 20-year incident HF in the population-based ATTICA cohort. Methods: Among 3042 adults free of cardiovascular disease at baseline (2001–2002), HF status was available for 2159 participants in 2022, of whom 241 (11.2%) developed HF. Diet quality, including the relative contributions of healthy and unhealthy food groups, was assessed using the Global Diet Quality Score (GDQS), derived from a validated food-frequency questionnaire. Logistic regression models were sequentially adjusted for age, sex, body mass index, education, physical activity, smoking burden, hypertension, diabetes, and hypercholesterolemia. Results: HF incidence was 20.7%, 5.1%, and 6.6% among participants with low, intermediate, and high diet quality, respectively (p < 0.001). In the fully adjusted analysis (n = 1973), better overall diet quality was associated with lower odds of HF (odds ratio [OR] per 1-point increment, 0.97; 95% confidence interval [CI], 0.94–0.99). A greater contribution of healthy foods was also inversely associated with HF (OR, 0.96; 95% CI, 0.93–0.98), whereas the unhealthy-food component was not independently associated with the outcome (OR, 1.04; 95% CI, 0.96–1.13). Conclusions: Better diet quality, particularly greater consumption of health-promoting foods, was independently associated with lower 20-year HF incidence in a Mediterranean population.",
  "abstract_shown": true,
  "affiliations": [
    "First Cardiology Clinic, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece",
    "Cardiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania",
    "Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Christina Chrysohoou",
      "orcid": "0000-0002-6340-3996"
    },
    {
      "affs": [
        0
      ],
      "name": "Panagiotis Iliakis",
      "orcid": "0009-0004-5768-9125"
    },
    {
      "affs": [
        1
      ],
      "name": "Ioana Christina Daha"
    },
    {
      "affs": [
        0
      ],
      "name": "Ioannis Leontsinis",
      "orcid": "0000-0002-6992-2906"
    },
    {
      "affs": [
        0
      ],
      "name": "Kyriaki Mavromoustakou",
      "orcid": "0009-0009-2692-095X"
    },
    {
      "affs": [
        2
      ],
      "name": "Evangelia Damigou",
      "orcid": "0009-0002-2632-9376"
    },
    {
      "affs": [
        0
      ],
      "name": "Konstantinos Konstantinou",
      "orcid": "0000-0002-3368-6737"
    },
    {
      "affs": [
        0
      ],
      "name": "Christos Pitsavos"
    },
    {
      "affs": [
        0
      ],
      "name": "Konstantinos Tsioufis",
      "orcid": "0000-0002-7636-6725"
    },
    {
      "affs": [
        2
      ],
      "name": "Demosthenes B. Panagiotakos",
      "orcid": "0000-0001-8583-153X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5tfgmbhttxfyc.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18193278",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666669/?tool=EBI",
  "id": "5tfgmbhttxfyc",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13666669",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2739|Nutritional Studies and Diet"
    ]
  ],
  "openalex": "W7220730487",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13666669/pdf/?tool=EBI",
  "pmcid": "PMC13666669",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/5tfgmbhttxfyc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:35Z",
      "native_id": "PMC:PMC13666669",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13666669"
    },
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.3390/nu18193278",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/19/3278"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Nutritional Studies and Diet",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Association Between Diet Quality and 20-Year Heart Failure Incidence: Findings from the ATTICA Cohort Study (2002–2022)",
  "title_text": "Association Between Diet Quality and 20-Year Heart Failure Incidence: Findings from the ATTICA Cohort Study (2002–2022)",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:56Z",
  "url": "https://research.draconitic.com/paper/5tfgmbhttxfyc",
  "venue": "Nutrients",
  "versions": []
}