Association Between Diet Quality and 20-Year Heart Failure Incidence: Findings from the ATTICA Cohort Study (2002–2022)
- 1First Cardiology Clinic, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
- 2Cardiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- 3Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
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.
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BibTeX
@article{chrysohoou2026association,
title = {{Association Between Diet Quality and 20-Year Heart Failure Incidence: Findings from the ATTICA Cohort Study (2002–2022)}},
author = {Christina Chrysohoou and Panagiotis Iliakis and Ioana Christina Daha and Ioannis Leontsinis and Kyriaki Mavromoustakou and Evangelia Damigou and Konstantinos Konstantinou and Christos Pitsavos and Konstantinos Tsioufis and Demosthenes B. Panagiotakos},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18193278},
url = {https://europepmc.org/article/PMC/PMC13666669},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association Between Diet Quality and 20-Year Heart Failure Incidence: Findings from the ATTICA Cohort Study (2002–2022)
AU - Christina Chrysohoou
AU - Panagiotis Iliakis
AU - Ioana Christina Daha
AU - Ioannis Leontsinis
AU - Kyriaki Mavromoustakou
AU - Evangelia Damigou
AU - Konstantinos Konstantinou
AU - Christos Pitsavos
AU - Konstantinos Tsioufis
AU - Demosthenes B. Panagiotakos
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18193278
UR - https://europepmc.org/article/PMC/PMC13666669
AB - 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.
SN - 2072-6643
ER -