Food intake influences the incidence of cardiovascular disease by driving cardiac remodeling — Evidence from a Mendelian randomization

Background: research on dietary habits and cardiovascular diseases shows inconsistent results. Diets on cardiovascular diseases are primarily mediated by cardiac structure, but specific pathways remain unclear. Material and methods: we conducted a Mendelian randomization study and identified twelve types of food were related to coronary artery disease, 17 to heart failure, and 16 to dilated cardiomyopathy; 13 were associated with atrial fibrillation. We then identified cardiac structure closely related to the four cardiovascular diseases and conducted mediation analysis. Results: increased consumption of grains, dried fruits, and cheese may tentatively reduce coronary heart disease risk through distinct biomechanical pathways-including reduced segmental longitudinal strain (grains, 18.7 %), decreased left ventricular stroke volume with narrowed ascending aortic area (dried fruits; mediation through 28.9 % and 18.5 % pathways), and attenuated myocardial wall thickness (cheese, 4.25 %)-while elevated alcohol intake might heighten risk via increased stroke volume (18.6 %), amplified segmental strain (8.6 %), and elevated cardiac workload. Exploratory analyses suggest coffee-associated heart failure risk could involve mediation by segmental/global circumferential strain (mediation through 14.5 % and 27.7 % pathways) and left ventricular volume (through 23.1 %, and 22.5 % pathways), whereas cooked vegetables may partially influence dilated cardiomyopathy risk through increased left ventricular mass (14.9 %) and myocardial wall thickness (20.2 %), potentially exacerbating atrial fibrillation via impaired global longitudinal strain (36.1 %). Observational data tentatively link feta cheese to dilated cardiomyopathy risk through altered left heart volumetric parameters: left atrial minimal volume (30.3 %), ventricular end-diastolic (14.8 %)/systolic volumes (14.8 %). Conclusion: our study provides new insights that dietary adjustments to improve cardiac remodeling may be a potent strategy for the prevention and management of cardiovascular diseases. However, the interpretation of the mediation results requires caution.