Two ACC.25 studies link healthy plant-based eating to lower mortality and find that poor health profiles raise women’s heart disease risk more sharply.
Two studies presented at the American College of Cardiology’s 2025 Annual Scientific Session (ACC.25) point to a notable overlap: people with cardiometabolic conditions who ate well had lower mortality, while women with poor health profiles faced a sharper rise in heart disease risk than men. The findings put diet in focus as a potentially meaningful part of cardiovascular risk management, especially for women.
Diet quality and mortality
A study of nearly 78,000 people with cardiometabolic disorders in the United States, United Kingdom, and China found that closer adherence to a healthy plant-based diet was associated with a 17 to 24 percent lower risk of death from any cause, cardiovascular disease, or cancer.
The pattern matters: the researchers’ definition of a healthful plant-based diet emphasized vegetables, fruits, whole grains, legumes, and nuts. Higher consumption of refined grains, sugary drinks, and animal-based foods, by contrast, was linked to a 28 to 36 percent increase in mortality risk.
“Among populations with cardiometabolic disorders, higher adherence to a healthful plant-based diet was significantly associated with a lower risk of total, cardiovascular, and cancer mortality,” said Zhangling Chen, MD, PhD, of the Department of Cardiovascular Medicine at the Second Xiangya Hospital of Central South University in Changsha, China.
Chen added: “More intake of healthy plant-based foods, less intake of unhealthy plant-based foods, and less intake of animal-based foods are all important.”
That distinction makes this less a case for simply eliminating animal products and more a finding about overall food quality. The study links a diet centered on minimally processed plant foods with lower mortality among people already managing conditions such as obesity, type 2 diabetes, or heart disease.
Women face a steeper risk increase
A separate ACC.25 study examined more than 175,000 Canadian adults with no prior history of heart disease. Researchers grouped participants by the quality of their health risk profiles and found that poor health was associated with a much larger relative increase in heart disease risk for women.
Women in the poor health category had nearly five times the risk of heart disease as women with ideal health profiles. Among men, the comparable increase was 2.5 times. Women in the intermediate-risk group also faced greater risk than men with a similar mix of positive and negative factors.
“We found that women tend to have better health than men, but the impact on outcomes is different,” said Maneesh Sud, MD, PhD, an assistant professor at Sunnybrook Health Sciences Centre in Toronto. “The combination of these factors has a bigger impact in women than it does in men.”
The result shifts attention from average risk-factor counts to how those factors combine. Sud’s findings suggest that a similar collection of health risks can carry different consequences for women and men.
Why food choices matter
The two studies don’t establish that plant-based eating explains the gender gap in heart disease risk. Taken together, though, they underscore the potential value of diet among people whose health profiles already raise cardiovascular concerns.
Plant foods can support several markers tied to heart health. Potassium-rich foods and lower sodium intake may help with blood pressure; fiber and unsaturated fats from foods such as nuts and seeds can support healthier LDL cholesterol levels. Whole grains and legumes can also help steady blood sugar, while plant foods contain compounds associated with lower inflammation.
The broader need is substantial: the World Health Organization estimates that 1.9 billion adults worldwide are overweight, including more than 650 million with obesity. The International Diabetes Federation reports that 537 million people live with diabetes, a figure projected to reach 643 million by 2030.
For clinicians and patients, the findings make diet quality a practical area to examine alongside other risk factors. The strongest signal from the research is specific: among people with cardiometabolic disorders, a diet rich in healthful plant foods was linked to lower mortality, while women’s heart disease risk rose more sharply as health profiles worsened.
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