What This Means
This research suggests that eating a higher quality diet is associated with a substantially lower risk of developing heart failure over a 20-year period. Using data from over 2,000 Greek adults followed from 2002 to 2022, researchers found that people with the lowest diet quality had a heart failure rate of nearly 21%, compared to just 5–7% in those with intermediate or high diet quality. Even after accounting for many other risk factors like age, obesity, smoking, high blood pressure, and diabetes, people who scored higher on a diet quality measure were less likely to develop heart failure.
Importantly, the benefit appeared to come specifically from eating more health-promoting foods — such as fruits, vegetables, legumes, and whole grains — rather than simply from avoiding unhealthy foods. The unhealthy food component of the diet score was not independently linked to heart failure risk on its own. This distinction matters because it suggests that actively adding nutritious foods to the diet may be more impactful than just cutting out junk food.
This research matters because heart failure is a serious and increasingly common condition, and diet is something people can potentially change. The findings add to a body of evidence suggesting that long-term dietary habits play an important role in heart health, and that focusing on increasing consumption of nutrient-rich, whole foods may be particularly beneficial. The study was conducted in a Mediterranean population, so results may be most applicable to similar dietary contexts, but the general principle of diet quality mattering for heart failure risk has broader relevance.