The Maastricht Study Links Healthy Diets to Heart Rate Variability
Cardiovascular researchers examining whether diet influences the subtle rhythms of the heart analyzed 24-hour recordings from 7,256 adults, finding distinct autonomic associations linked to specific nutritional patterns rather than uniform cardiac improvements across all tested diets, Scientific Reports reported.
- Higher adherence to DASH and Dutch Healthy Diet patterns showed positive linear associations with very-low-frequency heart rate variability power.
- Time-domain measures of heart rate variability revealed no significant associations with any of the four tested dietary patterns after full statistical adjustment.
- Beta-blocker medication use modified several observed associations between dietary habits and cardiac autonomic function.
Heart Rate Variability and Dietary Patterns in the Maastricht Study
Led by a team of investigators in the southern Netherlands, the cross-sectional analysis utilized baseline data from the Maastricht Study, an observational cohort that enrolled participants aged 40 to 75 between November 2010 and October 2020. Out of 9,187 initially recruited individuals, researchers included 7,256 participants after filtering out missing data, documented arrhythmias, prior cardiac or vascular surgeries, and interleukin-6 concentrations exceeding 10 pg/mL. Dietary intake was captured via a validated food frequency questionnaire covering 253 items across 23 groups, yielding adherence scores for the Mediterranean, Dietary Approaches to Stop Hypertension, Dutch Healthy Diet, and Mediterranean-DASH Intervention for Neurodegenerative Delay diets.
To quantify cardiac autonomic function, the study relied on 24-hour electrocardiogram recordings gathered through a 12-lead Holter monitoring system. Investigators extracted time-domain parameters, including the standard deviation of normal-to-normal intervals and the root mean square of successive differences, alongside frequency-domain parameters such as total power and very-low-frequency, low-frequency, and high-frequency power. Statistical models adjusted for demographic variables, lifestyle factors, clinical markers, and medication regimens, applying a Bonferroni-adjusted significance threshold of P < 0.00125 across 40 primary comparisons.
Cardiometabolic Profiles and Autonomic Associations
The participants exhibited a mean age of 59.19 years. Higher scores on the Mediterranean, DASH, and Dutch Healthy Diet patterns correlated with reduced smoking rates and lower systolic and diastolic blood pressure readings. Greater adherence to these three nutritional frameworks also aligned with lower body mass index values, reduced serum triglyceride levels, and increased physical activity, alongside higher total, high-density lipoprotein, and low-density lipoprotein cholesterol counts. Conversely, participants registering higher adherence to the MIND diet tended to present with higher body mass index figures and lower overall, high-density lipoprotein, and low-density lipoprotein cholesterol levels.
When evaluating autonomic function, unadjusted measurements showed demographic variations. Women demonstrated lower overall heart rate variability than men but registered higher high-frequency power and more adjacent normal-to-normal interval pairs differing by over 50 milliseconds. Individuals under 60 years of age displayed higher heart rate variability than older cohorts, while reduced variability tracked consistently with type 2 diabetes mellitus, obesity, smoking history, and beta-blocker therapy.
DASH and Dutch Diets Link to Heart Rate Fluctuations
Following full adjustment for potential confounders, time-domain measures showed no significant associations with any of the four dietary patterns. Frequency-domain analyses, however, detected significant positive linear associations between adherence to the DASH and Dutch Healthy Diet patterns and very-low-frequency power, which indexes slow fluctuations between successive heartbeats. Regression coefficients per point of dietary adherence stood at 11.81 for DASH and 4.66 for the Dutch Healthy Diet. The Mediterranean and MIND diets yielded no comparable significant associations after adjustment.
Subgroup evaluations established that beta-blocker usage modified the relationship between diet and cardiac rhythms. A significant interaction emerged between DASH adherence and beta-blocker use regarding very-low-frequency power. Among participants not taking beta-blockers, stronger adherence to both DASH and Dutch Healthy Diet patterns tracked with elevated very-low-frequency power. The physiological significance of very-low-frequency power in 24-hour recordings remains debated, and higher values do not automatically equate to superior cardiovascular status.
Cross-Sectional Design Prevents Establishing Direct Causality
The cross-sectional design prevents investigators from establishing direct causality between nutritional intake and cardiac autonomic regulation. Self-reported dietary metrics, potential residual confounding, and the oversampling of individuals with type 2 diabetes mellitus constrain broader generalization. Researchers note that prospective investigations and randomized controlled trials are required to determine the exact clinical relevance of these autonomic associations.
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