Abdominal aortic aneurysm is a progressive vascular condition with high mortality after rupture. While genetic susceptibility is a major determinant, the role of overall diet quality in AAA development has not been systematically evaluated in large-scale cohorts.
Using data from 176,397 UK Biobank participants, researchers assessed diet via AHEI-2010, a validated 11-component score emphasizing vegetables, fruits, whole grains, nuts, and limited red meat and sodium. A polygenic risk score for AAA was constructed using the PRS-continuous shrinkage method. Over a mean follow-up of 13.3 years, 619 incident AAA cases occurred. After full adjustment, higher AHEI-2010 was associated with a 27% lower AAA risk (highest vs lowest tertile: HR = 0.73). Each 1-standard deviation increase reduced risk by 12%. Among individual components, fruit (excluding juice) and whole grain intake showed the strongest protective associations. High PRS (top quintile) increased AAA risk more than 2-fold. Although no significant gene-diet interaction was detected, joint analysis revealed markedly lower risk among those with both low PRS and high AHEI-2010 (HR = 0.11). Absolute risk reductions from better diet were largest in the high-genetic-risk group.
This study provides the first large-scale evidence linking comprehensive diet quality to AAA risk. The findings suggest that improving fruit and whole grain consumption may reduce AAA risk across all genetic backgrounds, with the greatest absolute benefit in genetically susceptible individuals. Clinicians should consider dietary counseling as part of AAA prevention, alongside genetic risk assessment.
The work titled “Alternative Healthy Eating Index-2010, genetic predisposition, and abdominal aortic aneurysm risk: A prospective cohort study”, was published on Cardiac Research (accepted on Apr. 23, 2026).
DOI: 10.1097/re9.0000000000000016