Healthy diets and heart rate variability in a cross-sectional analysis of over 7000 adults attending the Maastricht study

A limited and conflicting body of evidence exists on the association between adherence to healthy diets and HRV. The current study aimed to investigate the association between the Mediterranean Diet, Dietary Approaches to Stop Hypertension (DASH), Dutch Healthy Diet (DHD), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and HRV in adults. The baseline data from the Maastricht study were used for this cross-sectional research. Dietary adherence was assessed via a validated Food Frequency Questionnaire. HRV parameters were measured using a 12-lead Holter system over 24 h. Mean HRV parameters across quartiles (Q4 vs. Q1) of diet adherence scores and their linear associations were assessed using analysis of covariance and linear regression in different multivariable adjusted models. A total of 7,256 participants aged 59.19 ± 8.66 years were included in the analysis. After full confounder adjustment, in the total population, none of the diets were associated with HRV time domains. The frequency-domain analyses showed that the DASH and the DHD diets were significantly associated with higher power in the very-low-frequency (VLF) range (linear association, P ≤ 0.001). A significant interaction effect was observed between beta-blocker use and adherence to the DASH diet in association with VLF ( P < 0.001). After stratification by beta-blocker use, the DASH and the DHD were significantly associated with higher VLF only among non-users (linear association, P ≤ 0.001). In conclusion, the DASH and DHD dietary patterns were significantly associated with a higher VLF. These associations were more evident among participants not receiving beta-blocker therapy. Future prospective investigations are needed to confirm these findings.