Among 8,716 UK Biobank cancer survivors free of cardiovascular disease at baseline, 1,116 developed CVD over a median 12.3 years. Comparing top with bottom quintiles of adherence, hazard ratios for total CVD ranged from 0.63 (Alternate Healthy Eating Index-2010) and 0.65 (DASH) to 0.72 (Mediterranean) and 0.82 (healthful plant-based index). Results held after generalized propensity score adjustment. The authors estimated that, at age 45, the highest adherers gained 1.66 to 3.32 years of life expectancy.
Cardiovascular disease is the leading non-cancer killer of survivors, yet dietary guidance for this group mostly borrows from general-population evidence or cancer-recurrence studies. This cohort supports a practical message: the same DASH-, Mediterranean-, and AHEI-style patterns that protect the general public appear to protect survivors, with effect sizes of roughly 25 to 37 percent lower risk. The strongest signals came from scores emphasizing vegetables, whole grains, nuts, and limited red and processed meat, plus anti-inflammatory eating, a plausible mechanism given chemotherapy- and radiation-related vascular injury. Caveats matter. Diet came from 24-hour recalls, which poorly capture usual intake and likely bias results toward the null, though they may also miss reverse causation if illness changed eating. Residual confounding from healthy-user behavior is likely despite propensity adjustment. UK Biobank skews healthier and wealthier than survivors at large, and cancer types and treatments were heterogeneous. The life-expectancy figures are modeled projections, not observed outcomes. Editorially, this is confirmatory rather than paradigm-shifting, but it fills a real evidence gap and justifies raising dietary quality at cardio-oncology visits.