A Vegan Athlete’s Heart—Is It Different? Morphology and Function in Echocardiography

Abstract

Plant-based diets are a growing trend, including among athletes. This study compares the differences in physical performance and heart morphology and function between vegan and omnivorous amateur runners. A study group and a matched control group were recruited comprising N = 30 participants each. Eight members of the study group were excluded, leaving N = 22 participants. Members of both groups were of similar age and trained with similar frequency and intensity. Vegans displayed a higher VO2max (54.08 vs. 50.10 mL/kg/min, p < 0.05), which correlated positively with carbohydrate intake (ρ = 0.52) and negatively with MUFA (monounsaturated fatty acids) intake (ρ = −0.43). The vegans presented a more eccentric form of remodelling with greater left ventricular end diastolic diameter (LVEDd, 2.93 vs. 2.81 cm/m2, p = 0.04) and a lower relative wall thickness (RWT, 0.39 vs. 0.42, p = 0.04) and left ventricular mass (LVM, 190 vs. 210 g, p = 0.01). The left ventricular mass index (LVMI) was similar (108 vs. 115 g/m2, p = NS). Longitudinal strain was higher in the vegan group (−20.5 vs. −19.6%, p = 0.04), suggesting better systolic function. Higher E-wave velocities (87 vs. 78 cm/s, p = 0.001) and E/e′ ratios (6.32 vs. 5.6, p = 0.03) may suggest better diastolic function in the vegan group. The results demonstrate that following a plant-based diet does not impair amateur athletes’ performance and influences both morphological and functional heart remodelling. The lower RWT and better LV systolic and diastolic function are most likely positive echocardiographic findings.

Efficacy of Popular Diets Applied by Endurance Athletes on Sports Performance: Beneficial or Detrimental? A Narrative Review

“…One cross-sectional study confirmed the information by investigating the difference in heart morphology and function according to the vegan and omnivorous diets in amateur runners [ 59 ]. The results showed that vegans had better systolic function, determined by longitudinal strain (vegan:−20.5% vs. omnivore:−19.6%), and diastolic function in vegans, determined by higher E-wave velocities (87 cm/s vs. 78 cm/s), compared to omnivorous athletes [ 59 ]. Therefore, we can confirm that vegetarian diets may have a beneficial impact on cardiovascular function; however, we still need further investigation on endurance athletes.…”

“…Studies on vegetarian diets have suggested that these diets may improve endurance performance by increasing exercise capacity and performance, modulating exercise-induced oxidative stress [ 72 ], inflammatory processes including anti-inflammatory and immunologic responses [ 4 ], and upper-respiratory tract infections (URTI) [ 73 ], and providing better cardiovascular function [ 59 ].…”

“…Studies measuring the aerobic capacity of vegetarian and omnivorous athletes reported controversial results [ 54 , 56 , 58 , 59 ]. Two studies showed that VO 2 max values were higher in vegetarian athletes compared to omnivore athletes [ 56 , 59 ], while a crossover study showed no difference between the groups [ 54 ].…”

“…Studies measuring the aerobic capacity of vegetarian and omnivorous athletes reported controversial results [ 54 , 56 , 58 , 59 ]. Two studies showed that VO 2 max values were higher in vegetarian athletes compared to omnivore athletes [ 56 , 59 ], while a crossover study showed no difference between the groups [ 54 ]. Studies supported higher VO 2 max values in vegetarians designed as a case study and two cross-sectional studies [ 56 , 58 , 59 ], which are considered as the lowest level of the etiology hierarchy.…”

“…Two studies showed that VO 2 max values were higher in vegetarian athletes compared to omnivore athletes [ 56 , 59 ], while a crossover study showed no difference between the groups [ 54 ]. Studies supported higher VO 2 max values in vegetarians designed as a case study and two cross-sectional studies [ 56 , 58 , 59 ], which are considered as the lowest level of the etiology hierarchy. A cross-sectional study in amateur runners reported that vegetarian female athletes had higher VO 2 max values than omnivorous female athletes; however, no difference was observed in VO 2 max values between vegetarian and omnivorous male athletes [ 58 ].…”