Association Between Dietary Macronutrient and Micronutrient Intake with Arterial Stiffness Progression in Healthy Adults: EVA Follow-Up Study

Background: Arterial stiffness is a key marker of vascular aging and an independent predictor of cardiovascular risk. Although diet has been proposed as an important modifiable factor influencing vascular health, the independent associations between specific macro- and micronutrients and the progression of arterial stiffness remain insufficiently characterized. Objective: To evaluate the association between dietary macronutrient and micronutrient intake and changes in arterial stiffness over a five-year follow-up in adults without previous cardiovascular disease. Methods: This longitudinal study included 466 participants from the EVA study who were evaluated at baseline and after a five-year follow-up (mean age 55.96 ± 14.15 years; 51.1% women). Arterial stiffnes was assessed using carotid–femoral pulse wave velocity (cfPWV) and the cardio-ankle vascular index (CAVI). Dietary intake of macronutrients and micronutrients was estimated using the EVIDENT smartphone application. Multivariable linear regression models were used to examine the association between nutrient intake and arterial stiffness progression. Model 1 was adjusted for age and sex, and Model 2 was additionally adjusted for lifestyle variables and cardiovascular risk factors. Results: Higher dietary fiber intake was independently associated with a lower increment in cfPWV after full adjustment (β = −0.025; 95% CI: −0.046 to −0.005). Alcohol intake showed a positive association with CAVI increment in the fully adjusted model (β = 0.020; 95% CI: 0.006 to 0.034). Iron intake was also independently associated with increased CAVI (β = 0.022; 95% CI: 0.004 to 0.041). Carbohydrate intake showed a small positive association with CAVI, whereas no consistent independent associations were observed for other macro- or micronutrients. Conclusions: In this adult population without previous cardiovascular disease, higher dietary fiber intake was associated with lower progression of central arterial stiffness, whereas alcohol and iron intake showed positive associations with peripheral arterial stiffness. Overall, most nutrients were not independently related to arterial stiffness after comprehensive adjustment. These findings suggest that selected dietary components may contribute modestly to vascular aging.