Researchers followed over 9,000 Australian women for 15 years to understand how stress and eating habits affect heart disease risk. They found that women who felt more stressed were significantly more likely to develop heart problems, regardless of how well they followed healthy eating guidelines. Surprisingly, eating a healthy diet alone didn’t protect against heart disease in this study. The findings suggest that managing stress might be just as important—or even more important—than diet when it comes to preventing heart disease in women.

The Quick Take

  • What they studied: How stress levels and healthy eating habits together affect a woman’s chances of developing heart disease over time
  • Who participated: 9,303 Australian women, average age 52, who didn’t have heart disease when the study started. Researchers tracked them for 15 years
  • Key finding: Women with high stress were 30% more likely to develop heart disease compared to women with low stress. Eating healthy didn’t reduce this risk. About 1,091 women developed heart disease during the study
  • What it means for you: If you’re a woman concerned about heart health, managing your stress may be just as important as eating well. However, this doesn’t mean diet doesn’t matter—both are important for overall health. Talk to your doctor about stress management strategies that work for you

The Research Details

This was a long-term follow-up study where researchers tracked the same group of women over 15 years. At the beginning, they asked women about their stress levels using a detailed questionnaire that covered 10 different areas of life (work, relationships, finances, etc.). They also collected information about what the women ate using a food frequency questionnaire with 74 different food items. Then, researchers used hospital records to track which women developed heart disease during the follow-up period.

The researchers used two different methods to measure how well women followed healthy eating guidelines—the Australian Dietary Guidelines Index and the Dutch Healthy Diet Index. This allowed them to check if their results were consistent across different ways of measuring diet quality. They also adjusted their analysis for other factors that could affect heart disease risk, like age, income, smoking, exercise, and weight.

This study design is valuable because it follows real people over a long time period, which helps show what actually happens in people’s lives rather than just what happens in a lab. By measuring stress and diet at the beginning and then tracking heart disease for 15 years, researchers could see which factors truly predict who gets sick. This approach is stronger than just looking at people at one point in time

This study has several strengths: it included a large number of women (over 9,000), followed them for a long time (15 years), used validated questionnaires (tools that have been tested and proven reliable), and confirmed heart disease cases using hospital records rather than just asking people. However, the study only included Australian women, so results might not apply equally to other populations. Also, stress and diet were only measured at the start, so we don’t know if they changed over time

What the Results Show

Women who reported higher stress at the beginning of the study were significantly more likely to develop heart disease over the next 15 years. Specifically, women with high stress had a 30% increased risk compared to women with low stress. This finding held true even after researchers accounted for other risk factors like age, smoking, exercise, and weight.

Interestingly, how well women followed healthy eating guidelines did not predict whether they developed heart disease. This was true whether researchers measured diet quality using the Australian guidelines or the Dutch guidelines. This was surprising because previous research has suggested that diet affects heart disease risk.

When researchers looked at stress and diet together, they found no interaction—meaning that eating well didn’t reduce the harmful effects of stress, and stress didn’t cancel out the benefits of healthy eating. The two factors appeared to work independently.

The study confirmed that about 1,091 women (roughly 12% of the group) developed heart disease during the 15-year follow-up period. The researchers were able to identify these cases using linked hospital records, which is a reliable way to confirm actual heart disease events rather than relying on people’s memories or self-reporting

Previous research has suggested that both stress and poor diet increase heart disease risk. This study confirms the stress finding but challenges the diet finding. The lack of association between diet and heart disease in this study is unexpected and differs from many other studies that have found diet quality matters for heart health. This could be because the women in this study generally had reasonably good diets, or because other factors not measured in this study are more important

This study only included Australian women around age 52, so results may not apply to men, younger women, or people from other countries. Stress and diet were only measured once at the beginning, so we don’t know if they changed over the 15 years. The study couldn’t prove that stress causes heart disease—only that they’re associated. Other unmeasured factors could explain the connection. Additionally, the study relied on self-reported stress and diet, which can be less accurate than objective measurements

The Bottom Line

Based on this research, women should prioritize stress management as part of heart disease prevention (moderate confidence). This could include exercise, meditation, counseling, or other relaxation techniques. Continue following healthy eating guidelines because they’re important for overall health, even if this particular study didn’t show a direct link to heart disease (high confidence). If you have high stress levels, talk to your doctor about strategies to reduce stress and monitor your heart health (moderate confidence)

This research is most relevant to women around age 50 and older who are concerned about heart disease prevention. It’s also important for healthcare providers who work with women in this age group. Men and younger people should note that this study doesn’t directly apply to them, though stress management is beneficial for everyone. People with existing heart disease should definitely work with their doctors on stress management

Stress management benefits can start appearing within weeks for mood and sleep quality, but heart disease prevention is a long-term goal. It typically takes months to years of consistent stress management to see measurable improvements in heart health markers. Don’t expect immediate changes in heart disease risk, but think of stress management as a long-term investment in your health

Want to Apply This Research?

  • Track daily stress levels using a simple 1-10 scale at the same time each day, noting what triggered high stress days. Also track stress management activities (meditation, exercise, time with friends) to see what helps most
  • Set a daily stress management goal—even 10 minutes of walking, deep breathing, or a relaxing activity. Use the app to remind you and track consistency over weeks and months
  • Review your stress patterns weekly to identify triggers and successful coping strategies. Monitor trends over months to see if your overall stress level is decreasing. Share this data with your doctor at annual check-ups to discuss heart disease prevention strategies

This research suggests an association between stress and heart disease risk in women but does not prove that stress causes heart disease. These findings apply specifically to Australian women around age 50 and may not apply to other populations. This information is for educational purposes and should not replace professional medical advice. If you have concerns about heart disease risk or high stress levels, please consult with your healthcare provider who can assess your individual situation and recommend appropriate prevention strategies. Always talk to your doctor before making significant changes to your health routine, especially if you have existing health conditions or take medications.