2025/05/30 by Xiang Jun Wang, Marinka Steur, Maryam Kavousi +1 · 1 voice
Environmental Science · Medicine · Agricultural and Biological Sciences · #Agriculture Sustainability and Environmental Impact #Nutritional Studies and Diet #Food Waste Reduction and Sustainability
paper · doi:10.1016/j.ajcnut.2025.05.012
openalex publication_date 2025/05/30 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/26
BACKGROUND: The evidence on the association between adherence to plant-based diets and longitudinal changes in preclinical cardiometabolic markers among general population is sparse. OBJECTIVES: This study investigates the associations of plant-based diet indices (PDIs) with repeated measurements of cardiometabolic markers, including systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and total:HDL cholesterol ratio. METHODS: This longitudinal study used data from the population-based Rotterdam Study. Relatively healthy aging participants from The Netherlands with baseline dietary data and ≥1 measurement of cardiometabolic markers at baseline and during follow-up. Specifically, participants were analyzed for blood pressure (N = 3670), lipid levels (N = 3274), and glucose metabolism (N = 5369), provided they were free of hypertension, hyperlipidemia or diabetes at baseline, respectively. To reflect diets higher in healthy and unhealthy plant-based foods, and lower in animal foods, an overall PDI, healthy PDI (hPDI) and unhealthy PDI (uPDI) were created. Multivariable linear mixed models were used to assess the associations. RESULTS: Higher hPDI scores at baseline were associated with, on average, lower SBP [β: -0.43 mmHg (95% confidence interval -0.82, -0.04), per standard deviation of hPDI score], DBP [-0.25 mmHg (-0.49, -0.01)], fasting glucose [-0.03 mmol/L (-0.05, -0.01)], triglycerides [-0.04 mmol/L (-0.07, -0.02)] and total:HDL cholesterol ratio [-0.10 (-0.13, -0.06)] and with higher HDL cholesterol [0.04 mmol/L (0.02, 0.05)], over the follow-up period (median 5 y, range 0.0-24.7 y). Similar associations were observed for the overall PDI, whereas no associations of uPDI scores with any of the cardiometabolic markers were found. CONCLUSIONS: Greater adherence to more plant-based dietary patterns, particularly those rich in healthy plant-based foods, is associated with favorable long-term changes in early cardiometabolic markers. Our findings provide further support for recommendations to transition to more healthy plant-based diets for early prevention of cardiometabolic risk.