Abstract
We evaluated the associations among different types of plant-based diet indices, risk of dyslipidemia, and individual lipid disorders in Asian populations with different dietary patterns from Western populations. Participants included 4507 Korean adults aged ≥40 years without dyslipidemia and related chronic diseases at baseline (2001–2002). Dietary intakes were assessed using an average of validated food frequency questionnaires measured twice. We calculated three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). During a follow-up of 14 years, 2995 incident dyslipidemia cases occurred. Comparing the highest with lowest quintiles, the multivariable-adjusted hazard ratios (HRs) for incident dyslipidemia were 0.78 (95% CI, 0.69–0.88) for PDI, 0.63 (95% CI, 0.56–0.70) for hPDI, and 1.48 (95% CI, 1.30–1.69) for uPDI (P-trend < 0.0001 for all). Associations between PDI and individual lipid disorders differed by sex. The PDI was inversely associated with risk of developing hypertriglyceridemia in men and with risk of developing low high-density lipoprotein cholesterol in women. The hPDI was inversely associated with risk of all lipid disorders, whereas the uPDI was positively associated with individual lipid disorders. The quality of plant foods is important for prevention of dyslipidemia in a population that consumes diets high in plant foods.
Highlights
Dyslipidemia is a major risk factor of cardiovascular disease (CVD), the top cause of death in the USA and worldwide [1]
We aimed to evaluate the associations between different types of plantbased diet indices (PDI, healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI)) and risk of dyslipidemia and individual lipid disorders using data from a community-based cohort of middle-aged and older Korean adults
In a community-based cohort, greater adherence to plant-based diet index (PDI) or hPDI was associated with a lower risk of incident dyslipidemia, whereas greater adherence to uPDI was associated with a higher risk, after adjusting for demographic characteristics and lifestyle factors
Summary
Dyslipidemia is a major risk factor of cardiovascular disease (CVD), the top cause of death in the USA and worldwide [1]. Dyslipidemia is a common public health problem because of its high prevalence in the general population [2]. Clinical trials of vegetarian diets have shown mixed results on improving lipid levels [4,5,6,7]. These studies have only explored the short-term effect of vegetarian diets on blood lipids and scarce data exist on how plant foods consumed for a longer period is associated with lipid disorders. Previous studies focused on only the restriction of animal food consumption with little consideration given to the type of plant foods consumed, some plant foods, such as refined carbohydrates or plant foods high in sugar and salt, have a distinct impact on metabolic health [3,6,7,8]
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