Plant-based diets and metabolic syndrome: Evaluating the influence of diet quality

Abstract

Diet plays a critical role in the prevention and treatment of metabolic syndrome (MetS). In addition to being environmentally sustainable, plant-based diets (PBD) have demonstrated a range of health benefits, including a protective effect against MetS. Most research on this topic has focused on PBDs as a whole, without considering the influence of diet quality. Data were obtained from 29 individuals with MetS. Subjects were asked to follow a PBD for 13 weeks. PBD quality was assessed using healthful PBD index (hPDI) and unhealthful PBD index (uPDI). Higher hPDI represented greater consumption of healthy plant foods and lower consumption of less-healthy plant foods. Higher uPDI represented greater consumption of less-healthy plant foods and lower consumption of healthy plant foods. For each participant, hPDI and uPDI scores were calculated at baseline and 9-weeks follow-up. Participants were divided into quintiles according to hPDI and uPDI scores. Statistical analyses were performed to determine the association between biomarker measures and PBD quality scores. After 2 weeks, mean weight was lower in hPDI quintile 5 compared to hPDI quintile 1, and higher in uPDI quintile 5 compared to uPDI quintile 1 ( p < .05). At baseline, hPDI was inversely associated with weight ( r = −0.445, p < .05), and uPDI positively associated with weight ( r = 0.437, p < .05). Using follow-up data, HDL-C was positively associated with hPDI ( r = .411, p < .05) and negatively associated with uPDI ( r = −0.411, p < .05). In individuals with MetS, adherence to a healthful plant-based diet was associated with lower weight and higher HDL cholesterol, highlighting the influence of diet quality on the health effects associated with PBDs. • Plant-based diets have demonstrated considerable health benefits, but not all plant foods are created equally. • Adherence to a healthful plant-based diet is assocaited with benefits for indiviaudals with metabolic syndrome. • These results highlight the influence of diet quality in the health benefits associated with plant-based diets.