A scoping review of approaches used to develop plant-based diet quality indices

Marchese, Laura E.; McNaughton, Sarah A.; Hendrie, Gilly A.; Wingrove, Kate; Dickinson, Kacie; Livingstone, Katherine M.

doi:10.1016/j.cdnut.2023.100061

Cited by 5 publications

(1 citation statement)

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“…Although all studies used the hPDI, uPDI, or both (or in a few cases the hPVD, uPVD, or both), there were some differences in how the indices were defined and calculated, even if based on the broad principles in Table 1 . The general concept, however, of distinguishing healthy versus less healthy plant-based foods, is incorporated in most current scoring methods for assessing plant-based diet quality ( 128 ). Further, the extreme comparisons of index levels were based on varying thresholds, which included quartiles, quintiles, and deciles.…”

Section: Discussionmentioning

confidence: 99%

Scoping review of the association of plant-based diet quality with health outcomes

2023

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IntroductionThe association of plant-based dietary patterns with health outcomes has traditionally been assessed without considering nutritional value. The plant-based dietary index (PDI), first published in 2016, overcomes this limitation with both a healthful PDI (hPDI) and an unhealthful PDI (uPDI), based on the quality of plant foods consumed plus the frequency of animal foods. We sought to summarize the breadth of research using the hPDI and uPDI to gain insight into how the quality of plant-based dietary patterns might be associated with health outcomes.MethodsScoping review of studies that used the PDI, hPDI, or uPDI to report associations with health outcomes. Multiple databases were searched from 2010 through April 2023 with 2 authors independently assessing eligibility and extracting data. In addition to assessing the association of the indices to health outcomes, we determined the frequency of concordant or discordant findings for hPDI versus PDI and for hPDI versus uPDI.ResultsWe included 95 articles (54% longitudinal, 37% cross-sectional, and 9% case–control) with a median sample size of 3,646. Higher hPDI levels were associated with favorable health outcomes in 36% of comparisons (most often for obesity, mortality, diabetes, cardiovascular disease, and psychiatric disorders), compared to 25% for the PDI and only 2% for the uPDI. Conversely, higher levels of the uPDI were associated with unfavorable health outcomes in 33% of comparisons, in contrast to under 1% for the hPDI and 2% for the PDI. When the hPDI association to an outcome was discordant with the uPDI or PDI, the significance and directionality always favored the hPDI over the uPDI, and nearly always favored the hPDI over the PDI.DiscussionDietary indices that account for the quality of plant foods can show health benefits that might be missed by a generic plant-based index. A greater focus on the quality of plant foods could improve nutrition guidelines, raise awareness about the benefits of adding unrefined plant foods to the diet, and empower consumers to make incremental additions of such foods to displace unhealthy foods. We anticipate increasing use of indices that address food quality in future research.

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Section: Discussionmentioning

confidence: 99%

Scoping review of the association of plant-based diet quality with health outcomes

2023

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Is there an “optimal” diet for prevention of inflammatory bowel disease?

Yao,

Fitzpatrick,

Machado

et al. 2024

JGH Open

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Nutritional epidemiological studies have evolved from a focus of single nutrients to diet patterns to capture the protective role of healthy diets on chronic disease development. Similarly, in inflammatory bowel disease (IBD), a healthy diet may be protective against its development in individuals with genetic susceptibility, but the definitions of the optimal diet pattern deserve further exploration. Hence, this review article presents evidence, mainly from prospective cohort studies, for the role of diet quality based on adherence to dietary guidelines, traditional and modern diet patterns in the prevention of IBD. Findings from a limited number of studies on diet quality suggest that high diet quality scores are associated with lower risk of developing Crohn's disease, but the data are inconsistent for ulcerative colitis (UC). There are signals that a Mediterranean diet pattern reduces the risk of Crohn's disease but, again, the data are inconsistent and further studies are much needed. Finally, the evidence is conflicting regarding the role of food additives, with difficulties in the assessment of their intake, namely non‐nutritive sweeteners and emulsifiers, precluding accurate assessment of a relationship with IBD risk. In contrast, emerging evidence for a role of ultra‐processed food in the development of Crohn's disease but not UC is identified. Given the potential influence of diet quality, a Mediterranean diet and ultra‐processed food intake on the risk of Crohn's disease, assessment and implementation of dietary advice for these patients need to be tailored. The search for an optimal diet for UC remains elusive and further research for increasing the evidence in the area is greatly needed.

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