Plant-Based Diets in Hispanic/Latino Adult Adventists in the United States and Their Association With Body Mass Index

Abstract

Purpose: To characterize plant-based dietary practices and examine their relationship with body mass index (BMI) in Hispanic/Latino Seventh-day Adventists (SDA). Design: Cross-sectional analyses of data among Hispanics/Latinos in the Adventist Health Study-2 (AHS-2). Setting: The AHS-2 is a cohort of SDA adults (n = 96 592) in North America. Participants: A total of 3475 Hispanics/Latinos who provided demographic, dietary, anthropometric, and lifestyle data at enrollment. Measures: Plant-based dietary practices were determined from food frequency questionnaire; BMI, demographic, and lifestyle data were assessed by questionnaire. Analysis: In linear regression analysis, plant-based diets were modeled as dummy variables with nonvegetarian as the referent group and log(BMI) as the outcome adjusted for age, sex, education, exercise, nativity, alcohol use, smoking, and energy intake. Results: We identified 202 vegans, 664 vegetarians, 409 pesco-vegetarians, 227 semi-vegetarians, and 1973 nonvegetarians. Compared to the nonvegetarian referent (BMI = 27.50), estimated BMI were lower among vegans (23.58, P < .0001), vegetarians (25.24, P < .0001), pesco-vegetarians (26.36, P = .0002), and semi-vegetarians (26.69, P = .130). Other factors associated with lower BMI were being female ( P = .001), nativity (Mexico, P = .002; South America, P < .0001; Caribbean, P = .004), having a college degree or higher ( P = .01), exercise ( P < .0001), and never smoked ( P = .0006). Conclusion: Hispanic/Latino SDAs who consumed plant-based diets had lower BMI than nonvegetarians. The application of a plant-based diet as practiced by the Hispanic/Latino Adventists in this population may have public health impact on US Hispanic/Latinos.

Participant characteristics and self-reported weight status in a cross-sectional pilot survey of self-identified followers of popular diets: Adhering to Dietary Approaches for Personal Taste (ADAPT) Feasibility Survey

“…In a cross-sectional analysis in a sample of 73 308 adults from the Adventist Health Study II cohort, vegans had lower BMI (24•1 kg/m 2 ) compared with vegetarians (26•1 kg/m 2 ) and semi-vegetarians (27•3 kg/m 2 ) (33) . Similarly, in a recent cross-sectional analysis of 3475 Hispanic/Latino adults, in comparison to the non-vegetarian diet followers, BMI was significantly lower in vegan, followed by vegetarian and pescatarian adults (29) .…”

Assessment of quality of information available over the internet about vegan diet

“…"Weight" and "nutrition" appeared most frequently, with cumulative counts of 347 and 385 across all websites, respectively. Despite research suggesting that the Vegan diet confers protection against diseases such as obesity, hypertension and cardiovascular disease (Fraser et al, 2014;Jaceldo-Siegl et al, 2019;Le and Sabaté, 2014;Matsumoto et al, 2019;Orlich et al, 2013), "blood lipid" appeared only twice throughout the 67 websites. It must be noted that our search was limited to the query term "Vegan diet".…”

Incorporating an Increase in Plant-Based Food Choices into a Model of Culturally Responsive Care for Hispanic/Latino Children and Adults Who Are Overweight/Obese

“…The food guide is depicted in Figure 1 , and shows that the highest tier (gold) involved eating whole plant foods with minimal processing (i.e., not battered, deep fried, heavily sauced, and/or fast food processing), and allowed a pesco-vegetarian pattern. Participants were coached on this tiered continuum and there were no strict vegetarian categories enforced (transitioning to gold-silver-bronze are all a “success”)—a method resonating with AHS-2 findings from Hispanic/Latinos that semi-vegetarian and pesco-vegetarian patterns have significant protective effects against obesity [ 7 ].…”

“…For the purpose of systematically adapting a plant-based diet intervention for Hispanic/Latino patients at high risk for cardio-metabolic disease, our group at Loma Linda University (LLU) undertook a series of pilot studies [ 6 , 7 , 8 , 9 ] to study plant-based diet practices in Hispanic/Latino Adventists. The findings from these studies were used to further test whether such plant-based diet patterns could be applied to Hispanic/Latino adults receiving health care in a federally designated medically underserved region of Southern California.…”

“…The US National Institutes of Health (NIH) have funded cohort studies at LLU that provide convincing evidence that a range of plant-based diet patterns (from semi-vegetarian to vegan) practiced by Adventists are associated with lower incidence of obesity and diabetes [ 12 , 13 , 14 , 15 , 16 ], and a longer life expectancy [ 17 , 18 ]. For example, in a national sample of 3475 US Hispanic/Latino Adventists [ 7 ] in the NIH-funded Adventist Health Study-2 (AHS-2), plant-based diet patterns were associated with significant percent decreases in body mass index (BMI) relative to patterns of frequently eating animal products: semi-vegetarians (−4.89 %, p = 0.011), pesco-vegetarians (−5.34%, p < 0.0001), vegetarians (−8.92%, p < 0.0001), vegan (−15.07%, p < 0.0001). In a Southern California sample of Mexican Adventists [ 6 ], the Adventist Multi-ethnic Nutrition Study (AMEN) study found that relative to omnivore diet patterns, plant-based diet patterns were associated with: (1) maintaining body mass index (BMI) in the recommended range of 19 to 25 kg/m 2 (24.5 kg/m 2 vs. 27.9 kg/m 2 , p = 0.006), and (2) significant decreases in waist circumference (34.8 vs. 37.5 in, p = 0.01), and fat mass (18.3 kg vs. 23.9 kg, p = 0.007).…”