Pro-vegetarian food patterns and cardiometabolic risk in the PREDIMED-Plus study: a cross-sectional baseline analysis

Abstract

Purpose We explored the cross-sectional association between the adherence to three different provegetarian (PVG) food patterns defined as general (gPVG), healthful (hPVG) and unhealthful (uPVG), and the cardiometabolic risk in adults with metabolic syndrome (MetS) of the PREDIMED-Plus randomized intervention study. Methods We performed a cross-sectional analysis of baseline data from 6439 participants of the PREDIMED-Plus randomized intervention study. The gPVG food pattern was built by positively scoring plant foods (vegetables/fruits/legumes/grains/potatoes/nuts/olive oil) and negatively scoring, animal foods (meat and meat products/animal fats/eggs/fish and seafood/dairy products). The hPVG and uPVG were generated from the gPVG by adding four new food groups (tea and coffee/fruit juices/sugar-sweetened beverages/sweets and desserts), splitting grains and potatoes and scoring them differently. Multivariable-adjusted robust linear regression using MM-type estimator was used to assess the association between PVG food patterns and the standardized Metabolic Syndrome score (MetS z-score), a composed index that has been previously used to ascertain the cardiometabolic risk, adjusting for potential confounders. Results A higher adherence to the gPVG and hPVG was associated with lower cardiometabolic risk in multivariable models. The regression coefficients for 5th vs. 1st quintile were − 0.16 (95% CI: − 0.33 to 0.01) for gPVG (p trend: 0.015), and − 0.23 (95% CI: − 0.41 to − 0.05) for hPVG (p trend: 0.016). In contrast, a higher adherence to the uPVG was associated with higher cardiometabolic risk, 0.21 (95% CI: 0.04 to 0.38) (p trend: 0.019). Conclusion Higher adherence to gPVG and hPVG food patterns was generally associated with lower cardiovascular risk, whereas higher adherence to uPVG was associated to higher cardiovascular risk.

Healthy plant-based diets improve dyslipidemias, insulin resistance, and inflammation in metabolic syndrome. A narrative review

“…Plant-based diets may effectively reduce cardiometabolic risk factors, thereby preventing MetS [ 22 ]. The cross-sectional analysis of the Primary Prevention of Cardiovascular Disease with a Mediterranean diet (PREDIMED)-Plus study suggests that higher adherence to a healthful provegetarian food pattern (hPVG) was associated with lower cardiovascular risk when compared to an unhealthful provegetarian food pattern (uPVG) in MetS participants, as measured by the MetS z-score [ 23 ]. By affecting the individual components of MetS criteria, PBD may help attenuate the progression of MetS patients.…”

“… A higher adherence to the gPVH and hPVG was associated with lower cardiometabolic risk in multivariate models. [ 23 ] Cross-sectional 29 with MetS. 3-d food records.…”

Characterizing Meat- and Milk/Dairy-like Vegetarian Foods and Their Counterparts Based on Nutrient Profiling and Food Labels

“…However, PB foods can also contain refined starches and simple sugars, which have been associated with the opposite effects [ 18 ]. A distinction is therefore made between the healthy and the unhealthy PB dietary patterns [ 65 , 66 ]. In this regard, there is also a need to evaluate the nutritional composition and quality of PB foods on the market.…”

Bioactive Peptides Obtained from Legume Seeds as New Compounds in Metabolic Syndrome Prevention and Diet Therapy

“…In total, 6439 overweight or obese participants meeting at least 3 criteria of metabolic syndrome were included in the study. As shown by the results, gPVG and hPVG were related with lower cardiometabolic risk compared to uPVG [ 69 ].…”