Healthful and unhealthful plant-based dietary patterns and their role on 10-year transition to metabolically unhealthy status in obese participants of the ATTICA prospective (2002-2012) study.
Session title: Nutrition, Malnutrition and Cardiovascular Disease
Topic: Nutrition, Malnutrition and Heart Disease
Session type: Best ePosters
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M Kouvari1 , DB Panagiotakos1 , C Chrysohoou2 , EN Georgousopoulou1 , C Pitsavos2 , D Tousoulis2 , 1Harokopio University - Athens - Greece , 2National & Kapodistrian University of Athens Medical School - Athens - Greece ,


On behalf: ATTICA study

Citation: N/A

Plant-based diets have been widely promoted for their protective role on cardiometabolic health. However, in the recent literature it is highly suggested that the quality of plant-based diets varies.

The association between plant-based diet indices and 10-year transition to metabolically unhealthy status in metabolically healthy obese (MHO) individuals was assessed.

A prospective study was conducted during 2001-2012 studying n=1,514 males and n=1,528 females (aged >18 years old) free of CVD. Healthy metabolic status was defines as absence of all NCEP ATP III (2005) metabolic syndrome components (excluding waist circumference). Follow-up CVD assessment (2011-2012) was achieved in n=2,020 participants (n=317 cases). Overall, healthful and unhealthful plant-based dietary indices (PDI, hPDI and uPDI) were created through a standard procedure; hPDI was principally characterized by increased consumption of fruits/vegetables, whole grains, nuts, legumes, oils, tea/coffee while uPDI was related with increased intake of juices, sweetened beverages, refined grains, potatoes and sweets.

MHO prevalence reached 4.8% (n=146) (4.9% in men and 4.7% in women, p=0.198). 28.2% of obese participants presented a metabolically benign status. Within the decade, almost half of MHO participants resulted as metabolically unhealthy obese (45% in men and 54% in women, p=0.04). Ranking from 1st to 3rd PDI tertile, transition to metabolically unhealthy status was for men, 63%, 48% and 22% (p<0.001) and for women 67%, 58% and 34% (p<0.001). Multiadjusted analysis revealed significant inverse associations between PDI and 10-year transition to metabolically unhealthy status for men [Hazard Ratio (HR)(3rd vs. 1st tertile)=0.63 95% Confidence Interval (95%CI) (0.41, 0.95)] yet –borderline significantly– for women [HR(3rd vs. 1st PDI tertile)=0.82 95%CI (0.67, 1.09)]. When the indices for quality of plant-based patterns were used (hPDI and uPDI), only participants assigned to the higher level of adherence to healthful plant-based pattern retained their metabolically healthy profile with this relation being stronger in women; [HR(3rd vs. 1st hPDI tertile)=0.55 95%CI (0.37, 0.84), for women] and [HR(3rd vs. 1st hPDI tertile)=0.79 95%CI (0.64, 1.03), for men]. Similarly, the aggravating effect of high adherence to less healthful plant-based food choices was higher for women [HR(3rd vs. 1st uPDI tertile)=1.68 95%CI (1.23, 1.99)].

Higher adherence to plant-based diet was associated with substantially higher likelihood for an obese individual to long-term retain its healthy metabolic status. Most importantly, the healthy or unhealthy food choices within this pattern seemed to determine cardiometabolic status with stronger remarks in women.